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Home My WebLink AboutZ-31008FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 31008 Date: 06/27/05 T~IS CERTIFIES that the building DWELLING Location of Property 430 WEST CREEK AVE (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 103 Block 0013 Subdivision Filed Map No. Lot No. CUTCHOGUE (H3%MLET) Lot 003 conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to wlk~ch CERTIFICATE OF OCCUPAlqCY NtrMBER Z- 31008 dated JLrNE 27, 2005 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH ATTACHED GAl{AGE * The certificate is issued to DONALD J MACLEOD (OWNER) of the aforesaid building. SUFFOLK COUNT~DEPARTMENT OF}~LT~A~PROVAL HSECI~ICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD ROUSING CODE INSPECTION REPORT IXK/ATION: 430 WEST CREEK AVE SUBDIVISION: N~ OF OW-~ (S): DONALD J MACLEOD OCCtrPANCY: SINGLE FAMILY DWELLING ~l'l-r~ BY: DAVID K-~PELL CUTCHOGUE W~%P NO.: LOT (S) DONALD J MACLEOD SOURCE OF P.~ST: DAVID KAPELL 6/16/05 DATE: 06/27/05 DWELLING ACCESSORY STRUCTURES: VIOLATIONS: CHAPTER 45 N.Y. STATE U~]IFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION kRT. SEC. INSPECTED BY: ~ ~A~ ON INSPECTION: 06/21/05 GEORGE GILLEN TI~ ~'TA]~T: 10:00 A~ [~D: 10:30 AM Form No. 6 TOWN OF SOUTHOLD BUILDING DEPAd~TMENT TOXVN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUP)aNCY This application must be filled in by typewriter or ink and submitted to the Building Depamnent with the following: A. For new building or new use: l. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/l 0 of 1% lead. 5. Commercial building, industrial building, multiple residences and sinfilar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Plmming Board Approval of completed site plan requirements. Bo For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate sup,,ey of property showing all property tines, streets, building and unusual natnral or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building h~spector shall slate the reasons therefor in writing to the applicant. C. Fees l. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00. Alterations to dwelling $25.00, (~Swimming pool $25.00, Accessory, building $25.00, Additions to accessory building $25.00. Businesses $50.00. Certificate of Occupancy on Pre-existing Building - $100.00 Cop3, of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residemial $15.00, Connnercial $15.00 Old or Pre-existing Building: X (check one) H6use No. Street ' - 'J Hamlet New Constmction: Location of Property: Owner or Owners of Property:-_ [~"~_K'~ ~ ,~:D~.~ O / Suffolk County Tax Map No 1000, Section _ ~ Block ~ ~ Lot Subdivision Lot: Filed Map. permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planmng Board Approval: Request for: Temporar3' Certificate Fee Subraitted: $ [ ~ -. dC,,,z.... Final Certificate: (check then)~ Applicant Signature CONSENT TO INSPECTION * "-~e~.a~ :, tO) ~-----~:~e~4~.~, o~ ex~ ~x~ the undersigned, do(es) hereby state: / - Owner(s} Name(s) That the undersigned (is) (are) the owner(s) of the premises in Re T~wn~of Southold, located at ~fX'O ~Z2~.~X~ C_r~t~.~...--U[.~). which is shown and designated on the Suffolk County Tax Ma~as District 1000, Section ~'~, Block ~, , Lot -,~ . That the undersigned (~as) (have) filed, or cause to be filed, an application in the Southold To~n. Building Inspector's Office for'the following: _ That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all ei the laws, ordinances, roles and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used in subsequent prosecutions for violations of the laws, ordinances, roles or regulations of the To~m of Southold. Dated: (Print Name) (Signature) (Print Name) LOCATION: (number & street) (municipality) SUBDIVISION: MAP NO.: LOT(S): NAME OF OWNER(S): ~/o ~9 o~I~£ ~ 0-', /nq/~-~. L.~'O~) OCCUPANCY: (type) (owner-tenant) ADMITTED BY: ~ ~ ~~ ACCOMPANIED BY: KEY AVAILABLE: t x & SUFF. CO. TAX MAP NO. 1000- Io3- 13-3 SOURCE OF REQUEST: ba.n~ ~"~ DATE: DWELLING: TYPE OF CONSTRUCTION: FOUNDATION: TOTAL ROOMS: IST FLR: BATHROOM(S): PORCH TYPE: C~/ xWoo b ~-,~/~r~ ~ # STORIES: ~ g EXITS: ~ ~o~ CELL~: C~ SPACE: ~ 2ND FLR: ~ P~'~3~ ~a: ~ TOILET ROOM(S): ] UTILITY ROOM: ~ ~ DEC~ TYPE: ~ PATIO, TYPE: ~ BREEZEWAY: - ~ ',, FIREPLACE: ! GARAGE: DOMESTIC HOTWATER: ~/~ ~YPE HEATER:- O/L-- AIRCONDITIONING: TYPE HEAT: ]7/°7- L"/~-7-~5'~V~ARM AIR: ~/~'~ HOTWATER: OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SWIMMING POOL: OTHER: STORAGE, TYPE CONST.: GUEST, TYPE CONST: VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: TIME START: /O; Oo/tan/'END: t/o ,[.~"o4e~ SURVEY OF PROPERTY SITUA T£D A T C UTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-103-15-03 SCALE 1"=30' FEBRUARY 7, 2005 AREA = 32,228.55 sq. ft. (TO TIE LINE) 0.740 ac, % THE EXISTENCE OF RIGHTS OF WAY Nh S [.~c No 4966d Joseph Ingegno Land Surveyor PHONE (651)727 2090 Fox (631)727 1727 -- 25 021