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HomeMy WebLinkAboutZ-31252FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 31252 Date: 11/01/05 THIS CERTIFIES that the building DWELLING Location of Property 860 OLD NORTH RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 055 Block 0001 Lot 007 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 31252 dated NOVEMBER 1, 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 ACCESSORY STORAGE BUILDING The certificate is issued to ANTOINETTE V. LYONS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. A ori ed Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 860 OLD NORTH RD SOUTHOLD SUBDIVISION: NAP NO.: LOT (S) MAKE OF OWNER (S): ANTOINETTE V. LYONS OCCUPANCY: RESIDENTIAL SINGLE FAMILY DWELLI ANTOINETTE V. LYONS ADMITTED BY: CARL AUSTIN ACCOMPANIED BY: SAME KEY AVAILABLE: HUFF. CO. TAX MAP NO.: 55.-1-7 SOURCE OF REQUEST: RUDOLPH BRUSH, ATTY 9/20/05 DATE: 11/01/05 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME $ STORIES: 2.0 M EXITS: 3 FOUNDATION: CEMENT BLOCK & BRICK CELLAR: PART CRAWL SPACE: PART TOTAL ROOMS: 1ST FLR.: 4 2ND FLR.: 2 3RD FIR.: 0 BATHROOM(S): 2.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S): PORCH TYPE: SCREEN PORCH SIDE DECK TYPE: PATIO TYPE: BREEZEKRY: FIREPLACE: ONE GARAGE: DOMESTIC HOTWATER: YES TYPE BEATER: OIL AIRCONDITIONING: TYPE HEAT: OIL NARK AIR: XX HOTWATER: OTHER: ACCESSORY STRUCTURES: GARAGE. TYPE OF CONST.: STORAGE, TYPE CONST.: ACCESSORY STORAGE GUEST, TYPE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE REMARKS: BP #31570-Z ISSUED ON 11/1/05 FOR DEMOLITION OF DWELLING. INSPECTED BY: J DATE ON INSPECTION: 00 00 00 GARY/J/ P SH I TIME START: 10:10 AM END: 10:40 AM Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. 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 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non -conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. 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. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $25.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. q- I (�-O S New Construction:ff,, Old or Pre-existing Build�ing:— ✓ (check one) Location of Property: SL QV © Q ` House No.. L "S"treet Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section �.5n Block % Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ n Applicant Signature 6--ar , b 9 /8.5 co a3us 2 CONSENT TO INSPECTION a9 YY(�m&u— LU u r\)am the undersigned, do(es) hereby state: Owner(s)Name(s) That the undersigned (is (a e) �the owner(s) of the p ises n the Town of Southold, located at_'L (!� S(� �. l D=lA which is shown and designated on the Suffolk County Tax Map as District 1000, Section 3W,Block_j Lot_? That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town 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 of the laws, ordinances, rules 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, rules or regulations of the Town of Southold. Dated: (Signature) (Print Name) S.C.T.M. NO. DISTRICT: 1000 SECTION: 55 BLOCK: T LOT(S):7 LAND N/F OR WILLIAM HAMEN LAND N/F OR MATHEW CAMPBELL PIPE FD 0.51 SU3.07' 22"E 275,80' NYf le CONC. MON. h A 67.5- A 0"1 N m n.. E�y Wz nr �0v 0.5 7�EArYNttt 'n. ' ..."� Q ie W e O O O z 04 00 CONE, 5 roe f d e� e A b LAND N/F OR CHESTER DICKERSON 40 THE WATER SUPPLY, WELLS AND CESSPOOL LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS. AREA: 45,563.9 S.F OR 1.05 ACRES ELEVATION DATUM: ------------------------- UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURREY MAP NOT BEARING THE LAND SURVEYORS EMOOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOA THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE. THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO TUE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY SURVEY OF: DESCRIBED PROPERTY CERTIFIED TO: THEODORE C. MARTZ JR. MAP OF: FIDELITY NATIONAL TITLE INSURANCE CO. OF N.Y.; ABSOLUTE ABSTRACT INC.; PILED: SUFFOLK COUNTY NATIONAL BANK; SITUATED AT: SOUTHOLD TOWN OF: SOUTHOLD KENNI 'PH M. WOYCHUK L.S. SUFFOLK COUNTY, NEW YORK/ , 4x* 4tpw C Lend Surveying and Design P.O. Bos 3. Yettituck, New York. 11952 FILE M 25-107 SCALE: 1"-40- DATE: AUG. 30, 2005. PHONE (0.71) 296-16e11 FAX (631) ZOO—leve N. Y. S. UC NO. W227 melntelnlnL the rwnrd. of;MNrt J. Hennery LOCATION: (number & street) (municipality) SUBDIVISION: NAME OF OWNER(S): OCCUPANCY: (type) MAP NO.: LOT(S): (owner -tenant) ADMITTED BY: C:"&4 kjm� ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000 - SOURCE OF REQUEST: DATE: DWELLING: d— TYPE OF CONSTRUCTION:� � o # STORIES:/ GLS # EXITS. �. FOUNDATION: - _ Z �T CELLAR: CRAWL SPACE: TOTAL ROOMS: 1ST FLR: 2ND FLR: 3RD FLR: BATHROOM(S): ! cUo T ILET ROOM(S): UTILITY ROOM: PORCH TYPE: ECK, TYPE: PATIO, TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTW_ ER: i- TYPE HEATER: AIRCONDITIONING: TYPE HEAT: WARM AIR: HOTWATER: OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SWIMMING POOL: OTHER: STORAGE, TYPE CONST.: ILI GUEST, TYPE CONST: VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. -� CrC� n . REMARKS: ( L� ��'A �� 1 j) 85 d� Drn,d1j�_ INSPECTED BY:91 X DATE OF INSPECTION: ?i TIME START: END: lO1�p