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HomeMy WebLinkAboutZ-31445FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 31445 Date: 02/27/06 THIS CERTIFIES that the building DWELLING I~cation of Property 1845 SHIPYARD I~A (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 038 Block 0001 Subdivision Filed Map NO. -- Lot NO. -- EAST MARION (HAMLET) Lot 020 conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 31445 dated FEBRUARY 27, 2006 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* The certificate is issued to NATKALIE L RACKETT (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTHAPPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A !~'ho rlz e d Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD ROUSING CODE INSPECTION REPORT ~OCATION: 1845 SHIPYARD LA SUBDIVISION: ~ OF OW~ (S): NATRALIE L RACKETT OCC~3P~CY: SINGLE FAMILY DWELLING ~]O~41'l-r~BY: GORDON RACKETT EAST MARION MAP NO.: LOT (S) NATHALIE L RACKETT ACCOMPANIED BY: SAME KEY A~L%ILABLE: SUFF. CO. TAX ~ NO.: 38.-1 20 SODRCE OF P~UNST: NATHALIE RACKETT, 2/1/06 DA~: 02/27/06 ACCESSORY STRUCTURES: G~E, TYPE OF CONST.: SWI~4ING POOL: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. 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 Dep~rtm~ht with the fol!0~i A. For new building or new use: 1. Final survey of property with accurate location of all bi~ildings, 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. )yr existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: Accurate survey of property showing all property lines, streets, building and unusual natural 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 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, Swin~ning 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 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. New Construction: Old or Pre-existing Building: V (check one) LocationofProperty:House]~qO~"No. ~str~/'~Fl.~ Owner or Owners of Property: /~ ) 0,~'Q ~-~Y,-- Suffolk County Tax Map No 1000, Section 3 ~' Block Subdivision Filed Map. Hamlet Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ] DO, (~ Final Certificate: (check one) Applicant Signature TOWN OWNER STREET FORMER OWNER /~1'~ S ' OF SOUTHOLD PROPERTY RECORD CARD VILLAGE SUB. DISTRICT ACREAGE ©..~00 TYPE OF BUILDING LAND IMP. TOTAL ':' .~ ,¢ 0 / -' LOT /// FARM COMM. 'IND. DATE REMARKS/c~.~.. AGE NEW NORMAL Farm Acre Tillable Tillable 2 Tillable 3 Woodland Swampland Brushland House Plot BUILDING CONDITION BELOW Value Per Acre ABOVE Value Total Extension Extension Extension Breezeway Garage Foundation Basement Ext. Walls Fire Place Porch Porch Patio Driveway Bath Floors Interior Finish Hec~ Attic Rooms Ist Floor Rooms 2nd Floor ,? CONSENT TO INSPECTION Owner(s) Name(s) · the undersigned, do(es) hereby state: That the undersigned (is) (are,) the owner(s) qf the premises in the Town of Southold, locatedat \¢~L[~ ~q~,,~0~d,./1Z:~ ~t~CC, r,..~ ~F_t,O~t~cl. Ot'r_~ which is shown and designated on the S%ffolk County Tax Map as District 1000, Section 3<~ , Block I _, Lot_ ~C~ 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, 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 Town of Southold. Dated: (Signature)--- . (Print Name) (Signature) (Print Name)