HomeMy WebLinkAboutZ-31587
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: z-
31587
Date: OS/26/06
THIS CERTIFIES that the building
DWELLING
Location of Property 770 (AKA
(HOUSE NO.)
County Tax Map No. 473889 Section 040
19) MIDDLETON RD.
(STREET)
Block 0005
GREENPORT
(HAMLET)
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-
31587
dated MAY
26, 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 WILLIAM E ADAMS, JR.
(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.
J'n~'~f!t&nature
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION:
770 (AKA 19) MIDDLETON RD.
GREEN PORT
SUBDIVISION :
MAP NO. :
LOT IS)
KAME OF OWHER (S): WILLIAM E ADAMS, JR.
OCCUPAHCY: SINGLE FAMILY DWELLING
WILLIAM E ADAMS, JR.
ADMITTED BY: JILL DUNBAR
ACCOMPAIiIIED BY: SAME
KEY AVAILABLE:
stIFF. CO. TAX MAP NO.: 40.-5-7
SOURCE OF REQUEST: EDWARD BOYD, ATTY 4/25/06
DATE: OS/26/06
DWELLING:
TYPE OF COJJSTRUCTION: WOOD FRAME
I STORIES: ~ I EXITS: --1
POURDATIOH: CONCRETE BLOCK
CELLAR, 3/4
CRAWL SPACE: 1/4
TOTAL ROOMS: 1ST FLR.: --1
2BD FLR.: -.Q
3RD FLR.: ....Q
BATHROC>>I(S): ~
TOILET ROOM (S): ---2....:....Q
UTILITY ROOM(S):
PORCH TYPE: FRONT -CONCRETE & BRICK
DECK TYPE:
PATIO TYPE: REAR - BRICK
BREEZEWAY:
FIREPLACE: ONE
GARAGE ,
DOMESTIC HOTWATER:
OIL
TYPE HEATER: OIL
AIRCOHDITIOJJDlG :
TYPE HEAT: OIL*
WARM AIR:
HOTWATER:
OTHER: *RADIATOR
ACCESSORY STRUCTURES:
GARAGE, TYPE OF COJJST.:
STORAGE, TYPE COJJST. :
SWIMMDlG POOL:
GUEST, TYPE COHST. :
OTIIER ,
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION
DESCRIPTION
ART.
SEC.
REMARKS: SP #31953-Z-COZ-31586 (ACCESSORY SHED)
~/..ffl4
MICHAEL J. VERITY
DATE OIl IRSPBCTIOR: 05/12/06
IBSPBCTBD BY:
TIME START: 10:25 AM END: 11:20 AM
r:
r;1
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Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
. ! TOWN HALL
I 765-1802
,
'APPLICATION FOR CERTIFICATE OF OCCUPANCY
lj
jR25
,
cli<OLD
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 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.
f
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
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
4.\-z."'\C>b
Date.
New Construction:
/'
(check one)
Old or Pre-existing Building:
Location of Property: \":l. (".....0) tv\\",..,-~-.:",-, '\<o"f>
House No. Street
Owner or Owners of Property: o"'..,~. \=\~P,""'~ '~.:H.c-'~.'" '"
~a~(,'-'po~
Hamlet
'C'y,-M~ ." ~'c'-........ c:: . ..t\.."",s,-:si.
Suffolk County Tax Map No I 000, Section
Subdivision ~~(:1'I"lO.'-b
40
Block
"S.
Filed Map.
'~S,\
Lot ~
Lot: -\I- C-
~<'"'l,~...3
Permit No.
Date of Permit.
Applicant:
Health Dept. Approval:
Planning Board Approval:
Underwriters Approval:
Request for:
Temporary Certificate
Final Certificate:
~
( check one)
Fee Submitted: $ \ <:> 0 .00
Applicant Signature
tbwA\Zb -4" ~cNb.1 C\-.-ro ,,0..>(:........ ~C1.'t...
.c'$(A"r~ GJ;:- ~\L'-t"""""'~. .p..."'A...... $\::rll .
8...<<..,.7 0 c9- 5 7
(' 0 'e: 315'lS'7
~
OWNER
11 (:;
I l'lJ. t;!
FORMER OWNER
RES. ). JO
LAND
"'100
AGE
NEW
Farm
Tillable 1
Tillable 2
Tillable 3
Woodland
Swampland
Brushland
House Plot
--
Total
- - ~
~
(t'(1--;~-l/.,/
SEAS.
IMP.
NORMAL
Acre
TOWN OF SOUTHOLD PIlOPERTY RECORD CARD
,;//.
STREET 7
MIDbLiITotl /'0
N
ACREAGE ,
. ;;) lj.!;)
TYPE OF BUILDING
VILLAGE
DISTRICT SUB.
;\' ,I ' ;/
.J d
E
S
W
VL.
FARM
COMM.
I IND.
I MISC.
I CB.
TOTAL
REMARKS
DATE
"3
BUILDING CONDITION
BELOW
ABOVE
FRONTAGE ON WATER
FRONTAGE ON ROAD
BULKHEAD
DOCK
,
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a
Value Per Acre
Value
r'f/'h'rLt ~ t-IJV
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.:if'!" ~:f;.,,;;T' ". ~ :
, ____ -.,ft
13y/('
Foundation Bath
Basement Floors
Ext. Walls Interior Finish
Fi re Place Heat . d/t (
/t;e Porch Roof Type
-'~"3- Porch Rooms 1 st Floor
Patio Rooms 2nd Floor
5'/1 Driveway Dormer
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CONSENT TO INSPECTION
~~o.) ~..f:\\)A""'S ,J;'l.E:W"O(' <51' ......,
;(S"'M~ ~ ~'''~'''''' (.. Al>"",..--:r~.
Owner(s) Name(s)
, the undersigned, doe es) hereby state:
That the undersigned (is) (are) the owner(s) of the premis~ in the Town of
Southold, located at \ '!> >-\ "'e"'.':> 120"" ('\"0 "" >'be"".'" eo.... ) , c:.({~......-(
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section 40 , Block 5 , Lot 'I
That the undersigned (has) (llll'/~ filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following: 'W< _ ~....,,'" do
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 South old.
The undersigned, in consenting to such inspections, doe 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:
4\'1."'\0&
--
/--
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(Signature)
~,."'''''''~. ~crIb (:\,-<0'_ "'-'-
> -
C,.,.",,, (Print Name)"" .,)'ce'''....I;.. jl>,'.M~, ,iQ.
(Signature)
(Print Name)
~ I SURVEY OF LOT 6, BLOGK "
85 ~~~~~S~~~.I;~D
1Sl,
0.. j SITUATE, GREENPORT
TOHN, SOUTHOLD
SUFFOLK c.o\JNTY, NY
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JOHN C.
6BASUfAINS11lEIIT N.Y's, uc. NO.Sll2Il2
RIVERIlBAD. N.Y. l1!l111
369-11288 Fu 30-1l237 RIlI'. \'COMPAQSER'~s\06\06-l5ll."",