HomeMy WebLinkAboutZ-32326
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-
32326
Date: 05/01/07
THIS CERTIFIES that the building
DWELLING
435
(HOUSE NO.)
County Tax Map No. 473889 Section 024
SKIPPERS LA
(STREET)
Block 0002
ORIENT
(HAMLET)
Lot 003
Location of Property
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-
32326
dated MAY
1, 2007
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 SEASONAL RESIDENCE WITH ACCESSORY 2 CAR WOOD FRAME GARAGE*
The certificate is issued to ANN L BLISS
(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.
~~
Authorized Signature
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATIOII':
435 SKIPPERS LA
ORIENT
SUBDIVISIOR:
MAP HO.:
LOT (S)
HAMB OF OWRER (8): ANN L BLISS
OCCUPANCY: SINGLE FAMILY DWELLING
ANN L BLISS
ADMITTKD BY:
ACCOMPANIED BY:
KEY AVAILABLE:
SUPF. CO. TAX MAP HO.: 24.-2-3
SOURCE OF REQUEST: ANN BLISS 01/31/07
DATE: 05/01/07
DWELLING:
TYPE OF CORSTRUCTIOH:
WOOD FRAME
:I STORIES: ~ # EXITS: ---1
FOUlIDATIOH:
STONE & CEMENT BLOCK
CELLAR: PART.
CRAWL SPACE:
TOTAL ROOMS: 1ST FLR.: --.!
2ND FLR.: 4
3RD FLR.: -9.
BATHROOM (S) : 2 . 0
TOILET ROOM(S): ~
UTILITY ROOM(S) :
PORCH TYPE: ENCLOSED REAR *
DECK TYPE:
PATIO TYPE:
BREEZEWAY:
FIREPLACE: ONE
GARAGE:
IX>>IBSTIC HOTiiATER: YES
TYPE HEATER: KEYSPAN GAS
AIRCONDITIOIlIDIG :
TYPE HEAT: NONE
1mRM AIR:
HO'I'WATER :
OTHER: *FRONT SCREEN PORCH
ACCESSORY STRUCTURES:
GARAGB. TYPE OF CONST.: 2 CAR WOOD FRAME
STORAGE. TYPE CORST.:
SWIMMING POOL:
GUEST. TYPE CORST.:
OTHER ,
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION
DESCRIPTION
ART.
SEC.
REMARKS: NOTE: "NO HEAT SEASONAL RESIDENCE") BP#32856Z-COZ-32325 (ALT BASEMENT)
IBSPIlCTED BY, .~ ~ DATE OIl IBSPBCTIOIl, 02/01/07
GEORGE GILLBH TIME START: 10: 30 AM BRD: 11: 00 AM
I'i
APPLICATION FOR CERTIFICATE <nr"6bCLltAN(Y i
This application must be filled in by typewriter or ink and submitted to the Building Deparb~;~/w~e following:
Form No, 6
TOWN OF SOUTHOLD,
BUILDING DEPARTME!':tT
TOWN HALL
765-1802
JAN 3 I.
>
Ii
A. For new building or new use:
I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or
topographic features.
2. Final Approval from Health Dep!. of water supply and sewerage-disposal (S-9 fonn).
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 I % 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:
I. Accurate survey of property showing all property lines, streets, bnilding 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,
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
Date.
Owner or Owners of Property:
A.v1V
Old or Pre-existing Building: /' (check one)
S J( Iff c;--a IJ L 1'1vv;-
Street
L. iJu~r
2-~
Q f2/(5)v J
Hamlet
New Construction:
Location of Property:
'-r 3>
House No.
Suffolk County Tal' Map No 1000, Section
Block
~
Lot .~
Subdivision
Filed Map.
Lot:
Pennit No.
Date of Permit.
Applicant:
Underwriters Approval:
Health Dept. Approval:
Planning Board Approval:
Request for:
Temporary Certificate
Final Certificate:
/
(check one)
Fee Submitted: $
6....QZ. '7;) ~ 3 ~
GJ Co ~ 3J3,,'(1P
~ [,...~65
. Applicant Signature
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CONSENT TO INSPECTION
4 IV tJ L ELI ss
Owner(s) Name(s)
, the undersigned, doe es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town of
Southold, located at ('" f;v'tfPtl'rZS;. L~~ 01-1,.,-".,.,:; NY
which is shown and designated on the Suffolk County Tax ap as District 1000,
Section ~ 4 , Block <J...., Lot 3
That the undersigned (has) (have) filed, or cause to be fil
Southold Town Building Inspector's Office for the following:
e~1 r/cA-'iC' ",) F-OrCu PITN-C'f
That the undersigned doe 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, 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: ~ O~
~ ~.ii:tls5
A (SignatureL I ,...
NbJ \,... 0.,..(5'"
(Print Name)
(Signature)
(Print Name)
SURVEY OF PROPERTY
51TUA TE: ORIENT
TOWN: SOUTHOLD
SUFFOLK COUNTY, NY
SURVEYED, Jon. 24, 2001
SUFFOLK COUNTY TAX #
1000 - 24 - 2 - 3
CBRTIFIBD TO:
AmI L. Bliss
NOTES,
o
PIPE FOUND
AREA = 8,304 S.F. or 0.1'106 ACRE
GRAPHIC SCALE
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JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STREET N.Y.S. UC. NO. 50202
RIVERHEAD, N.Y. 11901
369-8288 Fax 369-8287 REF.-\\Compaqserver\pros\07\07-108.pro