HomeMy WebLinkAboutZ-32783FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 32783
Date- 12/13/07
THIS CERTIFIES that the building DWELLING AND ACCESSORY
(aka 17 Sound Road)
Location of Property 275 SOUND RD GREENPORT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Nap No. 473889 Section 035 Block 0001 Lot 005
Subdivision
Filed Nap 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 N@IDER Z- 32783 dated DECEMBER 13, 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 DWELLING WITH ENCLOSED FRONT PORCH AND ACCESSORY TWO CAR
*
The certificate is issued to PATRICIA A MOTTO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL
Q
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
N/A
N/A
Autioriz d Signature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 275 SOUND RD GREENPORT
SUBDIVISION: NAP NO.• IAT (S)
NAME OF OWNER (S): PATRICIA A MOTTO
OCCUPANCY: ONE FAMILY PATRICIA A MOTTO
ADMITTED BY: LOUIS BLANK ACCOMPANIED BY: SAME
ABY AVAILABLE: SUFF_ CO. TAX MAP NO.: 35.-1-5
SOURCE OF REQUEST: LOUIS BLANK DATE: 12/13/0
DWELLING:
TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 2.0 # EXITS- 2
FOMMATXON: STONE & CONCRETE CELLAR. 1/2 CRAWL SPACE:
TOTAL ROOMS: LST FLR.: 2 2ND FLR.: 2 3RD FLR.: 0
BATBROOM(S): 1.0 TOILET ROOM (S): 1.0 UTILITY ROGM(S): YES
PORCH TYPE: ENCLOSED FRONT DECK TYPE: PATIO TYPE:
BREEZEWAY: FIXIMLACE• NONE
DOMESTIC NDTTATER: YES TYPE BEATER: OFF BOILER AIRCOIDITIONING:
TYPE BEAT: OIL MARK AIR- X BOT7ATER• X
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.: 2 CAR WOOD FRAME STORAGE, TYPE COMET.:
SMIMMIPG POOL: GUEST, TYPE COMSY.•
VIOLATIONS: CHAPTER 95 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
REMARKS: RE -INSPECTED 12/10/7
c
INSPECTED BY: DATE ON INSPECTION: 11/19/0
GARY J/" B TINA START: 9:40AM END: 10:05AM
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 fi om 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 praperty showing all property litres, 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,
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. Temporal), Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date. / r/ / ),/o
New Construction: Old or Pre-existing Buildings (check one)
Location of Property: talcI ;n le
House No, Street Hamlet
Owner or Owners of Property: �A I t" r1i4 ANN //n
Suffolk County Tax Map No 1000, Section 3 S
Subdivision
Permit No. Date of Permit.
Health Dept. Approval
Planning Board Approval.
Request for Temporary Certificate
Fee Submitted: $ /60. bo
Block I Lot
Filed Map. _— Lot:
Applicant:
Underwriters Approval:
Final Certificate: (check one)
/W 0,x,,,,4
Applicant Signature 177p�4
CONSENT TO INSPECTION
' '7 It 0,13 13 / "' ° 040 the undersigned, do(es) hereby state:
Owner(s) Name(s)
That the undersigned (is) (are) the owner(s)pf the premises in the Town of
Southold, located at ,77S S,7,, ac W,na-r/
which is shown and designated on the Suffolk County Tax Map as District
Section /fid , Block �, Lot ,
35
1000,
That the undersigned (has) (have) filed, or cause to be filed, ap application in the
Southold Town Building Inspector's Office for the following: 4z"(
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: //L5 107
(Signature)
Z-ec : r /! 4n/ - -
(Print Name)
(Signature)
(Print Name)
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TOWN OF SOUTHOLD PROPERTY RECORD CARD
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TYPE OF BUILDING
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MICS.
Mkt. Value
LAND
IMP.
TOTAL
DATE
REMARKS
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Tillable
FRONTAGE ON WATER
Woodland
FRONTAGE ON ROAD
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Meadowland
DEPTH
House Plot
BULKHEAD
Total
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802 -�
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ]
FRAMING/ STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ]
FIRER CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
l JZF r-�
0
DATE o INSPECTOR /"' X-�
LOCATION:
(number & street) (municipality)
SUBDIVISION:
NAME OF OWNER(S):
OCCUPANCY:
(type)
MAP NO.:
LOT(S):
(owner -tenant)
ADMITTED BY: Cp r ACCOMPANIED BY:
KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000 -
SOURCE OF REQUEST:
DATE:
DWELLING:
TYPE OF CONSTRUCTION: # STORIES: # EXITS: 02 -
FOUNDATION: BrD>vC CELLAR: CRAWL SPACE:
TOTAL ROOMS: 1ST FLR: a-+ 2ND FLR: 3RD FLR: �—
BATHROOM(S): test.-, TOILET ROOM(S): UTILITY ROOM:
PORCH TYPE: DECK, TYPE: PATIO, TYPE:
BREEZEWAY: FIREPLACE: olv GARAGE:
DOMESTIC HOTWATER:-- TYPE HEATER: AIRCONDITIONING:
TYPE HEAT: WARM AIR: HOTWATER:
OTHER:
ACCESSORY STRUCTURES.-
GARAGE,
TRUCTURES.GARAGE, TYPE OF CONST.:
SWIMMING POOL:
OTHER:
W'RAGE, TYPE CONST.:
GUE T, TYPE CONST:
VIOLATIONS: CHAPTER 144 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
ATION DESCRIPTION ART. SEC.
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REMARKS:
INSPECTED BY: '` DATE OF INSPECCTION:
TIME START: ` ` �� END: (Or" Or