HomeMy WebLinkAboutZ-32911FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 32911 Date: 03/05/08
THIS CERTIFIES that the building DWELLING
Location of Property 265 INLET LA GREENPORT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 043 Block 0004 Lot 036
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- 32911 dated MARCH 5, 2008
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 ATTACHED GARAGE & ACCESSORY STORAGE
BUILDING*
The certificate is issued to RUTH PHAFF & NANCY LILLIS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
EIJKC TICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 265 INLET LA GREENPORT
SUBDIVISION• MAP NO.. IAT (S)
MANE OF OMS (S): RUTH PHAFF 6 NANCY LILLIS
OCCUPANCY: SINGLE FAMILY DWELLING RUTH PHAFF & NANCY LILLIS
ADMITTED BY: NANCY MANDUCA ACCvPAR330 BY: SAME
KEY AVAII]1BLR: BUFF. CO. TAE MAP NO.: 43.-4-36
SOURCE OF REQUEST: JOSEPH MANDUCA 2/6/08 NATE. 03/05/08
DWELLING:
TYPE OF CK)MUTRUCTION: WOOD FRAME # STORIES: 1.5 # EXITS: 3
FOUNDATION: CEMENT BLOCK -- CEANL SPACE:
TOTAL RDONS: IST FLR.: 3 2ND FLR.: 2 3RD FIB.: 0
BATRSOUN(S): 1.0 TOILET ROOM(S): 1.0 UTILITY ROOM(S):
PORCH TYPE: ENCLOSED FRONT DECK TYPE: PATIO TYPE:
BREEZEMAX: FIREPLACE- ONE GARAGE: TWO CAR
DOMESTIC BonwTER: YES TYPE HEATER: OFF BOILER AIRC®IDTlIOMING:
TYPE SEAT: OIL HAM AIR: H01101TER• XX
OTHER: NOTE:2ND FL. IS 1/2 STORY WITH 2 ROOMS
ACCESSORY STRUCTURES:
TYPE OF GtmmT..
SMIIEIHG POOL:
♦�
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION 6 BUILDING CODE
REMARKS: BP#5789Z-COZ5202 (ADD) BP #13651Z-COZ-18469 (GREENHOUSE ADD)
INSPECTED BY:
GARY J.
DATE OI INSPECTION. 03/04/08
TINA START: 10:00 AM ED: 10:25 AM
Foran 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 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:
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.
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
Dat//e.
New Construction: Old or Pre-existing Building:y (check one) �+
Location of Property:__S2? (0 S / /�/ � 61 � APfiy
House No. Street 'Hamlet
Owner or Owners of Property /__C/i
Suffolk County Tax Map No 1000, Section q,6 Block Lot _3
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: $ mr _ jL
App] ant Signature
q, . `1cc
SIR co_L_3a�II
CONSENT TO INSPECTION
N&A1�4I o(IU-1-V I%%/4N1 44_/4 , the undersigned, do(es) hereby state:
Owner(s) Name(s)
That the undersigned (is) (are) the owner(s) of the premises in the Town of
Southold, located at ;96 f /./,4 9,;r L 012"
which is shown and designated on the Suffolk County Tax Map as Distri t 1000,
Section � ,Block J_, Lot 4,
That the undersigned (has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following: G' of O
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: per(- 10-0e-
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ignature)
(Print Name)
(Signature)
(Print Name)
QTY
RECORD CARD
DIST.
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COMM. CB. MISC. Mkt. Value
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DATE
REMARKS
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FRONTAGE ON WATER
rushland
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EDWIN KINSCHERF
ANTHONY N/O/)r
MILHELMINA PELUSO
EIMIRAYDN"M
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SURVEY OF PROPERTY
AT GREENPORT
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
1000-43-04-36
SCALE. 1'=30'
JANUARY 31, 2008
ANY AVERA ROW OR AD017ION TO THIS SURVEY IS A WOLA77ON
OF SEC RON 72OWF THE NEW YORK STA 7E EDUCA77ON LAW.
EXCEPT AS PER SEIP77ON 7209-SUBONIVON 2. ALL CER77RCA77ONS
w w �� ^. HEREQN ARE VAUD FAR NIS MAP AND COPIES THEREOF ONLY IF
SO SAID MAP OR COMES BEAR 7H£ IMPRESSED SEAL OF THE SURWMR
WHOSE SIONA7URE APPEARS HEREON.
('631) 765-5020 FAX �2
P.O. BOX 909
1230 TRAVELER STREET
SOUTHOLD, N. Y. 11971
1797
LOCATION:
(number & street)
SUBDIVISION: MAP NO.:
NAME OF OWNER(S):
OCCUPANCY:
(type)
(municipality)
LOT(S):
(owner -tenant)
ADMITTED BY: O"y ACCOMPANIED BY:
KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000 -
SOURCE OF REQUEST: DATE:
DWELLING:
TYPE OF CONSTRUCTION: # STORIES: 1�i # EXITS: 3
FOUNDATION: CELLAR: _ CRAWL SPACE:
TOTAL ROOMS: 1ST FLR: _ 2ND FLR: f rr 3RD FLR:
BATHROOM(S):— TOILET ROOM(S): cue. UTITY ROOM:
PORCH TYPE: DECK, TYPE: PATIO, TYPE:
BREEZEWAY: FIREPLACE: GARAGE: Two CA4L-
DOMESTIC HOTWATER: TYPE HEATER: Os�oa" : AIRCONDITIONING:
TYPE HEAT:}( WARM AIR: HOTWATER:
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.:
SWIMMING POOL:
OTHER:
VIOLATIONS
STORAGE, TYPE CONST.:
GUEST, TYPE CONST:
CHAPTER 144 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION I DESCRIPTION I ART. F SEC.
REMARKS:
INSPECTED BY:
1
DATE OF INSPECTION:
TIME START: /d - END: /O.