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HomeMy WebLinkAboutZ-32999FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 32999 THIS CERTIFIES that the building DWELLING Date: 04/24/08 Location of Property 255 DOGWOOD LA EXT EAST MARION (HOUSE NO.) (STREET) (HAMLET) County Tax Nap No. 473889 Section 037 Block 0001 Lot 009 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- 32999 dated APRIL 24, 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 ONE CAR GARAGE* The certificate is issued to WARREN A SAMBACH, JR. & ORS. (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. "� la'-�- \ horiz d Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 255 DOGWOOD LA EXT EAST MARION SUBDIVISION: PULP MD.: IAT (S) NAME OF OWNER (S): WARREN A SAMBACH, JR. & ORS. OCCUPANCY: SINGLE FAMILY DWELLING WARREN A SAMBACH, JR. & ORS. ADMITTED BY: DIANE DUNBAR ACCOMPANIED BY: SAME KEY AVAII.ABI.E: SUFF_ CO. TAX MAP NO.: 37.-1-9 SOURCE OF REQUEST: DEAN SAMBACH 4/10/08 DATE: 04/24/08 DWELLING: TYPE OF CONSTRUCTION; WOOD FRAME Y STORIES: 1.5 i EXITS: 4 FOUNDATION: CEMENT BLOCK CELLAE: 1/3 CRAML SPACE: 2/3 TOTAL ROOMS: IST FIR.: 5 2ND FIR.: 0 3RD FIR.: 0 BATHROOM (S) 2.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S): PORCH TYPE: SCREEN PORCH DECK TYPE: WOOD PATIO TYPE: BREEZEWAY: FIREPLACE: ONE GARAGE: 1 CAR DOMESTIC BOTH LTER: YES TYPE SEATER: OIL AIRCONDITIONING: TYPE BEAT: OIL MLRM AIR: HOTNATER• XX ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SWIMMING POOL: OTHER: STORAGE, TYPE CONST.: GUEST, TYPE COMET.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE REMARKS: BP#7005-COZ7585(ADD) BP#11328-COZ1115 (ADD) BP#13617COZ15463 (ADD) INSPECTED BY: GARY J DATE OH INSPECTION- 04/14/0 TIME START: 9:45 AM END: 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: i 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. 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. New Construction: Old or Pre-existing Building: ✓' (check one) �yy� Location of Property: J U e-,We>t)A Z^,:�iAS/ House No. Street Hamlet Owner or Owners of Property: J ew S/ Mhm-H Suffolk County Tax Map No.1000, Section Subdivision Permit No. Health Dept. Approval: Planning Board Approval: Date of Permit. Request for: Temporary Certificate Fee Submitted: $ /dU dd 6e co -2,3,�599 Block Filed Map. Underwriters Approval: Lot Lot: Final Certificate: ✓ (check one) Applicant Sigodhire CONSENT TO INSPECTION e4l-j Z l/n/gam` -,the undersigned, do(es) hereby state: Owner(s) Name(s) That the undersigned (is) (atF) the owner(s) of the premises in the Town of Southold, located at h 40fA;C- ljf ele x which is shown and designated on the Suffolk County Tax' Map as District 1000, Section J % , Block , Lot �? - That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: Of_ C- - LD 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: 26a ou< a igl ure) (Print Name) (Signature) (Print Name) 160,t3Q. LOT 9t) V IF Zol— Yx Cv 4V T 5 10,11 LOT 94 nzf,-A eftew�or addition, sun," is 0 of the 14!k4 rewmvo," Cope_ C -f this owjw rasa .Vint the Irnd sorwWo wife awl % — Qmtcssed Seal sholl rot be .&44,g{.1FF QL..K. CO. CAA MAP 0fE5IONATJQW-, to h' availd true copy,GOEMMOSS Inclicaled hwftn dm 011111 to the Damon for vdmrn The aurmy P prepared, and an his hshelf to ohs _ Vile company, ntal ager.W ancl 111allo 11ItItlon"I"19Tdoherson and to 1ha igna" of the lending inti.MAP QE PLaOPERT'y mitnion. Guwantos are not transferable ItO OdditiOnal insfitudOnS Or mboquent ow"em \AfIN-- N AMr-,APEIP &JiUsIle. 1$,1962 AV fv -)R,'YfEYED Fe 0 14 f977' 1, 0-7-0 © — �;A` - yd D =3 7 _/ _ TOWN OF SOUTHOLD PROPERTY RECORD CARD N R y WR STREET VILLAGE DIST. SUB. LOT F RMER OWNER � N E ACR , G W Yf r1IN•!E'AVA Sr- S W TYPE OF BUILDING RES. / I SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LANDIMP. TOTAL DATE REMARKS /,//y/ d Iivv sUcj -gait/ Ivo �v0o 3�0a 4/ <✓- - t m�L (J.).;�F ua010c) a Z �� 2 .. 8 P �` � o.0 o S?o�/6 Ar. � 4 Q1 3_S-SS2Vr�4 h ra 1p G, it - 42 � 5RDo aa®8f, 21 z OO O - rr ,�;a4 /-P-7ta ihs Ilk AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Vclue Acre 11 Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH House Plot BULKHEAD Z-- DOCK ��2�/\w «d � �G �� / ��/ �>��t� ~� .�k�� 2 � � � ��2�/\w � � \�\»: ■&\\�$�`: 2 � � .: � � �: � �} R \ƒ V1,- : LOCATION: (number & street) SUBDIVISION: NAME OF OWNER(S): OCCUPANCY: MAP NO.: (municipality) LOT(S): (type) (owner -tenant) ADMITTED BY:2w'1-'jC ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000 - SOURCE OF REQUEST: DATE: DWELLING: _ TYPE OF CONSTRUCTION: C1/ b # STORIES: # EXITS: xv FOUNDATION:L ' CELLAR: 13 CRAWL SPACE: TOTAL ROOMS: 1ST FLR: 2ND FLR: 3RD FLR: BATHROOM(S): TOILET ROOM(S): - — UTILITY ROOM: PORCH TYPE: © DECK, TYPE: L1J PATIO, TYPE: BREEZEWAY: FIREPLACE: 'c91I.. GARAGE: l tri, DOMESTIC HOTWATER: S TYPE HEATER: AIRCONDITIONING: TYPE HEAT:.64WARM AIR: HOTWATER: OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST:: SWIMMING POOL: OTHER: STORAGE, TYPE CONST.: GUEST, TYPE CONST: VIOLATIONS: CHAPTER 144 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. Of c2 v REMARKS: _COQ S_ .9 tc, I) WA 1 I �C0 INSPECTED BY: DATE OF INSPECTION: TIME START: r END: