HomeMy WebLinkAboutZ-33058FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 33058
THIS CERTIFIES that the building DWELLING
Date: 05/29/08
Location of Property 2950 VANSTON RD CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 111 Block 0005 Lot 007.002
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- 33058 dated MAY 29, 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 COTTAGE.*
The certificate is issued to RONALD F GALLAGHER & ANO TRUST
(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.
7 S
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 2950 VANSTON RD CUTCHOGUE
SUBDIVISION• MAP NO.: LOT (S)
NAME OF OIINIUR (S): RONALD F GALLAGHER & AND TRUST
OCCUPANCY: RONALD F GALLAGHER & AND TRUST
ADMITTED BY: ACCOMPANIED BY:
KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 111.-5-7.2
SOURCE OF BEQUEST: RONALD GALLAGHER DATE: 05/29/08
XM�M- Cottage
TYPE OF CONSTRUCTICM: WOOD FRAME # STORIES: 1.0 # EXITS: 1
FOUNDATION: CEMENT CELLAR: CRAWL SPACE:
TOTAL ROOKS: IST FLR.: 2 2ND FLR.: 0 3RD FLR.: 0
BATHROOM(S): 1.0 TOILET ROOKS): 0.0 UTILITY ROOM(S):
PORCH TYPE: DEM TYPE: PATIO TYPE:
RRE6ZK AY: FIREPLACE: GARAGE:
DOMESTIC HOTiATER: YES TYPE HEATER: ELECTRIC AIRCOI
TYPE HEAT- {ARM A32: B0T7ATER:
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CCHST.:
SWIMMING POOL -
OTHER:
STORAGE, TYPE CONST.:
GUEST, TYPE COKST.: SEE DESCRIPTION ABOVE
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
INSPECTED BY: DATE ON INSPECTION: 05/27/08
GARY J FI TIME START: 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:
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. 5 - QQ "r�
New Construction: Old or Pre-existing Building: ( JV (check one) �` l
Location of Property: IQ9 5O V C1ns 0� f�— 1 ���` "` t '
House Nonn
Owner or Owners of Property: C5
Suffolk County Tax Map No 1000, Section
Subdivision
Permit No.
Health Dept. Approval:
Planning Board Approval:
Street
to k-er AYJJ
Block
Filed Map.
Date of Permit.
Request for: Temporary Certificate
Fee Submitted: $ \ D C-) QQ
3-30sk
Underwriters Approval:
74 USS
Lot--) • 3�—
Lot:
Final Certificate: (check one)
? 44z,.l �-
pplicant ignature
73q -s� L/
CONSENT TO INSPECTION
F G;4//nq �e,e_ , the undersigned, do(es) hereby state:
Owner(s) ame(s)
That the undersigned (is) (are) the owner(s) of the premises in the Town of
Southold, located at4LSm 1494/o7.--4/ .eZ 6t,7a4 my ve,
which is shown and designated on the Suffolk County Tax
Section ice, Block _f- , Lot 7, Y
as District 1000,
That the undersigned (has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following: (_' pfi fir, Yo
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: a�0,Y 6,re�z___ (Si na
/3," CmI14j4e.4e%,
(Prin4 Name)
(Signature)
(Print Name)
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_ TOWN OF SOUTHOLD PROPERTY RECORD CARD
G STREET j � VIL1A DISTRICT SUB. LOT 3 fy
OWNERIU
o t�I dl F� MtirE iy n /4 A a �v fc;�a /�Zs ra Par - _
E ACREAGE y� d
FORMER O N BUILDING W TYPE OF BUILDSNG
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DATE REMARKS ¢/ ! l �f fa DQ Lr✓/tC�' �i�0�
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Value r o
Acre value Per Acre 3 6 z
Farm
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Tilloble 2 0
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Total . err
LOCATION:
(number & street)
SUBDIVISION:
NAME OF OWNER(S):
OCCUPANCY:
(type)
MAP NO.:
(municipality)
LOT(S):
(owner -tenant)
ADMITTED BY: ACCOMPANIED BY:
KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000 -
SOURCE OF REQUEST: DATE:
DWELLIN : C,)}#�_
TYPE OF C U,�,,# STORIES: # EXITS:
FOUNDATION: C_,,,�r-- CELLAR: CRAWL SPACE: --
TOTAL ROOMS: 1ST FLR: Z 2ND FLR: 3RD FLR:
BATHROOM(S): TOILET ROOM(S): UTILITY ROOM:
PORCH TYPE: DECK, TYPE: PATIO, TYPE:
BREEZEWAY: FIREPLACE: GARAGE:
DOMESTIC HOTWATER: VAS TYPE HEATER: )CE_c._ AIRCONDITIONING:
TYPE HEAT: F(f�, WARM AIR: HOTWATER:
OTHER:
ACCESSORY STRUCTURES: W �iU_
GARAGE, TYPE OF CONST.: Ai ►`,qc.{{c_.�, (CW_ STORAGE, TYPE CONST.:
SWIMMING POOL: GUEST, TYPE CONST:
OTHER:
VIOLATIONS: CHAPTER 144 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. I SEC.
REMARKS:
INSPECTED BY:
DATE OF INSPECTION:
TIME START: END: