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HomeMy WebLinkAboutZ-33132FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 33132 THIS CERTIFIES that the building DWELLING & ACCESSORIES Date: 07/02/08 Location of Property 500 VILLAGE LA ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 025 Block 0001 Lot 010 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- 33132 dated JULY 2, 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 COVERED WRAP AROUND PORCH, SOUTH SIDE PORCH/ DECK AND ACCESSORY SHEDS.* The certificate is issued to CYRIL K LUKEMAN, JR (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A EIJ?C TICAL F"611 PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 N/A N/A - "L �' X' thorized Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 500 VILLAGE LA ORIENT SUBDIVISION• MAP MO.: MIT (S) NAME OF OWNER (S): CYRIL K LUKEMAN, JR OCCUPANCY: ONE FAMILY CYRIL K LUKEMAN, JR A➢lQTTED BY: ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 25.-1-10 SOURCE OF REQUEST: CYRIL K LUKEMAN DATE: 07/02/0 DWELLING: TYPE OF CONSTRQCFIOW WOOD FRAME j STORIES: 2.0 * 88ITS• 3 FOUNDATION: STONE & CEMENT BLOCK CZEJ AR: 1/2 CRAWL SPACE: 1/2 TOTAL ROOM: LST PLR.: 5 2ND FLR.: 5 3RD FLR.: 0 BATHROON(S): 2.0 TOILET ROOM (s): 0.0 UTILITY ROOM(S): PORCH TYPE: COVERED WRAP AROUND & * DECK TRPS: PATIO TYPE: BRE 23107Y• FIREPLACE; 1 GARAGE: DOMESTIC HDTMATRR: YES- TYPE BEATER: AIRCO DITICEIRG: TYPE BEAT• NAT GAS WARM AIR• EK)THATER: X OTS: OFF BOILER, COVERED SOUTH SIDE ENTRY PORCH/DECK ACCESSORY STRUCTURES: GARAGE, TYPE OF COST.: STORAGE, TYPE CONST.: 2 SMALL SHEDS - SWIMMING POOL: GUEST, TYPE COMET.: OTHER: *UNDER 100 SQUARE FEET VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE REMARKS: BP32810 REPAIRS/ALT COZ32253 INSPECTED BY: DATE ON INSPECTION: 07/02/08 GARY J TIME START: 9:45AM END: 10:15AM SUR1T--Y OF PROPERTY 9MAATQV'�4�Soumow SUFE COtMM W 9w&rw�*2%2 aawax �nwrc(-w y" a woo -a - Ahrr Mots a w�um raw AIWA- ya sr. M==4 A04°5 6RARXf moi• 'N WE s 4w JOHN C. EHLMS LAND SURVEYOR 6AWKAWS� M.Y1UrM47m 0Y9®AD6KL MB Ma�s�aO �.a0t�panw�ee��IN,yn ND C3 Q N W ( N Form No. 6 t TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 31 - (00 765-1802 �g 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 n Real or ".j 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,.ef-1�0i`o`iea3� 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) Location of Property: C9O V 5 k LA 11.L ©11 House No. Street Hamlet Owner or Owners of Property: Y' 11 K. L c 4 k ty x h Suffolk County Tax Map No 1000, Section c11 S Block Subdivision Permit No. Health Dept. Approval: Planning Board Approval: Date of Permit. Request for: Temporary Certificate Fee Submitted: $ L M �ro ;2- 33 Filed Map. Applicant: Underwriters Approval: Lot 10 Lot: Final Certificate: vl"�_ (check one) Applicant Signature CONSENT TO INSPECTION u k, c tM4 In 7- Q- , the undersigned, do(es) hereby state: Owner(s) Name(s) That the undersigned (is) (are) the owner(s) of the premiss in the Town c Southold, located at ` 1 li L4, &,I w, 'tJ which is shown and designated on the Suffolk County Tax Map asD strict 1000, Section ;2:S , Block 1Lot ( O That the undersigned (has) (have) filed, or cause to be filed, an a plication 'n the Southold Town Building Inspector's Office for the following: Cep -4s ° -.k cc , pcm 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. l (Signature) K. C --v-g iJam-. (Print Name) (Signature) (Print Name) LOCATION: 51'b6VI'l t A-CCyc (number & street) SUBDIVISION: NAME OF OWNER(S): OCCUPANCY: (type) MAP NO.: (municipality) LOT(S): (owner -tenant) ADMITTED BY: Cu tU L� f1KeA4JACCOMPANIED BY: KEY AVAILABLE: I SUFF. CO. TAX MAP NO. 1000 - SOURCE OF REQUEST: DATE: DWELLING: TYPE OF CONSTRUCTION: GIiB (-��+"�1�� # STORIES: # EXITS: 3 FOUNDATION: -1a CELLAR: w CRAWL SPACE: TOTAL ROOMS: 1ST FLR: ,S` 2ND FLR: S 3RD FLR: ---- BATHROOM(S): TOILET ROOM(S): •�-- UTILITY ROOM: --- PORCH TYPE: RkP K, TYPE: PATIO, TYPE: • BREEZEWAY: FI PLACE: _ GARAGE: ��OMESTIC HOTWATER: TYPE HEATER: , AIRCONDITIONING: TYPE HEAT: ARM AIR: HOTWATER: OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: LA Ej&W STORAGE, TYPE CONST.: 5�,� �'.d►9 $ SWIMMING POOL: GUEST, TYPE CONST: S `4w.) ado ,_ OTHER: REMARKS: INSPECTED BY: DATE OF INSPECTION: Q � TIME START: 6 - s END: