HomeMy WebLinkAboutZ-33628FORM NO. 4
TOWN OF SOLVfHOLD
BUILDING DEPA~T~NT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 33628
Date: 04/01/09
THIS c~KTIFIES that the building DWELLING (HOUSE #6)
Location of property (~%a
6
Kimoaener
Point)
JACKSON ~T
(HOUSE NO.) (STREET)
County Tax Map NO. 473889 Section 116 Block 0006
subdivision
Filed Map No. __ Lot No. __
NEW SUFFOLK
(HA~4LET)
Lot 024.001
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 purs~t to which CERTIFICATE OF
~uu~/~C"f I~L~4B~ Z- 33628 dat~ APRIL 1, 2009
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 PORCH.*
· ~ne certificate is issued to KIMOGENOR POINT CO (RICCOBONI)
(OWNER)
of the aforesaid building.
N/A
N/~
N?A
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
BOUSING CODE INSPECTION REPORT
I~TI(~: 50 JACKSON ST NEW SUFFOLK
b~IlrlSID~: ~ IlO_: LOT (S)
l~ OF O~ (S): KIMOGENOR POINT CO (RICCOBONI)
OCCUPANCY: ONE FAMILY DWELLING KIMOGENOR POINT CO (RICCOBONI)
Al~-~-r~d; BY: RICHARD RICCOBONI ACClAIm/ED BY:
DWELLING:
TYPE OF C~S~IICTI(~: WOOD FP. AME # S'I~NS: 2.0 # EXITS: 4
I~TI(]~: PILINGS & BLOCKS r'~LT~%R: NO CI~ SPA(~: YES
ACCESSORY STRUCTURES:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
GEORGE GILLEN
~DA~IE C~ I~SPECTI(~: 03/31/09
MAR 2 7 2009
BLDG. DEPT. APP[
TOWN OF SOL~THOLD
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
CATION 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.
2J Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation fi'om 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 Plarming Board Approval of completed site plan requirements.
(~For existing buildings (prior to April 9, 1957) non-conforming or buildings and "pre-existing" land uses:
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 ofOccupfincy - 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.
~'~. Certificate of Occupancy on Pre-existing Building - $100.00
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:
Location of Property:
Old or Pre-existing Building: i,,,/ (check one)
House NO.
Owner or Owners of Property: ~ tt ~.,~-6 w}
Suffolk County Tax Map No 1000, Section
Subdivision
Permit No. Date of Permit.
Health Dept. Approval:
planmng Board Approval:
Street
Block
Filed Map.
Applicant:
Underwriters Approval:
Hamlet
Request for: Temporary Certificate
Final Certificate:
(check one)
Fee Submitted: $
Applicant Signature
M. Bldg.
Extension
Extension
Extension
Garage
O.B.
Foundation
Basement
Ext. Walls
Fire Place
Bath
Floors
Interior Finish
Heat
~ V q~( Porch
Porch
Patio ·
Driveway
~tt]c
Rooms 1st Floor
Rooms 2nd FlOor
CONSENT TO iNSPECTION
~e--~i c.~t~0 ~'~t'cc..c.,F3 o~.* , 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 ~'c.. i, ,~. ,~ ~
· . -- t~ ~e,~brt~ re[w~ ~-~o-, 4'~i'=~,,t_j~. , ~ ,l~$"wo
wNch ~s shown and designated on the Suffolk Cou{~ty Tax Map as DistEct 1000,
Section _/} ~, , Block _ & , Lot_/c~/O ~ c!, I.
That the undbrsigned~(have) filed, or cause to be filed, an application in the
Southold Town Building Insp~cctor's Office for the following: ~°r~-~ - C_. O.
That the undersigned do(es) hereby give consent to the Building luspcctors 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 preinises
comply with all of the laws, ordinances, roles and regulations of the Town of Southold.
The undersigned, in consenting to such iuspections, do(es) so with the lmowledge
and understanding that any information obtained in the conduct of such inspections m%,
be used in subsequent prosecutions for violations of the laws, ordinances, roles or
regulations of the Town of Southold.
Dated:
(Pr/nt Name)
t
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SITUA TED A T
NEW SUFFOLK
TOWN OF SOUTHOLD
S~FFOLK COUNTY, NFW YORK
TAX No. 1 000-11 6-06-P,/0 24.1
SCALE =
1" 40'
MAY 3, 2000
.VATIQNS ~ REFEEENCED TO N,G,V,D, 1929 DATUM
EXtS'I[fN(~ E.:LLr~A~ ARE SH~N THUS:~
EXIST~ ~R L~S ~ SHOWN THUS: .......