HomeMy WebLinkAboutZ-33652FORM NO. 4
TO~qq OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
NO: Z- 33652
Rte: 04/17/09
THIS CERTIFIES that the building DWELLING AND ACCESSORY
Location of Property 605 FOUNDERS PATH
(HOUSE NO.)
Co%~nty Tax Map No. 473889 Section 064
Subdivision
SOUTHOLD
(STREET) (HAMLET)
Block 0002 I~t 037
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
C~2UUFANC"f I%~3~ER Z- 33652 dated APRIL 17, 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 ACCESSORY TWO CAR GARAGE.*
The certificate is issued to ARTHUR W RATHJE & WF
( OWNER )
of the aforesaid building.
N/A
N/A
N/A
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
605 FOONDERS PATR
MAP NO_: LOT (S)
ACCESSORY STRUCTURES:
GAR~/~E, TI~PE OF CON~T.: 2 CAR WOOD FRAME ~TOP,~, ~"/PE C~T.:
VIOLATIONS: CF~PTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION kRT. SEC.
R~: BP34176 D2DDS COZ33651
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. 7/~/0~
New Construction: Old or Pre-existing Building: ~ (check one)
Location of Property: ~t:~- ~ /t~'~,S ~-/~ ~'~0 t~"/-~ ~/d
House No. Street
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section b~/t Block
$ -
Subdivision q~d~t~.~ Z ~ ~"~d(~If Filed Map.
Permit No. Date of Permit. Applicant:
Hamlet
Lot:
Health Dept. Approval:
Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate
Final Certificate:
(check one)
Fee Submitted: $
Abl~cant~nature
TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNEI~
FORMER ~WNER
STREET
N
S
VILLAGE ,,
E
W
DISTRICT SUB.
ACREAGE
TYPE OF BUILDING
LOT
CB. [ MISC.
VL FA RM COMiM. I N D.
LAND IMP. TOTAL DATE REMARKS " / ~6' ~
'"/ ? ,~ o
NEW NORMAL BELOW ABOVE
Farm Acre Value Per Acre Value
Tillable
Tillable 2
Tillable, 3
Woodland
Swampland
B rushlg~ll;I ~.,
House Plot
Bldg.' I 'P /'' ~/~Z .~;. ~ ? ~p>~ J! 3~/~ ' Foundation ~ ~ ~ , Bath
/4r~ ~ ~4' ~ ~ Basement I F~ / / Floors
'.xtension ] ~ ~t. Walls ~ ~ ~C~ Interior Finish
' I
/~ r.~ ~ ~ Fire Place /.~ Heart
:xt?2~o. /¢~'z / ~ ~ ~ .
J Porch Attic
j Porch Rooms 1st Flor
treezeway Patio Rooms 2nd Floor
~aroge ~ X~., ~ _~/ ~ ~ ~ Driveway
).B.
CONSENT TO INSPECTION
Owner(s) Name(s)
, the m~dersigned, do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the prenlises in the Town of
Southold, locatedat (~0~- /~t,.'tO(¢r'g pc,.4c/q, .~Otad(h~lltf._
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section ~t t// , 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: ~ ¢~
That the undersigned do(es) hereby give consent to the Building h~spectors 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 pretnises
comply with all of the laws, ordinances, roles and regulations of the Town of Southold.
The undersigned, in consenting to such inspections, do(es) so ;vith 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.
'(S~ .g~gire) .
(Print ~ne)
(Signature)
(Print Name)
$. 04'
o -- iron
numar 834
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