HomeMy WebLinkAboutZ-33671FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 33671
THIS CERTIFIES that the building DWELLING
Date: 04/24/09
Location of Property 2955 HYATT RD SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 054 Block 0001 Lot Oil
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- 33671 dated APRIL 24, 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 SCREENED PORCH AND BRICK PATIO.*
The certificate is issued to PHILIP E & JOYCE E LAGRECA
(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.
Authorized Signature
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 2955 HYATT RD SOUTHOLD
SUBDMSION: NAP NO.: LOT (S)
RANG OF OWNER (S): PHILIP E & JOYCE E LAGRECA
OCCUPANCY: ONE FAMILY DWELLING PHILIP E & JOYCE E LAGRECA
ADMITTED BY: DIANE DUNBAR ACCOMPANIED BY: SAME
KEY AVAIIJUILE: SUFF. CO. TAR MAP NO.: 54.-1-11
SOURCE OF REQUEST: PHILIP LAGRECA DATE: 04/24/09
DWELLING:
TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 Y EXITS: 2
FOUNDATION: BLOCK CELl-AR. FULL CRAWL SPACE: PART
TOTAL ROOKS: 1ST FLR.: 6 21ND FLR.: 0 3RD FLR.: 0
BATHROOM (S) 2.0 TOILET ROOK(S): 0.0 UTILITY ROOM(S):
PORCH TYPE: COVERED SCREENED DECK TYPE: PATIO TYPE:
BREEZEWAY- FIREPLACE- NO GARAGE:
DOMESTIC HOTHATER: YES TYPE HEATER: OIL AIRCON
TYPE HEAT: OIL BASEBD WARM AIR: HOTWATER:
OTHER: SEE PERMITS
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST..
SKIDECONG POOL:
OTHER:
STORAGE, TYPE CONST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
REMARKS. EP23058 ADD/DECK COZ25712,BP32295 ALTS COZ32189
INSPECTED BY:
GEORGE
DATE ON INSPECTION: 04/23/09
TIME START: END:
Farm No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUP
AUG 2 8 2006
This application must be filled in by typewriter or ink and subirtitted 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 naturalor
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. Conunercial 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 Planting 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:
I . Accurate survey oCpropert� showing al I propei7 lines, slreels, building and unusual natural or topographic
features.
2. A properly eoulpleted apph� a[ion and consent u, inspect sigmcd by the applicant. If a Certificate of Occupancy is
denied, the Buildiog Inspcchu shall `taf e the reasons therefor in writing to the applicant.
e
C Fees
I - Certificate of occupenc% Ncs, dwelll'W i 1> "J, Addi(ions to dwelling $25.00, Alterations to dwelling $25.00.
' Swimming pool $25 00. Accessol) buddim, $7s t)()- Additions to accessory building $25.00, Businesses $50.00.
CertifieateofOcctipanct on pre. exis(ingl3uildin>>.- $100.00
3. Copy of Ccdifica(e of Occupancy - $.25
4. Updated Certificate of occupancy - $SO.UO
5. Temporary Cerfihca(cofOccupancy Residen(Ml 1, 00, Conu»ercial $15.00
Date..
New Construction: _ Old or Pre-existing Building: ✓ (check one)
Location of Property: o�J�S 5" / /�T% -- �j�lTJfa/�
I -louse No Street Hamlet
Owner or Owners of Property:_A"46G �Eejq�__. -
Suffolk County Tax Map No 100, Section s3 - Block
Subdivision Filed flap Lot:
Permit No. Date of Permit Applicant:_—
-—
Health Dept. Approval: - Underwriters Approval:
Planning Board Approval: — --- - - --
Request for: Temporary Certificate
Fee Subnutted:
leo :3 ion '-
Final Certificate: ✓ (check one)
fit/
pplica Si ature
CONSENT TO INSPECTION
Pn t L i p Zq 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 %��21�h Sp �Tya�
which is shown and designated on the Suffolk C unty Tax Map as District 1000,
Section _ 6'� , 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:
PRE -i )fS7;IJ6� Qd
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: el vloe
(Signature)
(Print Name)
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LOCATION:
(number & s et) (municipality)
SUBDIVISION: -.0— MAP NO.: i-- LOT(S):
NAME OF OWNER(S):
OCCUPANCY:
gtype) A U 0 (owner -tenant)
ADMITTED BY: _ � ACCOMPANIED BY: _49ZW-v--
KEY AVAILABLE: jt + i SUFF. CO. TAX MAP NO. 1 00- 115-
SOURCE OF REQUEST: DATE: 0,9 d '-a
DWELLING:
w �7' /
TYPE OF CONSTRU N: # STORIES- # EXITS: X.
FOUNDATION: CELLAR: CRAWL SPACE,�t
NOTAL ROOMS: 1ST FLR: 2ND FLR: CRAWL
FLR:
*_BATHROOM(S): ,Z _ JOILET ROOM(S�: UTILITY ROOM:
PORCH TYPE: &A-,) CK, TYPE: !• PATIO, TYPE:
BREEZEWAY: /FIREPLACE: GARAGE:
DOMESTIC HOTWATER: fitt TYPE HEATER &Z AIRCONDITIONING:
TYPE HEAT:WARM AIR:
4VOTHER: ,ao4o
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.:
SWIMMING POOL:
OTHER:
HOTWATER:
STORAGE, TYPE CONST.:
GUEST, TYPE CONST:
VIOLATIONS: CHAPTER 144 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
111M DESCRIPTION�®
IMF
ANN _ _
REMARKS:
INSPECTED BY:
DATE OF INSPECTION: �Z-0--)_Z019
TIME START: 0' -S-- END: