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HomeMy WebLinkAboutZ-33769FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 33769 Date: 06/10/09 THIS CERTIFIES that the building DWELLING Location of Property 11860 NEW SUFFOLK AVE CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 116 Block 0006 Lot 009 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- 33769 dated JUNE 10, 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 PORCHES AND BRICK PATIO.* The certificate is issued to DOUGLAS MOORE of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 (OWNER) N/A N/A N/A AtZhorized Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 11860 NEW SUFFOLK AVE CUTCHOGUE SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S): DOUGLAS MOORE OCCUPANCY: ONE FAMILY DWELLING DOUGLAS MOORE ADMITTED) BY: JEFF MILLER ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 116.-6-9 SOURCE OF REQUEST: JEFF MILLER DATE: 06/10/0 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME Y STORIES: 2.0 M EXITS: 4 FOUNDATION: CEMENT C0ff-AR; CRAWL SPACE: YES TOTAL ROOMS: 1ST FLR.: 4 2ND FLR.: 5 3RD FLR.: 0 BATHROCM(S): 3.0 TOILET ROOM(S): 1.0 UTILITY ROOM(S): PORCH TYPE: ROOFED; SCREENED DECK TYPE: PATIO TYPE: BREEZEWAY: 'FIREPLACE: 2 GARAGE: YES DOMESTIC HOTWATER: X TYPE BEATER: OIL AIRCONDITIONING: TYPE MOAT: OIL WARM AIR: YES HO'1TATER: _ ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.. SWIMMING POOL: OTHER: STORAGE, TYPE CONST.: GUEST, TYPE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE INSPECTED BY: GEORGE DATE ON INSPECTION: 06/09/09 TINE START: END: MAY 2 9 2009 TOWN OF D Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 I%b 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: For existing buildings (prior to April 9,1957) non -conforming uses, or buildings and "pre-existing" land uses: 1. Accurate suryey 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 Copy of Certificate of Occupancy - $:25 4. UpdatedCertificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: House No. . Owner or Owners of Property: Date. V Old or Pre-existing Building: V (check one) Street Suffolk County Tax Map No 1000, Section 1 Block 6�1 Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ l 00 `) Ke -C �da0 Underwriters Approval: Final Certificate: (check one) CONSENT TO INSPECTION //V 1t-�JFt/Z— , 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 I I K'& Q AlfAi Sur -F -o z- ✓� ��r which is shown and designated on the Suf olk County Tax Map as District 1000, Section I 1 (.9 , 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: `-r 9( It t7—/A) G G o 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: /or, 1 ature) (Print Name) (Signature) (Print Name) TOWN OF SOUTHOLD ROPERTY RECORD CARD A OWNER STREET VILLAGE DISTRICT SUB. LOT (1 As * 0 o r e ej0) :;fjo/k /qve,, C cl AC, 16 v e 12 Pe.rA- FORMER OWNER N euvJ,4,nn__/, A6,, E * A, f�-/worth ACREAGE 4139 SAC617 1IC / W M,,&, `ie1-� 'd TYPE OF BUILDING RES. A9 / D SEAS. VL. FARM comm. IND. CB. MISC, LAND IMP. TOTAL DATE REMARKS ©o a Sao �dC) ZOUO � yv Z a a '9oe ,� ao 3/ G . - — y ftsaeo�ise4 A14 .I�t* s,76 A,444 oa 0 /D 6'06 G� AGE BUILDING DITION NEW NORMAL BELOW ABOVE Farm Acre Value Per Acre Value Tillable I Tillable - 2 Tillable. 3 Woodland yy�� S6T%I,i do /2C Q rt iC p SwamplandDQ 4 3 G.%, BrushNnd -%w „"' House Plot Total N i sew ord�M P r H� 7- p�CCAIIC, Sl✓Rv�'rEL3 Ti's` iii E-7-T4r A lr Scale rwu.a«Nw.��c.: aw•��s .. - .�bwM.Mt.MMrWtMlMrYrp1 hMae«W r.. +p Mw4u�L wifwMFiM�W wrM. - �r�RMM'na..M �ef'mi �NKwFrWbshrrenW �M rwuw�fw r�� waQwtiM�ww�w rwMNhO�i ' e.arwrrww4r.r�.arr� LOCATION: 1 I (number & street) SUBDIVISION: NAME OF OWNER(S): _ OCCUPANCY: MAP NO (municipali (type) (owner -tenant) ADMITTED BY: SW� /K,LU-'p-t^—^ ACCOMPANIED BY: KEY AVAILABLE: 04 SUFF. CO. TAX MAP NO. 1000 - SOURCE OF REQUEST: DATE: S a► `% C7 v - DWELLING: TYPE OF CONSTRUCTION: W 6 a D # STORIES: # EXITS: FOUNDATION:CELLAR: CRAWL SPACE: 1 TOTAL ROOMS: 1ST FLR: 2ND FLR: 3RD FLR: BATHROOM(S): AL 3 TOILET ROOM(S): UTILITY ROOM: PORCH TYPE: Roore D �edr CK, TYPE: PATIO, TYPE: B,PIcK BREEZEWAY: T- FIREPLACE: v'Z GARAGE: Xf,.,;S DOMESTIC HOTWATER: � TYPE HEATER: 0 I L., AIRCONDITIONING: TYPE HEAT: 61L WARM AIR: YDS' HOTWATER: -VW. OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SWIMMING POOL: OTHER: iVoNF STORAGE, TYPE CONST.: GUEST, TYPE CONST: VIOLATIONS: CHAPTER 144 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. Q REMARKS: INSPECTED BY: '/�. DATE OF INSPECTION: / TIME START: END: