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Home My WebLink AboutZ-34176FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~RTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 34176 ~te: 01/28/10 THIS u~TIFIES that the building DWELLING ~cation of Pro~rty 22750 CR 48 (HOUSE NO.) (STREET) County Taxx Map No. 473889 Section 084 Block 0004 Subdivision Filed Map No. __ Lot No. __ CUTCHOGUE (HAMLET) 002 three conforms substantially to the Requirements for a~FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUP~NCY~ER Z- 34176 dated JANUARY 28, 2010 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 THREE FAMILY DWELLING WITH WRAP AROUND PORCH.* The certificate is issued to MICHAEL Z HERBERT (OWNER) of the aforesaid building. N/A N/A N/A Authorized Signature Rev. 1/81 BUIL/3ING DE pART~4ENT TOWN OF SOUTEOLD MOUSING CODE INSPECTION REPORT LOCATI(~: 22750 CR 48 CUTCHOGUE MAP NO.: LOT (S) MICHAEL Z HERBERT ~A~: 01/28/10 DWELLING: TYPE OF C~UCTIG~: WOOD FRAME ACCESSORY STRUCTURES: LOCATION DESCRIPTION ~- 3 FAMILY INCLUDES: 1ST FL REAR: 2 BEDROOMS, KITCHEN, LIVING/DINING, BATH 2ND FL REAR: 1 BEDROOM, KITCHEN, LIVING ROOM, BATH FRONT: 3 BEDROOMS, KITCHEN, LIVING ROOM, FULL BATH AND 1/2 BATH E~: BP24291 ENC PORCH COZ25394~ BP34150 ROOF C0Z34150 GOERGE GILLEN TI~ S~: NAg): FormNo. 6 I~'~ ~ f~ ~ I] ~fl l~'~ TOWN OF SOUTHOLI~t II ~ k~ k~ U ~ ~ TOWN HALL III II1 APPLICATION FOR C ATE L p TOWN OF SOUII~0L~I This application must be filled in by typewriter or ink and submitted to tt[& Building Department wire me fc lowing: 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. Ifa Certificate of Occ?ancy 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 /- New Construction: Old or Pre-existing Building: x,~ (check one) Location of Property: Street Hamlet House,No. Owner or Owners oferoperty: ~{'"~.A-(~ ~-'~e',4' ~ ct~ ~N~k'Ck.L~ ~;~::v~- Suffolk County Tax Map No 1000, Section ~ ~ Block /"{ Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: -~ (check one) Applicant Signature ,o~o-; / .v-i TOWN OF SOUTHOLD PROPERTY RECORD CARD OWN~R STRE~ ~%-z',~., v.LA~E D~ST. SU~. LOT FOYER ~ ~ ~ ~ N E ' AC~ J W ~ OF BUILDING ~' ~ ~-O S~. VL FA~ C~M. CB. M]SC_ Mkt. Valu~ ' ~ND IMP. TOTAL DATE REMARKS ~ Acre ~amp~ FRONTAGE ON WATER ]rushland FRONTAGE ON ROAD / ~ouse Plot DEPTH / 7 ~ ' ~ ~ ~ ~ BULKH~D total DOCK Bldg. xtension ~xtension ~orch ~/se Breezeway ~$ement Ext. Wails ;ire Place Dormer I Driveway fiarage Total Bath 2.- Dinette Floors ~//~ ~-~ -interior Finish He~t ~ DR. Roo~ 1~ Flor * BR. 2nd Flor TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION , CONSENT TO INSPECTION Owner(s) Name(s) That the undersigned (is) (are) the~ o~er(s) of the ~j'emises in the Town of Southold, located at '7_ ]2'-7 .5~-O ~" ~- which is s~o, ,wn and designa, t,ed on the Suffolk County Tax Map as Dis'trict"l'000, Section D~ , Block t~/ , Lot That the undersigned (has) (have) filed, or cause to be filed, an application in the S~,~[__~old Town Building Insl~ector's Office for the foil.owing: '\ 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, roles or regulations of the Town of Southold. · - ~ (Signamr~)~ (Print Name) (Signature) (Print Name)