HomeMy WebLinkAboutZ-34394FORM 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- 34394
Rte: 06/09/10
THIS U~KTIFIES that the building DWELLING
I~Dcation of Prope~cy 465 BAILEY AV~ (AM 602) GREENPORT
(HOUSE NO.) (STREET) (HAMLET)
Co%u~t¥ Tax Map No. 473889 Section 034 Block 0004 I~t 007
Subdivision FiledMap No. Lot NO. __
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which C~KTIFICATH OF
(~2cuPANC~f N~MB~ Z- 34394 dated JUNE 9, 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 ONE FAMILY DWELLING WITH SCREENED PORCH.* (REPLACES PRE C/O Z4976
DATED 1/17/73)
· ~ne certificate is issued to MARGARET DUGGAN
(OWNER)
of the aforesaid building.
SUFFOLK COO1Tl~f DEPART~ENT OF HEALTH APPRO~-AL
ELEt-rKICAL CERTIFICATE NO.
PLUMBERS c~KTIFICATION DA'r~D
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTBOLD
BOUSING CODE INSPECTION REPORT
LOCAT~(~: 465 BAILEY AVE (AKA 602) GREENPORT
S~DI~-iSION: MAP NO.: LOT (S)
N~ME OF O$~FER (S): MARGARET DUGG~N
(~AN~: ONE FAMILY DWELLING
DATE: 06/09/10
1.5 # roUTS: __2
ACCESSORY STRUCTURES:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
]~: COZ29067 ADDS/ALT, PRE C/0Z34282 ACCY GARAGE
GEORGE GILLEN
~A~ (~ Ii~SPECTI(~: 06/08/10
BLDG. DE'c~l?rt''l t'''
TOWN OF SOUTHOLI)
This appli
Form No. 6
TOV~q OF SOUTHOLD
IUILDING DEPARTMENT
TOWN HALL
765-1802
N FOR CERTIFICATE OF OCCUPANCY
atton 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 fi-om Board of Fire Underwritars.
4. Sworn statement fi~om plumber certifying that the solder used in system contains less than 2/10 of 1°.4 lead.
5. Comrnereial build'g, 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 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.
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.
/
New Construction: Old or Pre-existing Building: ~/ (check one)
Location of Property:HouseA ONe. ~- '/~ '~'/t~'-7 Street"~'-' ~-~/~9?)
Owner or Owners of Property: //~ ~ ~
I
Suffolk County Tax Map No 1000, Section '~ q
Subdivision
Permit No.
Health Dept. Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $
Hamlet
BloCk
Filed Map. Lot:
Date of Permit. Applicant:
Underwriters Approval:
Final Certificate:
(check one)
ApPlican¢ignature
CONSENT TO INSPECTION
Owner(s) Nam~(8X
, the undersigned, do(es) hereby state:
That the underai~ned (is) (.are) th~ owner(s) of the llremisos in the Town of
wmcn ~s shown an~ ~es~gnated on the Suff61k Count,/Tax Map a,qDistriet ~1000,
Section , Block , Lot
That the undersigned (has) (have) filed, or cause to be filed, an application in the
S.o_uthold Town Building Inspector's Office for.the following: P/r_,< ~,~,,~f..e~.~ ~- ~,
~.~. w,/ aTcc~,7~r? -~-~_C /r~. /~"2'5 .'~'~ r · '-
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 South01d.
The undersigned, in ~onsenting 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, rotes or
regulations of the Town of Southold
Dated:
' /(~rintSmae) [/
'(Signature)
(Print Name)
OWNER
TOWN OF SOUTHOLD P~'OPERTY RECORD CARD
FOR~IER OWNER
RES...2/.~ SEAS.
LAND IMP.
AGE
NOR~M~L
W~lond
VL FARM
TOTAL DATE
/ ¢~ ~
VILLAGE
./J, I
DISTRICT [ SUB.
ACREAG~
TYPE OF BUILDING
LOT
REMARKS
BUILDING CONDITION
FRONTAGE ON WATER
BELOW ABOVE
Value Per Acre Velue
BULKHEAD
DOCK
Interror F[ni~
':Roof Type
I Rcoms 2nd Floor