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Home My WebLink AboutZ-34791FORM 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- 34791 I~te: 01/10/11 T~IS CERTIFIES that the building DWELLING AND COTTAGE Location of Property 865 NOKOMIS RD (ROUSE NO.) County Tax ~ap NO. 473889 Section 078 Su]~division SOUTHOLD (STREET) (HAMLET) Block 0003 Lot 026 Filed Map NO. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING b~ilt prior to APRIL 9, 1957 pursuant to which U~]~'rIFICATE OF OCuuMANCY I~q~ER Z- 34791 dated JANUARY 10, 2011 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 2 COVERED PORCHES AND ACCESSORY COTTAGE.* The certificate is issued to DAVID J VERITY of the aforesaid building. ( OWNER ) ~.RCTRIC3%L ~TIFICA~NO. PL~ C~TIFIC~%TION DA'r~o *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A ~u/tho/~ature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTMOLD MOUSING CODE INSPECTION REPORT SOUTHOLD ~AP NO.: ~OT (S) DAVID J VERI/~f TOILET ~3O(~($): 0.0 1.0 # EXITS: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. R~RKS: BP 36135 STG BLDG COZ-34789 BY: PiSB? ' BUILDING DEPARTMENT TOWN OF SOUTBOLD EOUSING CODE INSPECTION REPORT ~ OF O~ (S): DAVID J VERITY O~/~: ACCESSORY ONE FAMILY COTTAGE MAP NO.: LOT (S) DAVID J VERITY ACCESSORY STRUCTURES: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. 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: I. Final survey of preperty 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 iustallatiun from Board o f 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 V-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 Ce~ficate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees [. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alteratious 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 $15.013, Commercial $15.00 -New Construction: Location of Property: House No. Street owner or Owners of Property: H'~'~'ia ~/¢7 ~- ~'1 SUffOlk County Tax Map No i000, Section "~ ~ / Block ~ Subdivision ~ v{" ~-t0~ 2. .[O~r?~ne]~9 q/,/6'0FiledMap' Petiait No. Date of Permit. Applicant: Health Dept. Approval: Planning Board Approval: Date. ~5- -o9- - I 0 Old or Pre-existing Building: ~ (check One) Lot Lot: Hamlet Underwriters Approval: Request for: Temporary Certificate Final Certificate: Fee Submitted: $ ~~heck one) Applicga(Signatu~--~'~ CONSEI'~F TO INSPECTION · , the undersigned, do(es) hereby state: That the undersigned (is) (are) the owner(s) o.f th~,_l~remises in thl Town of Southold, locatedat ~ ~> B.J~_x~kc~rv~ 'x~.cx~c~I ~o ~--), which is shown and designated on the Suffolk County Tax Map as District 1000, Section "'] ~ , Block ~ , Lot ~-G, . That the undersigned (has) (have) filed, or cause to be filed, an application in the South,~,oldTownBuildinglnspector's Office for.the following: ~- ~,~c~, ~.~ That the undersigned do(es) hereby give con§¢nt to the Building Inspectors of the Town of fiouthold 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 ~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 insubsequent prosecutions for violations of the laws, ordinances, roles or regulations of the Town of Southold. ignature) (Print Name) '(Signature) (Print Name) LOCATION: (number & street) (municipality) SUBDMSION: NAME OF OWNER(S): OCCUPANCY: MAP NO.: LOT(S): (type) ADMITTED BY: ~ KEY AVAILABLE: ' ' ' ] ~ SOURCE OF REQUEST: (owner-tenant) ACCOMPANIED BY: SUFF. CO. TAX MAP NO. 1000- DATE: DWELLING: TYPE OF CON.STRUCTION: FOUNDATION. f~.~,,~..,~,.----/'~.~c~ # STORIES: ~ # EXITS: ,L-- CELLAR: /tSar// CRAWL SPACE: TOTAL ROOMS: 1ST FLR: ,~ 2ND FLR: 3RD FLR: BATHROOM(S): ~ __ TOILET ROOM(S): UTILITY ROOM: PORCH TYPE: ~J.~_~) DECK, TYPE: .... PATIO, TYPE: BREEZEWAY: FIREPLACE:. ~ GARAGE: DOMESTIC .HOT ~W~TER: TYPE HEAT. ~. ~-~f TYPE HEATER:. ~ ~ AIRCONDITIONING: OTHER: - WARM AIR: HOTWATER: ~ -- ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: /f--"f~ '~w/"v-/[/~OO~GE, TYPE CONST.: ..--Z~'~'-~-_. _~ SWIMMING POOL: -. OTHER: GUEST, TYPE CONST: ' VI L~AT~ONS: CH~/PT/ER 14~ N.Y. STYE UNIFORM FIRE PREVENTION& BUILDING CODE LOCATION ~ DESCRIPTION DATE OF INSPECTION:- ,/'/~C/,~ ~5? TIME START: END: N S84'21 'o0'W I sTY. N/O/F KEV1N z~ WILLIAM HARDING AREA=26,622 SQ. FT s~ow~ oN "~,~P or ~c,o~ 2 ~u~No WA]ER U~ ~r-~ 270.00' ~ 003- 78- 03-26 AREA~50,775 SQ, FT ~ ST~ SET SURVEY OF PROPERTY A T LA UGHING WA TER TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000- ?B-03-26 SCALE: 1'---30' AUGUST 18, 2010 49.5' N85', · =MONUMENT AREA=57,397 SO. FT. (6J1) 765-5020 FAX ~'-G~.,) 765-1797 P.O. BOX 909 1230 TRAVELER STREET I sou~Ho~o, N.× 1~ 110-198