HomeMy WebLinkAboutZ-34858FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEP~T~tENT
office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 34858 Date: 03/08/11
THIS U~'rIFIES that the building DWELLING
Location of Property 3175 WEST CREEK AVE CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 110 Block 0005 Lot 009
Sukx~ivision Filed Map No. __ Lot No. __
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 purs%u~nt to which CERTIFICATE OF
~C~/PANC~f ~]~BER Z- 34858 dated 9L~RCH 8, 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 W/COVERED FRONT PORCH & PATIO.* NOTE: BP9196 DECK
COZ7882, BP21076 UNHEATED ENC. PORCH COZ22141, BP36181 WOOD STOVE C0Z34856.
The certificate is issued to MARY ANNE HUNTINGTON
(OWNER)
of the aforesaid building.
SuF~OLKCOUNTY DEPAI~T~NT OF H]~ALTHAPPRO~rAL
ELEt-£KICAL CERTIFICATE NO.
PLIERS U~a(TIFICATION DA'rKo
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
N0USING CODE INSPECTION REPORT
MAP NO.: LOT (S)
TOILEr ROO~(S): 0.0 ~TILITY RO0~(S):
DECK TYI~E: YES PATIO TYI~E: FLAGSTONE
ACCESSORY STRUCTURES:
VIOLJ%TIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
DATE (~ INSP]~(~: 02/02/11
Form No. 6
TOWN OF SOUTtlOLD
BUILDING DEPARTMENT
TO~N H~LL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building DeparUuent with the following:
For new building or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or
topograpkin features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of eleclrical installation from Board of Fire Underwrkers.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead.
5 Commercial building, indus~ial 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 cmnpleted 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 apphcation and consent to inspect signed by the applicant. If a Certificate of Occupmcy 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
Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date.
New Construction: Old or Pre-existing Building: x
Location of Property: 3175 West Creek Avenue, Cutchogue
(check one)
House No. Street
Owner or Owners of Property: Mary Anne Htintington
SuffoLk County Tax Map No 1000, Section 110
Subdivision
perrmt No. Date of Permit.
Health Dept. Approval: n/a
Planning Board Approval: n/a
Request for: Temporary Certificate
Fee Submitted: $ 100.00
Hamlet
5 9
Lot
Lot:
Block
Filed Map.
Applicant:
Underwriters Approval:
FinalCertificate: x .(checkont)
t~ Applicant Signature
CONSENT TO INSPECTION
Mary Anne Huntington
Owner(s) Name(s)
_, the undersigned, do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town of
Southold, located at 3175 West Creek Avenue, Cutchogue
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section 110 ,Block 5 ,Lot 9
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-existing Certificate of Occupancy for dwelling constructed
in 1926±
That the undersigned do(es) hereby give consent to the Build'mg 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 determ'me that said premises
comply with all of the laws, ordinances, roles 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.
Dated:
~ry An(n~Jg~H u%~)n g t o n
(Print Name)
(Signature)
(Prim Name)
LOCATION:
(number & street)
(municipality)
SUBDMSION: MAP NO.: LOT(S):
NAME OF OWNER(S): _ -,
OCCUPANCY: ~ /~.fr ~'/,afl/7/d'~..
' ' (type) ' (owner-tenant)
ADMITTED BY: /.d/hq4 CCOMPANIED BY: ~ ,~,
KEY AVAII,ABLI~: ' ~ / / ' . J SUFF. CO. TAX MAP NO. 10~0-
SOURCE OF REQUEST': ,v DATE:
DWELLING:
TYPE OF CON.STR~UCTION: ~4.fl~ /~t.~_ # STORIES: ~ # EXITS:
FOUNDATION. (.~c,..~//y-- /~--.. CELLAR: ro~/ CRAWL SPACE.
TOTAL ROOMS: 1ST FLR: ~ - ~2~ ' - 3RD FLR:
BATHROOM(S): ~ , TOILET ROO~/(S): . ~ . UTILITY ROOM'~--'~'
PORCH TYPE:/~?~O~&a~)ECK, TYPE:~ 9/~./~ PATIO, TYPE:
B~EZEWAY: ~ ' ~REPLACE: ~~ , G~GE:
DOMESTIC HOT~ATER: ~ T~E HEATER:/~ ~ AIRCONDITION~G:
T~E H~A~ ,~~~4~IR: /'f ~OTWATER:
~ X~STRUCTU~:/~ [ /
ACCESSORY /9
GAUGE, TYPE OF CONS~ ~ ~ STOOGE, TYPE cONST.:
SWIMMING POOL: GUEST, TYPE CONST:
OTHER:
VIOLATIONS: CHAPTER 144 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDiNG CODE
LOCATION DESCRIPTION ART. SEC.
/ / ,/
REMARKS:
INSPECTED BY:
DATE OF INSPECT, ION: i/~h
TIMESTART: /'g~;~// /END: