HomeMy WebLinkAboutZ-35519Town of Southoid Annex
54375 Main Road
Somhold, New York 11971
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 35519
4/7/2012
Date: 4/7/2012
THIS CERTIFIES that the structure(s) located at:
SCTM #: 473889 Sec/Block/Lot:
Subdivision:
conforms substantially to the requirements for a
5330 New Suffolk Rd, New Suffolk
117.-2-6
Filed Map No.
Lot No.
built prior to
APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 35519
dated 4/7/2012 was issued and conforms to all the requriements of the applicable provisions of the law.
The occupancy for which this certificate is issued is:
wood frame one family dwelling with wood porch and unfinished full basement.*
NOTE: BP 4535 addition to dwelling COZ-3841; BP 6017 accessory shed COZ-4902; BP 7750 addition to dwelling
COZ-6679; BP 26249 alteration to dwelling COZ-26936.
The certificate is issued to
Thompson, Christine
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
Affthorized Signature
LOCATION:
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
5330 New Suffolk Rd, New Suffolk
SUFF. CO. TAX MAP NO.: 117.-2-6
NAME OF OWNER(S): Thompson, Christine
SUBDIVISION:
OCCUPANCY:
ADMITTED BY: Christine Thompson
SOURCE OF REQUEST: Thompson, Christine
DATE: 4/7/2012
DWELLING:
TYPE OF CONSTRUCTION:
FOUNDATION:
TOTAL ROOMS: 1ST FLR.:
BATHROOM(S): 2
PORCH TYPE:
BREEZEWAY:
DOMESTIC HOTWATER:
TYPE HEAT: HW Base.
# BEDROOMS: 3
OTHER:
yes
WARM AIR:
# KITCHENS:
# STORIES:
cement block CELLAR:
2ND FLR.:
TOILET ROOM(S):
DECK TYPE:
FIREPLACE:
TYPE HEATER:
# EXITS:
cellar ent. CRAWL SPACE:
3RD FLR.:
UTILITY ROOM(S):
PATIO TYPE:
GARAGE:
oil AIR CONDITIONING:
HOT WATER: X
BASEMENT TYPE: full unfinished
partial
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST:
SWIMMING POOL:
OTHER:
STORAGE, TYPE OF CONST:
GUEST, TYPE OF CONST:
VIOLATIONS:
REMARKS:
INSPECTED BY: ~ ~ DATE OF INSPECTION:
TIME START:
3/29/2012
END:
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: 1. Final survey of property with accurate location &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 iustallation from Board &Fire Underwriters..
4. Sworu statement from plumber certifying that the solder used in system contains less than 2/10 of I% lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of' Code Compliance from arcbitect or engineer responsible for the building
6. Submit Plarming 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 showiug all property lines, streets, building and unusual natural or topographic
f'eatures.
2. ^ properly completed application and consent to inspect signed by the applicant. Ifa Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees
I. Certificate °f Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00,
Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00.
Certificate of Occupancy on Pre-existing Building - $ 100.00
Copy of Certificate of' Occupancy - $.25
Updated Certificate of Occupancy - $50.00
Temporary Certificate o£Occopancy - Residential $15.00, Commercial $15.00
New Construction:
Location of Property:
OWner or Owne of.rope.y:
Old Pre-existin Buildin ·
or .~ ~:. /
House No. Street
SuffOlk County Tax Map No 1000, Seetion
Su6division
Block ·
Filed Map.
AppliCant:
Underwriters Approval:
(check one)
Hamlet
Permit No.
Health Dept. Approval:
Date 0f Permit.
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $
Final Certificate:
Lot
Lot:
(check one)
CONSENT TO INSPECTION
Owner(s) Name(~)
, the undersigned, do(es) hereby state:
That the undemigned (is) (are) ~e owner(s) of the,premises in the To..wn o.f ,,
Southold, locatedat ,~,~'?-~ ~_~0~0.(-~0~--01¢- I'~ lk~l ,c~-r)[~,
which is shown and designated on the Suffolk C~unt~ Tax Map as D]strict 1000,' ' "
Section 11'7 ,Block ~_ ,Lot ~
That the undersigned (has) (have) filed, or muse to be filed, an application in the
8outhold Town Building Inspector's Office for.the following:.
That the undersigned do(es) hereby give consent to ~he 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 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 oftlae laws, ordinances, rotes or
regulations of the Town of Southold.
{Print Name)
'(Signature)
(Print Name)
LOCATION:
(number & street)
(municipality)
SUBDIVISION: '~ ~MAP ~O' ~- LOT(S):
NAME OF OWNER(S):
OCCUPANCY: !
(type) 6/ (owner-tenant)
ADMITTED BY: ~~ ACCOMPANIED BY:
KEY AVAILABLE:
SOURCE OF REQUEST:
,--"-- SUFF. CO. TAX MAP NO. 1000- ! 1 7 ~ ,~. - (~
~ DATE: ~ -- ~'-~"-I ~
DWELLING
TYPE OF CONSTRUCTION: ~ ~
FOUNDATION: ~ ~ BASEMENT:
# OF BEDROOMS: 1ST FLR:
BATHROOM(S):
PORCH TYPE:
BREEZEWAY:
DOMESTIC HOTWATER:
3
TOILET ROOM(S):
DECK, TYPE:
FIREPLACE:
Y~fl TYPE HEATER:
2ND FLR: '
STORIES: [ # EXITS:
fo~ CRAWL SPACE:
3RD FLR:
UTILITY ROOM:
PATIO, TYPE: --
GARAGE:
AIRCONDITIONING:
HOTWATER: ~
TYPE HEAT: p/'
# OF KITCHENS:
WARM AIR:
FINISHED BASEMENT: YES -- - NO ~
ACCESSORY STRUCTURES
GARAGE, TYPE OF CONST.:
SWIMMING POOL:
OTHER:
STORAGE, TYPE CONST.:
GUEST, TYPE CONST:
VIOLATIONS: CHAPTER 144 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
REMARKS:
INSPECTED BY: _.~~'~
DATE OF INSPECTION:
TIME START: END:
TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET
FORMER owNER. ~O~)~ ~'~ I N Ii, ~ ~
VILLAGE DISTRICT SUB. LOT
ACREAGE
LAND IMP.
w
VL. FARM COMM.
TOTAL DATE REMARKS
TYPE OF BUILDING
IND. ~' CB. MISC.
Est. Mkt. Value
4~)AGE Z+tooI~-
NEW
Tillable 2
Tillable, 3
Woodland
~wampland
BrusNian~ '
House Plot
Tota I
BLI~ C¢ DIT~I(
FRONTAGE ON WATER
FRONTAGE ON ROAD 0~-~-~2~.
BULKHEAD
DOCK
Breezeway
Gorage
O.B.
Foundation
Basement
Ext. Walls
i Fi~'e place
Porch
Porch
Patio
Driveway -
Bath
Floors
Interior Finish
Heat
Roof Type
Rooms 1st Floor
Rooms 2nd Floor
Dormer
~*L~, ,'.~o' . ~ ~..~ Z. /