HomeMy WebLinkAboutZ-36024Town of Southold Annex
54375 Main Road
Southold, New York 11971
10/26/2012
No: 36024
PRE EXISTING
CERTIFICATE OF OCCUPANCY
Date:
10/25/2012
THIS CERTIFIES that the structure(s) located at:
SCTM #: 473889 Sec/Block/Lot:
Subdivision:
conforms substantially to the requirements for a
12395 Route 25, East Marion
31.-5-6.1
Lot No.
built prior to
Filed Map No.
APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 36024
dated 10/25/2012 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 covered porches and small slate patio and accessory barn with storage.*
The certificate is issued to
Oysterponds Historical Society
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
31-5-6.1
LOCATION:
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
12395 Route 25, East Marion
SUFF. CO. TAX MAP NO.: 31.-5-6.1
NAME OF OWNER(S): Oysterponds Historical Society
SUBDIVISION:
OCCUPANCY:
ADMITTED BY:
SOURCE OF REQUEST: Oysterponds Historical Society
DATE: 10/25/2012
DWELLING:
# STORIES: 2
FOUNDATION:
BATHROOM(S):
PORCH TYPE:
BREEZEWAY:
DOMESTIC HOTWATER:
TYPE HEAT: oil
# BEDROOMS: 4
OTHER:
# EXITS: 5
stone
TOILET ROOM(S):
DECK TYPE:
FIREPLACE:
X TYPE HEATER:
WARM AIR:
# KITCHENS: 1
CELLAR: small pit CRAWL SPACE:
1 UTILITY ROOM(S): pantry offkitchen
PATIO TYPE: slate
1 GARAGE:
offboiler AIR CONDITIONING:
HOT WATER: steam
BASEMENT TYPE:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST:
SWIMMING POOL:
OTHER:
barn & storage
STORAGE, TYPE OF CONST:
GUEST, TYPE OF CONST:
VIOLATIONS:
REMARKS:
INSPECTED BY:
GARYF
DATE OF INSPECTION:
TIME START:
10/5/2011
END:
Form [No. 6
~OWN OF $OUTHOLD
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:
Be
For new building or new use:
1. Final survey of property with accurateloeation of all buildings, property lines:, streets, and unusual natural or
. topographic features.
2. Final Approval from Health D.ept. of water supply and sewerage-disposal (S-9 form).
3.. Approval of electrical installation from Board Of Fire Underwriters.
4. 'aw.oru statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead..
5. Commeroial building, industrial building, mUltiple residences and similar buildings and installations, a certificate
of Code Compliaace'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) fion-conforming uses, or buildings 'and "Pre-existing" land uses'~
1. Accurate survey of proPerty showing all property lines, streets, building and. unusufil natural or topographic
features.
2. A properly C~,.mpleted application and consent to inspect signedby the applicant. Ifa Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
Co
Fees
1. Certificate of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $.50.00,
Swimmir~g po01 $50.00, ACCessory building $50.00, Additions to accessory building $50.00, Businesses $50.00:
Ce.rtifieate of Occupancy on Pre-existing Building - $I 00.00
Copy of Certificate of.Occupancy - $:25
Updated Certificate of Occupancy - $50.00
Temporary Certificate of Occupancy - Residential $15.00, CommerCial $15.00
(check one)
Old or Pre-existing Building:
3 '
House No. Street
New Construction:
Location of Property:
Owner or Owners of Property: ~:5~)/'Z'/'~ ~'~.~ /:,~.r'2~)z ~. ~C, ~:' ~O.
- .
Suffolk County T~ Map No 1000, S~tion ~/ Bi .
Su~si0n Ffl~ Map.
Permit No. Date of Permit. Applicant:
Health Dept. Approval:
Planning Board Approval:
Underwriters Approval:
Hamlet
Request for: Temporary Certificate Final' Certificate: (check one)
CONSENT TO INSPECTION
o er(s) ·
, the undersigned, do(es) hereby state:
That the undersigned (is) (aro) the'owner(s) ofthe premises in the Town of
which is shown and. designated'on the Suffolk Count5; Tax Map. as District 1000,
Section' ,$1 ,BIoek ~.. ,Lot G
That the undersigned. (has)(have) filed,, or muse to.be filed, an application in the
SouthOld Town Buildinglnspector's Office for.the following:
/'ate-
That the undersigned do(es)herebygive .consent to the Building Inspectors of the
Town of South°Id to.enter UPon the above described property, including any and all
buildings located thereon,, to conduct such inspections as they may de, em necessary with
respect to the aforesaid application, including inspections to determine that said premises
.comply withall oft he laws, ordinances; rules and'regulations.of the Town of South61d.
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 8outhold.
(Signature)
(Print Name)..
'(Signature)
(Print Name)
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Telephone (631) 765~ 1802
Fax (63 !) 765-9502
miler, dchert(~,town.so uthold, nv. us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Oyster Ponds Historical Society
Address: 12395 Main Rd City: East Marion St: NY Zip: 11939
Building Permit #: Section: 3fBIock: 5 Lot: 6.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: as built DBA: License No:
SITE DETAILS
Office Use Only
Residential ~ Indoor ~ Basement ~ Service Only ~
Commerical Outdoor 1 st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 3 ph Hot Water GFCI Recpt Wall Fixtures ~ Smoke Detectors
Main Panel NC Condenser Single Recpt Recessed Fixtures ~ CO Detectors
Sub Panel NC Blower Range Recpt Fluorescent Fixture [~ Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures~ Time Clocks
Disconnect Switches Twist Lock Exit Fixtures ~ TVSS
Other Equipment: BARN
Notes:
Inspector Signature:
Date: Oct 18 2012
81-Cert Electrical Compliance Form.xls
Town Hall Annex
5437,5 Main Road
P.O. Box 1179
Southold, NY 11971-09.59
Telephone (631) 765-1802
ro.qe r. riohe rt('d,t~:w(6n3.]s) o76u'~'1~5o(~1, ny. u s
BUILDING DF~ARTMF_aNT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
iREQUESTED BY:
Company Name:
Date:
Name:
License No.:
Address:
Phone No.:
JOBSITE INFORMATION: (*Indicates required
*Name:
*Address':
*Cross Street: ~
*Phone No.:
Permit No.:
Tax Map District: 1000 Section: , '.~ J Block: .~ Lot: ~'. I
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
(Please Circle All That Apply)
*Is job ready for inspection:
*Do you need a Temp Certifi.cate:
Temp Information' (If needed]
*Service Size: 1 Phase
*New Service: Re-connect
Additional Information:
YES / NO Rough In
YES / NO
3Phase 100 150 200 300 350 400
Underground Number of Meters Change of serVice
PAYMENT DUE WITH APPLICATION
Final.
Other
Overhead
82-Request for Inspection Form
SURVEY OF PROPERTY
SITUATE
EAST MARION
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-31-05-06
SCALE
AUGUST 27, 2011
MAIN ROAD
I Nathan Taft Corwln Ill
Land Surveyor
TOWN OF SOUTHOLD BUILDING
765-1802
INSPECTION
DEP'V
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH)[~ ELECTRICAL (FINAL)
REMARKS:
DATE
INSPECTOR~
LOCATION:
(number & street)
(municipality)
SUBDIVISION:
NAME OF OWNER(S):
OCCUPANCY:
MAP NO.:
LOT(S):
(type)
(owner-tenant)
ADMITTED BY:
KEY AVAILABLE:
SOURCE OF REQUEST:
ACCOMPANIED BY:
SUFF. CO. TAX MAP NO. 1000-
DATE:
DWELLING
TYPE OF CONSTRUCTION:
FOUNDATION:
# OF BEDROOMS: 1ST FLR:
/~~REEZEWAY:
DOMESTIC HOTWATER:
TYPE HEAT:
# OF KITCHENS:
BATHROOM(S): ~ _TOIL. xET ROOM(S):
PORCHTYPE~}/~. ~l_~'~-~x~d~, TYPE: ~
FINISHED BASEMENT: YES
OTHER:
(,~O-~ ~,z__ # STORIES: ~ # EXITS:
BASEMENT:c~adA///~/iL CRAWL SPACE: ~
~¢~ 2NO FUR: V 3~ FLR:
UTILITY ROOM:
FIREPLACE: ~ GARAGE:
TYPE HEATER: O~,~d-:.z_.- AIRCONDITIONING: - ~
ACCESSORY STRUCTURES
GARAGE, TYPE OF CONST.:
SWIMMING POOL:
OTHER:
STOI~--~E, TYPE CONST.:
GUEST, TYPE CONST:
VIOLATIONS: CHAPTER 144 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILD1NG CODE
LOCATION DESCRIPTION ART. SEC.
INSPECTED BY:
TIME START: //d~' ;~ END: