HomeMy WebLinkAboutZ-36048Town of Southold Annex
54375 Main Road
Southold, New York 11971
PRE EXISTING
CERTIFICATE OF OCCUPANCY
11/19/2012
No: 36048 Date: 11 /19/2012
THIS CERTIFIES that the structure(s) located at:
SCTM #: 473889 Sec/Block/Lot: 24.-2-19
Subdivision: Filed Map No.
conforms substantially to the requirements for a
APRIL 9, 1957
1780 Village Ln, Orient
36048
Lot No.
built prior to
pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-
dated 11/19/2012 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.*
NOTE: BP 7616 accessory building (shop and storage) COZ-7562.
The certificate is issued to
Terry, David
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 1780 Village Ln, Orient
SUFF. CO. TAX MAP NO.: 24.-2-19
NAME OF OWNER(S): Terry, David
OCCUPANCY:
ADMITTED BY: Janet Markarian
SOURCE OF REQUEST: Terry, David
SUBDIVISION:
DATE: 11/19/2012
DWELLING:
# STORIES: 1.5
FOUNDATION:
BATHROOM(S):
PORCH TYPE:
BREEZEWAY:
DOMESTIC HOTWATER:
TYPE HEAT:
# BEDROOMS:
OTHER:
# EXITS:
2
CELLAR:
brick
TOILET ROOM(S):
DECK TYPE:
FIREPLACE:
yes TYPE HEATER:
Nat'l Grid Ga WARM AIR: x
4 # KITCHENS: 1
3/4 CRAV~L SPACE:
UTILITY ROOM(S):
PATIO TYPE:
GARAGE:
National Grid Gas
HOT WATER:
BASEMENT TYPE:
1/2
AIR CONDITIONING:
unfinished
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST:
SWIMMING POOL:
OTHER:
VIOLATIONS:
STORAGE, TYPE OF CONST:
GUEST, TYPE OF CONST:
REMARKS:
INSPECTED BY:
GARYF
DATE OF INSPECTION:
TIME START: 10:30am
9/28/2012
END: 11:00am
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 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 from Board of 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 "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 $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.
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 $15.00, Commercial $15.00
Date.
New Construction:
Location of Property:
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section
Subdivision
Old or Pre-existing Building:
kD, k,.De--
House No. Street
(check one)
Hamlet
Block
Filed Map.
Lot
Lot:
Permit No.
Date of Permit.
Applicant:
Health Dept. Approval:
Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ [OC) . O D
Final Cert~
pplTcant Sign
CONSENT TO INSPECTION
Owner(s) Narfie(s)
That the undersigned (is) (are) theVowner(s) of the premises in. tt~e Town of
Southold, locatedat 1~St) ~1 ~'(O-~---~t~bet Ot'l~-~*'"~rr ~
which is show~ and designated on the Suffolk County Tax Map as District 1000,
Section Oc~ , Block Oc~ , Lot d) ~ c./
, the undersigned, do(es) hereby state:
That the undersigned (has) !have) filed, or cause to be filed, an applicationj,n the
Southold Town Buildin .~nspector s Office for the following:
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 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, rules or
regulations of the Town of Southold.
Dated:
· (Signature)
(Print Name)
(Signature)
(Print Name)
OWNER
LAND
/?TOWN OF SOUTHOLD PKOPERTY RECORD CARD
¢
AGE
NEW
Farm
Tillable 1
Tillable 2
Tillable 3
Wood]and
SEAS,
IMP.
ACREAGE
O, lbo
TYPE OF BUILDING
VL. COMM. lIND. [CB. r MISC..
TOTAL DATE REMARKS
BUILDING CONDITION
NORMAL BELOW
Acre Value Per Acre
LOT
Lt. Mkt. Value ,
Total
House Plot
Swc~mpland
Brushl~j~ ~ ~
FRONTAGE ON WATER
FRONTAGE ON ROAD ,.~//7.~'
~ ~/,~
ABOVE
Value
M, Blcl§,
Extension
Extension
Extensien
Foundation
Ext. Walls
Fire Piece
Floors
Interior Finish
Heat
I i Porch Rooms 1st Floor
Breezeway ! Patio Rao~s 2.a Froar J
~ Driveway Dormer ~
Garage ! _
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING/STFIAPPING
[ ] FIREPLACE & CHIMNEY
ROUGH PLBG.
INSULATION
[ ]FINAL ~/~_ C~
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
~)RruEMARKS:(~I~c~ ~ZA~. ~\ --~'-~L ~-- ~,,/~
LOCATION:
(number & street)
SUBDIVISION:
NAME OF OWNER(S):
OCCUPANCY:
MAP NO.:
(municipality)
LOT(S):
(type) (owner-tenant)
KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000-
SOURCE OF REQUEST: DATE:
DWELLING
TYPE OF CONSTRUCTION:
FOUNDATION: ~ t[4 c4c-
# OF BEDROOMS: 1ST FLR:
BATHROOM(S):
PORCH TYPE:
BREEZEWAY:
TOILET ROOM(S):
UTILITY ROOM:
TYPE HEAT: t~J~-~ ~,} ~ WARM AIR:
DECK, TYPE: PATIO, TYPE:
FIREPLACE: ~/[/r4:.~ c4 I0. GARAGE:
~ HOTWATER:
# OF KITCHENS: ~
FINISHED BASEMENT: YES
NO
OTHER:
ACCESSORY STRUCTURES
GARAGE, TYPE OF CONST.:
SWIMMING POOL:
~ TH~,/,/,7t
'~IOLATIONS: CHAPTER 144 & N.Y.
STORAGE, TYPE CONST.:
GUEST, TYPE CONST:
YNO CODE
DATE OF INSPECTION: