HomeMy WebLinkAboutZ-36454 Town of Southold Annex 8/20/2013
~ 54375 Main Road
Southold, New York 11971
~ *
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 36454 Date: 8/20/2013
THIS CERTIFIES that the structure(s) located at: 3330 Wells Rd, Peconic
SCTM 473889 Sec/Block/Lot: 86.-1-12
Subdivision: Filed Map No. Lot No.
conforms substantially to the requirements fora built prior to
APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER ~ 36454
dated 8/20/2013 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 dwellin¢ with rear cement patio and attached one car garage_*
NOTE: BP 7863 addition to dwelline COZ-6576
The certificate is issued to Agria, Rose
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
t rized ignat'[ire
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 3330 Wells Rd, Peconic
SUFF. CO. TAX MAP NO.: 86.-1-12 SUBDIVISION:
NAME OF OWNER(S): Agria, Rose
OCCUPANCY:
ADMITTED BY: Sheila Kadmas
SOURCE OF REQUEST: Apia, Rose DATE: 8/20/2013
DWELLING:
# STORIES: 1 # EXITS: 4
FOUNDATION: cement block CELLAR: 3/4 CRAWL SPACE: 1/4
BATHROOM(S): 1 TOILET ROOM(S): UTII.TTY ROOM(S):
PORCH TYPE: DECK TYPE: PATIO TYPE: cement rear
BREEZEWAY: FDtEPLACE: GARAGE: attached one car
DOMESTIC HOTWATER: yes TYPE HEATER: oil AIIt CONDITIONING: yes
TYPE HEAT: oil WARM AIIt: X HOT WATER:
# BEDROOMS: 2 # KITCHENS: 1 BASEMENT TYPE: unfinished
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST: STORAGE, TYPE OF CONST:
SWIMMING POOL: GUEST, TYPE OF CONST:
OTHER:
VIOLATIONS:
REMARKS:
INSPECTED BY: GARYF DATE OF INSPECTION: 8/6/2013
TIME START: END:
/ 111
~/~c(~~ ~1~~
Form No. 6
TOWN OF SOUTHOLD ~ ~5 ' X81
BUILDING DEPARTMENT
TOWN HALL
765-1802 - ~
APPLICATION FOR CERTIFICATE OF OCCUPANCY , ~ b ~
Phis application must be filled in by typewriter or ink and submitted to the Building Department with tie following:
A. For new building or new use:
1. Final survey of property with acctirate 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 farm).
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 2110 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.
b. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 4, 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 [he 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 '7
D/ate. ~ ~ Z ~J
New Construction: Old or Pre/-~existing Building: V (check one)
Location of Property: 333 ~ ~S ROct ~ ~Q I ~ ~ L~
House Norr-- ---~treet ! Hamlet
-Owner or Owners of Property. C- 5~ ~ ~ ~ F ~ (j J ~ ~ J
Suffolk County Tax Map No 1000, Section ~ b Block ~ Lot ~
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
Ap licant Signature
o~,~,OF SOUIy~
333 0 I,?~.~` ~ ~
,~~;G
TOWN OF SOUTNOLD BUILDING DEPT.
765.1802
i NSPECTION
[ ]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)
REMA KS: /C'ter/a
I?~T~~S .
DATE ~ INSPECTO
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OWNER STREET vJ ~ VILLAGE DISTRICT SUB. LOT
F RMER O NER, t~l a - - F E ACREAGE ~
~ S W TYPE OF BUILDMG
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Form Acre Volue Per Acre Value ~ j, ~ ,~~~GS
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Tillob[e 1
Tiltabfe 2
Tilloble 3 ~ ~
Wcodlond - - ~ -
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House Plot
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Extension ~f 7 ' G `w"~'"' Interior Finish `~'~'u~
l :n /4~ =15' ~ ' ~ 2 ~ i p `1 z Ext. VVolls r
Fire Place Heot ~ ~ ~
Extension - ~•Zp 1'.1~-- r
Porch Attic
Porch Rooms !st Floor
Breezeway Patio Rooms 2nd Floor -
Garage ~3~ ~ _ ~ I ~ 8 D ivewoy
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LOCATION:
(number & street) (municipality)
SUBDIVISION: MAP NO.: LOT(S):
NAME OF OWNER(S):
OCCUPANCY:
(type) " ~ ~ ~ (owner-tenant)
ADMITTED BY: cS~~ 'lf~l`7G}s ACCOMPANIED BY: ~~}w4
KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000-
SOURCE OF REQUEST: DATE:
DWELLING ~ /
TYPE OF CONSTRUCTION: W Jt)~/\!"I~i~°`~'V~ # STORIES: Bzu2r.# EXITS:
FOUNDATION: BASEMENT: 3~~ CRAWL SPACE:
# OF BEDROOMS: 1ST FLR: Ji 2ND FLR: 3RD FLR:
BATHROOM(S): ~ TOILET ROOM(S): UTILITY ROOM:
r
PORCH TYPE: DECK, TYPE: PATIO, TYPE: ,
BREEZEWAY: FIREPLACE: ~ GARAGE:
DOMESTIC HOTWATER: LS TYPE HEATER: aV' AIRCONDITIONING:
TYPE HEAT: ~ WARM AIR: HOTWATER:
# OF KITCHENS: C3~--
FINISHED BASEMENT: YES NO
OTHER:
ACCESSORY 5TRUCTURE N~-~?.J~_
GARAGE, TYPE OF CONST.: STORAGE, 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 INSPECTION:
TIME START: ~ - o~}) ND: