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Home My WebLink AboutZ-36975 Town of Southold Annex 6/16/2014 54375 Main Road Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 36975 Date: 6/16/2014 THIS CERTIFIES that the structure(s) located at: 5595 Pequash Ave, Cutchogue SCTM#: 473889 Sec/Block/Lot: 110.-6-1 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 36975 dated 6/16/2014 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 enclosed porch and accessory one car garage with attached storage.* Note:BP 6025 deck addition COZ-5705• BP 29599 deck repair and re-construction COZ-29660. The certificate is issued to Clausen, Gustave& Clausen, Janet (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 09 *PLEASE SEE ATTACHED INSPECTION REPORT. 4 A rized ignature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 5595 Pequash Ave,Cutchogue SUFF.CO.TAX MAP NO.: 110.-6-1 SUBDIVISION: NAME OF OWNER(S): Clausen,Gustave&Clausen,Janet OCCUPANCY: ADMITTED BY: Amy Kirincic SOURCE OF REQUEST: Clausen,Gustave&Clausen,Janet DATE: 6/16/2014 DWELLING: #STORIES: 1 #EXITS: 2 FOUNDATION: cement block CELLAR: 1/3 CRAWL SPACE: 2/3 BATHROOM(S): 1 TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: enclosed porch DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: 1 GARAGE: DOMESTIC HOTWATER: yes TYPE HEATER: Natl. Grid AIR CONDITIONING: Yes TYPE HEAT: Natl.Grid WARM AIR: Floor heated HOT WATER: #BEDROOMS: 3 #KITCHENS: 1 BASEMENT TYPE: unfinished OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: 1 car w/storage STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: GARYF DATE OF INSPECTION: 6/10/2014 TIME START: END: Form No.6 TOWN OF SOUTHO LD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY l c 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. BL_ or existing buildings(prior to April 9, 1957)non-conforming uses,or buildings and "pre-existing"land uses: 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. a2 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 $15.0�0�/ Date. -3D New Construction: Old or Pre-existing Building: 1/ (check one) Location of Property: JJ��S _p1r; Q l J,'2rSN jq- I E CC�tC'(-t M U E N /, House No. Street --�— amle Owner or Owners of Property: & !/C r t �I r,91�1G� �r A ulJ Suffolk County Tax Map No 1000, Section 1 1 (i 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: $ ` c)c)n(7 p rc nt Signature CONSENT TO INSPECTION d r�' `%�USrN the undersigned,do es h Owners)Narne(s) gn hereby state: That the undersigned(is) (are) the owner(s)of the premises inthe Town of Southold, locatedat S V (�3S which is shown and designated on the Suffolk County Tax Map as Di ct 000, Sectionlam,Block 'Lot That the undersigned(has)(have) filed,or cause to be filed, an application in the South. 4d Town Building Inspectors Office for:the following U6P / ,7 .tel •/' • That the undersigned do(es)hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described properly, 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: D / (Signature) Air C1.�, 9GCS1. it� (Signature) C? icy-,) (Print Name) SURVEYED FOR:-C7U.ST!_J�/E �. ,CL,QUS�'�1 LOCATED AT ��/ C,�/OGL�E , TOWN flF ��T /pi, Lp , SUFFOLK COUNTY N.Y. T LOT FILED MAP OF P�20FaE�fY o!c �gV•4]bc1E �E.4Lj"Y CaQ�4i - CO. CLK. NO. 53QJ OEC. 22, /9�p SCALE 1" SUFFOLK CO. TAX MAP DATA:- DIST. /l.L" , SEC. //D.G70 BLK. 46.00 LOT DO/.Q44 OFFSETS FROM STRUCTURES TO RELATIVE BCtUNJRY L1NE5R ,��G ��Q ON SURVEY, ARE FOR A ?"0url�15 SPECIFIC USE ONLY, AND SHOULD NOT BE USED FOR CONSTRUCTION OF FENCES Fo Myo OR OTHER STRUCTUR4 C �� •.�►9.s � 30.t `` I?s � h. u / ✓T� '`V►s sure w. c��i �LQh1� Sri Z►e.� �h x % 0 Gwen w O ��oj•� v o 2 Fv. �UQ.e,14 1E� a �► w �a T 19.990 A115E�t! .4V,--- 23Q�cC4Y� �3•�ve aim NE�.v�/�;ee -! SURVEYED 19615) BY WILLIAM R. SIMMONS JR. P/O BOX 377 JAMESPORT, L. I., N. Y. 11947 FILE NO. .�� c'G�✓ PAGE G''3 GRlD. J-� DRAWN BY AN ow �m■me��rm��mm■m m■■■ m■msma 1114mm■mm■■mm .. ■■AMEN ■1��■�� M �■��.!®ill■■�■■■■��■�� MINEEM1111111�� s f : LOCATION: (number & street) (municipality) SUBDIVISION: MAP NO.: LOT(S): NAME OF OWNER(S): OCCUPANCY: (type) (owner-tenant) c r ADMITTED BY: ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000- SOURCE OF REQUES : DATE: DWELLING TYPE OF CONSTRUCTION: # STORIES: EXITS: 2� 1 �r FOUNDATION: &.,&kBASEMENT: CRAWL SPACE: Z # OF BEDROOMS: 1ST FLR: 2ND FLR: 3RD FLR: —"--- BATHROOM(S): TOILET ROOM(S): UTILITY ROOM: PORCH TYPE: DECK, TYPE: IATIO,TYPE: BREEZEWAY: FIREPLACE: _ G RAGE: DOMESTIC HOTWATER: TYPE HEATER:Ar6 - AIRCONDITIONING: ' TYPE HEAT: GZ WARM AIR: ATER: # OF KITCHENS: (A--, FINISHED BASEMENT: YES NOy OTHER: ACCESSORY STRUCTURES GARAGE, TYPE OF CONST.: , TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST: OTHER: VIOLATIONS: CHAPTER 144 &N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. I SEC. REMARKS: INSPECTED BY: DATE OF INSPECTION: 0 TIME START: END: