HomeMy WebLinkAboutZ-23121FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRM EXISTING
~4~KTIFICATE OF O~U~ANCY
No Z-23121 Date JULY 27, 1994
THIS CERTIFIES that the building ONE FAMILY DW~?~.ING
Location of Property 3420 ~O~KY POINT RD. EAST MARION, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 21 Block 4 Lot 8
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a One Family Dwelling built
Prior to: APRIL 9, 1987 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-23121 dated J~LY 27, 1994
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is ONE FAMILY DWELLING WITH ACCESSORY C~%~AGE (BARN)*
The certificate is issued to FRANK G. ARNOLD
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
SEE ATTACHED INSPECTION REPORT.
Inspector
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 3420 ROCKY POINT ROAD
(number & street)
SUBDIVISION
NAME OF OWNER (s) F~ARIIOL1)
EAST MARION, N.Y.
(municipality)
LOT(s}
OCCUPANCY A-] P~S.~
(t~e.)
ADMITTED BY: BARBARA
KEY AVAILABLE
SOURCE OF REQUEST: ROBERT
FOUNDATION
TOTAL ROOMS:
BATHROOM (s)
PORCH TYPE
BREEZEWAY
DWELLING:
TYPE OF CONSTRUCTION WOOD FRA[~
PIERS & C~NT BLOCK
]ST FLR.
ONE
DOMESTIC HOTWATER
TYPE HEAT OIL
YES
CELLAR
6 2ND FLR.
TOILET ROOM (s)
BECK, TYPE
FIREPLACE
TYPE HEATER PROPAN~
WARM AIR XX
OTIiIiR:
~ STORIES I-1/2 # EXITS 2
PARTIAL CRAWL SPACE
1 3RD FLR.
UTILITY ROOM
PATIO CEMENT IN REAR
GARAGE
AIRCONDITIONING
HoTWATER
REAR ENTRY WAY (MUD ROOM) - RAISED CEMENT PATIO NORTH SIDE
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.
SWIMMING POOL
O'£~:R:
STORAGE, TYPE CONST.
, GUEST, TYPE CONST.
GARA~ (B~) W~TH SREU
ATTACHED
VIOLATIONS: Clltd~l~R 45 ~.Y. STATE DNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
REMARKS: BP #22088Z- CO Z-23119 (Add. & Repair to Accy Garage) & CO Z-23120 (Repairs to
Dwelling)
GARz/°'///~ISH/ TIME START 9:45 AM END ]0:20
AN
Form No. 6
TOWN OF SOUTI1OLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
~ APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: 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.
For existing buildings (prior to April 9, 1957~ non-conforming uses, or buildings and
pre-exzst~ng' land uses:
1.- ActUate Survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
If a_Certificate of Occupancy is denied, ~ Buildin~ Inspector shall state the
reasons therefor in writing to the applicant.
Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
Certificate of Occupancy on Pre-existing Buildi~ - $100.00_
Copy of Certificate of Occupancy-~-~-~-~-~-~-~-~-~.00 b-v~-y~'~-~O.00
4.Updated Certificate of Occupancy - $50.00
5~Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.OO
ew Construction ........... Old Or Pre-existing Building ....
~cation of Property.
House No. Street Hamlet
~wer or Owners of Property. ~.~,[~. ~! . .~[QQ.~.,. ~.-~,]~..~.. ~jQ~[¢!....~q%l~ f. ~)]Q~ .......
,Unty Tax Map No 1000, Section...C~ ...... Block ..... 9. ......... Jot ..... $ ................
~bdivision .................................... Filed Map ............ Lot ......................
'rmit No ................ Date Of Permit ................ Applicant.~%~j..~.~Q~ ........
alth Dept. Approval .......................... Underwriters Approval .........................
arming Board Approval ........................
quest for: Temporary Certificate ........... Final Certicate ...........
Submitted:
CONSENT
TO
IN.S P r~C'FION
Oxmmr(s)
do(es) hereby state:
Name(s)
· the undersigned,
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at .:5._.~q5)0. ~Oc.k,/ Ooin-}- ~-,eo~ '~o~4 fY)ocfor)
· which is show-n and designated on the Suffolk
County tax map as District 1000, Section .. OS } , Block ~ _, Lot
That the undersigned (has) (have) filed, 'or caused to be filed, an applica-
tion in the Southold Tox~m Building Inspector's Office for the ~ollowing:
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 thereonl 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 obtMned in the conduct of
such inspections may be used as evidence in subsequent prosecutions for vio-
lations of the laws, ordinances, rules or regulations of the Toxvn of Southold.
(print name)
(signature)
(print name)
£i i.~7
~AP OF P,r-2oPEP_TY
~T
E,~,ST tqAl~ i 0 t,.I
~,..,vql'q OF SO%JTHCL~,
MONUMENT
SUFR CO. TA~ FdA? DATA:IOOO-O21
RODE~tCI4
DEC.