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No:
Town of Southold
53095 Main Rd
Southold, New York 11971
PRE EXISTING
CERTIFICATE OF OCCUPANCY
37627 Date:
6/25/2015
6/25/2015
THIS CERTIFIES that the structure(s) located at: 1320 Little Peconic Bay Rd, Cutchogue
SCTM #: 473889 Sec/Block/Lot: 111.44-19
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-
37627
dated 6/25/2015 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 brick patio Wiper and lower wood decks partially finished basement. accessory
storage shed in need of repair.
The certificate is issued to Brown, Marcia
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
'�� 1944
A rized Signature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 1320 Little Peconic Bay Rd, Cutchogue
SUFF.CO.TAX MAP NO.: 111.-14-19 SUBDIVISION:
NAME OF OWNER(S): Brown,Marcia
OCCUPANCY:
ADMITTED BY:
SOURCE OF REQUEST: Brown,Marcia DATE: 6/25/2015
DWELLING:
#STORIES: 11/2 #EXITS: 2
FOUNDATION: cement block CELLAR: 1/2 CRAWL SPACE: 1/2
BATHROOM(S): 2 TOILET ROOM(S): 1 UTILITY ROOM(S):
PORCH TYPE: DECK TYPE: wood frame PATIO TYPE: brick
BREEZEWAY: FIREPLACE: 1 GARAGE:
DOMESTIC HOTWATER: yes TYPE HEATER: oil AIR CONDITIONING:
TYPE HEAT: oil WARM AIR: HOT WATER: yes
#BEDROOMS: 3 #KITCHENS: 1 BASEMENT TYPE: partial finished
OTHER:
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: wood frame needs repair
SWIMMING POOL: GUEST,TYPE OF CONST:
OTHER:
VIOLATIONS:
REMARKS:
INSPECTED BY: IPARYF DATE OF INSPECTION: 6/24/2015
TIME START: END:
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN .HALL
765-1802
` APPLICATION FOR CERTIFICATE OF OCCUPAIVCI'
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 $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
meal $ 5-00 Awe ory building $25.00, Additions to accessory building $25.00, Businesses $50.00.
Crrrtifcat6ofcoi%pancy om e -existing Building - $100.00
�. i
-oEertifit�te-af0acµpicy - $.25
P
pdated Certificate of O cup icy - $50.00
enj irylGrtite ocEu ancy - Residential $15.00, Commercial $ 15.00
. i Date. May f2, 2015
BLDG. DEt'T
N OF SOUTHOLD
ld or Pre-existing Building: X (check one)
Location of Property: 1 320 Little ttl e Peconic Bay Rd Cutchogue
House No. Street Hamlet
Owner or Owners of Property: Marcia K. Brown
Suffolk County Tax Map No 1000, Section 111 Block 14 Lot 19
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval:. Underwriters Approval:
Planning Board Approval: d
Request for: Temporary Certificate
Final Certificate
Fee submitted: $ -100.00 �
—OLKEN & OLSEN LLP � D� 32495 MAIN ROAD
`'�-�-- PO BOX 706 .
CU.TCHOGUE, NY 11935.
check one)
'Applicant Signature
TOWK CSP SOUTHOLD PROPERTY. RECORD CARD
OWNER STREET VILLAGE DISC. SUB. LOT �
-0v A A 6. q v
Fo �n r1 E
{ ASR.
S W TYPE OF 13GILDING
SEAS. VL. FARM COMM. CB. MISC. Mkt. Value
LAND IMP. I TOTAL DATE REMARKS� Zly � � �� �� � -- iy C�10
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l� Ei O'! G I! }1 i Da ld= r<s:vc'� QLD DOI rl0,a/ Z- C.
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d� 15t��,7J"- -� -
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NEW 1 $v� f AA1 BELOW ABOVE
FARM Acre Value Per Volue
F., Acre
Tillable 1
Tillable 2
Tillable 3
Woodland o F
1 FRONTAGE ON WATER
Swompl.and 0. a04-
I. FRONTAGE ON ROAD
Brushland r
.amu
b DEPTH
House Plot o o
BULKHEAD}
Total DOCK
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CONSENT
TO -
INSPECTION
David -Worthington Olsen as Attorney :;or Marcia K. Brown the undersigned,
Owner(s) Names)
do(es) hereby stat(;;
That, the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at 1320 Little pee
0.njr R y Rd., ('ntchngna
which is shown and designated on the Suffolk
County tax map as District 1000, Section 111 Block 14 Lot 19
That the undersigned (has) (have) filed, 'or caused to be filed, an applica-
tion in'tho Southold Town Building lnspecL,-i.L c�.rr��� ror +km fnlln,,vinLf:
Two story dwelling
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, includindi.nspections
to determine that said premises comply Ivith 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 maybe used as evidence in subsequent prosecutions for vio-
lations of the laws, ordinances, rules or regulations of the Town of Southold.
Dated: May 12, 2015
(signature)
David Worthington Olsen as Attorney
(print name)
(signature
print name)
OLSEN & OLSEN LLP
32495 MAIN ROAD
PO BOX 706
CUTCHOGUE, NY 11935
OLSEN & OLSEN, L.L.P.
ATTORNEYS AT LAW
GARY FLANNER OLSEN
ATTORNEY AT LAW
DAVID WORTHINGTON OLSEN
ATTORNEY AT LAW
32495 MAIN ROAD - P.O. BOX 706 - CUTCHOGUE, NEW.YORK 11935-0706
PHONE 631-7.34-7666 - FAX 631-734-7712 • olsenlaw@optonline.ner
May 12, 2015
Re: Brown to Macari
Our File 10604
To Whom It May Concern:
Enclosed herewith please find the following:
1. Application for pre-existing Certificate of Occupancy.
2. Consent to Inspect form.
3. Copy of survey.
4. Check in the amount of $100.00.
Please contact Geralyn Lang at 516-375-8468 to arrange for the inspection.
DWO:lmk
Enclosure
Southold Town Building Dept.
P. O. Box 1179
Southold, NY 11971
avTzr
1
Very trul yours,
DAVID WORTHINGTON OLSEN
E, U'Elli M
MAY 12 2015 �
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S.C.T.M. NO. DISTRICT: 1000 SECTION: 711 BLOCK: 14 LOT(S): 19
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P/0 LOT 233
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STOOP FENCE CONCOPOQti u
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P/O LOT 235 „ 6 ED) A 26s
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UNDER CONSTRUCTION
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THE WATER SUPPLY, WELLS, DR YWELLS AND CESSPOOL
LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS
AND OR DATA OBTAINED FROM OTHERS
AREA: 16,749 S.F. or 0.38 ACRES f ELEVATION DATUM: __—
UNAUTHORIZED ALTERATION OR ADDITION TO. THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TIRE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION
LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE.
THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE'FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS
AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE 77ME OF SURVEY
SURVEY OF: P/0 LOTS 233, 234 & 235 CERTIFIED TO: BUYER
MAP OF: AMENDED MAP "A" OF NASSAU POINT BUYER
FILED: AUGUST 16, 1922 No.156 TITLE COMPANY
SITUATED AT: NASSAU POINT BANK
TOWN OF: SOUTHOLD KENNETH M WOYCHUK LAND SURVEYING, PLLC
SUFFOLK COUNTY, NEW YORK �/► ��r Professional Land Surveying and Design
Jl�_fI /r P.O. Box 153 Aquebogue, New York 11931
PHONE (631)298-1588 FAX (631) 298-1588
FILE II 15-83 SCALE: 1 ".30' DATE: JUNE 1, 2015
N.Y.S. LISC. NO. 050882 maintaining the records of Robert J. HemeeV & Kemeth M. 8oychuk
DATE
INSPECTOR
LOCATION:
(number & street) (municipality)
SUBDIVISION: MAP NO.: LOT(S):..
NAME OF OWNER(S)-:
OCCUPANCY:
(type) (owner -tenant) -
ADMITTED BY: - ACCOMPANIED BY:
KEY AVAILABLE: SUFE. CO. TAX MAP NO. 1000 -
SOURCE OF REQUEST: _ DATE:
DWELLING
TYPE OF CONSTRUCTION: Mid44d�,k-. # STORIES: # EXITS:
FOUNDATION:ASEMENT
� : lft AWL SPACE:
c�I3
# OF BEDROOMS: 1ST FLR: 2ND FLR: - 3RD FLR:.. .
c
BATHROOM(S): TOILET ROOM(S): - UTILITY ROOM:
PORCH,TYPE: - DECK, TYPE: t / PATIO; TYPE: k> aac,�
BREEZEWAY: FIREPLACE: 1
DOMESTIC HOTWATI �WTYPE HEATER:
TYPE HEAT: WARM ATR:
# OF KITCHENS:_.
FINISHED BASEMENT: YESIA4 NO '
OTHER: �^
ACCESSORY STRUCT jRES
GARAGE: _ .
AIRCONDITIONING:
HOTWATER:
r A1 p
GARAGE; TYPE OF CONST.: _ STORAGE, TYPE ONST.:
SWIMMING P'O'OL: GUEST, TYPE CONST:
OTHER:
VIOLATIONS: CHAPTER 144 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
L LOCATION DESCRIPTION I ART SEC
REMARKS:
INSPECTED BY:
DATE OF INSPECTION:
TIME START: END:
'Aif Sall
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courm,N�'
TOWN OF SOUTHOLD BUILDING DEPT.
7654 802
INSPECTION
[ ] .FOUNDATION IST
[ ] FOUNDATION 2ND
[ ]
FRAMING/ STRAPPING
[ ] FIREPLACE A CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
[
___]—ELECTRICAL (ROUGH)
- [ ] CODE VIOLATION
REMARKS:
[ ] ROUGH PLUMBING
[ ] INSULATION
[ ] FINAL
[ /FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (FINAL)
[ ] CAULKING
DATE `�" �� INSPECTOR