HomeMy WebLinkAboutZ-37634No: 37634
Town of Southold
53095 Main Rd
Southold, New York 11971
6/29/2015
PRE EXISTING
CERTIFICATE OF OCCUPANCY
Date: 6/29/2015
THIS CERTIFIES that the structure(s) located at: 375 Munn Ln, Orient
SCTM #: 473889 Sec/Block/Lot: 17. -3 -9 -
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-
37634
dated 6/29/2015 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 seasonal one family dwelling with covered porch. *
Note: BP 39881- deck C/O Z-37633
The certificate is issued to Pardon, Shelley & Partlon, Terry
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
Autho d S gnature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 375 Munn Ln, Orient
SUFF. CO. TAX MAP NO.: 17.-3-9
NAME OF OWNER(S): Partlon, Shelley & Partlon, Terry
OCCUPANCY:
ADMITTED BY:
SOURCE OF REQUEST: Partlon, Shelley & Partlon, Terry
DWELLING:
SUBDIVISION:
# STORIES: 1 1/2 # EXITS:
FOUNDATION: cement block
BATHROOM(S): 1 TOILET ROOM(S):
PORCH TYPE: covered DECK TYPE:
BREEZEWAY: FIREPLACE: 1
DOMESTIC HOTWATER: TYPE HEATER:
CELLAR:
None
DATE: 6/29/2015
1/2 CRAWL SPACE:
UTILITY ROOM(S):
PATIO TYPE.
GARAGE:
AIR CONDITIONING:
TYPE HEAT: none WARM AIR: HOT WATER:
# BEDROOMS: 2 # KITCHENS: 1 BASEMENT TYPE:
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST:
SWIMMING POOL:
OTHER:
VIOLATIONS:
REMARKS:
INSPECTED BY: GARYF
AA � H
STORAGE, TYPE OF CONST:
GUEST, TYPE OF CONST:
gas
unfinished
DATE OF INSPECTION: 12/15/2014
TIME START:
END:
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN MALL
765-1802
I WE C E 0 E
D EC 1 1 2014
BLDG. DEPT.
TOWN OF SOUTliOLD
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 $50.09,:Additions,to dwelling $50:OO,.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 I're-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
New Construction: Old or Pre-existing Building: V (check one)
Location of Property: 376j lav" 1 <i -P'q mUAl'�
House No.
Owner or Owners of Property:
Street.-
Suffolk County Tax Map No 1000, Section j l d Q Block -W-D
Subdivision
Permit No.
Health Dept. Approval:
Date of Permit.
Filed Map.
Applicant:_
Underwriters Approval:
OlUft TT
i.t-
I
Lot 0,0
Lot:
Planning Board Approval: _
Request for: ...-Temporary, Certificate Final.Certificate:: (check one) 4
Fee Submitted: $ e)D
App cant Signature
. to
CONSENT TO INSPECTION
ID E C W E.
DEC 1 1 2014
BLDG. DEPT.
TOWN.OF GOUMOLD
1� the undersigned, do(es) hereby_ state:
Owners) Narne(s)
That the undersigned (is) (are) the owner(s) of the premises in the Town of
.Southold, located at 375- -PUT I%JL . -tI- f
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section . i 7 oD , Block 3 -OD , Lot.. -boo Iq5 �-
That the undersigned (has) (have) filed, -or cause to be filed, an application in the
Southold Town Building Inspeotoir's office for, the followinLg. &
That the undersigned do(es).hereby give consent to the Building Inspecfors •of the -
Town of Southold to enter -upon the above described property, including any and all
buildings located- thereon,. to conduct such-inspeetions'as they relay deem necessary with
respect to the aforesaid application, including inspections to determine that said ""premises
:comply with all of the laws, ordinances, rules ari(fmgulations-of the Town of Southold. .
The undersigned, in consenting to such inspections, db(es)-so with the knowledge
and understanding that any -information obtained in the conduct of such inspections.may
be used, in.subsequeni.prosecutions for violations of the laws, ordinances, lutes or
regulations of the Town of Southold.'
Dated:
(Signature)
(Print Name) -
TOWN OF souirHoLo PROPERTY
OWNER RECO -CARD
STREET 37.5 VILLAGf~
A4{ WP%�Q� p ,�} DIST. SUB. LOij
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TYPE OF BUILDING
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LAND IMP. TOTAL DATE REMARKS dr
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BLDG. DEPT.
TOWN OF SOUTHOLD
MON.
FND.
SURVEY OF PROPERTY
. A T ORIENT
TO WN OF SO UTHOLD
SUFFOLK COUNTY N. Y.
1000-17-03-9
SCALE: 1'--30'
DECEMBER 4; 2014
N/O/F PRIVATE RD JOINT OWNERSHIP
M A P L L
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JIM WELLES IRREVOCABLE
TRUST AGREEMENT
M A I N R 0 A
(S. R. 2 5 ) A
ANY AL7ERA77ON OR ADDI77ON TO THIS SURVEY IS A V70LA77ON
OF SEC77ON 7209OF 774E NEW YORK STA 7E EDUCA77ON LAW.
EXCEPT AS PER SEC77ON 7209 -SUBDIVISION 2. ALL CER77FICA77ONS
HEREON ARE VALID FOR 7HIS MAP AND COPIES THEREOF ONLY IF
SAID MAP OR COPIES BEAR 774E IMPRESSED SEAL OF 774E SURVEYOR
WHOSE SIGNATURE APPEARS HEREON.
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PYCONI C SOW MORS, P.C.
(631) 765-5020 FAX (631) 765-1797
P.O. BOX 909
1230 TRA VELER STREET
SOU THOLD, N. Y. 11971 14-125
OF SOUTy�Io
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�✓ TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
] FOUNDATION 1ST [
] ROUGH PLUMBING
] FOUNDATION 2ND [
] INSULATION
] FRAMING/ STRAPPING [
] FINAL - -
] FIREPLACE &. CHIMNEY
[ ] FIRE SAFETY INSPECTION
] FIRE RESISTANT CONSTRUCTION
[ ] FIRE RESISTANT PENETRATION
] . ELECTRICAL (ROUGH)
[ ] ELECTRICAL (FINAL)
] CODE VIOLATION [
] CAULKING
DATE r INSPECTOR