HomeMy WebLinkAboutZ-22461FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-22461 Date JULY 22, 1993
THIS CERTIFIES that the buildin~ ONE FAMILY DWELLING
Location of Property 13350 NEW SUFFOI~K AVENUE CUTCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 116 Block 6 Lot 19
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a One Family Dwelling built
Prior to: APRIL 9~ 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-22461 dated JULY 22, 1993
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 TWO CAR GARAGE *
CLARICE BLACKBURN & JEAN ARLEY
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
LOCATION:
SUBDIVISION
N~'iE OF OV~ER (s)
BUILDING DEPARTMENT
TOWN OF SOU~IOLD
HOUSING CODE INSPECTION REPORT
13350NEW SUFFOLK AVE.
(number & street)
HAp NO.
CLARICE BLACKBURN & JEAN ARLEY
CUTCHOGUE, N.Y.
(municipality
LOT (~)
OCCUPANCY A-] RES.
(type) (owner-tenant)
ADMITTED BY: CLAIRCE BLACKBURN
K]~Y AVAILABLE
SOURCE OF REQUEST: CLARICE BLACKBURN
ACCOMPANIED BY: SAME
SUFF. CO. TAX MAP NO. m16-6-19
DATE: JULY 12, 1993
DWELLING:
TYFE OF CONSTRUCTION
FOUNDATION
TOTAL ROOMS: IST FLR.
BATHROOM (s) ONE
PORCH TYPE
BREEZEWAY
DOMESTIC HOTWATER xx
TYPE HEAT OIL
OTUER:
WOOD FRANE
CE~NT BLOCK
'4
2ND FLR. 2
TOILET ROOM (s) ONE
DECK, TYPE WATER SIDE
FIREPLACE ONE
TYPE HEATER PROPANE
WARM AIR XX
~ STORIES I-I/2 # EXITS 2
CELLAR FULL CRAWL SPACE
3RD FLR.
UTILITY ROOM
PATIO, TYPE BRICK BOTH SIDES OF DECK
GARAGE
AIRCONDITIONING
HOTWATER
ACCESSORY STRUCTURES:
GARAGE, TYFE OF CONST.
S~IMMING POOL
OTHER: BATH ROUSE
2 CAR WOOD FRAME STORAGE, TYPE CONST.
· GUEST, TYPE CONST.
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
'AIRS TO STAIRWAYS SHALL RAVE HANDRAILS ON AT LEAST ONE SIDE NYCR}
~d FLOOR - 1242 (d)
2nd
REMARKS:
TIME START 9:30 ENI~ 9:50
FORM NO. 6
TOWN OF SOUTHOLD
. Building Department
Town Hall
Southoldo N.Y. 11971
765- 1802
TOWN
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled ~n typewriter OR ink, and submitted m mmmmm~ to the Building Inq3ec-
for with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3.Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5.Submit Planning Board approval of comp,a,,d ,~te~,,,n"""' ruquiremen[s wlmre applicable.
B. For existing buildings {prior to April 1957), Non-conforming u~es, or buildings and "pre-existing"
land u~es:
1. Accurate survey of p~operty showing all property lines, ~reets, buildings and unusual natural or
topographic features.
2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees:
l. Certificate of occupancy $25:00 -- flUS[NESS $50.00
2. Certificate of occupancv on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.'00, over 5 yeats $10.00
4.Vacant Land C.O. $ 20,00
Upd $" d..u!~ ]993
5. ated C.O. 50 O0 Date 12,
New C on s t, r uc t, ± on ...... Old or Pre-existing Building .X ........... Vacant Land .............
~l.e~ Suffolk ^venu~ Cutchoque
Location of Property ...............................................................
Hou~ No. Srre&, r Haml= r
Owner or Owners of ProperW Clarice Blackburn and Jean Arley ..,
]]6 6. ].9.
County Tax Map No. 1000 Section ............... BIock . Lot .
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ....................... .
Underwriters Approval ........................ Planning Board Approval ......................
Request
for
Temporary
..................... Final Certificate ,..~ ..............
Certificate
Fee Submitted $ ]00.00.
Construction on above described building and permit meets all applicable :gde~nd r~j'ulations.
· ,,.~z/,,'/~/..__. .
Applicant . ~a.r.y.F.I. Aqqe, r..Ols.e.n., Es~.~./.
Main Rd., P. 0'. Box 'Z])~'" ' ....................
n.,.~0.~o.Ta Cutchogue, NY 11935 /'
CONSENT
TO
INSPECTION
CIarice Blackburn and Jean Arley
, the undersigned,
O~mer(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at New Suffolk Avenue, Cutch0gue, NY
· which is shown and designated on thc Suffolk
County tax map as District 1000, Section 116 Block 6 , Lot ~ 19
That the undersigned (has) (have) £iled, or caused robe filed, an applica-
tion in'th, Southold Town ]3uxl~l[ng lnspcu~...~ c~rr~ ro.~ +~,,~ fnllnwinf:
for house, garage and bath house
That the undersigned do(es) hereby give consent to tile 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· includm~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 w~th the
knowledge and understanding that any information obtained In the conduct of
such inspections maybe used as evidence in subsequent prosecutions rot vio-
lations of the laws, ordinances, rules or regulations of the Town of Southold.
(signature)
Ckarice Blackburn
(print name)
~J~an Arley /
(print name)
'- /
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~. ~OON . .~ .;.....~.,
"' "::' SCALE: 40% l" ':'