HomeMy WebLinkAboutZ-25908FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 25908 Date: 08/21/98
THIS CERTIFIES that the building DWELLING
Location of Property 105 WEST CREEK AVE CUTCHOGUE
(HOUSE NO.) (STREET}
County Tax Map No. 473889 Section 103 Block 0013
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- 25908 dated AUGUST 21, 1998
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 SINGLE FAMILY DWELLING*
(HAMLET)
Lot 020.001
The certificate is issued to JOHN A CLARKE
of the aforesaid building.
(OWNER)
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
/ldfng Inspector
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 105 WEST CREEK AVE
SUBDIVISION:
NA~ OF OWNER (S): JOHN A CLARKE
OCCUPANCY: A-1 RESIDENTIAL
ADMITTED BY: JUDY DAVIS
CUTCHOGUE
MAP NO.: __LOT (S) __
JOHN A CLARKE
ACCOMPANIED BY: SAME
KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 103.-13-20.1
SOURCE OF REQUEST: ABIGAIL WICFJ{AM ESO. DATE: 08/21/98
DWELLING:
TYPE OF CONSTRUCTION: WOOD FRAME
FOUNDATION: CEMENT BLOCK
TOTAL ROOMS: 1ST FLR.: 7
BATHROOM(S): 2.0
2ND FLR.: ~
TOILET ROOM(S): O-O
DECK TYPE:
FIREPLACE: ONE
TYPE HEATER: ELECTRIC
HOTWATER:
# STORIES: 1.0 # EXITS: 3
CELLAR: FULL CRAWL SPACE:
3RD FLR.: O
UTILITY ROOM(S): --
PATIO TYPE:
~A~AGE, TYPE OF CONST.:
SWI~4ING POOL:
OTHER:
STORAGE, TYPE CONST.:
GUEST, TYPE CONST.:
VIOLATIONS:
CHAPTER 45 N.Y. STATE UNIFORM FIRE PP. EVENTION & BUILDING CODE
DESCRIpTIQ~
SEC.
P~S: BP4392-ADD-COZ3620. BP25126-ACCY-COZ25907.BP25050-HRATING SYS-COZ25909
DATE ON INSPECTION: 02/27/98
TIM~ START: 10:45 F/~D: 11:10
Form No. 6
BLDG. DEPT. ~
TOWN O,F SOUTHOLD ~
APPLICATION FOR CERTIFXCATE OF OCCUPANCY
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
~65-Z802
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 Mire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of XZ 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 reguiremente.
B.. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
~ l. Accurate survey of property showing all property lines, streets, building and
' unusual natural or topographic features.
2. A properly completed applicatiou and a 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, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building ~ $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4, Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction ........ Old Or Pre-existing XX
· -. Building .................
Location of Property,...~9~.~P~.Road.................and Pequash Av~...........Q~tchogue.... ..... ............ House No. Street ~amlet
Onwer or Owners of Property... OPbP. ~..M.cN.eil ..... : ......... % /
.... ' ............ ....
County Ta~ Map No 1000, Section.. 103 ......... Block .... 1~ .......... Lot ~- ;;,~-[~ .... ~-22
................................. ,,,_,_,,, ,,,,, .......
/ --
Permit No ................ Date Of Permit ................ Applicant,&~g~ .~-..W.i.q~, .~.tt. gr..n~y
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate..~£.Occupancy for Pre-Existing Use
APPLICANT
- A~igail A. Wickham ......
CONSENT
TO
INSPECTION
~l~,~fz_ ,~. I/,Jtct< HA Klq . theundersigned.
Owner(s) Name(s)
do(es) hereby state: -~.
That the undersigned (is)/~ the owner(s) of the premises in the To~
of Southold located at
. which is shoxm and designated on the Suffolk
County ~ m~p ~ ~i~i~ 1000, S~o, /~ . ~lo~ / 3 · =o~ [~.~
That the undersigned (has) (ha~e) filed, or caused to be filed, an applica-
tion in the Southold Tox~m Building Inspector's Office for the follow,g:
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, 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 as evidence in subsequent prosecutions for vio-
lations of the laws, ordinances, rules or regulations of the Town of Southold.
- ~/~signature)
(print name)
(siffnature)
(print name)
SURVEY OF PROPERTY FOR
LOT L/NE CHANGE
A T FLEETS NECK
TO WN OF SOUTHOLD
SUFFOLK COUNTY, N. K
Scale: Y'= 40'
Feb. 22,1994