HomeMy WebLinkAboutZ-20833
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FORM NO.4
Office
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-20B33
Date
JUNE 29, 1992
THIS CERTIFIES that the building
ONE FAMILY DWELLING
Location of Property B50 SMITH ROAD
House No.
PECONIC, N.Y.
Street
Hamlet
County Tax Map No. 1000 Section 9B
Block
3
Lot
30
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-20B33
dated JUNE 29, 1992
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 GARAGE
The certificate is issued to
DONALD DOHRMAN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
N/A
N/A
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/B1
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BUILDE;C DEP!\I'tT:.LSriT
TO';11-I OF SOUTHOLD, N. Y.
HOUSr;;C CODE mSPECTION REPORT
Location 850 SMITH ROAD
lnwuoer & streec)
Subdivision
PECOIHC, N.Y.
(HunlcipalicYJ
Nap No. Lot(s)
Name of Owner( s)
DONALD DOlIIlKAI!l
Occupancy
ONE FAMILY DWELLING
(type )
HRS. SCHOCH
OWNER
lowner--cemmc)
Accompanied by: ~
Ac...uitted by:
Key available
Suffolk Co. Tax No. 98-3-30
Source of request GARY FLAlIllKR ORSEN, A'ITY
Date 4/30/92
Dl..rELLING:
Type of construction
Foundation MASONARY
Total rooms, 1st. Fl
Bathroom(s) 2
Porch, type SCREENED
Breezeway
Type Heat OIL
Fireplace(s)
Domestic hotwater
Other
FRAME & MASONARY
#stories
1-1/2
80%
Cellar to'xl2' Crawl space
2nd. Fl 3 3rd. Fl
Toilet room( s)
Deck, type
Garage
. Warm Air
No. Exits
3
Patio, type_ FLAGSTONE
Utili ty room
Hob-later xx
3
Airconditioning
FURNACE
xx
Type heater
ACCESSORY STRUCTURES:
Garage, type canst. CEMENT BLOCK Storage, type const.
1 & FRAME SCREENED IN ADDITION -'- t t
Swimming poo Gues ~, ype cons .
Other SPLIT RAIL IN FRONT
CHAPTER 45--N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
.~
'-Art'. I
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Sec.
D~scriDtion
te of Insp. .JUNE 29, 1992
. Time start 2:00 end 2:25
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FORM NO.6
TOWN OF SOUTHOLD
. , Building Dopartment
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
h,
) 1....,.
c.
Instructions
, A. This application must be filled in typewriter OR ink, and submitted _ - to the Building Inspec-
tor with the following: for new bUildings or new use:
1. Final survey of property with accurate location of all buildings, propeny 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 F ire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions. a cenificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of pxopeny showing all property lines, streets, buildings and unusual natural or
topograph ic featu res.
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 peninent informa-
tion required to prepare a cenificate.
C. Fees:
1.Cenificateofoccupancy $25:00 -- BUSINESS $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50 . 00
3. Copy ofcenificate of occupancy $ 5.'00. Over 5 years
4.Vacant Land C.O. $20.00
5.Updated C.O. $'50.00
$10.00
NewConstruction...... Old or Pre-existing Building ..x.......... VacantLand .............
. 820'Smith Road, Peconic, New York
location of Property ................................ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
House No. Street Ham/at
Date .AJ~r:i.I.. ... .'. .1.9.9.2. .........
.
Owner or Owners of Property .. .Qq'1ql.q .Q~~~n;~~. . .. .... .. . ... '" . .. .... .... . :.:.... ... .....
. 098 03 30
County Tax Map No. 1000 Section ............... Block............... 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 Certificate. . . . . . . . . . . . . . . . . . . . .Final 'ficate .. ~ . . . . . . . . . . . . . . . .
Fee Subm itted $ . . . 199. . . '. . . . . . . . . . . . . . . . . . . .
.................
R...l0-l0,78
Construction on above described building and permit m ts II able co
/ ~
Applicant. . . .,.......--;;.. " . . ...../.
Gary Fanner Olsen, Isq.
P. O. Box 706
Cutchogue, NY 11935
6-.~. L{l{a.~1
eN.. Lo :c.. a 0'633
CONSENT
TO
INSPECTION
'"
Donald Dohrman
Owner(s) Name(s)
dotes) hereby state:
, the undersigned,
That the undersigned (is) (are) the owner(s) of the premises in the Town
of South old located at
820-~mith Road. Peconic, New York
, which is shown and designated on the Suffolk
County tax map as District 1000, Section 098
, Block 03
, Lot 30
That the undersigned (has) (have) filed, 'or caused to be filed, an applica-
tion iri-th" Southold Town BUllding Insp''';Lv> 'g orri~~ E~~ +h" following:
- .
Pre-existing one family house
That the undersigned dotes) 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 regularOns ~f the Town of Southold.
The undersigned, in consenting to such inspections, dotes) 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.
Dated: April3>O. 1992
~~\l- A .~~~"W->- ~^
. ' (signature)
V
Donald Dohrman
(print name)
~......
(signature)
(print name)
.~
/a(J~'-
OWNER
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TOWN OF SOUTHOLD PltOPERTY RECORD'~<CARI)'_~~;11..- 22.
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N
STREET
VILLAGE
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SUB. '
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FORMER OWNER
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ACREAGE
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TYPE OF BUILDING
S
W
VL.
FARM
COMM.
I IND.
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I MISC.
I Est~ Mkt. Value
, LAND
IMP.
TOTAL
DATE
REMARKS
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:
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AGE
NEW
NORMAL
BUILDING CONDITION
BELOW
BOVE
FRONTAGE ON WATER
FRONTAGE ON ROAD /0 0 x. /5 ~
BULKHEAD
DOCK
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~_ Farm
Acre
Value Per Acre
Value
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,Tillable 2
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1 Woodland
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k
r Brushland-
1. Hause Plat
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M. BldgJ
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Extension /.
Extension
S'
B reez<!way
Garage
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MAP OF" PROPERTY
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SU12vEVED FOR
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PAMELA ~CHQISTIANA
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TOWN OF SOUTHOLD N.Y,
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