HomeMy WebLinkAboutZ-38019 Town of Southold 1/5/2016
53095 Main Rd
cf.„ ,ti Southold, New York 11971
1i
PRE EXISTING •
CERTIFICATE OF OCCUPANCY
No: 38019 Date: 1/5/2016
THIS CERTIFIES that the structure(s) located at: 775 Hickory Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 54.-9-1
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- 38019
dated 1/5/2016 was issued and conforms to all the requriements of the applicable provisions of the law.
The occupancy for which this certificate is issued is:
one family dwelling with concrete patio and accessory storage shed.*
Note: BP 9835 accy structure COZ-9368; BP 8467 addition with porch to dwelling COZ-7959.
The certificate is issued to Stephenson, Shawn
(OWNER)
•
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
Autho >-. Si ature 2
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 775 Hickory Rd, Southold
SUFF.CO.TAX MAP NO.: 54.-9-1 SUBDIVISION:
NAME OF OWNER(S): Stephenson, Shawn
OCCUPANCY:
ADMITTED BY:
. SOURCE OF REQUEST: Stephenson, Shawn DATE: 1/5/2016
DWELLING:
#STORIES: 1 #EXITS: 2
FOUNDATION: Concrete Block CELLAR: 1/4 CRAWL SPACE: 3/4
BATHROOM(S): 1 TOILET ROOM(S): UTILITY ROOM(S):
PORCH TYPE: DECK TYPE: PATIO TYPE: Concrete
BREEZEWAY: FIREPLACE: Yes GARAGE:
DOMESTIC HOTWATER: Yes TYPE.HEATER: Oil AIR CONDITIONING:
TYPE HEAT: Oil WARM AIR: HOT WATER: X
#BEDROOMS: 2 #KITCHENS: 1 BASEMENT TYPE: Unfinished
OTHER:
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: Small Shed
SWIMMING POOL: GUEST,TYPE OF CONST:
OTHER:
VIOLATIONS:
REMARKS:
INSPECTED BY: GARYF - DATE OF INSPECTION: 1/4/2016
4°/(471/1:<-4-1 TIME START: END:
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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 m writing to the applicant.
C. Fees
1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,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 Pre-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
Date. December 28, 2015
New Construction: Old or Pre-existing Building: (check one)
Location of Property: 775 Hickory Road, Southold, New York
House No. Street Hamlet
Owner or Owners of Property: Shawn Stephenson
Suffolk County Tax Map No 1000, Section 054.00 Block 09.00 Lot 001 .000
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Ittf
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ 100.00
pplicant Signature
CONSENT TO INSPECTION
Shawn Stephenson ,the undersigned,do(es)hereby state:
Owner(s)Name(s)
That the undersigned(is) (are)the owner(s)of the premises in the Town of
Southold, located at 775 Hickory Road, Southold, New York
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section 054.00, Block 09-00—,Lot 001.000 •
That the undersigned(has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following:
Pre-existing Certificate of Occupancy
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 m the conduct of such inspections may
be used in subsequent prosecutions for violations of the laws, ordinances,rules or
regulations of the Town of Southold.
SI
Dated: December 28, 2015 " '� i elbj 7
ignatur
(Print Name)
(Signature)
(Print Name)
/—" Twomey, Latham, Celebrating Over 40Yars of Service
MAILING ADDRESS:
Shea, Kelley, Dubin & Quartararo LLP Post Office Box 9398
ATTORNEYS AT LAW Riverhead,New York 11901-9398
MAIN OFFICE:
Thomas A.Twomey,Jr. 33 West Second Street
(1945-2014) Riverhead,New York 11901-9398
Stephen B.Latham
John F.Shea,Ill Telephone:631 727.2180
Christopher D.Kelley Facsimile:631 727 1767
David M.Dubin o www.suffolklaw.com
Jay P Quartararo
Peter M.Mott dwassick@suffolklaw com
Janice L.Snead
Anne Marie Goodale December 28, 2015 Extension 318
Bryan C.Van Cott. Direct Fax:631.727 1767
Kathryn Dalli
Laura I.Dunathan
Lisa Clare Kombrink
Patrick B.Fife Mr. Michael Verity, Chief Building Inspector
Melissa H.Sidor Town of Southold Building Department
Martin D.Finnegan o
Town Hall Annex Building
Kelly E. ie54375 Route 25
LaaurennE..Stillesx
Patricia J.Russell P.O. Box 1179
Reza Ebrahimi
Bryan J Drago Southold,NY 11971
Bernadette E.Tuthill
Craig H.Handler
Alexandra Halsey-Storch Re: 775 Hickory Road, Southold,NY
Melissa S.Doris
SCTM#: 1000-54-9-1
OF COUNSEL .
Kevin M.Fox '
Karen A.Hoeg Dear Mr. Verity:
Jennifer P Nigro•
o NYS LA BARS
LL?I. TAXATION This Firm represents the owner of the property referenced above who seeks
IN
•
NYON,BARS
to obtain a Certificate of Occupancy on a pre-existing building located at the premises
O NY.NJ&PA
BART PA
above mentioned. Therefore, attached please find:
> Application for Certificate of Occupancy for pre-existing building; and
> Consent to Inspection; and
> Survey of subject property as prepared by PMJ Land Surveying,
PLLC, last dated December 9, 2015; and
> Check to cover requisite fee.
Please commence technical review of this application and should you have
any questions or concerns contact this office. Thank you for your consideration and
courtesies.
Respectfully,
OTHER OFFICE LOCATIONS: Aa": "ifirdida‘AeAL.‘
20 Main Street Diane K. Wassick
East Hampton,NY 11937 •
+631.324.1200
51 Hill Street
Southampton,NY 11968
631.287.0090
490 Wheeler Road
Suite 1650
Hauppauge,NY l 1788 Encl.
631.265.1414
56340 Main Road
P.O.Box 325
Southold,NY 11971
631 765.2300
m
TOWN OF SOUTHOLD PROPERTY RFc.ORD CARD ;.
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OWNER •
STREET `j 7 5 VILLAGE DIST. SUB. LOT
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Shautul eph 1 5�• )..1 ( C.kor rear ..,1..�' • -
c,� ACR.
FORMER OWNE D.r%t 3 f2� f E/
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S W l�yC� /• TYPE OF BUILDING
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* RES. �'1D SEAS. LI VL, FARM COMM. CB. MICS. Mkt. Value
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u) LAND IMP. TOTAL DATE REMARKS
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- 02 3 0 0 .•� eat-t--0 re a. - -
4. U 244) = = ° z/4"//tet , 57 /1;e> . T . - ALd, r4 .r.d L, t° /(Thi
E i 0 p o? !� S O O '/77 0/ 7,e• .• .« � _355 z� 09.CC Ef l07 ,F , .2�6,
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/ 2_.t o ei z.- a •_ 51/0 6) 1 //2 7,448/iz/ti-L izi58' 3355�-nddrrf ays 4n�' rete 4/4.4,
il2i)/n/-Li zY - - A'reKe.r ,Sly hi $ 413<n,
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AGE BUILDING CONDITION
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NEW NORMAL BELOW ABOVE
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FARM - Acre Value Per Value
Acre
m Tillable FRONTAGE ON WATER
Cr; Woodland • FRONTAGE ON ROAD /3`r' / Com' ao '_. / ).-• C G
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Meadowland IDEPTH
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Extension ■ , ■■ ■_-■■■■■■■■■■■
Extension
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Foundation • Both --T 1 Dinette
Basement , y1 '. Floors i---47/774/+-. .:,; K.
in Porch 4 % /i = 7 2. Sm - 3
'` Ext. Walls .- _ .Interior Finish 1,.R.
i, Porch £.>.� r. ,
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Fire Place - / Heat I DR
Breezeway `'
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Rooms 1st Floor BR.
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Patio - Recreation Room Rooms 2nd Floor FIN. B
1 - • 2Dormer Driveway111 O. B. .
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CERTIFICATIONS HEREON SIGNIFY THAT THIS PUT OF PROPERTY IS A TRUE AND CORRECT REPRESENTATION OF A RECENT SURVEY MADE UNDER MY DIRECTION IN ACCORDANCE WITH THE EXISTING CODE OF PRACTICE
FOR LAND SURVEYORS BY THE NEW YORK STATE ASSOCIATION OF PROFESSIONAL LAND SURVEYORS. SAID CERTIFICATIONS SHALL RUN ONLY TO THE PERSON WHOM THE SURVEY WAS PREPARED AND ON THEIR
BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON. THIS CERTIFICATION IS ONLY FOR THE LANDS DESCRIBED HEREON, ITS NOT A CERTIFICATION OF TITLE, ZONING,
OR FREEDOM FROM ENCUMBRANCES. CERTIFICATIONS ARE NOT NOT TRANSFERABLE TO ADDITIONAL OR SUBSEOUENT OWNERS.
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MASONRY
TAX LOT STOOP
13 18.2' -
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41.8'
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DWELLING
17.7' ;0 42.2' 26.2'
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FE POST AND RAIL
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0.3'E _ _ ID _ n
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S 42°15'40" W 130.00'
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TAX LOT
2
THE OFFSETS OR DIMENSIONS SHOWN FROM THE IMPROVEMENTS TO THE PROPERTY LINES ARE FOR A SPECIFIC PURPOSE AND USE, AND THEREFORE ARE NOT INTENDED TO BE USED AS A GUIDE IN THE ERECTION
OF FENCES, WALLS, POOLS, PATIOS, BUILDINGS,ADOTIONS TO BUILDINGS OR ANY OTHER IMPROVEMENTS. SUBSURFACE AND ENVIORNMENTAL CONDITIONS NOT SHOWN. PROPERTY CORNER MARKERS WERE NOT SET
AS A PART OF THIS SURVEY. EASEMENTS AND OR RIGHTS-OF-WAY OF RECORD, IF ANY, NOT SHOWN.
PJM LAND SURVEYING, PLLC UNAUTHORIZED ALTERATION OR
132 CLYDE STREET/SUITE 16 ADDITION TO THIS SURVEY IS A
VIOLATION. OF SECTION 7209 OF
WEST SAYVILLE, NY 11796 NEW YORK STATE EDUCATION LAW.
PHONE 631-563-0400
FAX 631-563-5808
PJMSURVEYING(2 AOL.COM
LOT. ---- REVISIONS
l'/41"PdA,
MAP OF: DESCRIBED PROPERTY /
•
FILED: NO:---- COUNTY: SUFFOLK
SITUATE: SOUTHOLD, TOWN OF SOUTHOLD COPIES OF THIS SURVEY MAP NOT
CERTIFIED TO: TITLE NO :EA1502-S BEARING THE LAND SURVEYOR'S
EMBOSSED SEAL AND SIGNATURE
SHALL NOT BE CONSIDERED A TRUE
WESTCOR LAND TITLE INSURANCE COMPANY AND VALID COPY
775 HICKORY,LLC PROJECT NO.:2015-401
DATE: 12/09/15
DRAWN:PM CHECKED BY:PM SCALE 1'=30' DISTRICT: 1000 SECTION. 54 BLOCK: 09 LOT(S):01
LOCATION:
(number & street) (municipality)
SUBDIVISION: MAP NO.: LOT(S):
NAME OF OWNER(S):
OCCUPANCY: i
(type) (owner-tenant) "
ADMITTED BY: 1 ACCOMPANIED BY:
KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000-
SOURCE OF REQUEST: . DATE:
DWELLING M1
TYPE OF CONSTRUCTION: f # STORIES: - XITS:
L
FOUNDATION: GNoC/c-__ BASEMENT: CRAWL SPACE?
. i
# OF BEDROOMS: 1ST FLR: i 2ND FLR: � 3RD FLR:
BATHROOM(S): TOILET ROOM(S): UTILITY ROOM:
PORCH.TYPE: DECK, : PATIO, TYPE: eat,
BREEZEWAY: FIR{PLACE: I GARAGE:
DOME IC HOTWATER: TYPE HEAT R . ;AIRCONDITIONING:`�'
Gw'T �
TYPE HEAT: &L WARM AIR: , HOTWATER: t/
i
# OF KITCHEN\j
FINISHED BASEMENT: YES NO
OTHER: •
ACCESSORY STRUCTURES
GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.:
SWIMMING POOL: GUEST, TYPE CONST:
OTHER:
VIOLATIONS: CHAPTER 144 &N.Y. STATEIUNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION S ART. SEC.
•REMARKS:
INSPECTED BY: %�, , j DATE OF INSPECTION: /
TIME START:. END: