HomeMy WebLinkAboutZ-37997 '' - Town of Southold 12/29/2015
'eco , 53095 Main Rd
6t
-• ?, Southold, New York 11971
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 37997 Date: 12/29/2015 ,
THIS CERTIFIES that the structure(s) located at: 9220 Route 25, East Marion
SCTM#: 473889 Sec/Block/Lot: 31.-8-4
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- 37997
dated 12/29/2015 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 one family dwelling with accessory apartment and 2 wrap around porches.*
Notes: BP 25715 addition to dwelling COZ-26781; BP 40037 porch repair COZ-37964.
The certificate is issued to Rogers Jacqueline Revc Tr
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
Authoriz gn rel
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 9220 Route 25, East Marion
SUFF.CO.TAX MAP NO.: 31.-8-4 SUBDIVISION:
NAME OF OWNER(S): Rogers Jacqueline Revc Tr
OCCUPANCY:
ADMITTED BY:
SOURCE OF REQUEST: Rogers Jacqueline Revc Tr DATE: 12/29/2015
DWELLING:
#STORIES: 2 #EXITS: 4
FOUNDATION: Stone CELLAR: Yes CRAWL SPACE:
BATHROOM(S): 3 TOILET ROOM(S): UTILITY ROOM(S):
PORCH TYPE: 2 Wrap Around DECK TYPE: PATIO TYPE:
BREEZEWAY: FIREPLACE: GARAGE:
DOMESTIC HOTWATER: Yes TYPE HEATER: National Grid AIR CONDITIONING:
TYPE HEAT: National Grid WARM AIR: X HOT WATER:
#BEDROOMS: 2 #KITCHENS: 2 BASEMENT TYPE: Unfinished
OTHER:
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST:
SWIMMING POOL: GUEST,TYPE OF CONST:
OTHER:
VIOLATIONS:
REMARKS:
INSPECTED BY: GARYF DATE OF INSPECTION: 12/28/2015
� � 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 in 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- $100.00
Copy of Certificate of Occupancy-$.25
Updated Certificate of Occupancy- $50.00 •
5. Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00
Deb,/ 81111.0
New Construction: Old or Pre-existing Building: V (check one)
Location of Propel q 2,ZO rt-T z' (eyt.l: l N Rc; C, mARA010
House No. Streets Hamlet
Owner or Owners of Proper A c r")12._ LY N I`CDG EIZS
Suffolk County Tax Map No 1000, Section41 3g set- asol Block B Lot if
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval.
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ ��
tApplican ignature�
CONSENT TO INSPECTION
jPsC,....cD v•--e7 _y g.6 GERS , 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 q 2,2b rk'T -LS, E, )u-1 p,re 0 Ni ,
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section 31 , Block g , Lot I— .
That the undersigned (has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following: c d.ca,-e dl , U
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 in subsequent prosecutions for violations of the laws, ordinances, rules or
regulations of the Town of Southold.
Dated: c`( 1Ic a_c �CQJ
(Signat e) _3
� ci-e,Ly 0 20 G L R-s
(Print Name)
(Signature)
(Print Name)
AFFIDAVIT
The State of New York ) Li DEC - 4 2015 L
) S.S. — ,
County of Suffolk ) •' `'' ^''' 'r
I, Jacquelyn Rogers, of Greenport, New York, MAKE OATH AND SAY
THAT:
1. In the early 70's, my husband Jon (deceased) and I bought property at
9220 Main Road, Rt 25 in East Marion, NY from Mary Miscalis (sp?) It
was a two family home. Ms. Miscalis told me her husband bought the
property from Mr. Gibbs in 1950 as a one family home.
Within the two years after purchase, Mr. Miscalis converted the
upstairs to an apartment containing a bathroom and kitchen, similar to
that on the first floor. He then rented out both apartments.
It was occupied by two tenants when we bought it.
SUBSCRIBED AND SWORN TO )
BEFORE ME, on the )
rp
. th Day of November, 2015 )
eb5'(-LtU )
TARY UBLIC J quelyn Rogers
My commission expires 3- I'4-10 )
JENNIFER B.GOULD
Notary Public, State of New York
No.02G05024640-Suffolk County
Commission Expires March 14, 20IE
r,,
r1- ►► 1
DEC - 4 2015 lb'
JACQUELYN ROGERS
1500 Brecknock Rd,Apt 112 — — -- ►
Greenport, NY 11944
631 477 9522
December 30,2015
Town Of Southold
PO Box 1179
Southold, NY 11971
Att: Building Department
Per your request to mail the Affidavit, herewith attached, which
attests that the property at 9220 Rt 25, in East Marion, NY was
remodeled to a two family home prior to 1957 as requested by Mr.
Fish, who inspected the property on Friday 8/28/15.
I look forward to hearing from you and very much appreciate your
prompt attention to this as it is now a much needed income property
for me.
Thanks for your help.
(2pL5A..AA
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LOCATION:
(number & street) (municipality)
SUBDIVISION: .. MAP NO.: LOT(S): ,
NAME OF OWNER(S): ,
OCCUPANCY: f :,:trice—-- r= , - - 6' ,. , .. . 4,0(7
(type) (owne f-tenant).
0
ADMITTED BY: '----•-i ACCOMPANIED BY:
KEY AVAILABLE: SUFF. CO. TAX MAP'NO. 1000-
SOURCE OF REQUEST: _ , DATE:
DWELLING Vr- , V
TYPE OF CONSTRUCTION: Gl.J6 # STORIES: ?' #EXITS:
FOUNDATION: v 5704-e.- \4-e.- BASEMENT: " ' S CRAWL SPACE:
# OF BEDROOMS: 1ST FLR: v ( 2ND FLR: ( . 3RD FLR:
BATHROO
\/ r----TOILET ROOM(S): ,�-- UTILITY ROOM:
PORCH.TY w44L 'E'CK., TYPE:
PATIO, TYPE:
BREEZEWAY: FIREPLACE: , , GARAGE: -
DOMESTIC HOTWA41/ CSS TYPE HEATER:/ GL A.IRCONDITIONING: -
TYPE HEAT:\,,,,t s' WARM AIR: ------: HOTWATER:
# OF KITCHENS: i- L ril -
FINISHED BASEMENT: YES N
OTHER: .
ACCESSORY STRUCTURES 14/t/...<__
GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.:
SWIMMING POOL: GUEST, TYPE CONST:
OTHER:
VIOLATIONS: CHAPTER 144 &N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
CP-ICAiii Y- -kp-u424- Qr), ,
, . _ y A dv,,,.47
1)-(0/ir -
REMARKS:
INSPECTED BY:
i--A.' DATE OF INSPECTION: //"/"--6/
TIME START: END: