HomeMy WebLinkAboutZ-26499FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED
PRE EXISTING
CERTIFICATE OF
No ~-26499
Date JUNE 14, 1999
THIS CERTIFIES that the buildin~
Location of Property 415 THIRD STREET
House No.
County Tax Map No. 1000 Section 117
Subdivision
ONE FAMILY DW]~LLING
NEW SUFFOLK, N.Y.
Street Hamlet
Block 9 Lot 19.2
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-26499 dated Ju~E 14, 1999
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 BARN, STORAGE BUILDING
AND PRIVY *
The certificate is issued to FRANK K. & MARY D. HOT3.%ND
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N/A
*pT-m~SE S~ ATTA~/~D INSPECTION REPORT.
NOTE:THIS UPDATES PRECO Z--22830 DATED JANUARY 1_0, 1994.
Inspector
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 415 THIRD ST NEW SUFFOLK
SUBDIVISION: MAP NO.: __ LOT (S)
NAME OF OWNER (S): EDWARD K & MARY D HOLLAND
OCCUPANCY: SINGLE FAMILy EDWARD K & MARY D HOLLAND
ADMITTED BY: MARY HOT,LA~D ACCOMPANIED BY: SAME
KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 117.-9-19.2
SOURCE OF REQUEST: ABIGAIL A. WICK~AM. ATTY 5/25/99 DATE: 0~/10/99
TYPE OF CONSTRUCTION: WOOD FRAME
FOUNDATION: CONCRETE BLOCK
TOTAL ROOMS: 1ST FLR.: _~_
BATHROOM(S): 1.0
PORCH TYPE: QPEN FRONT
BREEZEWAY:
DOMESTIC HOTWATER: YES
2ND FLR.:
TOILET ROOM(S):
DECK TYPE:
FIREPLACE: HQ
TYPE HEATER:
TYPE HEAT: OIL WAP24AIR:
OTHER: WALK IN CLOSET {PANTRY)
STORIES: 2.0 # EXITS: ~
CELI~AR: PART. CRAWL SPACE: --
3RD FLR.: __~
UTILITY ROOM(S): --
PATIO TYPE:
GARAGE:
AIRCONDITIONING:
XX
NO
HOTWATER:
~CCESSORY STRUCTUP. ES:
GARAGE, TYPE OF CONST.:
SWI~4ING POOL:
OTHER= *pRIVY (POOR CONDITION)
STORAGE, TYPE CONST.: BARN & STORAGE BLDGS *
GUEST, TYPE CONST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PP~EVENTION & BUILDING CODE
~OCATION ! DESCRIPTION ' ART.
SEC.
REFa%RKS: NOTE= THIS UPDATES PRECO Z-22830 DATED JANUARY 10. 1994
INSPECTED BY:
DATE ON INSPECTION: 06/10/99
TIME START: END:
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPA~CY
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 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.
Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
Vpre-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 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.
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 Buildin~ - $100.00
Copy of Certificate of Occupancy - , .25~.
Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.OO
Date 6/8/99
Pre-existing ~¥i~di~gs .....
New Construction ........... Old Or Pre-existing Building .............. tl-~aml±y owe±±zng, marn
Location of Propertv 415 Third Street, New Suffolk, New York Storage Building and Privy)
House No. Street Hamlet
Onwer or Owners of Property Mary Holland
County Tax Map No 1000, Section...~!~ ........ Block ..... ? .......... Lot.}?f~...(~./~/~..1).'J)-.-
Subdivision .................................... Filed Map ............ Lot ......................
Permit No ................ Date Of Permit ................ Applicant .............................
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $. 50,00 ....................... /~4~,//~//////./.,~..~~ ~./.'///.~///~/~./~-7/~-~
....... -
~PLIC~
~~&~~ Abig~l A. Wickhma, As Agent
CONSENT
TO
INSPECTION
Mary Holland ·
· the undersigned,
Owner(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 415 Third Street, New Suffolk, New York
, xvhich is shown and designated on the Suffolk
County tax map as District 1000, Section 117 , Block 9 , Lot 19.2
(f/k/a 19.1)
That the undersigned (has) (have) filed, 'or caused to be filed· an applica-
tion in the Southold Town Building Inspector's Office for the following:
One Family Dwelling, Barn, Storage Building and Privy
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 unde_rsigned, 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 Toxvn of Southold.
Dated: 6/8/99 ~ ~
/-' r (signature) ~
/
A0igail A. Wickham, As Agent
(print name)
<.'
_~_ ':i '? :?LL '2
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED
PRE EXISTING
CERTIFICATE OF OCcuPANCY
No Z-26500
Date JUNE 14, 1999
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 2155 JA~ON STREET NEW SUFFOLK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 117 Block 9 Lot 19.3
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-26500 dated JuNE 14, 1999
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 on FaNTT~ D~LLING WITH ACCESSORY STORAGE SHED *
The certificate is issued to MARY HO?J.AND
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTA~D INSPECTION REPORT.
N/A
N/A
NOTE:THIS UPDATES PR~CO Z-22830 DATE~
Inspector
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 2155 JACKSON ST
SUBDIVISION:
~ OF O%~T~R (S): MARY E HOLLAND
OCCUPANCY: ~INGLE F~MTT.y
ADMITTED BY: MARY H~T,T,AND
NEW SUFFOLK
MAP NO.: __ LOT (S)
MARY E HOLLAND
ACCOMPANIED BY: SAME
KEY AVAILABLE: SUFF. CO. TAX MAP NO.: ~17.-9-19.3
SOURCE OF REQUEST: ABIC. AIL WICK~AM. ATTY 5/15/99 DATE: Q~/14/99
TOTAL ROOMS
BATHROOM (E)
PORCH TYPE:
BREEZEWAY:
TYPE OF CONSTRUCTION: WOOD F~A~ME
FOUNDATION: TILE BRICK & CEMENT
1ST FLR.: .-.%
1.0
~ FRONT CO.RED
FIREPLACE:
DOMESTIC HOTWATER: yES
TYPE HEAT: QIL WARM AIR:
OTHHR: W;~LK IN ATTIC
# STORIES: 1,5 # EXITS: ~
CELLAR: 7/4 CRAWL SPACE: 1/4
2ND FLR.: ._~ 3RD FLR.: O
TOILET ROOM(S): O,O UTILITY ROOM(S): __
DECK TYPE: PATIO TYPE:
NO GARAGE:
TYPE HEATER: LILCO GAS AIRCONDITIONING:
EOTWATER:
~ggR~SORY STRUCTURES:
GARAGE, TYPE OF CONST.:
SWI~94ING POOL:
OTHER: * WOOD FRAME SOME STUCCO
STORAGE, TYPE CONST.: TQOL SHED*
GUEST, TYPE CONST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. I SEC.
REMARKS: NOTE: THIS UPDATES PRECO Z-22830 DATED JAN. 10. 1994
INSPECTED BY:
DATE ON INSPECTION: 0~/10/99
TIME START: END:
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPA~CY
Ao
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 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.
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 a consent to inspect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in w~iting to the applicant.
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.
Certificate of Occupancy on Pre-existing Buildinm - $i00.00
Copy of Certificate of Occupancy - , .25~.
Updated Certificate of Occupancy - $50.00
Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
6/8/99
Date .........................................
New Construction ........... Old Or Pre-existing Building~.~e~x~i~tin~uildings
Location of Property...2j55. OB~k~pD.~%.,.~e.w.~.~f~o.l~,.JlY ....... %i.~a~!!~..L~.?~.~.~)
House No. Street Hamlet
Mary Holland
Onwer or Owners of Property ..................................................................
County Tax Map No i000, Section..JJ7 ......... Block ...... ~ ......... Lot ....... 19.3.(f~k/a.%9.1)
Subdivision .................................... Filed Map ............ Lot ......................
Permit No ................ Date Of Permit ................ Applicant .............................
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certi~aSe ...........
Fee Submitted $ 50.00 ,,/ ~ /(~ ~// ~ n ~
/. '/ '.' ,,i~ ~ : /'~ ,"
"':' '/." ........ ' .......
Abigail&'. Wic~,C44q~ Agent
CONSENT
TO
INSPECTION
Mary Holland
· the undersigned,
Owner(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 2155 Jackson Street, New Suffolk, New York
, which is shown and designated on the Suffolk
County tax map as District 1000, Section 117 , Block 9 , Lot 19.3
(f/k/a 19.1)
That the undersigned (has) (have) filed, 'or caused to be filed, an applica-
tion in the Southold Town Building Inspector's Office for the following: __
One Family Dwellin§ and Shed
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 unde_Fsigned, 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.
~i/ ? ×? ~, ?I.:~
~' ~,"~ (sig6ature;
Abigail A. Wickham, As Agent
(print name)
0' C/..) i ,
'5] ~ C'~.o='N