HomeMy WebLinkAboutZ-24649FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-24649 Date SEPTEMBER 23, 1996
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 5400 GT. PECONIC BAY BLVD. LAUREL, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 128 Block 2 Lot 12
Subdivision
iled 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-24649 dated SEPTEMBER 23, 1996
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 *
The certificate is issued to RUSSELL IRELAND
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
Bu' ding Inspector
Rev. 1/81
DcrrAli Ftm
I MIl! ()r S0D 11101.0
DDUS I M; C0D1? I DSPIIC
I IDD Rcrul( I.
I.OCA 'IIoil : 5400 GT. PECONIC BAY BOULEVARD
LAUREL, N.Y.
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FIAT' D(),
IIAtlli 01` 01411101, (n) RUSSELL IRELAND
OccDrn!'I-Y A-1 RESIDENTIAL
- ---- -
OWNER
�Ilanel
uY: RUSSELL IRELAND
KEY
KEYAVAI nlll.lf ---- --�--- --
AVAI
ACCDID'ADill) RY SAME
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TA tlnP nu. 1000 IZ =2 IZ —
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P01111(:1? o17 it IFI ', I : RUSSELL IRELAND
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un I li: UG. 21
1996
I'YI'IS 01 ( olm 1.1mc-1 1011 WOOD FRAME
VOUDDAIIOIt PILINGS
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1WHARKl; BP #11016—Z—COZ-22366 (ADD&ALT), BP ;116805 -Z -CO Z-22367 (ADD),
BP #21459 -Z -CO Z-22748 6 Co Z-22749 (AGCY GARAGE, ALT.6ADDS) -
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GAR F H
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c�. -7e qL1 Form No. 6
BUILDING DEPARTMENT
TOWN HALLi
765-1802 L
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. 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:
I. 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 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 PrePX;ct-Buildin¢ - $100._00
3. Copy of Certificate of Occupancy - .25o,�
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . J
New Construction...... Old Or Pre-existing Buildin
Location of Property. .✓, 00,,E'CpYiC� �g. �uud1 /�•
House No. St&eet ar i� Haml���e�t[[ 7'k �V•
Onwer or Owners of Property..``
/ (� ......./...................
County Tax Map No 1000, Section...`. ,,,,,Block... .........Lot..l.
Subdivision ..... .............................Filed Map ............ Lot ......................
Permit No.�� ..Z,. q 7,
Date Of Permit. �X*/` Pplicant..
Health Dept. Approval...... (�
••••••-••••••••.....Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate........... Final Certicate....(, ,
Fee Submitted: $.../,,,,,,,,,
......................
��y�oL q APPLICANT
LOCATION:
SUBDIVISION
,NI a1
nurr,vrrrc vEl'nlzT:u,Nr
TOWN OF SOUT11OLD
HOUSING CODE INSPECTION ItE-PORT
��k%i l / � �Ey✓iG, /d✓1-4 4 I L11
er & street
MA r' NO
municitraI y
LOT (:; )
NAlIE OF OWNER
OCCUPANCY /fir%•1� —
zpe) (owner-tenan
ADMITTED BY:.SI/
ACCU,II'ANIED By:
KEY AVAILABLE SUFE. CO. TAX MAP NO.
SOUf.CC OF REQUEST:DATE . /v2
11�%���✓� 1 1�
DWELLING:
TYPE OF CONSTRUCTION
Q STORIES EMITS_
FOUNDATION iLi,v<S EXITS—
CELLAR- — _
CRAWL SPACE
TOTAL ROOMS: IST F.R. 2ND FLR. 3RD FLR.
BATHROOM (s) j /ter// 6��js TOILET ROOM (s) UTILITY ROOM
PORCH TYPE DECK, TYPE Gi/ PATIO, TYPE
BREEZEWAY �- PIREPLACE_
GARAGE
DOtfESTIC 7HO1 LATER yk t, TYPE HEATER�,(jgyllll�c AIRCONDITIONING
TYPE HEAT WARM AIR o/ IIOTWATER
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.
�..e�STORAGE, TYPE CONST.
SFIL`L*iINC POOI, GUEST, TYPE CONST.
OTTIER:
VIOLATIONS:
LOCA'rIOil
HEHARKS:
INSI'ECTED BY:
CnAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION b BUILDING CODE
DESCRIPTION
9
DATE ON INSI'I:CTION
TIME START®��o E D
ART. I SEC.
4
OJ
•00%,
o.
0
90
f M011
O �
G
Q
0
0
101f ppRE Z
PHyLL(
AREA = 43,402 sq. f t.
TO TIE LINE
p Jf
CERTIFIED TO f Rj RPyROR
JAMES IRELAND �y
St PRL
SURVEY OF
PROPERTY
A T LAUREL i
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y. -
Ia;
1000 — 128 — 02 — 12ell w0IY M o R f 3
Scale 1" = 40' p
Sept. 21, 1989 �,;°',.` R o� U3
*BO N. LIC. NO. 49618P.C.
7
N ROAD
JTHOLD, N.Y. 11971
VII
PPoPi¢ry is .n 14:L000 T.dvE, A+( V V"
N ]Mown ter. F/QM MAP 36oall it& c
Pra wed in accordance with the suhGauw Vvv
atandards for tills survey* as eats"shed
by the L.LA.LA and approved and adopted
for such use brr TAe Naw York State Land
T/t/e.AD01r. 7. REvarP
PROP. ADDIT. 2/ 93
REVJJ Pj ? _,/To
89 - 385
CONSENT
TO
INSPECTION
Owner(s) Name(s
do(es) hereby state:
the undersigned,
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at 'aDo
'14
L/
�vhich is shown and designated on the Suffolk
County tax map as District 1000, Section /70
" Block Lot 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:
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,
Dated: I_a�7�6
2
rules or regulations of the Town of Southold.
a�:tv�j - __M - --- —
(signature)
(print name)
(signature)
(print name)
TOWN OF SOUTHOLD PROPERTY RECORD CARD1 Ll
OWNER
STREET
VILLAGE
DIST. SUB. LOT
JY, w
6J '4k' C) c �-6
e -
,FORMER OWNER
-'1'7 I r—�/
/0"
i I
'6'( � !�' "
E vverl_S
U"L"r'W*-,-
ACR.
f
Z
$'-
W
TYPE OF BUILDING
RESII/ a40
SEAS.
VL.
FARM
Comm. CB`- MISC. Mkt. Value
�7
LAND
IMP.
TOTAL
DATE
REMARKS
0 0
e)
S6 6
c2--CrV�-2:)
J
'lq
".,-q -2
2 316 6
L.940<-- p 461 1 V -e ia tfcJ 4v bre ki vi w Pin vs��sd
C
AGE
139.1WING CONDO,.. e4 �LAG i� 4 1 t fY7
I C)Q GG. RQO(-fl0Kj 144-1o'dowl'iQ Ise— k-'ovo,
NEW
TR AL
B OW
ut) (- cars k
FARM
tl o+.
Acre
kv�o
Value Per
Value
Iq
Tillable I
E' C c' 0 c
Tillable 2
Tillable 3
Woodland
A e"
Swampland
FRONTAGE ON WATER
1y 2- r) z v
Brushland
FRONTAGE ON ROAD
('House PlotDEPTH
(�',f
0
BULKHEAD
Total
DOCK
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