HomeMy WebLinkAboutZ-20766 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-20766 Date JUNE 1, 1992
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 30235 MAIN ROAD CUTCHOGUE NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 102 Block 2 Lot 17
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-20766 dated JUNE 1, 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.& SHOP ADDITION
The certificate is issued to ESTATE. OF WALTER
(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.
ilding Inspector
Rev. 1/81
. .
RUi:.^i_.. - rim?;.i:1..~.7T
TO'.~~d Cc ~CUT;iOLD, t1.
F:Oli~Ii:G CODs. IiiS?~CTIO.1 iZ~POitT
L o c~ t i o n 30235 MAIN ROAD Ci1TCHOGUE , NEW YORK
~nu,..o~r .x ~ Free ~~•iu:.~cipali cy )
Subdivision 2•Iap A1o. Lot(s)
Na.::e of 0;•fner(s) ESTATE OF WALTER RAELIN
VACANT (OWNER)
Occupancy ONE FAMILY
hype) ~ o~:rner- Henan ~ )
Ad,:~itted by: JEAN VAN NAME Accompanied by: SAME
Key available Suffolk Co. Ta:c AIo. 102-2-17
Source of request VIRGINIA BRUER Date MAY 21, 1492
D?;'~LLI~IG
'Type of construction FRAME '`stories 2
Foundation CEMENT BLOCK Ce11ar PART Crai.~rl space PART
Total rooms, 1st. Fl~_2nd. Fl 4 3rd. Fl
BathroorZ(s) I Toilet roon(s) 1
Porch, type 1 SCREEN - Deck, type Patio, type_
Breeze:•ray Gara;s Utility room
Type Heat OIL 'rTarm Air Hot*:rater ~
Aircor_di Lycn_rb
Fireplace(s) 2 No. E:cits 2 ~
Domestic hot:rater ~ Type heater GAS
Other
ACC=:,SORY ST!?TJC'T'tTt°S : FRAME
Garage, type const. GARAGB WITH Storage, type const.
S~•ri;..minp pool SHO Guest, type const.
Other
V ~ OL_4TIOLIS : CHAPTER 45--N.Y. STATE UNIPOItM FIRI: PlZI:VENTIOV ~ BUILDING CODE -
Lncation DPscrintion ~Art.f Sec.
ACCESSORY WOOD STOVE IN SHOP IS TO CLOSE TO COMBUSTIBLES I ` 1243.1
PROVIDE PROTECTION BEFORE USING. E%TERIOR
SURFACE REQUIRE PROTECTION AND MAINTENANCE. 11 -
1
CELLAR I SECURE WIRING IN CELLAR, I I 1243.$ ,
PROVIDE E%TENSION ON RELIEF VALVE FURNACE AND I 1243.7
WATER HEATER
Rerlar::s
Insaccted ~ ~ Date of Insp. MAY 27, 1992
S FI R • Tine start 1:25 end 1:45
Corm No. fi
J f~ ~-,,r~;`~ TOWN OP 50UT[fOLD
4 ~ BUILDING DEPARTPIGNT
TOWN HALL
• 765-1502
APPLICATION COR CERTICICATL OC~OCCUP.\NCY
I
This application must be filled in by typeeariter OF.~inlc 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-° form).
3. Approval of electrical installation from Board of Pire Underwriters.
4. Sworn sCatement from plumber certifying that the solder used in system contains
less than 2/10 of 17 lead.
5. Commercial building, industrial building> multiple residences and similar buildings
and installations, a certificate of Code G:mpliance from archi_ect or cneineer
responsible for the building.
B. 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 showin; 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 Buildins Inspector shall state the
reasons therefor in writing to the applicant.
Fees '
1. Certificate of Occupancy - New dwelling }25.00, e\dditions to dtJelllllg $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 Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commerpcial $15.00
Date ~ /..a .
ew Construction......... Old Or Pre-ex ring Buil g
~ ~
ocation of Property....~~~~.....C.?.1rY~+:~:-+~
(louse No. SCreet Ham•uY C_ -
,wer or Owners of Propcrty......h~i~~:-:°~! :-~:..~...1~../~,~:•I`~•'::.:.
aunty Tax Atap No 1000, Section.... Y..~...Bluck...... a ..Lot......
:bdivision .riled D1:ip............Lot.
:emit A'o ................Daee Of ['crmi.t........... • • .Applicant....C~-~.~f~3~,~!`! '.1
alth Dept. Approval ..........................Underwriters Approval.........................
ginning Board Approval
quest for: Temporary Certificate........... Cinal Ccrticate...~.....
Submitted: $..t ~ .
~,zc,'~ 316• ~ • ~?~~~.'.`:1~-~.., .
APPLI A~
~ C.o X01 Lie
CU\SI:i:T
TO
Ii\: r~ccrio~
~/1 G~(/C~~-l~~J/~~~~•~i--sir)• thr, undc~rsi~ncd,
cJtvner(s) Namc(;;)
do(es) hereby state;
That the undersigned (is) (are) the ovmcr(s} of the prcmiscr, in the Tovm
of Southold located at ~-~/~~~,-~~~~~~r,,~ J
~rhich is ~hov:n and desinnated on the Suffolk
County tax map as District 1000, Section L'loclc Lot > ,
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in the 5outhcld To~err L'uilding Inspector's Office for the follo~cing:
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
an}' and all buildings located thereon, to conduct such inspections as they may
deem necessary Zvith respect to the aforesaid application, including inspections
to determine that said premises comnl,y with all of the la~cs; ordinances, rules
• and regulations of the Town cf Southold.
The undersigned, in consenting to such inspections, do(es) so with the
l:nov:ledge and understanding that any info: oration obtained in the conduct of
such inspections may be used as evidence in subsequent prosecutions For vio-
lations of the lays, ordinances, rules or regulations of the Town of Southold.
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SURVEY FOR
AREA = 31,»2 Sq. tr. ALLEN P. & JEA NNE E.
VAN NAME
Cerliiied Toj T CUTCHOGUE
Allen P. Van NamE TOWN OF SOUTHOLD
Jeanne E. von Name SUFFOLK COUNTY N. Y.
ARCS Morlgvge. lnc. JQQQ - 1Q2 - 02 - 17
SJVIe o/ New York Mortgage agency
Peconic dbslrocl Scale: 1" = 30'
May 14, 1992
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l'' ~s'+~ N, Y. S. LIC. NC. 496/6
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Prepared in vccerdvnce with the minimum - - ` -r ' - -
slandords for line surveys us established C~N/C $iJF~i ~ ORS, F'. C'.
by the L.I.A.LS. and oppreved and adopted ,i. 6 765 i
for such use by rht New York Stale Lond ~ ~6• ~'~c'~'`
Title Association. S
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,d~ .,''N. Y. l197i
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