HomeMy WebLinkAboutZ-26421 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- 26421 Date: 05/03/99
THIS CERTIFIES that the building DWELLING
Location of Property 7895 SKUNK LA CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 104 Block 0004 Lot 024
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- 26421 dated MAY 3, 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 & ACCESSORY TWO CAR GARAGE*
The certificate is issued to DOLORES RALLER 6 WSNDY LOWSNTHAL
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
Building Ins ector
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HO rN D rNan mm ~ oERORT
LOCATION: 7895 SRUNR LA CUTCHOGUR
SUBDIVISION: MAP NO.: LOT (S)
NAME OF OWNHR (s) : DQ~S H• ~ ~DY E. IL~$i1HAi,
OCCUPANCY: SINGLE FAMILY
ADMITTED BY: WENDY LOEWENTHAL ACCOMPANIED BY: SAME
R8Y AVAILABLH: SUFF. CO. TAX MAP NO.: 104.-4-24
SOURCE OF RSQVHST: AHIGAL WICRHAM. ATTY 4/8/1999 DATE: 05/03/99
DWELLING:
TYPB OF CONSTRUCTION: WOOD FRAME # STORIES: 1.5 # EXITS:
FOUNDATION: CEMENT BLOCK CELLAR: PART CRAWL SPACE:
TOTAL ROOMS: 1ST FLR.: 2ND FLR.: ~ 3RD FLR.: ~
BATHROOM(S): 2.0 TOILET ROOM(S): 1.0 UTILITY ROOM(S):
PORCH TYPE: DECK TYPE: FRONT MASONARY PATIO TYPE: CONCRETE
BREEZEWAY: FIREPLACH: TWO GARAGE:
DOMHSTIC HOTWATER: XX TYPE HHATER: OIL FIRED AIRCONDITIONING:
TYPE HEAT: OIL WARM AIR: XX HOTWATER:
OTHER:
~{.GHSSORY STRUCTUPRS:
GARAGE, TYPE OF CONST.: TWO CAR WOOD STORAGE, TYPE CONST.:
SWIMMING POOL: GUEST, TYPE CONST.:
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PRBVENTION & BUILDING CODE
LOCATION ~ DP.SCR7pT7pN ~ ART ~ SFn
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RHMARRS:
INSPECTHD BY: DATE ON INSPECTION: 04/28/99
HN M. BOUFIS TIME START: 10:00 AM END: 10:30
_ ~ I.
TOWN OF SOUTHOLD l ppR 19 I~!~9 i '
BUILDING DEPARTMENT
TOWN HALL
765-1802 ~ ~ r:~Pi
1 ~t~~TtIC`~_r,
APPLICATION FOR CERTIFICATE OF OCCUPAXCY
A. This application must be filled in by typewriter OP, ink and submitted to the building
inspector with the following: for new building or new use:
1. Final survey of property caith 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(5-O 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 17 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 325.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses 350.00.
Certificate of Occupancy on Pre-existing Buildins - $100.00
3. Copy of Certificate of Occupancy - .25~.
4. Updated Certificate of Occupancy - $50,00
5. Temporary Certificate of Occupancy - Residential S15.00, Commercial 315.00
Date March 25, 1999
New Construction.......,... 01d Or Pre-existing Building
Location of Property.,, 7895 Skunk Lane Cutchogue, New York
House No. Street Hamlet
Onwer or Owners of Property.,,,, Dolores H. Kaller/Wendy E. Loewenthal
County Tax Map No 1000, Section.,, ,104 ,_.Block.....~..........Lot...24
Nassau Farms .Filed Ma ...........Lot. 7
Subdivision p.
Permit No ................Date Of Permit................Applicant.............................
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate...........
~ ,
Fee Submitted: 3..100.00 ~
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Q~nT. S ~O' lo$~ ~ APPLICANT
n~~ ~acyaf
THE NEW YORK BOARD OF FIRE UNDERWRITERS '~-~r,
BUREAU OF ELECTRICITY
40 FULTON STREET, NEW YORK NY 10038
r,.- , -.rj ^,c io,-I - (Tf rrr
Date ~ - , ' Application No. on file - _ _ _ .
THIS CERTIFIES THAT
only the electrical equipment a.c described below and introduced by the applicant named on the above application number is in the premises of
i? ~~'~.~_E3!L,Eir?h','i~_I 715- `;`tN,. Tn;1,1E. r,r,_~,n~trE. NY
in the following location; ~ Basement 0 1st Fl. ~ 2nd Fl. t'''~~''~ =1`17 Section Block Lot
tt7.~^(i't' iE ~ '.r OO
was examined on and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER AMi. K.W. AMT. K.W. AMT. K.W. AMi. K.W. AMT. H.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT. K.W. OIL H.P. GAS X.P. AMT. NO. A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO. OF FEET AMT. WATTS
SERVICE DISCONNECT NO. OF S E R V I C E
METER NO. OF CC COND. A. W. G. A. W. G. A. W. G.
AMT. AMP. IVPE EHUIP. 1 0 2W 1 0 3W 3 0 SW 3 0 4W pER 0 OF CC. COND. NO. OF HI-LEG OF HI-LEG NO. OF NEUTRALS OF NEUTRAL
OTHER APPARATUS:
*~I~I 'i.T.:~Lt~i.. r1~i't'..^T~,: ~~AIi IE~t;1Cix~
sur~;el hu- t_~:,~ IuadG of the expose
~_~~;ar.ical .;uik;rc.nt iri tiie
k ienl:is._s ir;.i~ate:." „N,. -~bvicu~
~_ui ~.`Itlsid~'t.J v •~_cadit.iar~ folznd.
C. Y=.i,i~Ft /',QEt'IEN^.HP,r:
~ ` :i i~:C.R1K I.t1AIE
GENERAL MANAGER
i.l
Per
This certificate must not be altered in any manner; return to the aHice of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
COA'SENT ,
TO
INSPECTION
Dolores H. Kaller and Wendy E. Lpewenthal 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 7895 Skunk Lane, Cutchogue, New York 11935
which is shown and designated on the Suffolk
County tax map as District 1000, Section 1 C4 Block ,Lot
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:
Pre-CO for one family dwelling; copies of two Certificates of Occupancy ~
for additions made to premises
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-
lationG of the laws, ordinances, rules or regulations of the Town of Southold.
r ,1 ^
Dated: April 8, 1999 ' ~
~ (signature?
bigail A. Wickham, As Agent
(print name)
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