HomeMy WebLinkAboutZ-25312 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE 8%ISTING
CERTIFICATE OF OCCUPANCY
No Z-25312 Date OCTOBER 10, 1997
THIS CERTIFIES that the building ONS FAMILY DWELLING
Location of Property 7600 PECONIC BAY BOIILEVARD LAUREL NY
House No. Street Hamlet
County Tax Map No. 1000 Section 126 Block 11 Lot 13
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-25312 dated OCTOBER 10, 1997
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 A ONS FAMILY DWELLING WITH ACCESSORY GARAGE
The certificate is issued to ROBERT H. & RATHARINS S. ROCH
(owner's)
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.
Buil ing Inap c or
Rev. 1/81
_ RIIILDLNG DEPAR'rMEN'r
'rowN of souTUOLo
HOUSING CODE INSPECTION ItEPOR'r
T.O(:A'rION: 7600 Peconic Ba Boulevard Laurel _
number b street municipality
SUBDIVISION MAP NO. I.OT(s)
NAME OF OWNER (s) Robert H. b Katharine S. Koch
OCCUPANCY Single Family
hype owner-tenant
ADMIT'I'EU BY: Robert Roch ACCOMPANIED RY: same
KEY AVAILABLE SUFF.CO. TA% MAP NO. 1000-126-11-13 _
SOURCE OF REQUEST- Katharine S. Roch DATE: 7/29/97
DwEI.i.ING:
TYPE OF CONSTRUCTION woodframe # STORIES I~ # E%I'r5 4 _
FOl1NDA'rION Block _CELLAR full _ CRAWL SPACE
'I'O'rAI, ROOMS: IST FLR. 6 2ND FLR. 2 3RD FLK
I3A'I'HROOM ( s ) 2 TOILET ROOM ( s ) U'r II,I1~[ ROOM _
PORCH TYPE covered front porch DECK, TYPE wood (CCA) PATIO
BREEZEWAY FIREPLACE yes GARAGE _
DOMESTIC HO'rWATER gas TYPE HEATER gas AIRCONDITIONING
'TYPE HEAT WARM AIR HO'r41ATER
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. woodframe - two car STORAGE, TYPE CONST. wood frame
SWIMMING POOL GITEST, TYPE CONST_
o'ruER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVEN'LION b BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
RE~~g; BP#129172 - CO#212589 (add) b BP#243622 - CO#225311 (add b alt)
INSPECTED RY DATE OF INSPECTION 8/8/97
Michael J Verity TIME START 10:00 AM END 11:05 AM
Form No. 6
. TOWN OF 50UTHOLD ~
BUILDING DEPARTMENT O
' TOWN HALL hU~~ ~ - NGT
• 765-1802
I
SlOfi. DE
APPLICATION FOR CERTIFICATE OF OCC~
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:
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 1R 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 tp accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildine - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $1i15.00, Commercial $15.00
Date ....~.`~1~. a?,~9y 7
New Construction........... Old Or Pre-existinQg Building..:............
Location of Property... 7660........~e~.°.":'~..4~Ay ;Qod(eurtf®
..............~t:ujef
House No,Q. L ,.I Streelt~L Hamlet
Onwer or Owners of Property.. y}~:4~~~..t1:. ~D.`:~... d".. ~g;T,'1~??in.C . a:.
County Tax Map No 1000, Section......~~6.....B1ock......~t.........Lot...~ 3
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: $../G a•.a ~ ~~,1
Y?~-((~'~~3[a.• APPLICANT ~,.+I~l~/~,ve 5 • /loch
CONSENT
TO
INSPECTION
KR~hr~~~~e S Koch ~ ,the undersigned,
Owner(e~) Name($)
do(es) hereby state:
aR-
That the undersigned (is) (a~e)~the owner(s) of the premises in the Town
of Southold located at ~ b (56 ~ecv+~~c UAy ~aJ~e unr~ ~fwi e{ , ~ew ~er,~
which is shown and designated on the Suffolk
County tax map as District 1000, Section ) 2 C Block J/ Lot / 3
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 Ln 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,
Dated: ,2
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SURVEY, FOR ; ' ~ ri _ •
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i'•yi ~IY'•'• rYJ.~ ..iSl R' ',Y It~~J..
RCBERT N, kOCrH~,~,;'AIATHA lE. S. KOCH ~ i
AT LAUREL :+~~~,a'• ~~.~,,'~'tof tVrtyti,Y' ~ •
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TOYlN Of SOOT OL ,n!,,'%"~~ g.~P~p6E~ K•f9
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~UFFOL K COUNTY, N. 1:' . ~ NORTH SNORE ABSTRACT LTD.
~ ~ # OBERT N, KOCN B KdTHAq/NE S. KOCH
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