The URL can be used to link to this page

Home My WebLink AboutZ-38528 s4fFat� Town of Southold 9/29/2016 53095 Main Rd Southold,New York 11971 C PRE EXISTING CERTIFICATE OF OCCUPANCY No: 38528 Date: 9/28/2016 THIS CERTIFIES that the structure(s)located at: 515 Private Rd#12, Southold SCTM#: 473889 Sec/Block/Lot: 78.-6-10.1 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 38528 dated 9/28/2016 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood frame seasonal one family dwelling with wood entry and wood steps to crawl space.* Notes:BP 23485 deck addition COZ-24472;BP 40868 electric service COZ-38509; BP 41005 "as blt"alterations, including conversion of seasonal to year round use COZ-38527. The certificate is issued to Stegner, Daniel Stegner, Patricia (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. Aut ed Signa re BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 515 Private Rd#12, Southold SUFF.CO.TAX MAP NO.: 78.-6-10.1 SUBDIVISION: NAME OF OWNER(S): Stegner,Daniel&Patricia OCCUPANCY: ADMITTED BY: Bob Hiltz SOURCE OF REQUEST: Stegner,Daniel DATE: 9/28/2016 DWELLING: #STORIES: 1 #EXITS: 2 FOUNDATION: concrete block CELLAR: CRAWL SPACE: x BATHROOM(S): 1 TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: 2 wood entries DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: TYPE HEATER: AIR CONDITIONING: TYPE HEAT: WARM AIR: HOT WATER: #BEDROOMS: 2 #KITCHENS: 1 BASEMENT TYPE: OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF,CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: MIKEV DATE OF INSPECTION: 8/12/2016 TIME START: 2:45pm END: 3:15pm Form N(}.4 '1'O\'VN Qf OU HOLD L'Uf1,0ING DLPA12'TMENT TOWN !CALL 765-1802 APPLICATION POR CERTIFICATE Of, OCCUPANCY Y This application must be Cilled in by typewriter or ink and submitted to the Building Department with tete followin4; A. For new building,or new uSe: 1. Finat survey of property with accurate location of all buildings,property lines,streets, and unusual natural or topographic feature s. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form) 3. Approval of elootrical installation from 13oard of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of I% 1--ad. 5. Comnuxcial building, industrial building,multiple residences and similar buildings final installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. I . For existing buildings(prior to April 9, 1957) "On-ctinformiXXg uses, or buildings and"pre-existing" laud Wes: 1. Accurate survey of property showing all property lines, streets,building and unusual natural or topographic features. 2. A properly completed application and 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 I. Certificate•of Occupancy-New dwelling$50.00,Acklitions to dwelling$50.00,Alterations to dwelling$50.00, mi Swimng pool$50,00,Accessory building$50.00,Additions to accessory building$50.00,Btasinesses$50.00. 2. Certificate of Occupancy on Fre-existing Building- $100.00 3. Copy'6fCertificafeofcupancy-', �5"' _. ._._._ 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00,Comxra~rcial$15.00 Date. New Construction: Old or Pre-existing Building:_ (check one) Location of Property: 5 W,,i. V p;rii L 'o ALd L House No. 0 Street Hamlet Owner or Owners of property: 1CL V1 Ar- V,t_,iA_ Suffolk County Tax Map No 1000, Section Block Q eo Lot Subdivision Film Map Lot., Permit No. - „ _ Date of Perrnit. Applicant:_ Health Dept_ Approval: Underwriters Approval: Planning$card Approval: Request for: Temporary Certificate Final Certificate: (check one) Fcte Submitted: $ o o ov Applicaint Sianatu . 7n )TO -1 1" 1rlRrrr.k Vrk h17 I.nnrrni Trn r7•T C)Trl7 17n +fin CONSENT TO INSPECTION the undersigned, do(es) hereby state: Owners Name(s) That the undersigned (is) (are)the owner(s) of the premises in the Town of Southold, located at , which is shown and designated on the Suffolk County Tax Map as District 1000, Section T, Block 044 , Lot 10. / That the undersigned (has) (have) filed, or cause to be filed, an application 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 in subsequent prosecutions for violations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: 7/:;V (S Igrwt re) A (Print Na (Signature) (Print Name) SURVEY OF PROPERTY A T SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK 1000-78-06-10.1 SCALE. 1'-20' JUNE 9, 2016 +4l o� qN V$ 4pO� d 00 Qb o° oo• ww o o R� °°F 06011- 60 00- cy � c ww � o\63 B' h �F CRMO TSR y °3F you l �, rev 'z�• y �s`�• SF ti O � '�`O ?O.3• i W a nh N6¢¢3g 3 \ r-1S�S' 0 4- IN, �c RCA �N l � q N =TROgD • =REBARQ,. � • =PIPE ELEVATIONS ARE REFERENCED TO NA VD 88Yx Y.S. LIC. NO. 49618 ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION e NhP ORS, P.C. OF SECTION 7209OF THE NEW YORK STATE EDUCATION LAW. : 1 , 0'O FAX (631) 765-1797 EXCEPT AS PER SECTION 7209—SUBDIVISION 2. ALL CERTIFICATIONS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF P. 9 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR AREA=7,553 SQ.FT. 1230 TRAVELER STREET 16- 056 WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N.Y. 11971 7 _ , LOCATION: vv AI7-� (number & street (municipality) SUBDIVISION: - P NO.: _ _ LOT(S): NAME OF OWNER(S OCCUPANCY: - (ty (owner-tenant) te . ADMITTED BY: �_*4' ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP'NO. 1000- 7 8- -/0• SOURCE OF REQUEST: DATE: 074 DWELLING TYPE OF CONSTRUCTION: #STORIES: # E �S: �� FOUNDATION: . C • b' . BASEMENT: CRAWL SPACE: 1. # OF BEDROOMS: IST FLR: 2ND FLR: 3RD FLA: . BATHRO M(Sj\-j TOILET ROOM(S): UTILITY ROOM: P0RCH.TYP - DECK, TYPE: PATIO;TYPE: W - BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: TYPE HEATER: AIRCONDITIONING: TYPE HEAT: �'— WARM AIR: '—' HOTWATER: # OF KITCHENSN FINISHED BASEMENT:- YES NO OTHER: ACCESSORY STRUCTURES GARAGE, TYPE OF CONST.: _ STORAGE,TYPE CONST.: ~ SWIMMINGPOOL: GUEST,'TYPE CONST: OTHER: VIOLATIONS: CHAPTER 144 ,&N.Y. STATE UNIFORM FIRE PREVENTION& BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: INSPECTED BY: DATE OF INSPECTION: TIME START:, 2' �''� END;._ 3