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HomeMy WebLinkAboutZ-38849 �SUFCo Town of Southold 3/1/2017 3�o Gy 53095 Main Rd N Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 38849 Date: 3/1/2017 THIS CERTIFIES that the structure(s)located at: 24775 Route 25, Orient SCTM#: 473889 Sec/Block/Lot: 18.-2-35 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- 38849 dated 3/1/2017 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 one family dwelling with enclosed porch and accessoryag_rage_* Note:BP 41377 alterations COZ-38848 The certificate is issued to Wysocki,Helen (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. A t%JAA— ed Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 24775 Route 25,Orient SUFF.CO.TAX MAP NO.: 18.-2-35 SUBDIVISION: NAME OF OWNER(S): Wysocki,Helen OCCUPANCY: ADMITTED BY: Edward Wysocki SOURCE OF REQUEST: Wysocki,Helen DATE: 3/1/2017 DWELLING: #STORIES: 2 #EXITS: 3 FOUNDATION: concrete block CELLAR: full CRAWL SPACE: BATHROOM(S): 1 TOILET ROOM(S): 1 UTILITY ROOM(S): PORCH TYPE: enclosed DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: no GARAGE: DOMESTIC HOTWATER: x TYPE HEATER: see BP 41377 AIR CONDITIONING: TYPE HEAT: gas WARM AIR: forced air HOT WATER: #BEDROOMS: 4 #KITCHENS: 1 BASEMENT TYPE: unfinished OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: wood frame STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 2/28/2017 TIME START: 2:36pm END: 3:1Opm Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. 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 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 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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool $50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00,Commercial$15.00 • Date. DEC- �o� ; ac)I (� New Construction: Old or Pre-existing Building: V (check one) Location of Property: a H-7'7 5 ON , RJ , House No. Street f Hamlet Owner or Owners of Property: t/I -e`�� L Suffolk County Tax Map No 1000, Section , Block Lot 3 `j Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ r App 'cant Signature CONSENT TO INSPECTION the undersigned, do(es) hereby state: Own&(s)Name(s) That the undersigned (is) (are)the oer(s) of thUr remises in the Town of Southold, located at a y 1:35 N/ . 00� j which is shown and designated on the Suffolk County Tax Map as District 1000, Section , Block C)a ___, Lot `� 5 That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: �S rZ T l 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. r Dated: gnature) Ed wa ck i (Print Na e) (Signature (Print &-a ) epe-S l01+1) ire- Cd VU y s c'— t-5� SO(/ly�lo Town Hall Annex Telephone(631)765-1802 54375 Main Road �, y� m�ax(631)765- 5Q2 P.O.Box 1179 G� • �Q rogerAchert(a�town.south�o d.ny.us Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY- .�� r 1koje� e Date: I , [-7 Company Name: I h eA r P h Name: pt " License No.: 3� � F 1 h Address: 30i�S I"'1 a 111 Roca 0 b-�e�t� Al Y Phone No.: C. 31- o G- 3 F I R JOBSITE INFORMATION: (*Indicates required information) *Name: p *Address: 2 42Z (tom t *Cross Street: *Phone No.: Z/o' ((g 3 l- 5_'47— T 7— Permit No.: Tax-Map District: 1000 Section: Block: Lot: *BRIEF DESCRIPTION OF WORK(Please Print Clearly) (Please Circle All That Apply) *Is job ready for inspection: YES / NO Rough In Final *Do you need a Temp Certificate: YES / NO I Temp Information (if needed) *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other *New Service: Re-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION c� 82-Request for Inspection Form ( r TOWN -OF SOU - OWNERL'RE:C r CR'D CHAD VILLAGE DIST. SUB. LOT V" --�...��fi� _ i•/1 eco-, ���,s� �� FORMER OWNERcrpsEAW,� 50CA-7 44 ACR. � 1 � (� cS r JW s / i `'� •lam-' TYPE OF BUILDING SEAS.. VL. FARM COMM. CB. MISC. Mkt. LAND Value IMP. TOTAL DATE REMARKS • AGE BUILDING CONDITION '4EW NORMAL BELOW ABOVE :ARM Acre Value Per Value Acre liable 1 liable 2 liable 3 :)odlond ampland ashland FRONTAGE ON WATER use Plot FRONTAGE ON ROAD o a DEPTH 2, z. BULKHEAD al fit' DOCK } N�y NOON■■ ■©�■■■ENO■■■■i■■■ ■■■■■RRim HE Fd■■■■■■■■■■■■■■■■ 2 MOL on INN :. " •. E 1 1' ■■■..� ... NONE■■� ■MENNE ■ �i■■■■■■■■■■■■■■ r Y ,k Sy i rn C w G . � ■EEE■ a R r ■■NEEENNE ■ ■NEIL;■E � NOON■■E■■■■■■■ s gyp'• ,y{' �•tom r s+ +, N . .. Yt 3da (�' r, t , '+ a: �A•. w. 'Hr}f- s°f 4N, , , 4, h 'T ; r�'.•:i; r•, ; ,._ , :;r; ■■■■■E �■�nEEE■■■■EEE■■■■■EN OMEN■LiKim �illliiiE■■■■■■■EEE■E■N■ ■■E■■E EEE■NENNNNNEENN■ENN■ ENMENNE No • • / • ' Interior 5URYEY OF PROPERTY 51TUATE: ORIENT N TOWN: SOUTHOLD 5UEEOLK COUNTY, NY SURVEYED 12-21-2016 SUFFOLK COUNTY TAX # 1000 - 18 - 2 - 55 S CERIVIM TQ EDWARD I WYS®CKE t¢o ,?,0 �6 by 72 y c) d � c 7 7k, ��30 _ X65A - ���®G�Ef 7��� tivetnor�oa aterauon«ma�uor�to a s"r.,ey 0q su.. l s2 1s a,fl bbtbn a section izoa sw-aMsbe 2 of l� CIO V New York State Eaucatim Lan' NOTES: 1 - 1- only copes f«9ne o xa ai of tnls 7� 7C kea w�tn an , i of lane euro stanF eG seal snarl ee iaerea to w vaib true <op�es• MONUMENT FOUND < G Hfkatiosh— !htt Ws f"111-11 Pr'aclke for LaM Surveys aaoptea -X—X—X— CHAIN LINK FENGE SFS02 c �[` -� o�ab r oaneNr,he�gwsnIx,snaSwtaSteaecalaroeAwcrcemtee2rorn1etgltFackooanrtotlpnbuante•y a SPhgHapeolrrl e-erpoWrmn-nndnlya- .e LAND ttuv +et�Wtbn Gertawo- tbra Jb`cvi Na'Sterable to aaa2bnal bl5titvttart AREA = 11,655 S.E. OR 0.27 AGRE JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S.LIC.NO.50202 &RAPHIG SGALE 1"= 30' RIVERHEAD,N.Y. 11901 REF.C:\UsersVohn\Dropbox\16\16-209.pro 369-8288 Fax 369-8287' �VG- z �T Fso r�� lY�� �o cOUM'1,a�Q TOWN OF SOUTHOLD BUILDING- DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: fir I O-X PQA�lj�q kft, -jr wftt,-,/f t 6, LSV V ' ,d '✓ •�6 DATE i °I '1dl INSPECTOR z� PT- pF SOUry� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] I . ULATION [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: �'ia�nvvr�n - I * L? DATE INSPECTOR LOCATION: L �' (number& street) (municipality) SUBDIVISION: MAP NO.: LOT(S): NAME OF OWNER(S): N"ur4 yjg5oC - OCCUPANCY: 04fot011& (04 (type) I (owner-tenant)- ADMITTED B �iDW�1��, yd1/SDu ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NQ. 1060: 1 SOURCE OF REQUEST: 6,0101M wy�b (G DATE.' DWELLING ° J WOOD . _�Nl TYPE OF CONSTRUCTION. - 1 STORIES: PJ�f� �#EXITS: . _ FOUNDATION: � �.MOA!/ BASEMENT: CRAWL SPACE: ,# OF BEDROOMS: IST FLR. 0 2ND FLR: 3RD FLR: BATHROOM(S): ._ TOILET kOOM(S):� I UTILITY ROOM: PORCH-TYP" W_ V_�Sk— DECK, TYP E: . PATIO;TYPE: od � � BREEZEWAY:' _. FIR.LPLACI,., GARAGE: W 1377 DOMESTIC HOTWATER: TYPE HEATER: �A'S _ AIRCONDITIONING: _ M� TYPE HEAT: ape> WARM AIkl-: 4 � HOTWATER: # OF KITCHENS.--V, 01\je,/ FINISHED BASEMENT: YES N OTHER: ACCESSORY STRUCTURES GARAGE; TYPE OF CONST.: OL CVA r Z"� STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST: OTHER: ; VIOLATIONS: CHAPTER 144 &N.Y. STATEjUNIFORM FIRE PREVENTION & BUILDING CODE i LOCATION DESCRIPTION ART. SEC. lit*^i FS vt Y V~ ✓ �IKh t� ?dWZO«- M REMARKS: INSPECTED BY: DATE OF INSPECTION: ,1ActN - Zid TIME START: END: n-� P4