HomeMy WebLinkAboutZ-23425FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-23425
THIS CERTIFIES that the buil
Date DECEMBER 27, 1994
ONE FAMILY DWELLING
Location of Property 550 GROVE DRIVE SOUTHOLD NY
House No. Street Hamlet
County Tax Map No. 1000 Section
Subdivision
80 Block 4 Lot 23
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-23425 dated DECEMBER 27, 1994
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*
The certificate is issued to EDWARD J MC GURN TRUST
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
c
s
Bui ing InNrector
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 550 GROVE DRIVE SOUTHOLD
Ui—ttmber 6 street municipality
SUBDIVISION REYDON SHORES MAP NO. LOT(s)
NAME OF OWNER (s) EDWARD J. MCGURN TRUST
OCCUPANCY ONE FAMILY VACANT
type (owner -tenant) -
ADMITTED BY: EDWARD J. MC GURN ACCOMPANIED BY: SAME
KEY AVAILABLE SUFF.CO. TAX MAP NO. 80-4-23
SOURCE OF REQUEST: EDWARD J. MC GURN
DATE: 12/19/94
DWELLING:
TYPE OF CONSTRUCTION FRAME # STORIES 1 # EYITS 3
FOUNDATION MASONARY (CEMENT BLOCK) CELLAR PARTIAL CRAWL SPACE PARTIAL
TOTAL ROOMS: IST FLR. 3 2ND FLR-LOFT 3RD FLR.
BATHROOM (s) TOILET ROOM (s) UTILITY ROOM
PORCH TYPE DECK, TYPE PATIO
BREEZEWAY FIREPLACE 1 GARAGE
DOMESTIC HOTWATER YES TYPE HEATER L.P. GAS AIRCONDITIONING
TYPE HEAT L.P. GAS WARM AIR FLOOR FURNACE
HOTWATER
OTHER:
AC(:F.SS(TRV STRTTCTTTRAC -
GARAGE, TYPE. OF CONST.
SWIMMING POOL
OTHER:
FRAME W/STORAGE STORAGE, TYPE CONST.
GUEST, TYPE CONST.
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION 6 BUILDING CODE
LOCATION DESCRIPTION
ART- SEC.
CELLAR L.P. FLOOR FURNACE REQUIRES SERVICING IF USED
11243.10
CELLAR SUPPORT CHIMNEY CONNECTOR FROM FURNACE AND PROVIDE CLEARANCE
OF 18" FROM COMBUSTIBLE MATERIALS
CELLAR REMOVE OLD WIRING IF NOT IN USE
1243.80
LIVING RIM REMOVE FIREPLACE INSERT (SOLID FUEL APPLIANCE) OR INSTALL TO
1243.1(]
CODE BEFORE USING.
1260.2(1
LOFT PROVIDE TEMPORARY RIDGE (ROOF SUPPORT) FOR CONSTRUCTION UNDER
CURRENT OPEN BUILDING PERMIT 022536Z.
INTERIOR DWELLING NON -HABITABLE WITH EXPOSED INSULATION
718.1(1
REMARKS. BUILDING PERMIT 122536Z ISSUED FOR DORMER AND ADDITION TO DWELLING IS IN EFFECT
WILL EXPIRE 6/19/96.
INSPECTED BY THOMAS J. FIS7E!DATE OF INSPECTION_
TIME START 11:00 AM
12/22/94
END 11:40
1)
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802 9 1994
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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 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 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 to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00�y
Date.. �CG�///J� RC2
New Construction........... Old Or Pre-existing Building... ...........
Location of Property ...
...:��, , , , , , , , , , , ,,,,. . .Ro.. .
House No. Street Hamlet
Onwer or Owners of Property. L - .Zilit%�� /. �.
County Tax Map No 1000, Section... z �......Block.....�4.........Lot..°R -73
Subdivision....................................Filed Map ............ Lot ...................... .
Permit No..'5 ,q 'f%.e....Date Of Permit................Applicant.............................
Health Dept. Approval..........................Underwriters Approval.........................
Planning Board Approval ........................
Request for: Temporary Certificate........... Final Certicate...........
Fee Submitted:OPc 2:: . . .
e a3ya5
APPLICANT
..... ..............
CONSENT
TO
INSPECTION
Owner(s) Name
do(es) hereby state:
UEC 191994
, the undersigned,
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at�Ut/?7- Z_D
which is shown and designated on the Suffolk
County tax map as District 1000, Section Block 1 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:
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-
lations of the laws, ordinances, rules or regulations of the Town of Southold.
Dated: D&-7(2-
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TOWN, OF SOUTHOLD PROPERTY RECORD CARD
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION:
(number & street) municipality)
SUBDIVISIONy�7oil9 S,l S MAP N0. LOT(s)
NAME OF OWNER (s) /1C (50,OO/ T7e<J s Z
OCCUPANCY
type
ADMITTED BY:
llee-
KEY AVAILABLE
SOURCE OF REQUEST:
5we-
(owner-tenant)
ACCOMPANIED BY:
.CO. TAX MAP NO.
,n7r-" DATE: /��/PZIQil.
DWELLING:
TYPE OF CONSTRUCTION�# STORIES # EXITS
FOUNDATION4/4SoW,Z � ,�/r BLt ( CELLAR ��//G CRAWL SPACE
TOTAL ROOMS: IST FLR. 2ND FLR. 3RD FLR.
BATHROOM (s) TOILET ROOM (s) UTILITY ROOM
PORCH TYPE DECK, TYPE PATIO
BREEZEWAY FIREPLACE l GARAGE
DOMESTIC HOTWATER TYPE HEATE 6WJ- AIRCONDITIONING
TYPE HE � iPo�1l/� �,¢� WARM AIR ,4;-Zvo1c_' fa_ 4A06X-_ HOTWATER
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. W V,-- ZQ STORAGE, TYPE CONST..
SWIMMING POOL , �GUES., TYPE CONST.
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
T�
LOCATION_DESCRIPTION„�..
i
. /� ,
A R ME KamFR,
VA
PAN,
"M
M
REMARKS' ��3�
INSPECTED DATE . OF INSPECTION ��-L , -:?I—
TIME- START END
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