HomeMy WebLinkAboutZ-39326 f
SOFat 4' N Town of Southold 11/3/2017
coG� 53095 Main Rd
c Southold,New York 11971
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 39326 Date: 11/3/2017
THIS CERTIFIES that the structure(s) located at: 2625 Bay Shore Rd, Greenport
SCTM#: 473889 Sec/Block/Lot: 53.4-21
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- 39326
dated 11/3/2017 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.*
Note:BP 1793 addition COZ-1476;BP 8953 addition COZ-8042; BP 25352 addition and alteration COZ-26600; BP
24220 interior alteration COZ-26599.
The certificate is issued to Dwyer/Barth Revoc Fam Trt
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
00 ho ' d Signature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 2625 Bay Shore Rd,Greenport
SUFF.CO.TAX MAP NO.: 53.4-21 SUBDIVISION:
NAME OF OWNER(S): Dwyer/Barth Revoc Fam Trt
OCCUPANCY:
ADMITTED BY: Jo Ann Wind,Realtor
SOURCE OF REQUEST: Dwyer/Barth Revoc Fam Trt DATE: 11/3/2017
DWELLING:
#STORIES: 1 #EXITS: 3
FOUNDATION: cement block CELLAR: no CRAWL SPACE: no
BATHROOM(S): 2 TOILET ROOM(S): UTILITY ROOM(S):
PORCH TYPE: enclosed DECK TYPE: PATIO TYPE: paver/brick
BREEZEWAY: FIREPLACE: GARAGE:
DOMESTIC HOTWATER: yes TYPE HEATER: electric AIR CONDITIONING:
TYPE HEAT: electric 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: JOHNJ DATE OF INSPECTION: 11/2/2017
TIME START: 2:35pm END: 3:20pm
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 2110 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 a 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$15.00
Date. 16 23 17
New Construction: Old or Pre-existing Building: f/ check one
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Location of Property:A �► S I\tireQI �Qe�r�Q('�-
House No. Street Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section 53 Block "1 Lot 2-1
Subdivision p Filed Map. Lot: r :
Permit No. O�0 Date of Permit._ u?[ Applicant: Rev F TiU5
I—�i a1 1 Iz
Health Dept.Approval: Underwriters Approval:
Planning Board Approval: F ,
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitfed:$ t CID I CIG
C, C oog Applicant Signature
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CONSENT TO INSPECTION
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'q �]�/ /��� , the undersigned,do(es)hereby state.
Owner(s)Name(s)
That the undersigned (is) are) the owner(s)of the premises in the Town of
Southold, located'at J&-15 c 01-ed 6`'-e e 6/-)/-
which is shown and designated on t e Suffolk County Tax Map as District 1000,
j
Section S3 , Block Lot____
That the undersigned(has)(have)filed,or cause to be filed,an application in the
Southold Town Building Inspector's Office for the following: IA 54er-f 'ntoc'o
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.
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5
Dated: 10
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SURVEY OF:
PROPERTY LOCATED AT ARSHAMONAOUE
LOT 45 AS SHOWN ON
AMENDED MAP 'A- OF PECONIC BAY ESTATES
FILED; MAY 19, 1933: FILE No, 1124
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C.T,M, Or 1000-53-4-21
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
f\ f 1 0 r Alf
1
DATE 'yINSPECTOR
LOCATION: Y Y
Y"� r �• r a�"1
(number & stre t) (muni •ipality)
SUBDIVISION: MPXO.:� LOT(S): ..
NAME OF OWNER(S)*:
OCCUPANCY: N i
(type)
AMA � S�p er�t).
ADMITTED BY. �� ACCOMPANIED BY:
KEY AVAILABLE: SUEF. CO. TAX MA�
SOURCE OF REQUEST: DATE:
DWELLING
TYPE OF CONSTRUCTION: . STORIES: �_4 EXITS:
FOUNDATION yl !!��/ 19AS9MENT: W 'CRAWL SPACE:
# OF BEDROOMS: IST FLR: '. 2ND FLR: _ 3RD F'LR:
BATHROOM(S): TOILET ROOM(S): UTILITY ROOM:
��-
PORCH,TYP' D'ECKy TYPE: �. PATIO;TYPE. G✓
f
BREEZEWAY:' _ FIREPLACE:'_ GARAGE.
DOMESTIC HOTWATER: TYPE HEATER: v AIRCONDITIONING:
TYPE HEAT:( . �G�/1���� ARMS AIR: HOT WATER:
J
# OF KITCHENS:
FINISHED BASEMENT:- YES NO tf
OTHER: o --Y �m co CO. Wqke CD �
ACCESSORY STRUCTURES .
GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.:
SWIMMING POOL: GUEST,TYPE CONST:
yA
I
OTHER:
VIOLATIONS: CHAPTER 144 &N,Y, STATE UNIFORM F;RE PREVENTION & BUI, ,DING CODE
LOCATION D +,SCRIPTION ART. SEC.
REMARKS:
INSPECTED B , Join 3 - 3 H SIS DATE OF INSPECTION:
TIME START: !�•��!J END: .$ ofm