HomeMy WebLinkAboutZ-19962FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-19962 Date JUNE 10. 1991
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 2710 PRIVATE ROAD #18 SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 54 Block 1 Lot 14
Subdivision Filed Map No. Lot No.
conforms substantially to the requirements for a Private One Family
Dwelling built prior to: APRIL 9, 1957 pursuant to which
CERTIFICATE OF OCC. #Z-19962 dated JUNE 10, 1991
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
The certificate is issued to ESTATE OF EDWARD W. OFFENHEISER
(owner)
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.
B ilding Inspector
Rev. 1/81
BUILDI:;G DEPARTHE T
T07 �i OF SOUTHOLD, N. Y.
HOUSIi:G CODE INSPECTION REPORT
Location 2710 PRIVATE ROAD #18 SOUTHOLD, N.Y.
�numoer (:c street) �i,iuniuipality)
Subdivision Nap No. Lot(5)-
Name of Owner(S) ESTATE OF EDWARD W. OFFENHEISER
Occupancy A-1 OWNER
(type) owner-cenanz)
Admitted by: Ray Offenheiser Accompanied by: SAME
Key available
Source of reques
DITEMLING :
Suffolk Co. Tax No.
ROBERT E. OFFENHEISER Date
54-1-14
MAY 16, 1991
Type of construction WOOD FRAME Tstories ONE
Foundation CEMENT BLOCK Cellar NO Crawl space II
Total rooms, 1st. F1 5 2nd. F1 3rd. F1
Bathroom(s) ONE FULL Toilet room(s)
Porch, type FRONT ENCLOSED Deck, type Patio, type_
Breeze,aay Garage Utility room
Type Heat OIL 'alarm Air Hotwater K%
Fireplace(s) NONE _No. Exits 2 Airccnditioning
Domestic ho twater YES Type heater OFF THE FURNACE
Other
ACCESSORY STRUCTURE'S:
Garage, type const._
Swimming pool
Other
Storage, type const.
Guest, type const._
VIOLATIONS: CHAPTER 45—N.Y. STATE UNIFORM FIRE PREVENTION BUILDING CODE
Remar!cs • BP #6568/CO z-5436, BP # 15040/CO Z-19818
Inspected by: Date -of Insp. MAY 29, 1991
�' ISH Time start 9:40 end 10`_
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
7
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.
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—tural 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 - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .May. 161 .1.991 ..........................
New Construction........... Old Or Pre-existing Building .... X............
Location of Property..2710 Private. Road _ # 18 c . Southold t , New .York ........ ....... . .. . .
. . . .. .. .......... .... .....
House No. Street Hamlet
Onwer or Owners of Property Estate'.of. Edward W. Offenheiser
. . . ... .. .............
County Tax Map No 1000, Section...5
.......... Block..1.............Lot.14
Subdivision....................................Filed Map ............ Lot ......................
Permit No................Date Of Permit................ Applicant.Robert E. Offenheiser, Admin-
i'stra'tor
Health Dept. Approval..........................Underwriters Approval.........................
Planning Board Approval ........................
Request for: Temporary Certificate........... Final Certicate... :�.......
Fee Submitted: $.100;00,,,,,
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CONSENT
TO
INSPECTION
Estate of Edward W. Offenheiser
ROBERT E. OFFENHEISER, as Administrator of the / the undersigned,
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at 2710 Private Road #18, Southold, New York
, which is shown and designated on the Suffolk
County tax map as District 1000, Section 54 , Block 1 , Lot 14
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:
Certificate of Occupancy on pre-existing building
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: 5/16/91
(signature)
(print name
BUILD'T',::-
TOaid OF SCUT: OLD .; N .
Y.
FOU- I::C CCD- IiS?_CTIGi; R- ORT
Location „270
k.:L:.aoer (u s tree u )
Subdivision M,
trlun: cipall :y)
No. Lot(s)
e
i ��..1 of Owner(s)
Occupancy f} -
t L'yp o
Admiy-ted by:
_ -AcCcimpanied
owner-zenar . )
by:
Key available Suffolk Co. T
Source of request
Tax
No.
Date
DWELLING:
Type of construction
Foundation �� �� � stories
� Cellar�Craw1 space �-
Total rooms, I-1- 2n
1st. F1 .d. F1
Bathroom(s)3rd. F1
Toilet room(s)
Porch, t -y -pe U Deckp type
YPe Patio, type
Type Heat
Breezeway Gara��
d Utility room
Warm Air
Fireplace(s) /o�� Ho twater
No. E;ti is v� Aircondi Lioni.-gig
Domestic ho treater
Type heater/
Other
ACCESSORY STRUCTLTRFS:
Garage, type const.
Storage, type const.
Sri„ �,,mi ng pool Guest type ype const.
v i VLA-! CHAPTER 45--N.Y. STATE IINTrnum r. Tnr. n.,.,♦.... _____
Remarks: t P #- �
P /Sb Vo C 0 V_/ Hoppe
Inspected by: Z
Date of Insp.
✓`�
Time start -L& end '
TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER
STREET
VILLAGE
DfSTRICT
SUB.
LOT
FORMER OWNER
A" 4 --
E
ACREAGE�
S
W
TYPE OF BUILDING
RES D
SEAS.
VL.
FARM
COMM.
IND.
CB.
I misc.
LAND
IMP.
TOTAL
DATE
REMARKS
,q
CC =
Ly
AGE
BUILDING CONDITION
NEW
NORMAL
BELOW
ABOVE
Farm
Acre
Value Per Acrd
Value
Tillable 1
Tillable 2
Tillable 3
Woodland
Swampland
Brush -i5l' nd %-*
House Plot
Tota I
CIr
M. Bldg.
Foundation.rL�i.Bath
Extension
Basement
Floors
Ext. Walls
Interior Finish
Extension
Extension
2. 7
Fire Place
-JA
Heat
Porch
Attic
Porch
Rooms Ist Floor
Pati
Rooms 2nd Floor
Breezeway
Garage
Driveway
0 B.