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Home My WebLink AboutZ-28342FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 28342 Date: 04/17/02 THIS CERTIFIES that the building DWELLING AND ACCESSORY Location of Property 1205 SOUND AVE GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 033 Block 0004 Lot 075 Subdivision 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- 28342 dated APRIL 17, 2002 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 FRONT PORCH AND ACCESSORY ONE CAR GARAGE.* The certificate is issued to JOHN H PEDERSEN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 1205 SOUND AVE GREENPORT SUBDMSION: MAP NO.: LOP (S) NAME OF OWNER (S): JOHN H PEDERSEN OCCUPANCY: SINGLE FAMILY JOHN H PEDERSEN ADMITTED BY: KIM CORWIN ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 33.-4-75 SOURCE OF REQUEST: JOHN H PEDERSEN DATE: 04/17/02 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 2 FOUNDATION: CONCRETE BLOCK CELLAR: FULL CRAWL SPACE: TOTAL ROOMS: IST FLR.: 3 2ND FLR.: 0 3RD FLR.: 0 BATHROOM(S): 1.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S): PORCH TYPE: SMALL FRONT DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: X TYPE BEATER: ELECTRIC AIRCONDITIONING: TYPE BEAT: OIL WARN AIR: X HOTWATER: OTHER: REAR MUD ROOM; BILCO DOOR ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: ONE CAR WOOD STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION L DESCRIPTION I ART. INSPECTED BY: DATE ON INSPECTION: 04/1S/02 J 'i M BOUFIS TIME START: 10:00AM EMD: 10:20AM I r� PR, 32002 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 q � ` -ISSN IG+ M Ca f,)1 n 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. ---7B.` or existing buildings (prior to April 9, 1957) non -conforming uses, or buildings and "pre-existing" land uses: 1. Accurate-tFveyoi 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. Photocopy of Certificate of Occupancy - $ 0.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15,00 ate. New Construction: Old or Pre-existing Building: — check one) Location of Property: `-1 - �(r}'u House No. j Streeter-� Hamlet Owner or Owners of Property: � Q C T . �J� Suffolk County Tax Map No 1000, Section 33 Block 4 Lot Is— Subdivision Filed Map. Lot: Permit No. /-) 1 CL Date of Permit. IJ ( C` Applicant: Health Dept. Approval: 0J(J.-, Underwriters Approval: L) OL Planning Board Approval: by �--- Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ 1 DO - b O CA, ; L4(T; Applicant Signature i CONSENT TO I INSPECTION IA i the undersigned, Own C.1 Names) do(es) hereby slate: 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 Ias District 1000, Section 33 Block_, Lot That the u dersigned (has) (have) filed, *or caused to be filed, an applica- tiioon it the Sout old Town Building tnspc:cw. o.rrL— r..+Ho rnllowinfz: 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 i deem necessary with respect to'the aforesaid application, including -inspections to determine tnt 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 inspection maybe used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: II (Sig, � ' V �of{al �-!, �EJEt2S�fJ (print name) signature SURVEY OF PROPERTY 51TUATE: NORTH OF THE VILLACGE OF CGREENPORT TOWN: SOUTHOLD SUFFOLK COUNTY, NY SURVEYED 03-19-02 SUFFOLK GOUNTY TAX # 1000-33-4-15 CERTIFIED TO: KIMBERLY GORNIN ANDREW F. GORNIN THE NORTH FORK BANK \ COMMONWEALTH LAND TITLE IN5URANGE COMPANY C� V" °1�0�p �1 e z� z cjcy e` �o�� \ oli 0� �7� \ div� O sm �pca NOTES: ■ MONUMENT FOUND AREA = -7015 5F OR 0.18 AGRE5 GRAPHIC SCALE I"= 20' •�J NES ..,.., rvP, ;. �0 SSR 50202 �A N O ben r _.. r.grnzy la . JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.\\Hp server\d\PROS\02-140.pro LOCATION: SUBDIVISION: aUs (number & street) NAME OF OWNER(S): OCCUPANCY: (municipality) LOT($): (owner -tenant) ADMITTED BY:/ ACCOMPANIED BY: �✓`�. KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1 00 - SOURCE OF REQUEST: Al Ae DATE: 3 DWELLING: TYPE TYPE OF CONSTRUCT ON: # STORIES: an # EXITS: FOUNDATION: /,� CELLAR:Z CRAWL SPACE: TOTAL ROOMS: 1ST FLR: I -r 2ND FLR: 3RD FLR- BATHROOM(S): TOILET ROOM(S): UTILITY ROOM: PORCH TYPE: ,j7 a&f DECK, TYPE: PATIO, TYPE: —� BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: _„ L TYPE HEATER: AIRCONDITIONING: TYPE HEAT: B WARM AIR: HOTWATER: OTHER: C O GSL ACCESSORY STRUCTURES: GARAGE, TYPE OF CONSTSTORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST: OTHER: VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION I DESCRIPTION I ART. I SEC. REMARKS: INSPECTED BY;/[� � DATE ON INSPECTION: �l�J lrj TIME START: aeJ END:. ieaa -33 — y — 7s- TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST. SUB. LOT 14. (� S L1 a. ER �^ �J,ry :FORMTriffI •*'C. / N > . .._.;., +cam .: l E f, L i... P ( / [ 0� a AC (o SMW TYPE OF BUILDING RES..,:,)6A SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS i r c) d t&&,wd R N .3- � cz L AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Acre Value Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD 7 -6 - -6-Meadowland Meadowland DEPTH 'J House Plot BULKHEAD .-• .+ Total ► DOCK �1 i \ v COLOR TRIM 4,te64 7 -- - _ - ...N..N..........N�iNi ...�.MEN .....M..MME .N�� ......�........N �...�.......8.... ...mom ....M..�..... .� IME ....N....�� 'Extension Extension Extension .. :.Baths - • :. oors Finish • -- - • . -. D• •!Dormer