HomeMy WebLinkAboutZ-27999FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 27999
Date: 10/05/01
T~IS c~TIFIES that the building
DWELLING
Location of Property 26550 MAIN RD
(HOUSE NO.)
County Ta~ Map No. 473889 Section 109
CUTCHOGUE
(STREET) (HAMLET)
Block 0004 Lot 008.001
Subdivision Filed Map No. __ Lot No.
confo~ms su]~stantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CERTIFICA~ OF
OCCUPANCY NI~4BER Z- 27999 dated OCTOBER 5, 2001
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 FD24ILY DWELLING WITH ACCESSORY 1-1/2 CAR GAP~AGE & 3 CAR ACCESSORY
G~LRAGE WITH STORAGE *
~e certificate is issued to FP3~NK B. & FP~ANCES ROGERS
(OWNER)
of the aforesaid building.
SUFFOLK COU/F~Y DEPARTMENT OF ~R~LTIq APPROVkL
ELEChf~ICAL CERTIFICATENO.
PLL~4BERS CERTIFICATION DA'£~3
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
/fh°~zed Signature
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
I&)CATION: 26550 MAIN RD CUTCHOGUE
subDIVISION: MAP NO.: LOT
NAME OF OWNER (S): FRANK B. & FRANCES ROGERS
OCCUPANC~{: SINGLE FAMILY FPJ~NK B. & FRANCES ROGERS
ADMI'~rI~U BY: MRS. ROGERS ACCOMP~I~DBY: SAME
K~Y A%L~II~iBLE: SI]FF. CO. TAX W~P NO.: 109.-4-8.1
SOURCE OF I~URST: GARY FLANNER OLSEN, ATTY 9/28/01 DAT~: 10/05/01
DWELLING:
T"fPE OF CON~TRUCTION: WOOD FRAME # S~gRIES: 2.0 ~ EXITS: 4
FOUNDATION: CEMENT BLOCK CEIJ~AR: P~LRT. ~ SPACE: PART.
· ~)TAL ROO~S: 1ST FI,H.: 6 2ND FLR.: 4 3~D FLR.: 0
BATIfl(OON (S): 2.0 TOILET ROOM (S): 1.0 UTILITY ROO~ (S}:
PORCH TYPE: DEC~( TYPE: PATIO TYPE:
BP~I~EZEW~Y: FII~EPI~kCE: NONE C~%RAGE:
DOMF~TIC HO~A'£F~K: YES ~"fPE~A'£M/(: OIL /~IRCONDITIONING:
TYPE HEAT: 0IL WARM AIR: HOTW~r~: XX
ACCESSORY STRUCTURES:
C~d%GN, TYPE OF CONST.: (2)-1.5 CAR&3CD~R W STORE. ST~Pu%GE,
SWIPING POOL: GUEST, TYPE CONST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
INSP~L-~'F~ BY:
DATE ON INSPECTION: 10/04/01
START: 10:10 AM END: 10:40 AM
bUILD±i~G DEF~(THLN'f
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and submitted to the-~uildir
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 buildi
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
Vpre-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 appiicam
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, SwJ~.ing pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildinm - $i00.00
3. Copy of Certificate of Occupancy - = .25¢.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ..$~p~b~r.Z~,.2OO~ .................
X
New Construction ........... Old Or Pre-existing Building .................
Location of Property...2655QR4ai~ ~,~.C~t~%og~D ..........................................
House No. Street Hamlet
Onwer or Owners of Property...Emanc~.~ ~o~o~ _r_~ ........................... . ..................
County Tax Map No 1000, Section.,.l~9 ........ Block. 4 .............. Lot..$.k ............
Subdivision .................................... Filed Map ............ Lot .................
Permit No ................ Date Of Permit ................ Applicant ........................
Health Dept. Approval .......................... Underw-riter~proval ....................
Planning Board Approval ........................
, .......
Cutcho e, NY 11935
CONSENT
TO
INSPECTION
Frances Rogers by Gary Flanner Olse~, as Attorney
· the undersigned,
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
26550 Main Rd., Cutchogue,
of Southold located at
, which is shown and designated on the Suffolk
County tax map as District 1000. Section 109 , Block 4 , Lot 8.1
That the undersigned (has) (have) filed, 'or caused to be filed, an applica-
tion in"th~ Southold Town 13ullcling lnspe~L~,~ .~ ort~oo to,- +h.~ rnllowLn~:
Two story frame house, Frame Building and Frame Garage
That the undersigned do(es) hereby give consent to the Building Inspectors
of the Town of Southoldto enter upon the above described property, iucluding
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 ot
such inspections may be used as evidence in subsequent pf,,~ions for
//
lations of the laws, ordinances, rules or regulations o~/the_~o~vn~ of Southold.
Dated: September 27, 2001 ~'/~~ure
, (~g n at )
Gary Flanner 01sen as ~ttorney for
(print name)
Frances Rogers
(signature)