HomeMy WebLinkAboutZ-27716FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEP~RTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 27716
Date: 05/29/01
~IS CERTIFIES that the building DWELLING
Location of Property 900 MASON DR CUTCHOGUE
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 104 Block 0007
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 plzrsuant to which C~TIFICATE OF
OCCTYPANCYlqUI~BER Z- 27716 dated MAY 29, 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 FAMILY DWELLING *
(HAMLET)
Lot 004
·"ne certificate is issued to KAREN A & JESSE F SKELTON
(OWNER)
of the aforesaid building.
SUFFOLK COU/F~YDEPARTMENTOF~ALTHAPPROVAL
ELEt-£KIC3%L u~TIFICATE NO.
PLUMBERS CERTIFICATION DAT~u
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
Rev. 1/81
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 900 MASON DR CUTCHOGUE
~U~DI~-/SION: MAP NO.: LOT (S)
~ OF OWN~ (S): KAREN A & JESSE F SKELTON
OCcumANCY: A-1 RESIDENTIAL KAREN A & JESSE F SKELTON
AD~I'i-r~ BY: JESSE SKELTON ACCOmpANIED BY: SAME
KEY A%5%ILABLE: ~UFF. CO. TAX MAP NO.: 104.-7-4
SOURCE OF P~ST: GARy FLANNER OLSEN, ATTY 5/16/01 DA~'~: 05/29/01
DWELLING:
TYPE OF CONSTRUCTION: WOOD FP, AME ~ STORIES: 1.5 # EXITS: 2
FO~DATION: CEMENT BLOCK CEIJ~%/~: PIT ~ SPA~:
~ R~S: 1~ F~.: ~ 2~ F~.: ~ 3~ F~.: ~
~(S): 1.0 ~I~ R~(S): 1.0 ~ILI~ R~(S): ONE
~R~ ~H: D~ ~PE: PATIO
BR~Y: FI~P~: ONE ~E:
~IC H~'r~: YES ~PE ~'r~: OFF BOILER ~R~ITION~G:
~E ~T: OIL ~ ~R: H~: XX
ACCESSORY STRUCTURES:
STORAGE, TYPE CONST.:
(~JEST, TYPE CONST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
P,~D~F~g: BP #27338-Z-CO Z-27715 (DORMER ADDS)
DATE ON INSPECTION: 05/22/01
TIME START: 10:00 AM ~/D: 10:20 AAM
TOWN HA~LL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Bo
This application must be filled in by typewriter OR ink and submitted to the buildil
inspector with the following: for new building or new use:
[. Final survey of.property with accurate location of all buildingS, property line
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 build
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:
l. 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 appltc~
If a Certificate of Occupancy is denied, the Building Inspector shall state th~
reasons therefor in writing to the applicant.
Co
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 $25.01
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existinR Buildinm - $I00.00
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.O0
Date ...Ma~ .Ltl,/DD~ ....................
X
New Construction ........... Old Or Pre-existing Building ........ f~a~ .fiamiL~ dwelling
Location of Property .... 900. Mason. Drive,.Cutchogue .....................................
House No. Street Hamlet
Onwer or Owners of Property..Jesste. A,.Skel~om.and.Ka:an .~.~k~mlXx~ .... , ...............
County Tax Map No 1000, Section..%~ ......... Block. 93 ............. Lot..OO4 ..........
Subdivision .................................... Filed Map ............ Lot ...............
Permit No ................ Date Of Permit ................ Applicant ......................
Health Dept. Approval .......................... Underwriters/~proval ..................
Planning Board Approval ........................ /
/
Request for: Temporary Certificate ........... Final~
/
100.00
Fee Submitted: $ .............................
APPLICANT
GARY FLANNER OLSEN
Main Rd, PO Box 706
Cutchoi;ue, NY H935
CONSENT
TO
INSPECTION
Gary Flanner Olsen as attorney for Jesse F. Skelton and , the undersigned,
Owner(s) Name(s) Karen A. Skelton
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at 900 Hason Drive, Cutchogue, NY
· which is shown and designated on the Suffolk
104 07 004
County tax map as District 1000, Section , Block , Lot
That the undersigned (has) (have) £iled, 'or caused to be filed, an applica-
tion in'th. Southold Town ltullding lnspeuL.~ '~ o~£:,.,o .%-- +h. rnllnwin~:
One family house with front,.dormer
That the undersigned do(es) hereby give consent to the Building Inspectors
o£ the Town of Southold to enter upon the above described property, including
any and ail 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 ~uch 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 [ ~-~cutions for rio-
/
lation$ of the laws, ordinances, rules or regulations pi/t! ~rown of Southold.
Dated: May 16, 2001 ', /z ' (signature)
Gary Flanner 01sen
(print name)
(signature)
(print name)
GARY FLANNER OLSEN
Main Rd, PO Box 706
Cutchogue, NY 1193~
tv
MASON DF IVE
S
N,/F CORBLEY
N 72' 24' 50" E
4'
75.5 ·
JB.?' C
ONe'S/ 1/2 sI-ORy--~
~q-~.,., RES.
~. ~"' DORMERS
"~CHAIN LINK
II.?'L
/
S 52' 20' 29' W
S 77' 4J' 47"w.L_._~
18.24'J
N 56' 1~'41/4~8W,~__~.~. :
WA TER LINE
SUR VE Y OF
DESCRIBED PROPER TY
SI TU A ?E
N/F S~lTu
~ON LINE
GUARANTEES INDICATED HERE ON SHALL RUN
ONLY TO THE PERSON FOR ~,ttOM THE SURVEY
IS PREPARED, ANO ON HIS BEHALF TO THE
TIILE COMPANY, GOVERNMENTAL AGENCY,
LENDING INSDTUTION, IF LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDING INSTITUTION.
GUARANTEES ARE NOT D~ANSFTZRA~LE TO
ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS.
UNAUTHORIZED AL TERAI?ON OR ADDIDON TO THiS
SURVEY 15 A HOLADON OF SECtiON 7209 OF
THE NEW YORK STATE EDUCAITON LAY~
COPIES OF TIllS SURVEY MAP NOT BEARING
IHE LAND SURVEYORS EMBOSSED SEAL SHALL
NOT BE CONSIDERED TO BE A VALID TRUE
COP ~
SURVEYED 26 MARCH, 2001
SCALE 1":40'
AREA= 22, ,55056 5F
OR
O, 518 ACRES
TM 1000-104-07-04
GUARANTEED TO
RICHARD M. BLAIR, Jr.
FIDELITY NA??ONAL I?TLE INS. CO., OF NY
IN,4SHIIVGTOiV MUTUAL HOME' LOAIVS~ INC.
CU TCHOGUE,
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
SURVEYED FOR R/CHARD M. BLAIR, Jr.
SURVEYED BY
STANLEY J. ISAK~EN, JR.
P.O. BOX 294
NEW IS~,JFFOLK. NY 119,~6
/NYS L/C, NO. 4~127~ ~
01R995