HomeMy WebLinkAboutZ-26932FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 26932
Date: 02/17/00
THIS CERTIFIES that the building DWELLING
Location of Property 1150 SMITH DR N SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 076 Block 0002 Lot 011
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- 26932 dated FEBRUARY 17, 2000
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 ENCLOSED PORCH AND CEMENT BLOCK AND BRICK
PATIO.
The certificate is issued to ESTELLE TRAUTMAN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
/~ u/t~or/ize~S ~gnat u re
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 1150 SMITH DR N
SUBDIVISION:
NAME OF OWNER (S): ESTELLE TRAUTMAN
OCCUPANCY: SINGLE FAMILY
ADMITTED BY: REAL ESTATE AGENT
KEY AVAILABLE:
SOURCE OF REQUEST~
SOUTHOLD
MAP NO.: -- LOT (S) --
~STELLE TRAU~
ACCOMPANIED BY: SAME
SUFF. CO. TAX MAP NO.: 76o-2-13
DATE: 02/17/00
TYPE OF CONSTRUCTION:
WOOD FRAME
FOUNDATION: CEMENT BLOCK
TOTAL ROOMS: 1ST FLR.: __~
BATHROOM(S): 1.0
PORCH TYPE: ~CLOSED
BREEZEWAY:
DOMESTIC EOTWATER: YES
TYPE EEAT: OIL WARM AIR:
OTHER:
# STORIES:
CELLAR: PART
2ND FLR.: ~
TOILET ROOM(S):
DECK TYPE:
FIREPLACE: 1
TYpE HEATER: ~
HOTWATER:
1.0 # EXITS:
CRAWL SPACE:
3RD FLR.: __0
UTILITY ROOM(S): --
PATIO TYPE: CEMENT BLOCK & BRICK
GARAGE:
AIRCONDITIONING:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.:
SWI~4ING POOL:
OTHER:
STORAGE, TYPE CONST.:
GUEST, TYPE CONST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION I ART.
SEC.
REMARKS: BP#5568-Z ADDITION CO~Z-5224,
,
GARY J. F
DATE ON INSPECTION: 02/17/00
TIME START: 9:40 AM END: 10:15 AM
TO~E~i' OF SOUTHOLD
TOWN HALL
765-1802
FOR CEI~TIFICATE OF OCCUPANCY
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 i% 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 c6mpleted site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
Upre-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 applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
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-existinR Buildinm - $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
New Construction ........... Old Or Pre-existing Building .... ~ ...........
Location of Property .... ...........................
House No. Street Hmmlet
Onwer or Owners of Property...~g~g~.Pf.~P~g~D. Ir~u~m~p .....................................
Countw Tax Map No iOOO, Section.gzP:gP9 ...... Bloek..P :PP ......... Lot..9}}:999 .............
Subdivision .................................... Filed Map ............ Lot ......................
Permit No ................ Date Of Permit ................ Applicant .............................
Health Dept. Approval ......................... iUnderwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee S~bmitted: $.%qq qq ......................
~C ~OS~ '''~'~'~:ICANT u it Carrick, Executrix
CONSENT
TO
INSPECTION
Estate of Estelle Trautmap
· 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 ].070 Smith Drive North
· which is shown and designated on the Suffolk
County tax map as District 1000, Section 76 , Block 2 , Lot 11
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: ~
Pre-existing C.O. for a one family dwelling
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.
(print name)
(signature)
(print name)
Executrix