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HomeMy WebLinkAboutZ-30857 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 30857 Date: 04/15 05 THIS CERTIFIES that the building DWELLING Location of Property 280 PINE TREE RD COTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 138 Block 0002 Lot 001_ 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- 30857 dated APRIL 15, 2005 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 ACCESSORY 1OX10 METAL STORAGE SHED* The certificate is issued to GEORGE LESSARD JR. (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. //utho ized gnature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 280 PINE TREE RD CUTCHOGUE SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S) : GEORGE LESSARD JR. OCCUPANCY: RESIDENTIAL GEORGE LESSARD JR. ADMITTED BY: GEORGE LESSARD JR. ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 138.-2-1 SOURCE OF REQUEST: GEORGE LESSARD, JR. 4/7/05 DATE: 04 15 O5 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 2 FOUNDATION: CEMENT BLOCK CELLAR: 3 4 CRAWL SPACE: 1 4 TOTAL ROOMS: 1ST FLR.: 3 2ND FLR.: 0 3RD FLR.: 0 BATHROOM(S) : 1.0 TOILET ROOM(S) : 0.0 UTILITY ROOM(S) : PORCH TYPE: SCREENED PORCH DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: YES TYPE HEATER: L.P. AIRCONDITIONING: TYPE HEAT: OIL WARM AIR: FLOOR HEAT HOTWATER: OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.: 1OX10 METAL SHED 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: r.' INSPECTED BY: DATE ON INSPECTION: 04 14 OS GARY J. /IS TIME START: 9:4.0 AM END: 10:10 AM Form No.6 nn TOWN OF SOUTHOLD ` t BUILDING DEPARTMENT ��i i B 2��5 TOWN HALL _ J 765-1802 oLDc DE Pr, _- ' ----JQV1Lj `fir c 7H nL`'`__L 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: l. 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. B. 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 natural or topographic features. 2. A properly completed application and 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- $100.00 3. Copy of Certificate of Occupancy -$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00 Date. �J0 New Construction: Old or Pre-existing Building: V / (check one) Location of Property: 0 jA e,-T)-Tr- R OCLCY CltYC 7O Q House No. Street ee _ H t Owner or Owners of Property: se0 ri C- f- SQ./'G(. J Suffolk County Tax Map No 1000, Section /c3 ,9. 00 Block 0 Lot 00/,, 000 Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: �_ (check one) Fee Submitted: $ 100 . 00 Ap6e6t Si e Q�,c.• C��9 86 aVI.I r ■E■■■■ ■MEM■■■MEM■MM■E■■ ■■■■■■■■■■■■■■■■■■■ Ems., 7 •t$'c ti= ■■■■■N!!Lw MEN MEMO � MEME■ 92W M■■EN �� r: ■EOM■■Lii®i■■■OE �s7 '.. � l ' ` ■■EE■EEOEM■OEM■■■ME - __ _ - _ o-�..., y r=- � - - — �_ ■M■E■M■■■MBE■■■ Fire Place . . . . - - ,eW r: ■■OEM■■NNM■E■■■NME ' _ - MEMO■■N■E�MM■■MM■E •• IKOOMS I st .. o 00 0 - r.�0 - -� TOWN OF SOUTHOLD OPERTY RECORD CARD Al-10 OWNER STREET 2 VILLAGE DISTRICT SUB. LOT dHf Qf /d it/2f J FORM- Ete OWNER N 1, E , ACREAGE CL An45 S - W._ TYPE OF BUILDING RES. SEAS. VL. FARM COMM. I IND. I CB. I MIk. I Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS 3 Q 6, 1306 16 6 Q 6 /A 1&4 l0 5 S- 9/a AGE BUILDING CONDITION NEW NORMAL . BELOW ABOVE FRONTAGE ON WATER Farm Acre Value Per-Acre Value FRONTAGE ON ROAD Tillable' 1 BULKHEAD �� Tillable 2 DQGK 1 /Q Tillable, .3 Woodland Swampland Brushland House Plot Total • N N OAD 86• 58 40„ E E E R 6.07, oE .108. PE Iu nE_ 250.0' 3� 50 w N • w W Cr1 63 cM N o 0 A�yAc A CONC. q wA1 K 26.5 O 20.7 �p BILKOCL O 0, DOOR O U .5" c X1 X1.4' Q CHIMNEY" N CHIMNEY �+`V 2.0 v aZ 0. , N/F Kj 1 S ro y 16.3 R �N N RES. £NccoS&7 ✓ORDAN P�CH cA.i 17,7. 10' av J� ?_RML • SCE N AI'IPL£ REMNENC£or SIt71C1YADE F£NC,- (� ov S 86' 58' 40" *R F£Nc£c£NCY ON uNE . FO D cM v - -- - — 180 89 Y'F EN N 2.4' 59 So 40- N/F 9.90'' ;9 S 86; 58, 4p CABRAz I4.33 W GUARANTEE'S/NDfCAIED HERE ON.SHALL RUN ONLY TO THE PERSON FOR NHCM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY" GOVERNMENTAL AGENCY, LENDING/NSflTUTION. IF LISTED HEREON. AND TO THE ASSIGNEES Or THE LENDING INSTITUTION. GUARANIES ARE NOT TRANSFERABLE TO ADOIAONAL INSITTUnONS OR SUBSEQUENT ONHERS UNAUTHO ZED ALTERATION OR ADDITION 70 THIS SURVEY IS A VIOLA AON OF SECTION 7209 OF THE NEW YOQK STATE EDUCATION LAW. SURVEY OF COPIES OF THIS SURVEY MAP NOT,BEAR/NG P/O L 0 T 124 THE LAND SURVEYORS EMBOSSED SEAL SHALL IN s NOT BE CONSIDERED TO BE A VAUD TRUE COPY. MAP OF NASSAU FARMS SURVEYED 17 APRIL, 2000 SITUATE SCALE 1"=40' AREA= 22,799.68 SF CU TCHOGUE (PECONI C), 0.523R ACRES TOWN OF SOCU THOLD SUFFOLK COUNTY, N. Y TM 1.000-I38-02-01 SURVEYED FOR GEORGE LESSARD, JR. FM / 1179 FILED MAR. 28, 1935 SURVEYED BY , SSTANJFY .fir 'S,4KKS- I�f,'::)R. P.O. LQ �94 _ 6 - Fr�B# °N 56 Y: 1 GUARANTEED TO GEORGE LESSARD, JR. NY LIES: NC).;:'!; '17 .�` ��' OR899 CONSENT TO INSPECTION Geocq< Les sir Jr�'. , the undersigned, do(es) hereby state: Owner(s) Name(s) That the undersigned (is) ( the owner 4 of the��emises in th�To n of Southold,located at U0 �i�e / reC Za.Cl 017 L.c_ which is shown and designated on the Suffolk County Tax Map as District 1000, Section /3,Y,00, Block 'Oa.00 , Lot 00/. 000 . That the undersigned (has) (ham filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: ✓e - ��k1'_07 Cr !r-t ei/�l i, ca,{G o4 OCcc� artc 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 in subsequent prosecutions for violations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: 7 OS ( iePro.Zeossiz .,-Cl (?ep/zrC, (Print Name) (Signature) (Print Name) LOCATION: .Zdv t t4 (number & street) (municipali SUBDIVISION: MAP NO.: LOT(S): NAME OF OWNER(S): OCCUPANCY: (type) (owner-tenant) ADMITTED BY: 6- 64-fs� ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000- SOURCE OF REQUES DATE: DWELLING: TYPE OF CONSTRUCTION: k # STORIES: EXITS: FOUNDATION: Llc_ CELLAR: CRAWL SPACE: TOTAL ROOMS: 1ST FLR: 2ND FLR: 3RD FLR: BATHROOM(S): pnCL TOILET ROOM(S): UTILITY ROOM:- PORCH TYPE: DECK, TYPE: PATIO, TYPE: BREEZEWAY: FIREPLACE: 15K — GARAGE: DOMESTIC HOTWATER: r'1kYPE HEATER: AIRCONDITIONING: TYPE HEAT: WARM AIR: �kj4gg2<_HOTWATER: OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST.: STORAGE, TYPE CONST.: /o,r/a SWIMMING POOL: GUEST, TYPE CONST: OTHER: VIOLATIONS: CHAPTER 45 &N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE OCATION DESCRIPTION ART. SEC. REMARKS: INSPECTED BY: DATE OF INSPECTION: ���6z© TIME START: / END: �©��