HomeMy WebLinkAboutZ-30982 FORM NO. 4
TOWN OF SOUTHOL_D
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-30982 Date JUNE 15, 2005
THIS CERTIFIES that the building SEASONAL DWELLING
Location of Property 95 NAVY STREET ORIENT
House No. Street Hamlet
County Tax Map No. 1000 Section 26 Block 1 Lot 12.2
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a Seasonal Dwelling built
Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-30982 dated JUNE 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 SEASONAL ONE FAMILY DWELLING & 2 ACCESSORY STORAGE BUILDINGS*
The certificate is issued to JERILYN B. & JOHN H. WOODHOUSE
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
r
�-1
B i din Inspe or
Rev. 1/81
LOCATION: 95 NAVY STREET OR11W.
(number&street) (municipality)
SUBDIVISION: MAP NO.: LOT(S):
NAME OF OWNER(S): JERILYN B- & : MN H. L�
OCCUPANCY: SF.A9nNaT. OW FA Y I7k�f LM
(type) (owner-tenant)
ADMITTED BY: ACCOMPANIED BY:
KEY AVAILABLE: SUFF.CO.TAX MAP NO.loon- 26-1-12.2
SOURCE OF REQUEST:JERHYN B. WOOfflWSE DATE: May 4, 2
DWELLING:
TYPE OF CONSTRUCTION: WOW FRW #STORIES: 2 #EXITS: 3
FOUNDATION: S ME & POSTS CELLAR: CRAWL SPACE:
TOTAL ROOMS: 1ST FLR: 4 2ND FLR: 2 3RD FLR:
BATHROOM(S): ' CHE TOILET ROOM(S): UTILITY ROOM:
PORCH TYPE: DECK,TYPE: PATIO,TYPE:
BREEZEWAY: FIREPLACE: GARAGE:
DOMESTIC HOTWATER: YES TYPE HEATEMEYSPAN CAS AIRCONDITIONING:
TYPE HEAT: NOW WARM AIR: HOTWATER:
OTHER: *WATER TA OFF KTfCHE
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST.: STORAGE,TYPE CONST.: 2
SWIMMING OQO8i x GUEST,TYPE CONST:
OTHER:
VIOLATIONS: CHAPTER 45&N.Y. STATE UNIFORM FIRE PREVENTION&BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
REMARKS: 1013755-Z-DOZ-23538 (ADD&ALT) BV131196Z--COZ30981 (FU)CR REPS)
INSPECTED BY: - DATE OF INSPECTION: May 12, 2005
Gary J F'
TIME START: 10:30 M END: l l:OD AM
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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.
CB. or 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. Aar
ell
New Construction: Old or Pre-existing Building: 'y (check one)
Location of Propert S� /t/ cj
House No. Street Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section / D Block to Lot / Z, 'Z.
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: $
plicant Signature
33
-?- '?09(a
CONSENT TO INSPECTION
the undersigned, do(es) hereby state:
Owner(s)Name(s)
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 as District 1000,
Section boo , Block 06- , Lot / Z• Z .
That the undersigned (has) (have) filed, or cause to be filed, an a plication in the
Sout.old Town Building Inspector's Office for the following: C' y
P�lGc� mid
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: SJ �GN
(Signature)
(Print Name)
(Signature)
(Print Name).
LOP
AV
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION iST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
DATE � II-of INSPECTOR J�
LAWRENCE M. TUTHILL
Vr' PROFESSIONAL ENGINEER
`f
I ; 3� P.O. BOX162
GREENPORT, N.Y 11944
• 1
(631) 4777652
.-A
6511. DEPT.
T0Vt! QF
June 9, 2005
Mr. Michael J. Verity, Department Head
Southold Town Building Department
Main Road
Southold, NY 11971
Re: Residence John Woodhouse
Navy Street
Orient, NY
To Whom It May Concern:
I have inspected the above mentioned residence as
to the floors in the kitchen and the living room
being spongy and found that the deficiency has
been corrected by the installation a 6"x6" timber
girder along side of the existing 4"x6" girder
as shown on the attached plan.
Sincerely,
Lawrence M. Tuthill, P.E.
032264-t
N. `.,.
SLTBDIVISION
N
ORCHARD STREET
JOHN H. WOODHOUSE E. WOODHOUSE w E *1
� elli aw �
_ AT ORTNT, _ ng
S LP
TOWN OF SOUTHOLD
WILLOW 5T
d,��lling SITE
MAR 2 21��5 SLIFFOLK COUNTY, NEW YORK
f NAVY STREET
OLD FARM ROAD
-T
SUF FOLK COUNTY TAX MAF NUMBS iR EET
1000-26-1-12 -
NOTE: THIS PROPERTY'IS LOCATED el �I
IN THE ORIENT HISTORIC DISTRICT treetT
Willow
JOHN WOODHOUSE
d JERI LYN WOODHOUSE \�o .42 L 8' O W n g
° e � LOCATION MAP
118
P.O. BOX 360 x
x =
ORIENT, NEW YORK _ - 2oi w� Q
n SGALE I" = 600'
n - - el. 8' 65P 5
SUFFOLK COUNTY HEALTH DEPT. 0;;5 el_ j 4 x
REF. # 5I0-02-0014 o � Land now or formerly of:
N O O O Nil horn H. Oessel l a
��\\\� O N 0 ° � �� Joann T.
d N8Q 56 00 E Oesse I I
VAO� w or for'�1erly of . 4 z 54.53'
Lon 5Cof fold, Jr v�
I�
reder.lc G O_ 9
s -a ° o.2'Nob
025
SURVEYED Oq-22-q8 D
rev. 06-05-02, 01-02-02, N
II-04-02, 04-08-03, 01-22-04,
02-18-04, 07-20-04,12-02-04 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
12-16-04, 03-01-05 0 I Hauppauge,New York MAIR 2 5 =5i
O 1�
° OT 2
125-qb� el. -1I I� 0104 5F 13.3' �-
32'I O II This iS TEST HOLE DETAIL
N83 ^' 4
{ence N � cer�fy that the proposed Realty Subdivision or Development
for o_edF OV�S G. In the 6/13/2002
of
S Q a a with a total of lots was 3:30 P.M.
_ corner o 4 - �— (McDonald Geoscience)
— -_ LP. � 6' 34.3' _ v approved on the above date.Water Supplies and Sewage Disposal
e I - 8' DIP, o - - -- - 0 Q � Facilities must conform to construction standards in effect at the time of el.T Dark
O 4' DEEP C0 construction and are subject to separate permits pursuant to those &I a
{or
�' � 4 standards. This approval shall be valid only if the realty �m
4 s T s subdivisic n/development map is duly filed with the County Clerk within 5'
O
Q fl N
one year of this date.Consent is hereby given for the filing of this map l3ro. w
on which this endorsement appears in the Office of the County Clerk in s K
// 222,250 p+ accordanc with provisions of the Public Health Law and the Suffolk
_ .L- O Frarene 9 22 6' 0 O Coun an WC e. 22 -
warrrz
d� l�E!<� i \ 4.3 N Garoag' s I fl VTTO A.MINEI P.E.
THIS I5 TO GERTIFY, BASED UPON AN EVALUATION AND VISUAL INSPEGTION OF A 10.4 WELL voter
THE SEWAGE DISPOSAL SYSTEM(S) AND WATER SUPPLY SERVIMO THE EXISTING �A,
QCf E }"G'9_ \ O 9 p 24.5' _ Director,Division of Environmental Quality &fin
BUILDIN6(5), THAT THEY APPEAR TO BE FUNCTIONING PROPERLIY AND TO - a�,AG ? _M 5.0' - ��
ADEQUATE TO SERVE THE EXISTING USE OF THE BUI DIN&(S). r
03, U1 O 5!1'S ECT TO COVENANTS& RESTRICTION'S Lis ER 1 �
.rv11$7 � r- a�..} \ � N PAGE &awn
-- ---- -------------
LAWRENGE M. TUTHILL NY5 P.E. LIG. # 32254 (1 (�
03225+t 1 g,� O WELL 0.0' v \J I' sN
°'Off t w % 24 O' O sand
QFE:jS10 � \ 7AO trellis,
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Story - P.
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\ fIG es - - 8'
Frame {amsy �.3' 5T DTP OI 16.5' 9I4.6' J GAL. 4' DEE t r
Q le il ) �x;, y
"I HEREBY CERTIFY THAT THIS MAP WAS MADE BY U5 FROM ACTUAL SURVEYS N (y'�9 5' DEEP 2 StOroUSe °4OPTIG
COMPLETED SEPT. 22, 1498 d THAT ALL GONGRETE MONUMENTS i SHOWN THUS: ® \ O O
O
HEREON ACTUALLY EXIST AND THEIR P051TIONS CORREGTLY SIHOWN AND frame 11 ) TANK • '�
ALL DIMENSIONAL AND GEODETIG DETAILS ARE CORREGT. 20.2 �51ng1e 51
\ 24.3' LP A5 PER C 28 8' _
O �NvIN ER LO' 6 O
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58
JOHN C. E 5 N.Y.P L.S. LIG # 50202 k; -+ \ 6' I n 0�
�( GOn G.
Navy
NOTES:
0 l
- e 1. 11245 # F1
rw
TOTAL AREA = 42,154 5F OR O.q-1 ACRES \ \ �/ � r
REFERENCE DEED: L. 11725 P. 54-7 d I Ing 15444 # AB I of IMUED.
APR 1 9 2M5
ADJACENT SEPTIC LOCATIONS /
dwe I I ing �a�N.,�.
PROVIDED BY OTHERS FILED DPP 192005EDWARD .\ 1 ROMAIhI�a
C��3K OF SUFFOLK GOUi'JfiY
ZONE 015TRIGT R-40
A DECLARATION OF COVENANTS AND RESTRICTIONS \
HAS BEEN FILED IN THE OFFICE OF THE CLERK OF !SUFFOLK
COUNTY IN LIBER 12371 PAGE 684.
'u,otrorllea alLerotlon or—,Uoh to a 5rvey
map-nkq a bce——5aveyors eetll n o
\1 \ \ o -tg of 58ctlon 120.5W-tlNlsfon 2,of the
\ \ vl New York State Etivcatlon Lev.'
"only copses from the\ oognol of thte Survey
arkea r�,tn an alglnol of the Iona 5urveyo,b GRAPHIC SCALE 1"= 30' S°am�aSeal-11bs , -to- true
0 that
thl6
'cerml�atlon5—d I'h tl Hereon 5g,ny mat--
\ \ Survey.vas f P—t tl in acco d 5 wile o t -
Sting Gotle of 5t tica for Lantl ref Pr a 11-1
by the H=ti York State A55oclatlon of Profe551onol
Lmtl.p—on
or is ce th is at lore,Shall p only
!� to the per5ol tar nncm the wrvey b prepareh-
0 3 0 6 0 9 0 tl t an nl5 Henan da tale eampany governmen-
tal agency ma lena"a lnstllution 115tea Hereon.a,a
t0 the as5lgnee5 of the 18ntl,ng Iretltutlon.G-talca-
tlors or.nCt tr—fercble to adalt.onol I tit,tian5
MONUMENT FOUND
PIPE FOUND \
TFH15 15 TO CERTIFY THAT THIS SUBDIVISION PLAT HAS BEEN APPROVED BY THE PLANNING \
—xxx- WIRE FENCE
BOARD OF THE TOWN OF 50UTHOLD BY RESOLUTION ___________________________ JOHN C.
I '
—000- WOOD FENCE DATED ----------------- BY ------------------------------------ \
= HEDGE CHAIRMAN'S SIGNITURE d,v�//�� 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202
C/
EXISTING WELL
RIVERHEAD, N.Y. 11901
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