Loading...
HomeMy WebLinkAboutZ-30971 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- 30971 Date: 06/09/05 THIS CERTIFIES that the building DWELLING Location of Property 2750 PINE NECK RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County;Tax Map No. 473889 Section 070 Block 0010 Lot 003 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- 30971 dated DUNE 9, 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 CEMENT PATIO.* The certificate is issued to HELEN MACNISH (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. r Authorized Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT. LOCATION: 2750 PINE NECK RD SOUTHOLD SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S) : HELEN MACNISH OCCUPANCY: SINGLE FAMILY HELEN MACNISH ADMITTED BY: CECILIA LOUCKA ACCOMPANIED BY: BRUCE LOUCKA KEY AVAILABLE: SUFF_ CO. TAX MAP NO.: 70.-10-3 SOURCE OF REQUEST: ELIZABETH NEVILLE DATE: 06109105 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 3 FOUNDATION: CEMENT BLOCK CELLAR: PART CRAWL SPACE: PART TOTAL ROOMS: 1ST FLR.: 6 2ND FLR.: 0 3RD FLR.: 0 BATHROOM(S) : 2.0 TOILET ROOM(S) : 0.0 UTILITY ROOM(S) : PORCH TYPE: DECK TYPE: PATIO TYPE: CEMENT BREEZEWAY: FIREPLACE: 1 GARAGE: DOMESTIC HOTWATER: YES TYPE HEATER: AIRCONDITIONING: TYPE HEAT: OIL HOT WA WARM AIR: HOTWATER. YES OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: RE-INSPECTED 6/e/05 BP4355 Add COZ5546 ; BP5552 AccyBldg COZ5547 ; . BP21970 Alter COZ22923 ; BP31168 Add to Accy COZ30970 INSPECTED BY: DATE ON INSPECTION: 06/01 05 GEORGE GILLEN TIME START: 10:20AM END: 10:50AM L5_ Form No.6 I I TOWN OF SOUTHOLD l MAY MM i � BUILDING DEPARTMENT L TOWN HALL 765-1802 0 17Ci. CEP?. SCJUTI!0i_D 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. 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 Y 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial$15.00 Date. New Construction: Old or Pre-existing Building: n(check one) Location of Property: 715 House No. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section `�� Block /6 Lot 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: $ ° o �p D 1 pplicant Signa4de 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 70 Block /D , Lot A That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Buildin Inspector's Office forl the following: 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. Theuundersigned, 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: As -T C44( nature) (Print Name) (Signature) (Print Name) i I - 71. 7 t i I e I --I I z I A. Bldg. 3 X r ! oundation Bath .xtension asement p Floors S � � .xtension Ext. Walls. Interior FinishArk :xtension Fire Place Heat Porch Roof Type Porch Rooms 1 st Floor 3reezeway Patio Rooms 2nd Floor ;arage ® Driveway Dormer ). B. d o L S :S'U Q �o TO OF soUTHOLDk,0PE_"_TY 7ECO-M C*47D OWNER STREET J�"D VILLAGE DISTRICT SUB. LOT { FORMER O ER N t E ACREAGE. S W ..: TYPE OF I LDI NG 9s:ES. SEAS. VL. F RM CO I IND. I B. I MISC. I Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS 6 r co --46 J� (a r AGE BUILDING CONDITION ' NEW -NORMAL BELOW ABOVE FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD 1 2 -illable 1 BULKHEAD "illable. 2 DOCK "illable, 3 � ' $tJi f f3 c� • hair 97AIV,�az) GCS Voodlond 'wompland . ;rushland louse Plot 'otal ! r c c ni?�r Mion er d:rt�on j ' ^Z 010, a!the"s•rr Vor �l :S ` J' �}( !"7 0 r�. ci th!n stsnrsY MIT not ea{d b9 rf :i _ t 1d surveyors initad sam_• i :j all not be cansidsrssf A'. 8 ` 3 7'!D."F weed sell sh w be,a valid true COPY, ! ,:,sranteea Indicated hereon shalt rv11 O 6 r j ::rty to tha Parson for whom the sur-mt � a end on his behalf to tha is prepared.e f cvemmontal a;Qr y and h- car,-,spy.A institution listed harccn and .. " t: ;ha csrignaas of the loncia,i I of irn.Gucrar,eas are not transfa Uenf I to Lam:ittO^el institutions Or subs9a FAST,goys ` 71 r r ; .S a R 1 11 UR Ci (1r1 'I ? /f ' r' Imo} �c1-VAJV .o t' ,4 °�C S 256�� i. •I TL C �1 TV G,lnr:.r• ., .r :1. .l ' Y i „" � ; , J h /• 4, LOCATION: `�7 �`° P `'y'� IAfp 7- i Ak (number& street) (municipality) SUBDIVISION: MAP NO.: LOT(S): NAME OF OWNER(S): a c Af L� i _ OCCUPANCY: ©N E � 0 vv-%' L (type) (owner-tenant) ADMITTED BY: {, ACCOMPANIED BY: P'``.ce d��`� KEY AVAILABLE: t L N SUFF. O. TAX MAP NO. 1000- 7-0 - /o -3 SOURCE OF REQUEST: A � DATE: DWELLING: _ TYPE OF CONSTRUCTION: l�D°� �RL # STORIES: #EXITS: FOUNDATION: ,. CELLAR: P8g7-, CRAWL SPACE: 4%7 TOTAL ROOMS: 1ST FLR: 2ND FLR s - 3RD FLR: BATHROOM(S): oil TOILET ROOM(S): UTILITY ROOM: PORCH TYPE: DECK, TYPE: — PATIO, TYPE: C161g-EW 7- BREEZEWAY: — FIREPLACE: GARAGE: DOMESTIC HOTWATER: _ TYPE HEATER: AIRCONDITIONING: TYPE HEAT: 0 L oT _WARM AIR: HOTWATER: y�S OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: STORAGE,TYPE CONST.: i SWIMMING POOL: GUEST, TYPE CONST: OTHER: VIOLATIONS: CHAPTER 45 &N.Y. STATE UNIFORM FIRE PREVENTION &BUILDING CODE LOCATION DESCRIPTION ART. SEC. of � O c 06 og oS , REMARKS: INSPECTED BY: '` DATE OF INSPECTION: TIME START: / END: , �°