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Home My WebLink AboutZ-32422 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- 32422 Date: 06/21/07 THIS CERTIFIES that the building DWELLING Location of Property 2030 MILL RD PECONIC (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 067 Block 0007 Lot 010 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- 32422 dated DUNE 21, 2007 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* The certificate is issued to KURT R YOUNGBERG (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. Au orized Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 2030 MILL RD PECONIC SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S) : KURT R YOUNGBERG OCCUPANCY: SINGLE FAMILY DWELLING (SEASONAL KURT R YOUNGBERG ADMITTED BY: KURT R. YOUNGBERG ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO_ TAX MAP NO.: 67.-7-10 SOURCE OF REQUEST: KURT YOUNGBERG 6/18/07 DATE: 06/21 07 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.5 # EXITS: 2 FOUNDATION: CEMENT BLOCK PIERS CELLAR: -- CRAWL SPACE: -- TOTAL ROOMS: 1ST FLR.: 4 2ND FLR.: 0 3RD FIR.: 0 BATHROOM(S) : 1.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S) : PORCH TYPE: SCREENED DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: YES-ONE GARAGE: DOMESTIC HOTWATER: XX TYPE HEATER: AIRCONDITIONING: TYPE BEAT: NONE WARM AIR: HOTWATER: XX OTHER: HOT WATER HEATER (NOTE: LOFT ON 2ND FLOOR) 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 I ART. I SEC. REMARKS: INSPECTED BY: DATE ON INSPECTION: 06/20 07 GEORGE GILLEN TIME START: END: Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL765-1802 oluq -. 695-5 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 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00 Date._ 06 )IF A-7 New Construction: Old or Pre-existing Building: (check one) Location of Property: Z o3 p on; �� 1�� ?0 )c by l 7p e Co i c 7 1 House No. Street IHamlet Owner or Owners of Property: '+" V p b if Suffolk County Tax Map No 1000, Section (p _7 Block �7 Lot / V 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: $ l 0 Lf Applicant S' ature �,� �0 qa'2, ' ......................_-_- TOWN OF SOUTHOLD PROPERTY - RECORD CARD __TTREET A LOT cc IL Al�, ACREAGE Aw TYPE(OF BUILDING Ln RES. SEAS. LAND IMP. TOTAL DATE REMARKS ED Ln cn; AGE BUILDING CONDITION cn NEW NOR' MAL BELOW ABOVE Acre Value Form Acre Value Per Tillable I Tillable 2 Tillable, 3 Wcodiand -" . ' Swampland � o Brushland � House Plot c '------ � z / "� __________ ________________ CD ... ..........................:...:. Cu CL Cu ..f :. W CE a_ CD Ln MEMOIR" 0i 1 ? �;_S if — _ 1 a7 Ex M. Bldg. F t �� Foundation `"`ru"�� • o 7�-' .7� f ? Bath 1 r, to m extension ;t�-� l,� �,.� ,' t Bmen aset ` Floors f in CL xtension i i Ext. Walls .c•� Interior Finish Wo extension , Fire Place -` ; % Heat H (�,y Porch , - Attic D —- .�# --_-- -- --- Porch Rooms 1st Floor - -- _ 3reezewa Y Patio i Rooms•2nd Floor',�.. cv garage Driveway {_ _' ____ _ __ _ i; f 0 p p N • Ql lD CONSENT TO INSPECTION the undersigned, do(es)� ( )hereby state: Owner(s)N e(s) That the undersigned (is) (are) the owne s) of the remises in the Town of Southold, located at p , ecolvi c .J`f I 5-5 , which is sh wn and designated on the Suffolk County Tax Map as District 1000, Section , Block ' Lot _. That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: r b 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: 0� J ALA (Signa re) o ri �e (Print Name) (Signature) (Print Name) � Sl,QjO IV y MAP of �N� . • SURVEYED FAR T AE L. G LASsmi : m S AT PE o T4t�v�, .50 OFUTWoiv fru►« t o. 111 If Pow#�- N �7p3�•w 40 YOH LL OA0 Nato : Lot tiu�r.�r� � �� ; � Gu«vu.�#s•�d icy �- h� �-'. _ t tcd i► H� o�k� # Q� ACrf , ' :Otto W.~ Q� Wurvo. w. Awl !�mq P 9 LOCATION: �?-0 3 o /Ildt 4k O a ' (number& street) (municipality) SUBDIVISION: MAP NO.: LOT(S): NAME OF OWNER(S): OCCUPANCY: (type) (owner-tenant) ADMITTED BY: ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000- 67- -7-10 SOURCE OF REQUEST: DATE: DWELLING: �� TYPE OF CONSTRUCTION # STORIES: # EXITS: FOUNDATION: • CELLAR: CRAWL SPACE: TOTAL ROOMS: 1ST FLR: 2ND FLR: ITT' 3RD FLR: BATHROOM(S): TOILET ROOM(S): UTILITY ROOM: PORCH TYPE: SCk0ef/lE DECK, TYPE: PATIO, TYPE: BREEZEWAY: FIREPLACE: -� GARAGE: DOMESTIC HOTWATER: TYPE HEATER: AIRCONDITIONING: TYPE HEAT: AtO NgC- WARM AIR: HOTWATER: OTHER: . ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST: OTHER: VIOLATIONS: CHAPTER 144 &N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: r INSPECTED BY: � DATE OF INSPECTION: A' / TIME START: END: 1