HomeMy WebLinkAboutZ-26467 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- 26467 Date: 05/20/99
THIS CERTIFIES that the building DWELLING & ACCESSORY
Location of Property 2022 HYATT RD SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 050 Block 0001 Lot 021
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- 26467 dated MAY 20, 1999
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 GARAGE.
The certificate is issued to JEANNE C LOWELL
(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.
B ilding Inspector
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 2022 HYATT RD SOUTHOLD
SUBDIVISION: MAP NO.: LOT (S)
NAME OF OWNER (S) : JEANNE C LOWELL
OCCUPANCY: SINGLE FAMILY JEANNE C LOWELL
ADMITTED BY: RONALD LOWELL ACCOMPANIED BY: SAME
KEY AVAILABLE: SUFF. CO. TAX MAP NO. : 50 -1-2
SOURCE OF REQUEST: JEANNE LOWELL DATE: 05/20/99
DWELLING:
TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 2.0 # EXITS: 6
FOUNDATION: CEMENT BLOCK CELLAR: FULL CRAWL SPACE:
TOTAL ROOMS: 1ST FLR.: -A 2ND FLR. : -1 3RD FLR.: 0
BATHROOM(S) : 3.0 TOILET ROOM(S) : 0.0 UTILITY ROOM(S) : BSEMNT
PORCH TYPE: DECK TYPE: WOOD DECK PATIO TYPE: BRICK
BREEZEWAY: FIREPLACE: 1 GARAGE:
DOMESTIC HOTWATER: YES TYPE HEATER: OFF BOILER AIRCONDITIONING:
TYPE HEAT: OIL WARM AIR: HOTWATER: X
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. : WOOD FRAME STORAGE, TYPE CONST. :
SWIMMING POOL: GUEST, TYPE CONST.:
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART ' SEC.
:
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REMARKS: BP#8675 DECK CO#Z 7121 BP#17848 ADDITIONS CO#Z-18951 BP#18745 ADDITION & ALTERATION CO#Z-19081
INSPECTED BY: "- / DATE ON INSPECTION: 05/20/99
GARY J FIS TIME START: 9:40 AM END: 10:12
0 TOWN OF SOUTHOLD
D BUILDING DEPARTMENT
TOWN HALL
MAY 3 !999 �L� � 765-1802
BLDG.DEPT. APPLICATION FOR"CERTIFICATE'OF OCCUPANCY
TOWN OF SOUTHOLD
A. Thi's application must be filled in by typewriter OR ink and submitted to the buildir
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 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildi
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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings a
'-'pre-existing"1an--d uses:
1. Accurate survey of property showing._all property lines, streets, building and
unusual natural or to ographic fe_atures_.
2. properly -completed_.application and a consent to inspect signed by the applican
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
r
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,
dditions to accessory building $25.00. Businesses $50.00.
C.
2 Certificate `of Occupancy on Pre-existing Buildine - $100.00
Copy of Certificate of Occupancy - .25C.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . S�/. (• . . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . . Z Old Or Pre-existing Building. . . . . . . . . . . . . .
Location of Property. . ... ... . . . . . . .. .. . ..� �? �//G.. . . . . . . . . . . . . . . . .
House No. Stre/et, Hamlet
Onwer or Owners of Property.. P- / .. . . . . .. . . . . .
7
County Tax Map No 1000, Section. . . . . . 45 .� . ..Block. . . .. (.. . . . . . . . .Lot. . .2�. . . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . .
PermitNo. . . . . . . . . . . . . . . .Date Of Permit. . .. . . .. . . . . . . . .Applicant. . . . . . . . . . . . . . . . . ... . . . . . . .
Health Dept. Approval. . . . . . . .. .. . . . . . . . . . . . .. . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . .. . . . . ... . . . .. .. . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . :�. . . .
00
Fee Submitted: $. . . /. . . . . . . . . . .. . . . . . . . . .
(aj�0 ��' o�b'1'�� Jeanne e• �o�e�-Q . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
APPLICANT
CONSENT
TO
INSPECTION
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 2_02Z E?
which is shown and designated on the Suffolk
County tax map as District 1000, Section S�y Block _�, Lot 2
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:
s
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, `krules
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.
Dated: s11-31 _
(signature)
(print name)
(signature)
(print name)
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Unau+horizedat's-rz areddition
M,BU f2N5 S cti
ti on 208 e of the Maw York State
2 ,C VV r� / Education Law.
O Copies of this survey map not bearingth
����
�� Q� j / embossed se shill not be westdered
to be a valid OW Copyt
Guarantees indceted hereon shall run <,
\� M.BURNS _-- / only to the person fors eh the survey
is PrePered.and On his behalf to the o
title company,governmental agency and ��o Np LS2IW6
lending Institution listed hereon and S J
V1 to the assignees of the lending Instl- FD LAND 5 N
tution.Guarantees nrs not transferable
N NO R to additional ins huuans or subsequent
O CSC I owners.
W
WlTHEPSPOON "p j
G15SON GUARA�tTEED TO THE TE i NY
LE GUARANTEE COMPA
PS SU IZV EY EU JAN5,1972
OFFENHEISER ` 2W t
HORTION LAN E c
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UCEN5ED LNND.-5URVEY0.R5
/ vR.EENPC�;ZT�MY.
N L OC&TI ON _ MAC'
SCAL:E710 J'-i"
DEC.i4r19 ,..
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: p7{]y
number j9 street municipality
SUBDIVISION " MAP NO. LOT (s)
NAME OF OWNER (s)
OCCUPANCY
(type)—
ype owner—tenant b '
ADMITTED BY:- AL�A(.0 ��/ / ACCOMPANIED
KEY AVAILABLE SUFF. CO. TAX MAP NO.
SOURCE OF REQUEST: DATE:
DWELLING:
TYPE OF CONSTRUCTION G10doke STORIES # EXITS
FOUNDATION ��, L,,,/; � CELLAR CRAWL SPACE
TOTAL ROOMS: 1ST FI.R. 2ND FLR. 3RD FLR.
BATHROOM (s) TOILET ROOM (s) UTILITY ROOM lam/
PORCH TYPE DECK, TYPE Cp� / PATIO, TYPE ,2lG/C
BREEZEWAY — FIREPLACE GARAGE
DOMESTIC HOTWATER TYPE HEATER 65e�� L� AIRCONDITIONING
TYPE HEAT WARM AIR HOTWATER G�
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: / rf 'f_l.J S
INSPECTED BY: . DATE ON INSPECTION
TIME START r Q r/oL
/a.o= _3-6 _- _ z/ T0" 1 OF SOUTHOLD P-7OPE"TY "ECORD QotRD
OWNER STREET ;`�-" � VILLAGE DISTRICT SUB. LOTJv
FORMER__OWNER/ N E ACREAI�k _
a S iv
II W, TYPE OF BUILDING
DE*S. 0 7 i SEAS. VL. FARM comm. I IND. I CB. I MISC.
LAND IMP. TOTAL DATE REMARKS .( �
W' ' V[J
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13a6-0 '-'a OD (P 19 6 q 7z 3 Sao D
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7 o d /S /Zs ? Ali,/ .s%t d-. e ,L,�reG/-7a' Z6tdell
2-400CohS l e}S—s n,- pa M;
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
i
- ,a�o� moo
Farm Acre Value Per Acre Value MAW
N e e
Fillab:le 1
f illable 2
tillable, 3
Nood land
>wampland
3rushland
House Plot v
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Bldg. z�j. .. .
®■ 3
:. Floors
lensi• > Interior
Fire PlaceHeat
�� Porch
®® P •.. Floor
eezewa Patio Rooms 2nd Floor
.. ® Driveway