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Home My WebLink AboutZ-27220 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- 27220 Date: 07/28/00 THIS CERTIFIES that the building DWELLING Location of Property 36960 MAIN RD CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 097 Block 0003 Lot 005 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- 27220 dated JULY 28, 2000 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 DORIS B RICHMOND (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 t rized ignature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 36960 MAIN RD CUTCHOGUE SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S) : DORIS R RIC:HMOND OCCUPANCY: RESIDENTIAL DORIS B RICHMOND ADMITTED BY: ROBERT WIL IAMSON ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 97.-3-5 SOURCE OF REQUEST: JUDITH R. WILLIAMSON 6/21/00 DATE: 07/28/00 DWELLING; TYPE OF CONSTRUCTION: WOOD FRAME. # STORIES: 1.5 # EXITS: 3 FOUNDATION: STONE & CEMENT BLOCK CELLAR: 1 3 CRAWL SPACE: 2/3 TOTAL ROOMS: 1ST FLR.: -1 2ND FLR.: 3RD FLR.: 0 BATHROOM(S) : 1.0 TOILET ROOM(S) : 1.0 UTILITY ROOM(S) : PORCH TYPE: DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: ONE GARAGE: DOMESTIC HOTWATER: YES TYPE HEATER: ELECTRIC AIRCONDITIONING: TYPE HEAT: OIL WARM AIR: XX HOTWATER: OTHER: ACCESSORY STRUCTURES : - GARAGE, TYPE OF CONST.: WOOD FRAME 1 CAR STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION i ART ' SEC i REMARKS: INSPECTED BY: DATE ON INSPECTION: 07/27/00 CZ, Y J. F H TIME START: 9:45 AM END: 10:00 AM 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 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 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. 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 a 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 - .2 . 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. *. . . . . . . . . . . . . Location of Property.R:D:#11. Box.12. •1, ,CutchogueR ,NY , ,11935 , (Corner of, FX441$. AZLIle. . House No. . . Street Hamlet and Main Road) Onwer or Owners of Property.Estate of Doris ,B.. Ri(;hMgxld,, JL}ciitt, .V,. .Wi lliAT[iSOri.,. . . . . . Executrix - County Tax Map No 1000, Section. . . 97 . . . . . . . .Block. . . A . . . . . . . . . . .Lot. . . . .5 . . . . . . . . . . . . . . . . Subdivision. , not. a li . . . . . . . . . . . . . . . . . .j?p .Filed Map. .Lot. PermitNo. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . HealthDept. Approval. . . . . . . . . . . . . . . . . .. . . . . . . . .Underwriters Approval. . . . . . . . . . . . . .. . . . . . . . . . . Planning Board Approval. . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $, 100.00. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICANT c�j `s t CONSENT TO INSPECTION ESTATE OF DORIS B. RICHMOND Judith R /Williamson, Executrix • . 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 R.D.#1, Box 121, Cut chogue, NY 11935 (Corner of Skunk Lane and Main Road) ; ?.•_ :. I , _ -_ which is shown and designated on the Suffolk County tax map as District 1000, Section 97 Block 3 Lot 5 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: e Certificate of Occupancy on pre-existing building 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 det^r.:rina- 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 as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: sig ature) c/ao.ry ,P. #111-c 1A n roa (print name) (signature) (print name) 1 f TY MAP OF PrOPEr2 _ �� JG - - - DENYSE�_ WHITES--�� Y 12�A� AT PEFCON rC I _I TOWN DF SOUTHOL O,N.Y.� fad �p5� .SST - pg( i - Gocsc M • NEB M � ti . m1 A 264= 11,�12 $o.Fr.- `� 1 u 4 N ti p �y"' I 5UFFCX-Jd CouNTY Tax MAP OE51GK4TroN. PtsT, 1000, SECT. 097, E5LV-. 3, Pr-L.5. +. .O fi "FQ. EA¢TH 021VE 0. unautno,—..c.._._._aor u sdc..... I to this survey is a violation of LA N section 7208 of iM New York stare �6Ep sV Oy education tsar. u� pip ,t.tMES G , theWWembo..ata�k''.""Wmra ea .i•�r11 A�O��p 4 . f Z 4 i N N > teaa,.U.u.cM. Q W'S ttanvan n t„ttk..d n«.en r,v ut Q v - ¢d1.E o MON. ? ff EDGH ' Dory to tha t> brarttam tlr attrvay IwW tp lmbftn Road tenon and C, f .7 >39.92 / to u,.aurora 01=11naro waaroat. 1 03 8 g cuanttws w rot troruforabM Qt- COMt:. MOt.I. y. to additional instirf-ns or sub"cluent �F ly LEAtt3 0.1 E. owners. Gu4e4waim To Joi*q At DENYSE W4t7SL� ` - \ AND TU FlDEL1TY NATIOHAL TITLE It wzAwd NIP M/o s L EY Compw4Y, As Stie VEYEO Juc_Y :8,2000, f 4NTHONY W. LEWANti OWS!l LICENSED LAND SU2VISY02 o. E30x -448 I ' �� SOUTI-l7LD , N.Y. 1 r97!