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HomeMy WebLinkAboutZ-27914 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- 27914 Date: 09/05/01 THIS CERTIFIES that the building DWELLING Location of Property 295 OLD ORCHARD LA EAST MARION (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 031 Block 0007 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- 27914 dated SEPTEMBER 5, 2601 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 SHED & GARAGE WITH WORK & SCALLOP SHOP WITH OUTDOOR STORAGE OF EQUIPMENT CONNECTED WITH AQUACULTURE* The certificate is issued to DOUGLAS & JEAN ROGERS (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 horized Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 295 OLD ORCHARD LA EAST MARION SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S) . DOUGLAS & JEAN ROGERS OCCUPANCY. SINGLE FAMILY DOUGLAS & JEAN ROGERS ADMITTED BY: DOUGLAS ROGERS ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 31.-7-21 SOURCE OF REQUEST: DAVID KAPELL, 2/19/98 DATE. 09/05 01 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 2.0 # EXITS: 2 FOUNDATION: STONE CELLAR: 1 3 CRAWL 'SPACE: 2/3 TOTAL ROOMS: 1ST FLR.: 4 2ND FLR.: 3 3RD FLR.: 0 BATHROOM(S) : 1.0 TOILET ROOM(S) : 0.0 UTILITY ROOM(S) : YES PORCH TYPE: FRONT UNHEATED ENCLOSED DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: YES TYPE HEATER: OIL FURNACE AIRCONDITIONING: TYPE HEAT: OIL* WARM AIR: HOTWATER: OTHER: * BASEBOARD i ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: 2 CAR WOOD FRAME WITH * STORAGE, TYPE CONST.: WOOD SWIMMING POOL: GUEST, TYPE CONST.: OTHER: ACCY WORK & SCALLOP SHOP-OUTDOOR STORAGE OF EQUIPMENT FOR AQUACULTURE VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION I ART. I SEC. REMARKS: 13P##5491Z-COZ5348-ADD TO GARAGE INSPECTED BY: , DATE ON INSPECTION: 03 04 98 TIME START: 10:25 AM END: 11:30 AM Form No. 6 L5 _ TOWN OF SOUTHOLD BUILDING DEPARTMENT "FEB I I 1\ TOWN HALL 5 ��-✓� 765-1802 N H , APPLICATION FOR.CERTIFICATE OF OCCUPANCY A. 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and e-existing" land uses: l: ) Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 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 t. Certificate of O'ccup"ancy - 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. Certificate of Occupancy on Pre-existing Building - $100.00 Copy of Certificate of Occupancy - .25V, 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential II$15.00, Commercial $15.00 Date . . . .�:1.� �. . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or re-existing Buildin .� . . . . . Location of Property. . . . . . . . . . . . . . 1. �`!. . . . . . . House No. Street Hamlet Onwer or Owners of Property. . . y. . . .ea:^. . .1.L� - . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . . . . . . . . . . .Block. . . . . . . . . . . . . . . .Lot. .. 2. . . . . . . . . . . . . . Subdivision. . . . . . . . . .�.1. .\ . . . . . . . . . . . . . . . . . . .Filed Map. . �.I.A. . .Lot. . . . . . '.A . . . . . . . . Permit No. . . 1 . . . . .Date Of Permit. . . . . . . . ;Applicant. . . . ..`1v d:�. . . . . . . . . . . . . . .. . . Health Dept. Approval. . . . . . `. . . . . . . ... . . . .Underwriters Approval. . . . . 11lllwl I . . . . . . . . . . . . . . Planning Board Approval. . . . . . .:,,�A. . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. .X/. . . . . Fee Submitted: . .��:.��. . . . . . . . . . . . . . . . . G.K- �0��3 �. . . APPLICANT e-Q . er S D ykc v i�y Post o�yoo � / . � h n w �a0/779C ` shad � a - v o JPoreh Porr/I ; 0 Ho MSG o - � - ri h o4Z`00" W. 1 9 Z Conc; Ro w o f Pos7s M o r- y Thiari. 98r MAP OF PROPE/4TY SURVEyE� FOR GwanwntBed fheownarandAoh9e DOUGLAS ROGERS North Fork Bonk and TrostCom/vony S/TUATE AT ps surveyed APri/ /3 /9S.S. EAST A4A,9'/O/V Of-i`o YV. VAn Tuy/� SOri TOWN OF SOUTHOLO �� SUFFOLKCOYJMn;N.Y Sco% '= Licens�dLa ,5'urvcyror's Green ort Iv Y. CONSENT TO INSPECTION F&ksc� the undersigned, Owners) Name(s) do(es) hereby state: That the undersigned (is) (:.ire) the owner(s) of the premises in the Toum of Southold located at 0 = t ®o,� _, which is shown and designated on the Suffolk County tax map as District 1000, Section Block Lot 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: 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 i 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 as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or re ulations of the Town of Southold. D atc d:_ 7i 4 _ "��• C�—�r _ cQ � ' C;A %V!nA (signature) (print name) (signature) (print name) ' A t ■■■■■■ ■■�/IIf�■■■■■■■■■g ■■ 11■■■i1t�11 Lei■■■■�■■■■■■■ill■�■■I ■■■Rromil MMI■ 'MONE■■■■■■11© ■■ ■■■NUM111l UNI■■■■■■■■■■■■11■■■■ ..■■■■UTTflM■■■■■■■■■■I■■I��. ......■�i-■■■■■■■■■■■■ ■■■ . ■■■■■.■ ■■■■■■■■■■■■■■■■■■Foundation Both' Basement Ext. Walls Interior Finish Fire Place •.. •.. .. TOWN::, 'OF•.SOUTHOLD PROPERTY RECORD CARD 1 Y., OWNER STREET; c9`j VILLAGE DIST.I SUB. LOT Aft LA�vcr C FO • E MER OW ER N W TYPE OF BUILDING,..,, _1 ,I ', RES. SEAS. VL. FARM 'COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS C d z `/ o ao 3 o -0 AGE' : BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value t. Acre �. Tillable 1 Tillable 2 .Tillable 3 Woodland Swampland ` FRONTAGE ON WATER FRONTAGE ON ROAD Brushland y ll Z �;2 House Plot DEPTH 3..__ BULKHEAD t_ Total DOCK 1 BUILDING DEPARIIIENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: /- 5�� ��., /<~ r number & street municipality SUBDIVISION MAP NO. LOT (s) NAME OF OWNER (s) OCCUPANCY (type) (owner-tenant) ADMITTED BY: ACCOMPANIED BY: t KEY AVAILABLE SUFF. CO. TAX MAP NO. �- ` SOURCE OF REQUEST: 011 DATE: Jr DWELLING: TYPE OF CONSTRUCTI N # STORIES 7— # EXITS !s FOUNDATION CELLAR CRAWL SPACE Ot TOTAL ROOMS: IST FLR. 2ND FLR. 3RD FL . BATHROOM (s) OILET ROOM (s) UTILITY ROOM PORCH TYPE �e�� AECR, TYPE PATIO, TYPE BREEZEWAY FIREPLACE _ GARAGE DOMESTIC HOTWATER TYPE HEATER ( �- IRCONDITIONING r - TYPE HEAT WARM AIR HOTWATER OTHER: ACCESSORY STRUCTURES: a_6.p< 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. 67 / C;L 7� REMARKS: $' q I - Gc) -F, 5 3 INSPECTED BY: � DATE ON INSPECTION TIME START �® END ��-r