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Home My WebLink AboutZ-28840FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 28840 Date: 09/04/02 THIS c~KTIFIES that the building DWELLING & ACCESSORIES Location of Property 130 GROVE DR (HOUSE NO.) County Tax Map No. 473889 Section 080 SOUTHOLD (STREET) (HAMLET) Block 0004 Lot 017.002 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 CERTIFICATH OF OCC~JPANCY NUMBER Z- 28840 dated SEPTEMBER 4, 2002 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 TWO CAR GAR3~GE WITH STORAGE AND METAL SHED.* The certificate is issued to JOSEPHINE VRBINAR (OWNER) of the aforesaid building. SUFFOLK COUI~TY DEPARTMENT OF ~RALTHAPPROVAL EI~t-£~IC3%L CERTIFICATE NO. PLUMBERS CERTIFICATION DA'l'~u3 N/A N/A N/A *PLEASE SEE ATTACHED INSPECTION Rev. 1/81 BUILDING DEPARTMENT TOWN OF S0UTHOLD HOUSING CODE INSPECTION REPORT LOC-%TION: 130 GROVE DR SUBDI'~ISION: ~ OF OW~ER (S): JOSEPHINE VRBINAR OCCUPANC"f: SINGLE FD2/ILY · A~Ml-l-r~u BY: GEORGE CDJ4ILLERI SOUTHOLD MAP NO.: LOT (S) JOSEPHINE VRBINAR ACCO~iPANI~) BY: SAME K~Y A~'S~II~I~: ~OFF. C~). TAX ~ NO.: 80.-4-17.2 SOURCE OF RF~q/ST: GEORGE CAMILLERI DATE: 09/04/02 DWELLING: TYPE OF CONS4~UCTION: WOOD FRAME # STORIES: FOUNDATION: CEMENT CRr. TJ%R: B~Yr~OOM (S): 2.0 PORC~ TYPE: BRE E Z H~a_y: 4 2~/D FI~R.: 2 TOILET RO(~ {S): 0.0 DECK TYPE: DOMESTIC H(Yl~/;Yr~U(: YES · ~JPE~AT: 0IL ~%RM~2[R: X OT]fER: BILCO SEE BELOW* FIPd~PIJ~C~: TYPE HF~'r~/t: ELECTRIC 1.5 ~ EXITS: 2 3RD FLR.: 0 UTILIT"J ROO~(S): PATIO TYPE: GAffE: AIRCOtIDITIONING: YES* ACCESSORY STRUCTURES: GAI~%GE, TYPE OF CONST.: 2 C;LR W/STOP~AGE STOP~hGE, TYPE CONST.: METAL SHED ~ING POOL: ~, ~PE ~.: Or~: CONCRETE PATIO BY G~GE VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. RI~a~K~: BP#12~%D~ COZ720, BP#28719 CENTRAL AIR C0Z28839 INSPR~-r~J BY: DATE O~ INSPECTION: 08/19/02 / ~ B OIIFIS ~ TI~E START: 10:10AM ]~/D: 10:45AM Form No. 6 TOWN OF SOUTHOLD .;] i ~ 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 Department with the following: Ao Bo 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. Ap~oval 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 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. 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 - $25.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Location of Property: i S O House No. Owner or Owners of Property: C~{) (~ Suffolk County Tax Map No 1000, Section Subdivision Perufit No. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Old or Pre-existing Building: Street Date of Permit. Date. / (check one) Block ~ Lo __ t~, ~-~ Filed Map. Lot: Applicant: Underwriters Approval: Final Certificate: (check one) Af~icant Signature CONSENT ! INSPECTION Ov~ne~(s) Name(s) do(es) hereby s~atc: , the undersigned, That the unidersigned (is) (are) the owner(s) or the premises in the Town or outhold locaied at ¢O, . ~T~OC~r , which is sho,~ and desigm, ted on the County tax mapias District 1000, Section ~ , Block , ~ot That the u~dersigned (has) (have) riled, 'o~ caused to be riled, an applica- tion in'th. Southold To~ ~uzlaing lnsp~u~, .~ orrt., r.. +h~ fnllnwina: 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 ail buil~lings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including'inspections to determine th~at said premises comply with ail or the laws, ordinances, rules and re~'ulations! or the Town of SouthOld. The underaigned, in consenting to such inspections,, do(es) so with the knowledge and Understanding that any information obtained In the conduct or such inspeetlonS may'be used aS evidence in subsequent prosecutions for vi.o- lations or: the laws0 ordinances, rules or regulations or the Town of Southold. ~-~ A(signature) ~' . -- (print name) {signature} z I f MAP OF PQ_0PEQTY s QVEYF D Fob. 40 \vj 0 S Ar 1 _ T t -0 H6 casxaly ( TOWN OF SOUTHOU GROV I, j • � r e 7510 40 FENCES ti2� 5 CNGES (o - 27.6 {3 'i�^8'0I 27'6 r<rw�..n�o-� '1•�°-moi.� ! ! ,,/�"1�' � l + �-> j�+ ell ct In �'� ( /Yl• y i / ,,,1. / + -+/i I /j( i ''1 •._, F'w+' R'� ..•d \\ `�v ''•k + I �,/' }J.._ �_',_. 1 L�--'' _.•t./'�I .� / Y Lit♦ .J 1`..J ')4 ! UNAUTHORIZED ALTERATION OR ADDITION p 1 1` TO THIS SURVEY IS A VIOLATION OF i SECTION 7209 OF THE NEW YORK STATE - .i j EDUCATION LAW. T ! �kTV'A COPIES OF THIS SURVEY MAP NOT BEARING ! THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED iY R °-i ' • i • \ '� �� , 1 � I '` Q• + � r TO BE A VALID P';UE COPY. v \`' _ i GUARANTEES iNDV A'ND HEREON SHALL RUN ; I ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS G:,:,e,LF TO THE � TITLE COMPANY, GUY61k,-.LNIA. A,i.NCY ANDLENDING INSTITUTION S 1 ! LISTED TOTE ASSIGNEE$OF THELENDINGNINSTI- ;� TUTION.GUARANTEES ARE NOT TRANSFEPABLI I I TO ADDITIONAL INSTITUTIONS OR SUMQUINT PWNERS,S GAPA tw L a Tf _ c t � TITLE L E Y " —-- _ .. r~'�- `�^� �'..E L.. TO I� E:., MAP OF 'Po { a, � • ; CUMG�� t3L;t:�C h' 4N•_F(L _T't�FF= �' r�; � ;• ;; ..� r ._�. ._',__. :.�._,_,___-•--,; l o 2S.0 ELE AT Cts _ ...__. 0� t l.. - �l a NaK < « rAaE R�,! tt Q f'f�ElVdi `' 2 3 Tf7LE COMP4 P, NOI a774 - a 114 4 47 I 22,� - jfir} SHE.:a FENCE NT LINE ��, Q 91.10 ).0 15 c- ,, g�,�. _ I X4.4G Li - I 4_.� , , ;�; -h, AINO ,� � N.69" �' a"'�' ,{3�,,1 0 •� N.69� 8,40 W, .°._.. . •� r"� .s -+., ��..� �.3r;�� r.�� 1� E TNY, J .r+ a+ w ; CdrrNAAP nf! PQOpEQTY `` , . -Illy � " • � �, '.�rCXF1fn' ,�`. riq " E ..,.�. a is €frY+a c1r41vc� q �j g .. . '�-- k R T BAY VIE VV G C q) $j R A `tet .. ,q5.75*40 10 0 '77T77-F C—NCIES 01 _ a t r t .tor ell "�7 -_ a. f ' 1, _ 1 . :s t�'� _ '.." F t UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 72THE NEW 09 OF YORK STATE EDUCATION LAW. T ' •t �., .... "fir'' . COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR { y- tf^,y,� �^yy } , A EMBOSSED SEAL SHALL NOT BE CONSIDERED ��,,`}t o^1k',:`P �.K,,"'� ... I �E M�, i �, TO BE VALID H UE COPY. 73 j 1 THE PERS HER}WHOM SHALL RUN ONLY TO CSS TND!ONL FOR V 4 OM THE SURVEY ' IS PREPARED, AND Op�)WS B kLF TO THRV i t � , l ` TITLE COMPANY, QQVL .h A, A ktiGY AND ✓' A� ? { T LENDING INSTITUTION LISTED HLREON, Awl) t TO THE ASSIGNEES OF THE LENDING INSTI- f � 324 i i TUTION.GUARANTEES ARE NOT TRANSFERABLE J OWTO NERSTIONAL INSTITUTIONS OR SUBS€QUINT f i J ia. G&RAG '`,e n, ! f C p /� F M ;.. _, s a ` � .1 i '� ...,< I lty^Y� Z' Fd { i'{ p") w.lt'• a C„ f..... .E.,,. I ( C u rITL P� }Mat?'�r` N , 1 ^M DATUM S(jTIQ� , :. Q AT t , TI TLE COMPS ��! z I t a77 , 1 i , 2? . F E NCE, Pry' LIN CJ 3c .C3 _ ►. . ,� - ,1 tG,I,., ' _ 1 �, _ w2 !\11 r „ t i I ., * «0 t M fi��'•.,, 3 ''.,"f ti... Y G�. 8 40%w, F I�m.� fey 4 �'�.;,'• F � t t,T,r r V4, "aJ 9 vt -