HomeMy WebLinkAboutZ-40207 !" Town of Southold 2/14/2019
53095 Main Rd
Southold,New York 11971
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 40207 Date: 2/14/2019
THIS CERTIFIES that the structure(s) located at: 8805 Oregon Rd, Cutchogue
SCTM#: 473889 Sec/Block/Lot: 95.4-11.3
Subdivision: Filed Map No. Lot No.
conforms substantially to the requirements for a built prior to
APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 40207
dated 2/14/2019 was issued and conforms to all the requriements of the applicable provisions of the law.
The occupancy for which this certificate is issued is:
wood frame one family dwelling with covered porch and concrete and stone patio and an accessory wood frame
barn/garage, accessory chicken coop and accessory pump house.*
Note: BP 9229 addition to garden shed COZ-15693; BP 39156 electrical survey COZ-40206
The certificate is issued to Domaleski, Theodore& Geraldine
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
u o ' ed Signature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 8805 Oregon Rd,Cutchogue
SUFF.CO.TAX MAP NO.: 95.-1-11.3 SUBDIVISION:
NAME OF OWNER(S): Domaleski, Theodore&Geraldine
OCCUPANCY:
ADMITTED BY: Virginia Surozenski
SOURCE OF REQUEST: Domaleski,Raymond DATE: 2/14/2019
DWELLING:
#STORIES: 2 #EXITS: 3
FOUNDATION: stone and brick CELLAR: full CRAWL SPACE:
BATHROOM(S): 1 TOILET ROOM(S): 1 UTILITY ROOM(S):
PORCH TYPE: covered porch DECK TYPE: PATIO TYPE: concrete&stone
BREEZEWAY: FIREPLACE: GARAGE:
DOMESTIC HOTWATER: x TYPE HEATER: oil AIR CONDITIONING:
TYPE HEAT: oil WARM AIR: HOT WATER: radiators
#BEDROOMS: 3 #KITCHENS: 1 BASEMENT TYPE: unfinished
OTHER:
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: pump house shed
SWIMMING POOL: GUEST,TYPE OF CONST:
OTHER: chicken coop&barn/garage
VIOLATIONS:
REMARKS:
INSPECTED BY: JOHNJ DATE OF INSPECTION: 10/19/2018
TIME START: 10:38 am END: 11:10 am
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT T k +
TOWN HALL " 018
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:
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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00,
Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,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$15.00 "�
Date. I U ' l2' 1
New Construction: Old or Pre-existing Building: Y (check one)
Location of Property: 8605 K"�q-qO-y-1 Rd
House No. Street Hamlet
Owner or Owners of Property: rE) OwlaA QS V_i
Suffolk County Tax Map No 1000, Section 9-'b Block Lot �� 3
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: x (check one)
Fee Submitted:$ 1 W �—
pli ant Signa re
CONSENT TO INSPECTION
} ?(e S k� ,the undersigned, do(es)hereby state:
wner(s)Name(s)
That the undersigned (is)(are)the owner(s)of the premises in the Town of
Southold, located at 8ffi 5 v¢ q o,�;-�'Map
l u o a U
which is shown and designated on the Suffolk ountTax as District 1000,
Section 95 , Block I Lot
That the undersigned (has) (have) filed, or cause to be filed,anplication in the
Southold Town Building Inspector's Office for the following: [,o a� CD -�o✓
local
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: to f 1 Zl �$ Ak�
(Si na
►( 'nip U.Y�S1Q�5k i
(Print Name)
(Signature)
(Print Name)
WM W am W I AW ,WI.all t J—x NL I]-Iin
'♦,'�, Cerfifiod to:
Premises known as: �`\�`\ SAFE W WR WLE AGENCY(SH178373SS) Mi ch a e1 W. Minto, L.S.P.C.
8805 Oregon Rood, Cutchogue F1W AMERICAN TIRE WMNCE COMMY LICENSED PROFESSIONAL lANO SURVEYOR
ry9h, `�� ,` ♦`` NEW YORK STATE LICENSE NUMBER 030871 `
Area= 2.45 Acres e7 woodview Lane
f, ♦\ .♦ Cent erect ch, N.Y. 11720
.`1 •, �, PNONE/FAX: (631) 360-1202
Q' `♦ `\` �7 `CL.- CELLULAR: (631) 766-9714
EMAIL. mikemintolspeO9moil.eom J1
UNAUTHORIZED ALTERATION OR ADDITION
TO THIS SURVEY IS A VIOLATION OF
�� "� ,,! + ♦ `\4\\
SECTION
ECTIC O 7 TI 7709 OF THE NEW YORK STATE
EDU
LAW.
QQ
,ty� `\ \ ♦ � COPIES OF THIS SURVEY AAP NOT BEARING
COY ` \ THE RANO SURVEYOR'S INKED SEK OR
♦ A EMBOSSED SEAL SHALL NOT BE CONSIDERED
{� r \\,�� �` •♦ ♦, 0 TO BE A VALID TRUE COPY.
GUARANTEES INDICATED NEREON SHALL RUN
`,♦ ` Y1 \♦ \ ONLY TO THE PERSON FOR WHOM THE SURVEY
\\ ,\ 4 y� ✓�\\ \` \, ` IS PREPMRLD,AND ON HIS BEHALF TO THE
\♦ \` 9 �� `, �� \\ O.O TITLE COMPANY. GOVERNMENTAL AGENCY AND
YAi
LENDING INSTITUTION LISTED HEREON.AND
`\ �, `♦ !wl `�.` `\ yt V TO THE ASSNCNEES OF THE LENDING WST1-
• \ ) ♦ \ ♦ TUTION. GUARANTEES ARE NOT TRANSFERABLE.
` \\ �` ,i � `\ • THE 0GSTENCC OF RKHTS OF WAY
�0�\\ ,� L� 1 `♦ `\ ! `♦ AND/OR EASEMENTS OF RECORD IF
j
`Pj. \ ANY, NOT SHOWN ARE NOT
\`\\`\ ,1'y I % �pS\\ \\ ♦ `♦ 1y5e' GUARANTEED.
Survey of Described Property
situate at
Cutchogue
\,�' , '���,� z�` \\•ti`,�sem. �� ��\ Town of Southold
♦
Suffolk County, New York
eIII Neq, District 1000 Section 95 Block 1 Lots 11.3 & 12
Scale I"= 50' Surveyed November 30, 2017
��`\ �" .► �� GRAPHIC SCALE
7R i0 100 200
\♦\ 'l`TOF' s'�p c �5 JQC�
NO
1 �
IN FEET
1 Inch - 50 fL
ORJBni N Me 101 I OME at MIS M1J17-11= � ��\ Certified to:
Premises known os: SAFE wmoR TITLE AGENCY(SH178373SS) Michael W. Minto, L.S.P.C.
(1805 Oregon Rood, Cutcho ue o, �, \`\\ � FIM AYERjCAH TLE INSURANCE COMPANY LICENSED PROFESSIONAL LAND SURVEYOR
9 9 X950 NEW YORK STATE LICENSE NUMBER 050871 `
87 Woodview Lane
Area= 2.45 Acres moo,
\` \` Centereach, N.Y. 11720
PHONE/FAX: (631) 580-1202
CELLULAR: (631) 766-9714
`\ \\ EMAIL• mikemintoI3pG9gmoiLcom
\ \
UNAUTHORIZED ALTERATION OR ADDITION
\ TO THIS SURVEY S A VIOLATION OF
SECTION NLA OF THE NEW YORK STATE
�O� .y� 'C• ¢ `\ `\�\ G EDUCATION IAN.
COPIES OF THIS SURVEY MAP NOT BEARING
THE LAND SURVEMBOSSED SEAL SMALL INKED
BE CONSIDERED
0 TO BE A VALID TRUE COPY.
C~ GUARANTEES INDICATED HEREON SHALL RUN
NLY TO THE PREPARED. AND FOR
BEHALF TO THE
EY
S
qi \ \ \ 4. Q�p TITLE COMPANY GOVERNMENTAL AGENCY AND
\ `\ �{{ n `\ �y `\ y Y/'1, LENDING INSTITUTION LISTED HEREON,AND
\\ \ \ `�♦ \ v TO THE ASSIGNEES OF THE LENDING INSTI-
\ \� > �\ �� a TUTION. GUARANTEES ARE NOT TRANSFERABLE.
THE EXISTENCE OF RIGHTS OF WAY
ANO/OR EASEMENTS OF RECORD IF
\ i �v �� ANY, N07 SHOWN ARE NOT
`\\�`\ VQ ,y + 1 /// \\\ `\\` '• \`\\` �L�Oiy GUARANTEED.
3LnO5
Survey of Described Property
situate at
" M Cutchogue
00. `1°55��� Town of Southold
Suffolk County, New York
of NE Fy District 1000 Section 95 Block 1 Lots 11.3 & 12
Scale 1 I'= 50' Surveyed November 30, 2017
°$`\� ' .► GRAPHIC SCALE
so 0 25 so too 2W
87\ JQ,�
IN FEET)
1 Inch - 50 IL
STATE OF NEW YORK:
:ss..
COUNTY OF SUFFOLK:
Virginia M. Surozenski,residing at 1525 Crown Land cane, Cutchogue,New York.
11935,being duly sworn,deposes and says:
I am one of the owners of the property located at 8805 Oregon Road,Cutchogue,
New York )1935 (SCTM#1000.095.00-01.00-011.003), I am familiar with the interior
room layout of the house located on the property, including the room located off of the
kitchen,which is a half bathroom containing a,sink,toilet and which additionally serves
as a laundry room containing a washing machine and clothes dryer. I have knowledge
that this room was formerly a pantry and was converted to its existing use prior to 1957.
V inia ozenski
Sw m to before ane this
�,day of febrLay 2019,
p �C� OdC�
� D
Notary Public
Notary Pubft F E B - 7 2019
go*of New York
county 1 "olakd
Teresa L. yMMiG
.p,Date c.12,20
Lie DsTOWN OF SOUT]<i01,D
211000makeski2019
AAU51-; wl-ZAv2tj •-�-
1 O - - - TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET VILLAGE DIST. SUB. LOT
e-j .,f
ACR. -
b REM R S
I
`rJ 9 _ '
TYPE OF BLD.
e5k PROP. CLASS -
LAND IMP. j TOTAL DATE
� �'zv � �Sr^s�� �- k�Lr ►��tlnY 'sUb CC �3
l
541A00 6So� ✓ �� I
TOWN OF SOUTHOLD
FRONTAGE ON WATER TILLABLE
FRONTAGE ON ROAD WOODLAND
DEPTH MEADOWLAND
BULKHEAD HOUSE/LOT a�
TOTAL
DISTRICT SUB. LOT
N y Q EK " "A,CREAGE
j�
Daij,ALEs,r/ S L� 071 �c� S�Lvj, TYPE OF BUILDING 2�
(6Y- 3f(j�.�6
RES. SEAS. VL. FARM comm. IND. CB. misc.
LAND IMP. TOTAL DATE REMARKS --
�/ o c
ado
00 0
o o S' _12/7s� ay Arr4. 4rf. ) A. D"'"/9
v a fl eiv 0 J 3 .S .i-17 734b, Pf R, *942 2 2 1- 19DD ?rpN %a F flz, SC �4'
as 3 v � C�
—
S�.�Ob BUJYDICONDITION ` 2Z
NEW NORMAL BELOW ABOVE
Farm Acre Value Per Acre Value
Tillable 1 e �� 5-13 Y
Tillable 2
Tillable, 3
Woodland
Swampland
Brushland
House Plot
Tool 1/0 1 Z
y
•OC�
■■liiiii■i■■■SMI■■■■■■■
■■■iii■■■��J■■■■■■
■■■■■■■■■Liil�■Yii■ii■i1
■■■■■■■■■■■■■■■■■■■■
: .. i 0 Tc FoundationBath
3.Cp 0 Basement Floor
Extension Ext. Walls Cc, Interior Finish
Extension L Fire Place Heoit
a • off ,q J�d
rPorch Attic
yy ®�■ Porch Rooms
'..
• Rooms . Floor
ale e
----------------
t"
1 •.Dr
(9 ��' °pt& Cv�l-r,Gt ✓??/ j S- l- tj
yOF SOUjy
3 O
TOWN OF SOUTHOLD BUILDING DEP
n
765-1802 fw 1,
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
� u
k1 ��► '
t i ,
DATE U a log INSPECTOR
�0�O &tr9lvz..- I:(. — (-l 1.5 . re, C O
pF SO(/Tho
# TOWN OF SOUTHOLD BUILDING DEPT.
`�cou�m 765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS: /11
A-7- � 7&r
let
o
DATE INSPECTOR6.4 7A2
LOCATION: gm�
0
(number & treet) ( icipality)
SUBDIVISION: ' 1 . 1�0.: LOT(S):
NAME OF OWNER(S)': pl M t�►
OCCUPANCY: WG► Vl
(type) (owner-tenant)-
ADMITTED BY: ACCOMPANIED BY:
KEY AVAILABLE: SUEF. 'CO. TAR MAP . 1000-
.
SOURCE OF REQUES ✓ DATE:
DWELLING
TYPE OF CONSTRUCTION: W_e STO-MES: _Y # EXITS: V
FOUNNDATION: I l Y�'�r,� 18AS9MENT: 'CRAWL SPACE:
# OF BEDROOMS: IST FLR: 2ND FLR: E�D FLR:
BATHRO-OM(S): TOILET B;dOM(S):, UTILITY 00'M:
PORCH.TYPE: DECK, TYPE: PATIO;T'YPE:cft".
Qw
BREEZEWAY:'_. FIREPLACE: _ OARAGE:
DOMESTIC HOTWATERY: TYPE HEATER: , ,� AIRCONDITIONING:
TYPE HEAT: 0 1V WARM AIR: _ HOTWATER: 9,4
# OF KITCHENS: !VZ, ,
FINISHED BASEMENT:- YES NO
OTHER:
ACCESSORY STRUCTURES ✓kole-e
GARAGE; TYPE OF CONST.: STORAGE, TYPE CONST.:�Wn
SWIMMING P'0-OL: GUEST,TYPE CONST:
OTHER: PVMOL G►s✓ �jrlvr G v �, Chl4ft
VIOLATIONS:. CHAPTER 144 &N.Y, STATE:UN.IFOR.M FX PREVENTION & BUILDING CODE -
LOCATION DESCRJPTION ART. SEC.
— IW
l Q v
✓t t
REMARKS:
INSPECTED BY:Oh/1 l ���'1 DATE OF INSPECTION:
TIME START: 0 END: