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Home My WebLink AboutZ-22721FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-22721 Date NOVEMBER 10, 1993 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 365 SUNSET WAY SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 91 Block 1 Lot 12 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-22721 dated NOVEMBER 10, 1993 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 STORAGE SHED The certificate is issued to JOHN & AVIS ZAZECKI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. _ 1-e ilding Inspector Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTIIOLD HOUSING CODE INSPECTION REPORT LOCATION; 365 SUNSET WAY SOUTHOLD, NEW YORK number 5 street municipality SUBDIVISION MAP NO. LOT (s) NAME OF OWNER (s) JOHN 6 AVIS ZAZECKI OCCUPANCY A-] OWNER ltypel (owner -tenant) ADMITTED BY:. JOHN ZAZECKI ACCOMPANIED BY: SAME - KEY AVAILABLE SOUL;;:: OF REQUEST: SUFF. CO. TAX MAP NO. 1000-91-1-12 JOHN S AVIS.ZAZECKI DATE: NOVEMBER 4, 1993 DWELLING: TYPE OF CONSTRUCTION WOOD FRAME FOU`iDATION CEMENT BLOCK TOTAL ROOMS: IST FLR. 5 2ND FLR. BATHROOM (s) 1 FULL BATH TOILET ROOM (s) PORCH TYPE DECK, TYPE 6 STORIES ONE CELLAR 3RD FLR. BREEZEWAY FIREPLACE ONE DOMESTIC HOTWATER YES. TYPE HEATER OFF BOILER TYPE HEAT OIL WARM AIR OTIIER: ACCESSORY STRUCTURES: # EXITS CRAWL SPACE UTILITY ROOM PATIO, TYPE GARAGE AIRCONDITIONING_ HOTWATER 1x GARAGE, TYPE OF CONST. STORAGE, TYPE CONST SWIMMING POOL GUEST, TYPE CONST. ACCY SHEC VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION h BUILDING CODE 2 REMARKS: BP #91522 -CO Z-22720 - ADD INSPECTED BY: DATE ON INSPECTION NOVEMBER 10, 1993 GARY SH TIME START 9:30 AM END 9:50 AM Form No. 6 _7�- / h/ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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. D/ 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 - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date New Construction......,,,. .. Old Or SSPre-existing Building.... Y: ........... Location of Property. , ('i .......f v iv .5,6 : ................................... House No. Street Hamlet Ower or Owners of Property....�C}.0 .:! l✓.... ... .` (<.l ..................... County Tax Map No 1000, Section ....qj........ Block ..... ........... Lot ... 4 ............... Subdivision....................................Filed Map ............ Lot ...................... Permit No................Date Of Permit ................ Applicant ............................. Ilealth Dept. Approval..........................Underwriters Approval......................... Planning Board Approval .........:.............. Request for: Temporary Certificate........... Final Corticate........... ''ee Submitted: $.0 D D :.��................. ....................... APPLICANT �Y/1 CONSENT TO INSPGCIFION «mcr(s) Name do(es) hereby state: the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at /97 , which is shown and designated on the Suffolk County tax map as District 1000, Section q Block I Lot / That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: //- �) J3 (sigatu e) —' (print t name) (sign ur A/ (print name) -0- 7- Lij L "T S - k -,-516--4-4 40 E'. T <CI --.7-MLE -COINO", U Unauthoriz, a 0 teration or addition to this survey is violation of <1 Section I Education tof a Now York State, LY �f Ed W. Copies of this Ilu 'SlnkedsWor + the land survGiPr y map not bearing em bossed saaj�halknot be obrisidered to be a valid tru G, n fed IOV NE uaMnteesi = 11 only to the Persod f Iii8on shall run AA- A U` 0 OM the survey is Prepared. and o Is titly.e behalf to a v en and toin se 'r n d lending tutio -e le dinInsti. re U.rallse-arenontransferable toa 'jtj i's, ors. w nsorsubs uent SFG LAND FQC7:,r)A Q' �ACHPXIZK"�Ori- NOTE -07L-N 5 -REFER --M P-0 Z 'U -TYCLF-PV.foOFf�ICEA$' 11�, F I -N A,,FQ-LK -0 - W. RE5Qc' K,C - OP 5-U W�q-r Q WM I FF, S.TQ- 7, '77= 7- :4' EY AN NRCE�m -ASISURV EQ-, -CX C, VL 1z 729, , ted a 'or r IS al nrri�, st utc 22�ptal-ag as irgn a Hp eo G a ar. onal r RV N- 0� NVIS 777