HomeMy WebLinkAboutZ-20202FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z20202 Date SEPT. 9, 1991
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 3100 SOUNDVIEW AVE. MATTITUCK
House No. Street Hamlet
County Tax Map No. 1000 Section 94 Block 02 Lot 04
Subdivision Filed Map No. Lot No.
conforms substantially to the REQUIREMENTS FOR A PRIVATE ONE FAMILY
DWELLING BUILT PRIOR TO APRIL 9, 1957 pursuant to which
Certificate of Occupancy Z20202 dated SEPT. 9, 1991
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 ***SEE INSPECTION REPORT
The certificate is issued to EDWARD ZIMNOSKI AND WF.
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*** SEE INSPECTION REPORT
Building Inspector
BUILDING DEPARTHENT
TO.•!,i OF SOUTHOLD, N. Y.
HOUSIidG CODE IIISPECTION REPORT
Location 3100 SOUNDVIEW AVE. MATTITUCK
(numoer a street) (Piun.icipaiity)
Subdivision Map No. Lot(s)
Name of Owner(s) EDWARD ZIMNOSKI 6 WF.
Occupancy A-1 residential
(type)
Admitted by: DIANE BEDRICK Accompanied
Key availabl
OWNER
owner -tenant
by: SAME
Suffolk Co. Tax No. 94-2-4
Source of request EDWARD 6 DOROTHY ZIMNOSKI Date 7/15/91
D`YELLING :
Type of construction wooD FRAME il
vstories 1 STORY
Foundation CEMENT BLOCK Cellar FULL Crawl space
Total rooms, 1st. Fl 5 2nd. F1 3rd. Fl
Bathroom(s) 1 FULL BATH Toilet room(s)
Porch, type -- Deck, type Patio, type -
Breezeway Garage 1 CAR ATTACHED Utility room
Type Heat OIL Warm Air Hotaater XXX
Fireplace(s) YES (1) No. E:cits 3 Airconditioning
Domestic hotwater YES Type heater OFF BOILER
Other LAUNDRY ROOM
ACCESSORY STRUCTURES: NONE
Garage, type const. Storage, type const.
Swimming pool Guest, type const._
Other
VIOLATIONS: _CHAPTER 45—N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
Lncation
Description IArt.1
Sec.
PERMIT REQUIRED FOR DECK, FIREPLACE AND CARPORT.
FIREPLACE FRESH AIR TO THE EXTERIOR INSPECTED.
BP $20124Z C.O. Z20201 for the above wnrk
ALSO -
I
IBP9924 C.O. 21290 ADDITION
I
Remarks:
Inspected by: Q<RY FISH Date of Insp. 8/1/91
Time start 9:50 end
Form No. 6
�.
..- TOWN OF SOUTHOLD
BUILDING DEPARTMENT 7*1'
3 19%TOWN HALL . (�y
765-1802[a
BLDG: DEPT. ,, � / � � .�cn &9
)WN U�HOL----��PLICATION 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.
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 pp$15.00, Commercial $15.00
Date �.i y...� 1 � �.................
:ew Construction.........../Old Or Pre-existing Building... j7/) /' ..
.ovation of Property...... ........... :fl ocs-.C%L,�.`.......�.fi.U.°'^':Y:`:........
House No. Street Hamlet
nwer or Owners of Property.. .................................. .
..................
ounty Tax Map No 1000, Section... !!....... Block....fz .......... Lot ... jj_.................
ubdivision....................................Filed Map ............ Lot ......................
armit No................Date Of Permit ................ Applicant .............................
=alth Dept. Approval..........................Underwriters Approval.........................
fanning Board Approval ........................
2quest for: Temporary Certificate........... Final Corticate...........
_e Submitted: .............
V9J-% % P Q rye,,'.
APPLICANT
U tl
r)
CONSENT
TOBLDG. DEPT.
TOWN OF SOUTHOLD
INSPECTION
do(es) hereby state:
the undersigned,
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southoldlocatedat dl"ez -
which is shown and designated on the Suffolk
County tax map as District 1000, Section Block Lot L}
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in the Southold Town Building Inspectors 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 regula
ti
o
ns of� the Town of Southold.
Dated: 7 /J_ ! (wv`Lis�vlLd�tz.G
(signa ure)
�oW�( 1Q- b 7-, /nW0Sk/
(print name)
(signature)
1Z4k-r-�� L 7-;101V051<"
(print name)
SOUND
40 00-E. 20000
NOTE
I. p _ MONUMENT p o STAKE
2 SUFFOLK COUNTY TAX MAP
DIST. 1000 SECT. 94 BLK. 2 LOT 4
BRANDIS A SONS INC.
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JUL 2 31991
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SURVEY FOR
EDWARD ZIMNOSKI Q DOROTHY ZIMNOSKI
AT MATTITUCK
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
M UNAUTHORIZED ALTERATION OR ADDITION TO THIS
SURVEY R A VIOLATION OF SECTION 7205 OF THE
NEW YORK STATE EDUCATION LAW
*COPIES OF THIS SURVEY NOT SEARING THE LAND
SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SMALL
NOT BE CONSIDERED TO BE A VALID TRUE COPY
RGUARANTEES INDICATED HEREON SMALL RUN ONLY TO
THE PERSON FOR WHOM THE SURVEY IS PREPARED
ANO ON HIS BEHALF TO THE TITLE COMPANY, SOVERN-
MENTAL AGENCY AND LENDING INSTITUTION LISTED
HEREON, AND TO THE ASSIGNEES Of THE LENDING
INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE
TO ADDITIONAL IMSTITUTWMS OR SUBSEQUENT
OWNERS
N DISTANCES SHOWN HEREON FROM PROPERTY LINES
TO EXISTING STRUCTURES ARE FOR A SPECIFIC
PURPOSE AND ARE NOT TO BE USED TO ESTABLISH
PROPERTY LINES OR FOR THE ERECTION OF FENCES
DATE: JUN, 25, 1991
SCALE I 40
NO. 91 - 0525
S�P�E OF .NF1,,, r
06
� O �
/ I
I �-� IARD
9
YOUNG a YOUNG SRH' o"�wroR E
ALDEN W. YOUNG, PROFESSIONAL ENGINEER
AND LAND SURVEYOR N.Y.S. LICENSE NO. 12845
HOWARD W YOUNG, LAND SURVEYOR
N.V.S. LICENSE NO.45893
BUILDI:,;G DEPART11IENT
TO, -TIN OF SOUTI-iOLD, N. Y.
HOUSING CODE INSPECTION REPORT
a
Locatio r_�4
(number & street
Subdivision Ma -Q No.
Name of Owner(s)
Occupancy
(type)
Admitted by:fi=jaji,Accompanied
J
unicipaiity)
Lots)
owner --tenant)
by:
Key available Suffolk Co. Tax No. �Z —
Source of request l�N.t+r� 41'yDate %
DWELLING: r �� Q
Type of construction WWd-4 ,.,, ,stories
Foundation_ v c Cellar.,,Q Crawl space
Total rooms, lst. Fl 2nd. F1 3rd. F1
Bathroom(s) f r� Toilet room(s)
Porch, type Deck, type Patio, type_ 7 -
Breezeway Garage tCe.,_ tility. room
Type Heat 2vVarm Air Hotwater
Fireplace(s) 4 S ( No. E, -{its ,-? Aircor_ditioni nb__=
Domestic hotwaterTyp e heater
Other
ACCESSORY STRUCTURES: AVE-
Garage,
type const. Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS: CHAPTER 45--N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
•
Remarks:
Inspected by: A Date of Insp.
Time start end
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-Descri-ption_
c.
20W V IMP
7 is
Remarks:
Inspected by: A Date of Insp.
Time start end
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