HomeMy WebLinkAboutZ-19944FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-19944 Date JUNE 5, 1991
THIS CERTIFIES that the building DWELLING
Location of Property 1100 VILLAGE LANE ORIENT, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 25 Block 1 Lot 19
Subdivision Filed Map No. Lot No.
conforms substantially to the requirements for a One Family Dwelling with
Apartment & Store or Office built prior to: APRIL 9, 1957 pursuant
to which UPDATED CERTIFICATE OF OCC. #Z-19944 dated JUNE 5, 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 WITH NON -CONFORMING APARTMENT & BUSINESS
BUILDING (STORE OR OFFICE) & ACCESSORY BUILDING.
The certificate is issued to SHEILA ZUHUSKY
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED
*NOTE: THIS UPDATES PRE -CO Z-7667 DATED MAY 19, 1977.
'�� . z
Building Inspector
Rev. 1/81
sY
�IFr`O`iI�
'! OV
LiV.L '
n = arniru�rFNt
d = FIA`'
/pfo oly
a
IQ
C.
Im 1 p
1
7
1
w
•
P
r
V
�A
F
1+
sY
�IFr`O`iI�
'! OV
LiV.L '
n = arniru�rFNt
d = FIA`'
/pfo oly
a
IQ
C.
Im 1 p
1
7
1
0.W C.:'I � IC! - L n i .0
SMS S i' ON
.Ak
UFi1 ? IN 5J5 :
(MF IN; S"'.
e- S e f JR
sO At t 14L.R -',YL ..
uUAAWUS N 6I • 3 Y SIAL, 3UF
M" 'O IN£ Ithlul 1, ll'u r.(
S,k,fl R kNF AAF - NC ' l Vl.,'
10 IPE I'll,_NEJ A,
AMO 1{N,1N y 1� J'cnM 5IE0
HEREON, AND IF; i S5,'" 5 Dl 'HF
L£NDwb n+s f. ,., .r,.� GlA a 1FEi •RE
HHi lA&kVCRAb,E IC CS'f:M1NA;
IPS7I7U4IdNS JI SlLSf C�Ctii���RHEkS:
�r
REVISION' YOUNG & YOU
00 OSTRANDER A1'i:NUE, RIVLR[4
ALOEN W. YOUNG j
PROFESSIONAL ENGINEER AND
LANO SEJPVEYOR. 'N. r. S. u:.: NP. '.26«
SURVEY FOR:
JOHN MCIVEIL
/CZE OF NFyr
faPsl) ly Yn
hi01`�L:cr1 YOi
LAN 1`ir, OR
ATVR T ' GIIARANTLLD TO:
JE'Y
C ,Y SOLITAOL0 SAVINGS FAA'lf
TOWN OF : .ME rITLE GV,4RANtEECO.
SOU THOca
SUFFOLK CO., N. y s%.d !lslQ1� Gl.
SCALE: „QR7E: NO.
J eo tFJAY 17, 1.9,77 77 - 300
w
0.W C.:'I � IC! - L n i .0
SMS S i' ON
.Ak
UFi1 ? IN 5J5 :
(MF IN; S"'.
e- S e f JR
sO At t 14L.R -',YL ..
uUAAWUS N 6I • 3 Y SIAL, 3UF
M" 'O IN£ Ithlul 1, ll'u r.(
S,k,fl R kNF AAF - NC ' l Vl.,'
10 IPE I'll,_NEJ A,
AMO 1{N,1N y 1� J'cnM 5IE0
HEREON, AND IF; i S5,'" 5 Dl 'HF
L£NDwb n+s f. ,., .r,.� GlA a 1FEi •RE
HHi lA&kVCRAb,E IC CS'f:M1NA;
IPS7I7U4IdNS JI SlLSf C�Ctii���RHEkS:
�r
REVISION' YOUNG & YOU
00 OSTRANDER A1'i:NUE, RIVLR[4
ALOEN W. YOUNG j
PROFESSIONAL ENGINEER AND
LANO SEJPVEYOR. 'N. r. S. u:.: NP. '.26«
SURVEY FOR:
JOHN MCIVEIL
/CZE OF NFyr
faPsl) ly Yn
hi01`�L:cr1 YOi
LAN 1`ir, OR
ATVR T ' GIIARANTLLD TO:
JE'Y
C ,Y SOLITAOL0 SAVINGS FAA'lf
TOWN OF : .ME rITLE GV,4RANtEECO.
SOU THOca
SUFFOLK CO., N. y s%.d !lslQ1� Gl.
SCALE: „QR7E: NO.
J eo tFJAY 17, 1.9,77 77 - 300
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWNHALL
^ � 765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
X. 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 archi'-ect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
1.: 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 $15.00, Commercial $15.00
Date ........ ...V.zJ,/5�/................
few Construction..... Old Or Pre-existing Building........ ....
,ocation of Property. /0 SU l�iFI� ,/�CahE,._.„.,,,,,,,,,,�!lcocr ................
House No. Street Hamlet
inwer or Owners of Property .....H,�ICR.,.. Zv,H0s�e�............... .................
ounty Tax Map No 1000, Section..... �.....Block...1............Lot.......1..`............
ubdivision....................................Filed Map ............ Lot ......................
ermit No................Date Of Permit ................ Applicant .............................
ealth Dept. Approval..........................Underwriters Approval.........................
lanning Board Approval ........................
equest for: Temporary Certificate........... Final Certicate...........
ee Submitted: $.............................
�akc.yl8`IS.`R : yy/%%/ ............
19 9 y
APPLICl(id`i' .
�f i
((1,61 L a
Owner(s) Nan•
do(es) hereby state:
CONSENT
TO
INSPECTION
the undersigned,
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at j0 50 V I L L IQ 6' r'- 4.RAIAF
OR/EAJ T which is shown and designated on the Suffolk
County tax map as District 1000, Section a Block ( Lot l
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:
UA
!h\i MAY 281991 lJI�
(signatur
cS if ILiq Z L)44 U3 }G
(print name) /
signature
(print name)
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION:
number & street
SUBDIVISION
NAME OF OWNER (s)
OCCUPANCY
(type
ADMITTED BY:
KEY AVAILABLE
SOURCE OF REQUEST:
.(municipality
MAP NO, LOT (s)
towner -tenant
ACCOMPANIED BY:
SUFF. CO. TAX MAP NO.
DATE:
ACCESSORY
DESCRIPTION
ART.
SEC.
DWELLING:
C-'
TYPE OF CONSTRUCT
ON�
STORIES #EXITS
FOUNDATION
174
CELLAR ) 7 CRAWL SPACE 3
TOTAL ROOMS:
IST FLR. 2ND FLR.
3RD FU.
BATHROOM (s)
TOILET ROOM (s)
2 UTILITY ROOM,
PORCH TYPE
cj1S DECK, TYPE
PATIO, TYPE
BREEZEWAY
FIREPLACE
GARAGE
`
DOMESTIC HOTWATER 4J TYPE HEATER L,16
C0 AIRCONDITIONING
TYPE HEAT
` WARM AIR
HOTWATER
OTHER: J7"--
.G
ACCESSORY STRUCTURES:
L
GARAGE, TYPE OF CONST. C ' G`��' STORAGE, TYPE CONST.
SWIMMING POOL GUEST, TYPE CONST.
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION
DESCRIPTION
ART.
SEC.
1
174
C-
r
0 v
j
n =k=
-S 4 1-U ceIi 3
REMARKS:
INSPECTED BY: ' DATE ON INSPECTION, 1�
TIME START / ,� ENDC