HomeMy WebLinkAboutZ-40651 �fr� Town of Southold 8/22/2019
,f G 53095 Main Rd
�` Southold,New York 11971
W
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 40651 Date: 8/22/2019
THIS CERTIFIES that the structure(s) located at: 3150 Boisseau Ave, Southold
SCTM#: 473889 Sec/Block/Lot: 55.-6-8
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- 40651
dated 8/22/2019 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 front porch, accessory wood frame one car garage and accessojy block
and wood frame 2 story barn with gas heat.*
Notes: BP 13207 addition to dwelling COZ-14303; BP 18426 addition to accessory barn COZ-19579; BP 44044
electric COZ-40631.
The certificate is issued to Swiatocha, Wayne
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
Aut o ed Signature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 3150 Boisseau Ave, Southold
SUFF.CO.TAX MAP NO.: 55.-6-8 SUBDIVISION:
NAME OF OWNER(S): Swiatocha,Wayne
OCCUPANCY:
ADMITTED BY:
SOURCE OF REQUEST: Swiatochia,Wayne DATE: 8/22/2019
DWELLING:
#STORIES: 2 #EXITS: 3
FOUNDATION: brick and poured concrete CELLAR: partial CRAWL SPACE: partial
BATHROOM(S): I TOILET ROOM(S): 1 UTILITY ROOM(S):
PORCH TYPE: front covered DECK TYPE: PATIO TYPE:
BREEZEWAY: FIREPLACE: 1-gas GARAGE:
DOMESTIC HOTWATER: yes TYPE HEATER: gas AIR CONDITIONING:
TYPE HEAT: gas WARM AIR: forced hot air HOT WATER:
#BEDROOMS: 3 #KITCHENS: 1 BASEMENT TYPE: unfinished
OTHER:
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: wood frame 1 car STORAGE,TYPE OF CONST: block/wood frame 2 sty barn w/gas
SWIMMING POOL: GUEST,TYPE OF CONST:
OTHER:
VIOLATIONS:
REMARKS:
INSPECTED BY: JOHNJ DATE OF INSPECTION: 8/6/2019
TIME START: 11:29am END: 11:57am
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT (0
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:
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). ,,;0�' (�
3. Approval of electrical installation from Board of Fire Underwriters. i,�. = -Zf 1 �
,... t
4. Sworn statement from plumber certifying that the solder used in system contains less th r /d 0�- 1&fa lead.
S. Commercial building,industrial building,multiple residences and similar buildings and t dations,a certificate .`
of Code Compliance from architect or engineer responsible for the building. JUL - g 2019
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-existipj.. es 1
1. Accurate survey of property showing all property lines,streets,building and unusual natural o"6-
��} �
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$15.00 q
Date. o 1
New Construction: Old or Pre-existing Building: (check one)
Location of Property: 3 ' 870 Al Sit a-7- s ou-T¢(a C_0
House No. Street Hamlet
Owner or Owners of Property: r --L- cSC4jzA r O C
Suffolk County Tax Map No 1000, Section Q) c�7 cS— Block O Lot 0
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: '/ (check one)
Fee Submitted:$ / 06
1111UAJA f)
P� u
icant Signature
CONSENT TO INSPECTION
L&OIt 9VT A[0 C A ,the undersigned, do(es)hereby state:
Owner(s)Name(s)
That the undersigned(is) (are)the owner(s) of the premises in the Town of
Southold,located at 3 1 S-0 l�,c0,:PSS�-A(A 4 ,AY/hUS SOuTNOCV ,
Which is shown and designated on the Suffolk County Tax Map as District 1000,
Section OSS,Block C7( ,Lot 00
That the undersigned(has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following:
eon
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: bllae,- d6
'
Signature)
Gc/fl y ,l S 6(J Z A T a G#A
(Print Name)
(Signature)
(Print Name)
00
N
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TOWN OF SOUTHOLD PROPERTY
r
OWNER STREET = i i VILLAGE DIST.F SUB. LOT
,
kc"o
FORMER 4�&IER Ne E ACR.
06
S 7,— 4w TYPE OF BUILDING
d
1 .,',5
RES.
SEAS. VL. FARM comm. CB. MICS. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
% !0
3 2 0 7Y2 w S
_q,
-5 10-49 614 d� bA R id
i d9lq,,) L 7 72746 -TYA,// 117) J��71kl I)1 irl aro Al
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o ri?o i nwy)o
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�60 ZY6
BUILDING CONDITION
AGE /3 S 7,F
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value
Acre
Tillable aki
Ci FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD
P9
Meadowlan in DEPTH
House Plot BULKHEAD
Total-,, DOCK
0
COLOR L-j 1-4 e TRIM a 0
A
C7
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Extens
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Extension
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n io
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Porch easement
Floors i K.
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xt. Walls Interior Finish e,/ ':4 LR.
Breezeway
�,IF-ire Place Heat DR.
Garage
`Vol ;Type Roof Rooms 1st Floor BR.
Patio
Recreation Room, Rooms 2nd Floor FIN. B
O. B. or
U44 Driveway
Total
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Y,
00
0
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TOWN OF-SOU'rHOtE).NY,
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# TOWN OF SOUTHOLD BUILDING DEP .
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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:
lir
oy . &- "�
CL u -Al
�ioh'1 U1c�c
DATEINSPECTOR
LOCATION: 7QIP° civ,�
(number & street) (municipality)
SUBDIVISION: P-NO.: LOT(S): .
NAME OF OWNER(S)': W 9
OCCUPANCY: i
(type) (owne'r-tenant)-
ADMITTED BY: ACCOMPANIED BY:
KEY AVAILABLE: SUFF. CO. TAX MAP�O. 1000-
SOURCE OF REQUEST: OW�� , . . DATE: J
DWELLING
TYPE OV,CONSTRUCTION: #STO'RIES: #EXITS: _
ti�
FOUNDATION• C RASgMENT: 2fik--'CRAWL SPACE:
S
-40F BEDROOMS: IST FUR: I 2N\D FLR: 3RD FLA: -f--�
-BATHRGOM(S): TOILET RiOOM(S): UTILITY ROOM: _
PORCH-TYPE: DECK, TYPE: .. . .. PATIO;TYPE:
BREEZEWAY:' . , FIREPLACE: QARAGE:�Jjak4 .
DOMESTIC HOTWATER: TYPE HEAT.M' ,6K. AIRCONNDITIONIN�G:
TYPE HEAT v WARM AIR: f` HOTWATER:
# OF KITCHENS:
FINISHED BASEMENT:- YES NO
OTHER:
ACCESSORY STRUCTURES,
/�� JJ
GARAGE; TYPE OF CONST.:✓ WfA I "STORAGE, TYPE CONST.:
SWIMMING P'O$OL: GUEST,'TYPE CONST:
OTHER:
VIOLATIONS:. CHAPTER-144 &N,Y. STATE UNIFORM FARE PREVENTION & BUILDING CODE
LOCATION DESCIUPTION ART. SEC,
REMARKS:
INSPECTED BY:811111, lJi DATE OF INSPECTION; i
TIME START;AIJI END: