The URL can be used to link to this page

Home My WebLink AboutZ-29293FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 29293 Date: 03/06/03 THIS CERTIFIES that the building DWELLING Location of Property 33195 MAIN RD ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No_ 473889 Section 019 Block 0001 Lot 013 Subdivision Filed Nap 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- 29293 dated MARCH 6, 2003 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 GARAGE * The certificate is issued to EUGENE H SUSAN J. MOISA (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTI Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 33195 MAIN RD ORIENT SUBDIVISION: MAP NO.: LOT (S) MAKE OF OWNER (S): EUGENE H SUSAN J. MOISA OCCUPANCY: SINGLE FAMILY EUGENE H SUSAN J. MOISA ADMITTED BY: JOE WYSOCKI ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 19.-1-13 SOURCE OF REQUEST: EUGENE H. MOISA 2/13/03 DATE: 03/06/03 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 2.0 # EXITS: 2 FOUNDATION: CONCRETE CELLAR: PART CRAWL SPACE: TOTAL ROOMS: 1ST PLR.: 5 2N11) PLR.: 2 3RD FLR.: 0 BATHROOM(S): 2.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S): 1 PORCH TYPE: DECK TYPE: PATIO TYPE: CONCRETE BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTMATER: XX TYPE HEATER: NAT.GAS AIRCONDITIONING: TYPE BEAT: NAT.GAS MARK AIR: HOTWATER: XX OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF COMET.: 2 CAR WOOD STORAGE, TYPE CONST.: METAL STORAGE SKINNING POOL: REMOVED GUEST, TYPE COMET.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION I DESCRIPTION I ART. SEC. INSPECTED BY (/ r ll� / DATE ON INSPECTION: 02Z28/03 JONM M. BOUFIS TIME START: 9:50 AM EN): 10:30 AM Y.� 3 --Q 7L Cl Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL FEB ► 3 20 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY L -- 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. CBor 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 topogi aphic 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 $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 - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Old or Pre-existing Building: Date. 751716P ice_ ?6413 (check one) Location of Property: 3 3/ 9S� /'//-F//V RD 0RJ FtVT House No. Street Hamlet Owner or Owners of Property: ,E(4 ,r -Nr- )i 4- SUSITN eT 1110-1519- Suffolk County Tax Map No 1000, Section Subdivision Permit No. Date of Permit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Az �co�. a9ag3 Block f Filed Map. Applicant: Underwriters Approval: Lot Lot: — Final Certificate: v,"� (check one) Applicant Signature _J CONSENT TO INSPECTION + SraSH-1U �— the undersigned, do(es) hereby state: Owner(s) Name(s) That the undersigned (is) (_e) the owner(s) of the premises in the Town of Southold, located at 3 3/ 9. M AiN AD. O RiFNT which is shown and designated on the Suffolk County Tax Map as District 1000, Section Iq , Block / Lot /3 That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: LGl?Tlrl CY+ -C of-- DCC -U 04wV/ 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: WR l a, JO e 3 -- (Signature) (Print Name) [� (S gnatur ) SAnr T- - f\,) f) i<A (Print Name) Y103141.1 `r ` ", , 3VY115.Nw1LON 3IV 53:1; i, -IISN( nNia 01 11.1 30 S11; 0mv $10:9—I 111iil V -ns 'm w ', 8' i Nna IIVH) 13 ONr"V39 icN 8v.l alyLs A0A h\;N 111 JJ 20 NQ!iVI�IA V SI 'A 14 JW,— J:z 0 bv = E, 1. N -V/ .A ir, V-C/Ow aOO-V' LOCATION: .00::, � ! ✓ (number & street) SUBDIVISION: NAME OF OWNER(S): OCCUPANCY: (type) , MAP NO.: (municipality) LOT(S): (owner -tenant) ADMITTED BY:d C �,uiJspL ACCOMPANIED BY: KEY AVAILABLE: Or SUFF. CO. TAX MAP NO. 1000 SOURCE OF REQUEST: ,k 3' c a- -WaJ-i,1 DATE: /a DWELLING: TYPE OF CONSTRU TION: # STORIES: # EXITS: FOUNDATION: _CELLAR:�CRAWL SPACE: TOTAL ROOMS: IST FLR: 2ND FLR: _ 3RD FLR: BATHROOM(S): TOILET ROOM(S): UTILITY ROOM: PORCH TYPE: DECK, TYPE: PATIO, TYPE: ai G'i} t z BREEZEWAY: FIREPLACE: GARAGE: ----- DOMESTIC HOTWATER: TYPE HEATER: 4/&r AIRCONDITIONING:------- TYPE HEAT: Al T ��_ WARM AIR: HOTWATER: OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OFC NST.: �� STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST: OTHER: 1 14 l S�45.4 VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION I DESCRIPTION I ART. I SEC. REMARKS: INSPECTED BY-Vgl& I�! DATE ON INSPECTION: J � TIME START: i END: o