Loading...
HomeMy WebLinkAboutZ-41118 ,f�S1lFppl�., Town of Southold 3/7/2020 Gy 53095 Main Rd A . Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 41118 Date: 3/9/2020 THIS CERTIFIES that the structure(s)located at: 220 Cottage Pl, Southold SCTM#: 473889 Sec/Block/Lot: 62.-3-14 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- 41118 dated 3/9/2020 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 wood frame front covered porch and concrete patio.* Note:BP 44769 oil to gas conversion COZ-41117 The certificate is issued to Poliwoda, Daniel&Ruth (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. u ho ' e Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 220 Cottage Pl, Southold SUFF.CO.TAX MAP NO.: 62.-3-14 SUBDIVISION: NAME OF OWNER(S): Poliwoda,Daniel&Ruth OCCUPANCY: ADMITTED BY: owner&Jerry Cibulski SOURCE OF REQUEST: Poliwoda,Daniel DATE: 3/9/2020 DWELLING: #STORIES: 2 #EXITS: 2 FOUNDATION: brick w/cement block CELLAR: full CRAWL SPACE: BATHROOM(S): 2 TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: front covered DECK TYPE: PATIO TYPE: concrete BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: x TYPE HEATER: gas AIR CONDITIONING: TYPE HEAT: oil WARM AIR: HOT WATER: baseboard #BEDROOMS: 3 #KITCHENS: 1 BASEMENT TYPE: unfinished OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 3/5/2020 TIME START: 11:59am END: 12:18pm Form No.6 3 / ?✓ bA TOWN OF SOUTHOLD BUILDING DEPARTMENT 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). 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. B. 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 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,Accessoi buildin 50.00,A itis 49 accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Build' - $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 Date. New Construction: Old or Pre-existing Building: (check one) Location of Property: 2 2—C-2 �d Y¢A fj �,D1AC,ESeo House No. Street Hamlet Owner or Owners of Property: N4 ,C' Po Suffolk County Tax Map No 1000, Section �j Block 3 Lot j Subdivision Filed Map. Lot: Pen-nit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate:� (check one) �O Fee Submitted: $ ZODl®re,�V , - ra�C.,q(s 0 NF� Applicant Signature iftsf s 0 * # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND < [ ] INSULATIOWCAULKING [ ] FRAMING /STRAPPING [ ] FINAL ` [ ] FIREPLACE & CHIMNEY - [ ] -FIRE SAFETY INSPECTION [ ] -FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ECTRICAL (FINAL) [ ] CODE VIOLATION PRE C/O REMARKS: _ re, — A�) &nA ✓ v 1(ti• ©� - Mo Wti �(o — vowv X v� i l DAT - 3l� INSPECTOR I CONSENT TO INSPECTION -)A�J,EG Polt f 'D,)14 , the undersigned, do(es)hereby state: Owner(s)Name(s) That the undersigned (is) (are) the owner( of the premises in the own of (17 17 Southold, located at 26 G Ge j g'7 I which is shown and designated on the Suffolk County Tax Map as District 1000, Section 40�)- , Block 3 , Lot /�( _. That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: of 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: (Si nature) A4-,u.°e 4© 1A,0004- (Print `c.0004- (Print Name) (Signature) (Print Name) Wm. upmosm (FoUga.L c�a�v�INs} N N. 13. 16, W, E. 1�1.�8 POST Sim a r ? u.. Lu I r y ca � ,Q o C �tfiARAS cl . TV 13 10 '` W. 1IS 11T �--� �u>zToN I � SCALES 30 ` :. j ,� _ MAS ' Or L � Kffl SUzveyso rom T ( TL � H ° - 3 � � � aMD C� T C) GUAQAQ1660 To TUe SeCUVT' 1111L, UY, L SON 'j014l� a� Snt�T .� oLU e-�.� , 5ultvEy6n SE�.T. i2, cgb6 4) uA1555 Amp, 11415.lov) J( F, ; { o1 9 NHN i Nofz-js C j LAh1.F OF w !D w " Mhp 0 LAND Or JS,14HJr6 COCUa.49 " FILSO Its JUS SLIfF LV. I, IC�Fjvti;ll 1.�1�in 9 Cnu�r�y cIt2V.-s OFflCE A5 MA? Ns 39;4 Gja58HpolL; , E1 �►V �(0�� d . TOWN OF SOUTHOLD PROPERTY REFI� r � I OWNER STREET (A. VILLAGE- DIST.1 SUB. LOT a FORMER OWNER ACR. _-�`---'` S W { TYPE OF BUILp6qG -2•ti�1Z.. �..��L...ct��•�s.:.� j;� ✓�,,d�fc��,.., �.�` '+:�.-��, - ✓�yiT "rs„�`-'-u``'- r RES. SEAS. IV FARM COMM. CB. MI4, Mkt. Value LAND IMP. TOTAL DATE REMARKS I ^ j _ i AGE BUILDING CONDITION NEW NORMAL ! BELOW ABOVE FARM Acre i Value Per Value Acre Tillable FRONTAGE ON WATER Woodland I I FRONTAGE ON ROAD Meadowland �� _ T DEPTH House Plot BULKHEAD i Totals —J , � DOCK ys- .'�. _s ,. ;" .v • a . /Coo ,�: _ � _ �.:':��?:'_ --K�•, ^'it..:�; OhlCOLOR ..a r��: TRIM ;.. I FF 1 I. 1 Y M. Bldg. ,f 1',7,0Z 0 1 Extension ► �'' (",/ ,t I ; )3 1 �j Extension Extension 4 i Foundation Bath Dinette Porch i `Basement - Floors K. ' Porch I Ext. Walls ' 'In terior Finish :� ' '+ F � SLR. ( Breezeway i Fire Place Heat E DR. Garage Type Roof Rooms 1st Floor BR. Patio Recreation Room Rooms 2nd Floor Fl N. B O. B. i Dormer {Driveway Total f I - dao C©t+��� �L,��-e 14. 13' 16' W, E. — 14-:Z:A-1. s ::;,- slot) 4 t i a j G sg I :i Ls RAGE w . — ! c� . 13Iii' 50'' 111. - I I i 7T v VMT0N SAP 0r L KI D 1 5CAL 30 ' = 111 f r {� f V 0l,-L IG VB A �i- U T ( TL H S- 3 ! M61_ _ F -- -_- -W 0 L 111GuA2au (� �3 TO T"AE 136COUT1 llll,� Awn Cib' :1R .,N jY COMPAW� 5 0 n tZ�RA I�� S AMS 14151 OV) 10 VS Logi I NHP NOR NG0.C`j ob!.F of LOT !D oj, " MAp Or. LANs, Or JFHH116 COCIMhµ " F�LSD tN TLK SUfFOLV Laltn 5ut,�q qmq C001411 C6SRIG'S DFfICE A5 MAV N? J9;4 ttiCEN �OIL; law Dvl LOCATION: '�O •�// '°P� P� o/ l� (number & str t) (municipality) SUBDIVISION: "APWO.: LOT(S): .. NAME OF OWNER(S)': P9t I W O'CCUPANC V: n % to (type) (owner-tenant)- ADMITTED BY: t{'1W►QMN!L%., c1,.C1%bAzI,�CCOMPA.NIED BY: KEY AVAILABLE: SUFE. 'C0. TAX MAP'NO 1000- SOURCE OF REQUEST: DATE: oftA& it DWELLING TYPE OF CONSTRUCTION; N STO-RTES: # EXITS: F'OUNNDATION:;, CL roAJ M&6,kSVMENT' : 'CRAWL SPACE: _ # OF BEDROOMS: IST FLR: 2ND FLI2:_ 1/, 3RD FLR: . BATHRO'OM(S): TOILET AOOM(S): UTILITY ROOM: PORCH.TYPE'— III OE-CK., TYPE: PATIO;TYPE: BREEZEWAY:' FIREPLACE: QARAGE: _ DOMESTIC AVER: T t HE ER: AIRCONDITIONING: TYPE HEA W MA HOTWATER: 4 OF KITCHE `. k FINISHED BASEMENT:- YES NO OTHER: ACCESSORY STRUCTURES GARAGE; TYPE OF CONST, LAYM 1AA STORAGE,TYPE CONST.: SWIMMING POOL: _ GUEST,'TYPE CONST: OTHER: VIOLATIONS: CHAPTER]44 &N.Y. STATE.UNIFORM F;RE PREVENTION & BUILDING CODE L ATION DESCRIPTION ART. SEC. u rw REMARKS: INSPECTED BY�JVN J � I�� DATE OF INSPECTION: TIME START; r _ END; Y.