HomeMy WebLinkAboutZ-41439 Town of
�p�sU �I�COG.ra 3095 Main Rd Southold 10/15/2020
Southold,New York 11971
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 41439 Date: 9/12/2020
THIS CERTIFIES that the structure(s)located at: 4510 Rocky Point Rd, East Marion
SCTM#: 473889 See/Block/Lot: 21.-3-26.1
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- 41439
dated 9/12/2020 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 front brick porch and rear covered concrete porch.*
Note:BP 11415 accessory storage building COZ-11867; BP 45075 "as built"central air conditioning COZ-41438
The certificate is issued to Dzenkowski AR Family Trt
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
Wt4c.4" e •
AuthodSignatu
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 4510 Rocky Point Rd,East Marion
SUFF.CO.TAX MAP NO.: 21.-3-26.1 SUBDIVISION:
NAME OF OWNER(S): Dzenkowski AR Family Trt
OCCUPANCY:
ADMITTED BY: Kim Dzenkowski
SOURCE OF REQUEST: Dzenkowski AR Family Trt DATE: 9/12/2020
DWELLING:
#STORIES: 1 #EXITS: 2
FOUNDATION: concrete block CELLAR: x CRAWL SPACE:
BATHROOM(S): 1 TOILET ROOM(S): 1 UTILITY ROOM(S):
PORCH TYPE: brick&covered concrete DECK TYPE: PATIO TYPE:
BREEZEWAY: FIREPLACE: GARAGE:
DOMESTIC HOTWATER: x TYPE HEATER: electric AIR CONDITIONING:
TYPE HEAT: electric WARM AIR: HOT WATER:
#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: MIKEV DATE OF INSPECTION: 7/8/2020
TIME START: 9:45am END: 10:30am
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802 r
I
APPLICATION FOR CERTIFICATE OF OCCUPANCY
' J U N 1 6 2020
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, andfunusual-naturalnor* `
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,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
Date. 6 f 12, (�0 2,Q
New Construction: Old or Pre-existing Building: V (check one)
Location of Property: PV D A-R
House No. treet Hamlet
Owner or Owners of Property: A L 1 Ge, Q Q Z.G,✓ k o w S I{ l
Suffolk County Tax Map No 1000, Section -2, 1 Block 3 Lot
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval: /
Request for: Temporary Certificate Final Certificate: V/ (check one)
Fee Submitted: $ I C96 . 00
Applicanr Signature
CONSENT TO INSPECTION
A L(G G -OZ Gti R O W S i , 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 L4 5-'l C7 R 6G(4..i PNT g 10 if1k5 T AA*4104/
which is shown and designated on the Suff c County Tax Map as District 1000,
Section 2( , Block 3 , Lot 2 G . ( .
That the undersigned (has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following:
G. 0 . J i�7� 1= .IST l•✓Q SA � �PKM (L�/ >P�S .
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:
(Signature)
02e4-A&W5It ► ,o . f� -
(Print Name)
(Signature)
(Print Name)
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LIBER 6665 PAGE 280
SuRvEYDF BOUNDARY AGREEMENT
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Mme �..�.o+v+ •��� >-� EAST MARION,TOWN OF SOUTHOLD
�>< 98 zap �� ami ai e�*�+m� I�•• SUFFOLK COUNTY,NEW YORK
SURVEY DATE- 04/05105---- SCALE 1•-•50'
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CERTIFIED ONLY T'o'
ALICE R DZENKOWSIG AND WARREN P WALKER DESTIN G GRAF
LAND SURVEYOR
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S.C.T.M. NO. DISTRICT: 1000 SECTION: 21 BLOdk: 3 LOT(S):26.1
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THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL
04-10-20 SET MONUMENTS LOCA71ONS SHOWN ARE FROM FIELD OBSERVATIONS
AND OR DATA OBTAINED FROM OTHERS.
AREA:98,725.07 SQ,FT. or 2.27 ACRES ELEVATION DATUM:
UNAUTHORIZED ALTFRA77ON OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL.RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO 7HE 777LE COMPANY, GOVERNMENTAL AGENCY AND LENDING INS77TU77ON
LISTED HEREON, AND TO THE'ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE.
THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUC77JRES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
NOT INTENDED TO MONUMENT 7HE PROPERTY LINES OR TO GUIDE THE EREC77ON OF FENCES, ADD177ONAL STRUCTURES OR AND 07HER IMPROVEMENTS EASEMENTS
AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY
SURVEY OF: DESCRIBED PROPERTY CERTIFIED TO: ALICE R. DZENKOWSKI;
MAP OF:
FILED:
SITUATED AT. EAST MARION
TOWN OF: SOUTHOLD KENNETH M WOYCHUK LAND SURVEYING, PLLC
SUFFOLK COUNTY, NEW YORK Professional Land Surveying and Design
P.O. Box 153 Aquebogue, New York 11931
PHONE (831)298-1588 FAX (831) 298-1588
=FILEJ26 SCALE:1"-4Q' DATE: FEB. 19, 2020 N.YS. LISC. NO. 050882 maintaining the records of Robert J. Hennessy & Kenneth M. Woychuk
o _ , TOWN OF SOUTHOLD PROPERTY RECORD CARD zz
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OWNER STREET e-1 VILLAGE DIST. SUB. LOT
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RES. SEAS. VL. FARM COMM. CB. MISC, Mkt. Value
LAND IMP. TOTAL DATE REMARKS
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C� Gfo o o 7 € �' = I - L-�Z579 ��-� 1►+ aC - lal kei, n�1�
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BVIL, ING CON TIO n
NEW NORMAL BELOW AB VE
FARM Acre Value Per Value
Acre
Tillable 1
I
Tillable 2
Tillable 3
Woodland
Swampland FRONTAGE ON WATER
Brushland FRONTAGE ON ROAD
House Plot 1 he 1 1c.00 (Qpm DEPTH
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`ycourmNF`' 765-1802
INSPECTION
[ ] FOUNDATION 1ST _ [ ] ROUGH PL13G.
[ ] FOUNDATION-21SID - [ ] INSULATIOWCAULKING
[ ] FRAMING/STRAPPING [ ]- FINAL
[ ] FIREPLACE & CHIMNEY- [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT-PENETRATION -
[ ] ELECTRICAL (ROUGH) [ ]�PREC/o
CTRICAL (FINAL)
[ ] CODE VIOLATION [
REMARKS:
Alf
DATE 07 INSPECTOR
LOCATION:
(number & street) (municipality)
SUBDIVISION: - MAP N'O.: __. ., LOT(S):
NAME OF OWNER(S)':._
OCCUPANCY:
(ty (owner-tenant),
ADMITTED BY: ACCOMPANIED BY:
KEY AVAILABLE: SUPT. 'CO. TAX MAP'NO, 1000- ^
SOURCE OF REQUEST: DATE: eezn;y;�
t.
DWELLING
TYPE OF CONSTRUCTION: GAJ* STOMES: # EXITS: �—
._._.
FOUNDATION: �� : ]�ASEIVIENT: 'CRAWL SPACE:
# OF BEDROOMS: IST FLR: 2ND FLA.: _ 31�.D FLA: .
,BATHROOM(S): TOIIrET AOOM(S): UTILITY ROOM:
PORCH.TYPE: -. ECK, TYPE: .. . PATIO;TYPE: �1
BREEZEWAY:' �FIREPLACE: ®� QAPAGE:
DOMESTIC HOTWATER: TYP9 HEATER: ' AIRCONDITIONING:
TYPE HEAT: WARM AYR: HOTWATER:
# OF KITCHENS: j
`
FINISHED BASEMENT:- YES NO
OTHER:
ACCESSORY STRUCTURES .
GARAGE; TYPE OF CONST.: STORAGE,TYPE CONST.:
SWIMMING P'O'OL: - GUEST,'TYPE CONST:
OTHER:
VIOLATIONS:. CHAPTER.144 &N,Y, STATE:UNIFORM FARE PREVENTION & 13UILDING CODE
LOCATION PRSCP PTION ART. SEC.
C.
oe A
� dso
REMARKS: V
INSPECTED BY: DATE OF INSPECTION: 071P J
TIME START:` ���_. END: