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Home My WebLink AboutZ-29401FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 29401 Date: 04/30/03 THIS CERTIFIES t~at the building DWELLING Location of Property 1305 PEQUASH AVE CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 103 Block 0007 Lot 018 Subdivision Filed Map No. __ Lot No. -- conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF (~C~/PANC"~lq~3MBER Z- 29401 dated APRIL 30, 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 iB ONE FAMILY DWELLING WITH ACCESSORY ONE CAR GARAGE & ACCESSORY WOOD SHED * The certificate is issued to HELEN SLEDJESKI TRUST & ORS. (0WNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF ~IEALTHAPPROVAL H~ECTRICAL CERTIFICATE NO. PLUMBER~ CERTIFICATION D~£~ *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTROLD HOUSING CODE INSPECTION REPORT LOCATION: 1305 PEQUASH AVE CUTCHOGUE SUBDIVISION: MAP NO.: --, LOT (S) __ NAME OF OWNER (S): NELEN SLEDJESKI TRUST & ORS. O(2CI/~ANCY: SINGLE FAMILY HELEN SLEDJESKI TRUST & ORS. SO~JRCE OF REQUEST: LARK & FOLTS, ATTYS 4/22/03 DATE: 04/30/03 ACCESSORY STRUCTURES: C~E, TYPI~ OF CONST.: 1 CAR WOOD FP, A24E STOR~E, ~'YPE CONST.: WOOD FR3~ME SHED VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. P-~: BP #29292-Z-COZ-29373 (FRONT PORCH ENCL) DAT~ ON INSPECTION: 04/25/03 TI~ START: 9:40 AM ~D: 10:00 AM Form No. 6 TOWN or SOUTHOLD ~ ~ 2003 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: Ao For new building or new use: I. 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. Bo 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. Co 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 - $25.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. April 22,2003 New Construction: Location of Property: 1305 Old or Pre-existing Building: X Pequash Avenue (check one) Cutchogue Hamlet 018.000 House No. Street Owner or Owners of Property: Lucille Stepnoski et al. Suffolk County Tax Map No 1000, Section 103.00 Subdivision Permit No. Date of Permit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ 100.00 Block 07.00 Lot Filed Map. Lot: Applicant: co Jq q0 ! Underwriters Approval: Final Certificate: X 7 (check one) V~pplicfin{ Signature Barbara Goehr£nger CONSENT TO INSPECTION Barbara Goehr:[nger the undersigned, do(es) hereby state: Owner(3) Name¢) one of That the undersigned (is)~(m'e-) the owner(s) of the premises in the Town of Southold, located at 1305 Pequash Avenue, Cutchogue, New York ., which is shown and designated on the Suffolk County Tax Map as District 1000, Section 103 Block 7 , Lot 18 That the undersigned (has) (4~,e) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: Cert±ficate of Occupancy on Pre-ex±st±ng Bu±ld±ng 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, roles 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, roles or regulations of the Town of Southold. Dated: April 22, 2003 Barbara Goehringer (Print Name) (Signature) (Print Name) TITLE No. o~ I - ~ ~o~, ~o" ~ ~S.~' 0 0 ~ O~ . ~ ~ ~' ~0" W ~.00' ~E~S~E~ENT IN U.S. 8T~N~D [ ~ENOT EXISTENCEsHoWN ARE ~NOTR~GuARA~EED,OF WAYS AND~R EASEl.S ~ RE~D, · ~, THE DI~ENSlON~ SHOWN HEREON, FROM ~E STRUCTURES TO THE PROPER~ UNE, A~E FO~ ~ SPECIFIC PU~POSE ONLY. THEY ARE ~~~ ~ ~-~ SECTION BLOCK DATE L~ND ~S, P.C. ~./~ · o~ ~- ' GUARANTEED TO AIL~NG ADDRESS o~ {516) 431-93~8 P.O. ~OX 118 ~ g~F0 c~ (914) 7~304 73 ~5TCHESTER A~. COUNTY