HomeMy WebLinkAboutZ-29548FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEP/~RTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 29548 Date: 07/01/03
THIS CERTIFIES that the building
DWELLING
Location of Property 8295 MAIN RD
(HOUSE NO.)
County Tax Map No. 473889 Section 031
EAST MARION
Subdivision
(STREET) (}IAMLET)
Block 0002 Lot 032.003
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
OCCUPI~NCYN73MBER Z- 29548 dated J~3LY 1, 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 COVERED FRONT PORCH, SIDE TRELLIS AND SLATE
PATIO.*
The certificate is issued to BETTY GOLDRICH & CARA GALOWITZ
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION D/~rmu
N/A
N/A
Rev. 1/81
*PLEASE SEE ATTACHED INSPECTI~T.
Authorized S~ature
BUILDING DEPARTMENT
TOWN OF SOUTNOLD
HOUSING CODE INSPECTION REPORT
I~TION: 8295 MAIN RD EAST MA~RION
SDBDIIr~SION: P~AP NO.: LOT (S}
N;~ OF OWIWER (S): BETTY GOLDRICH & CA}LA GALOWITZ
OCCDPANC"f: SINGLE FAMILY BETTY GOLDRICH & CARA GALOWITZ
SOIIRCE OF I~QI~: SAME DA~'E: 07/01/03
ACCESSORY STRUCTURES:
VIOLATIONS: CHAPTER 45 N.Y. STATE LTNIPORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
I~: NOTE:~ IS SAME AS PRE-C/O DONE ON 11/21/95
]-.7:~ Form No. 6
' TOWN OF $OUTHOLD
BUILDING DEPARTMENT
; ' TOWN HALL
, 765-1802
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. Connnercial 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 Plalming 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. Ifa 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 - $I00.00
3. Copy of Certificate of Occupancy- $.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, ConnnercialDate. $15.001~/'j~/~'//3
(check one)
New Constmctiou:
Location of Property:
Old or Pre-existing Building:
House No. Street
Hamlet
Owner or Owners ofProperty: j~Lg'. , .¥~ ~O~t~ ~' C~'~'~ &~-~/l~"~'
Suffolk County Tax Map No 1000, Sectiotn/00~) '"~/%~ :~ ~'~IBlock ~ Lot~__
Subdivision Filed Map. Lot:
Permit No. Date of Permit.__ Applicant:
Health Dept. Approval:
Planning Board Approval:
Under~vriters Approval:
Request for: Temporary Certificate
Fee Submitted: $
Final Certificate: (check one)
· ' ~']Applicant Signatfire /~ ff~ '
CONSENT TO INSPECTION
~,~X 0~ C ~-~t & '~, the undersigned, do(es) hereby state:
Owner(s) Name(s)
That the undersigned (is) (al'e) the own_erE) of the premises irt the Town of
Southold, located at C t
which is shown and designated on the Suffblk County Tax Map as District 1000,
Section , Block , 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:
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, roles or
regulations of the Town of Southold.
Dated:
Si am )
(Print Name)
SURVEY OF'
LOT 2
SUBDIVISION MAP OF
PROPERTY SURVEYED FOR
DONNA INGLE$IA$ WEXLER
FfLE No. g9~5 FILED NOVEMBER 21, 1996
SITUA TED A T
EAST MARION
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-51-02-52.5
SCALE 1"=30'
MARCH 18, 1997
AREA 45,566.46 sq. ff.
1.000 ac.
%,
CERTIFIED TO:
Pi[CONIC ABSTRACT, I~c.
BTANDARD FEDERAL BANK
BETTY GOLDRICH
CARA L. GALOWITZ
Joseph A. Ingegno
Land Surveyor
PHONE (516172~'-20g0 Fax (516)722-5095