The URL can be used to link to this page

Home My WebLink AboutZ-29546FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 29546 Date: 06/25/03 THIS CERTIFIES that the building DWELLING Location of Property 26170 OR 48 CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 084 Block 0005 Lot 004 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 OCCUPANCY NUMBER Z- 29546 dated JUNE 25, 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 6 ACCESSORY SHEDS & 1 LARGE BARN The certificate is issued to BERTHA PAWLUCZYK (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 INSPECTION REPORT. A }ori d Sign tune Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 26170 OR 48 CUTCHOGUE SUBDIVISION: MAP NO.: LOT (S) MAKE OF OWNER (S): BERTHA PAWLUCZYK OCCUPANCY: SINGLE FAMILY BERTHA PAWLUCZYK ADMITTED BY: IRENE STULSKY ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 84.-5-4 SOURCE OF REQUEST: IRENE STULSKY 6/20/03 DATE: 06/25/03 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.5 # EXITS: 2 FOUNDATION: CEMENT BLOCK CELLAR: FULL CRAWL SPACE: TOTAL ROOKS: IST FLR.: 4 2ND FLR.: 2 3RD FLR.: 0 BATHROON(S): 1.0 TOILET ROOK(S): 0.0 UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: NONE GARAGE: DOMESTIC ROTWATER: OIL TYPE HEATER: OFF BOILER AIRCONDITIONING: TYPE BEAT: OIL WARM AIR: HOTWATER: XX OTHER: PANTRY OFF KITCHEN, REAR MUD ROOM ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: 2 CAR WOOD FRAME STORAGE, TYPE CONST SWIMING POOL: GUEST, TYPE CONST.: OTHER: 6 SHEDS 1 LARGE BARN VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE INSPECTED BY: DATE ON INSPECTION: 06/28/03 TIME START: 10:05 AM HND: 10:30 AM Form No. 6 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 $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 Date. 00 ') New Construction: Old or Pre-existing Building: (check one) Location of Property: -26,1%o C /C V1 House N�1!t a 44 GUo.. � Street / / / L Hamlet ,/l Owner or Owners of Property: L r� / /k C' 2 cj/� 6 -Peri F �Aa 1/5 y j, -C4 c'A J/ r Suffolk County Tax Map No 1000, Section R L Block o� 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: (check one) Fee Submitted: $ Applicant Signature .O & Lif 15nl C d CONSENT TO INSPECTION the undersigned, do(es) hereby state: Owner(s) Na e(s) That the undersigned (is) (are) the owner(s) of the premises in the Town of 1 Southold, located at 5-e)60 Z3hic44e �anp 7 ,-7 /�,IP7P- 0,R 41k /> which is shown and designated on the Suffolk 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, rules or regulations of the Town of Southold. Dated: _ 4t c�.e I ( (90 'L, 0,x$Ag-aa, 1 Z�xE C a7a�Z) (Signature) ehe S'' uLS4<'V (Print Name) (Signature) (Print Name) Al TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST. SUB. LOT Et�:T t4 A :U�>W JL LJ e 7-1,J! Cv 7ec iia 2 v e ta' 1- , P Q` FORMER OWNER N Ml EL o. /lo- e � ACR. S W TYPE OF BUILDING RES. SEAS. VL FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS -oA�j (3 eLod t 1960 14 b - t AGE BUILDING'CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Acre Value yj 14 Tillable 1 Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD House Plot o 0 Q 14 Q 6) DEPTH BULKHEAD Total ,.. r DOCK E �: ;� � --. TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET 2(p -'� VILLAGE DIST. SUB. LOT C,IZ ��- r J.1fifd I -- ACR. 'O REMARKS ' TYPE OF BLD. 141L) 03 au), u PROP. CLASS � r LAND IMP. TOTT,AL� DATE FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOT TOTAL �e LOCATION: (number & street) (municipality) SUBDIVISION: MAP NO.: LOT(S): NAME OF OWNER(S): o� OCCUPANCY: (type) (owner -tenant) ADMITTED BY: -t ACCOMPANIED BY: _4 . KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000 - SOURCE OF REQUEST: DATE: DWELLING: � TYPE OF CONSTRUCTION: �sL, # STORIES: /y # EXITS: �Z FOUNDATION: CELLAR: < CRAWL SPACE: TOTAL ROOMS: 1ST R: _ C 2ND FLR: 3RD FLR: �-----: BATHROOM(S): c/'x_�L_ TOILET ROOM(S): - - UTILITY ROOM: PORCH TYPE: --- DECK, TYPE: _ PATIO, TYPE: BREEZEWAY: DOMESTIC H< TYPE HEAT OTHER: �L �-- N REPLACE: o4ER: TYPE HEATER: Com' WARM AIR: GARAGE: AIRCONDITIONING: HOTWATER: a --- ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.:-2coK �!n STORAGE, TYPE CONST.: C_40e&kC_ &.42 SWIMMING POOL: GUEST, TYPE CONST: OTHER: VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION I DESCRIPTION I ART. I SEC. REMARKS: INSPECTED BY: S DATE ON INSPECTION: ` to O TIME START: �� ' �� END: