HomeMy WebLinkAboutZ-29650 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 29650 Date: 08/20/03
THIS CERTIFIES that the building DWELLING
Location of Property 395 MIDDLETON RD GREENPORT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 040 Block 0005 Lot 012
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- 29650 dated AUGUST 20, 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.*
The certificate is issued to CHESTER KONARSKI
(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.
/vv
Authorized S' ature
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 395 MIDDLETON RD GREENPORT
SUBDMSION: MAP NO.: LOT (S)
NAMH OP OWNHR (S): CHESTER KONARS KI
OCCUPANCY: SINGLE FAMILY CHESTER KONARS KI
ADMITTHD BY: ROSEMARY KONARSKI ACCOMPANIED BY: SAME
RSY AVAILABLE: SUPF. CO. TAY MAP NO.: 40.-5-12
SOURCH OP RHQUHST: WILLIAM H PRICE, JR, ESQUIRE DATE: 08/20 03
DWELLING:
TYPH OP CONSTRUCTION: WOOD FRAME # STORMS: 1.5 # HYITS: 2
POUNDATION: CONCRETE BLOCK CHLLAA: FULL CRAWL SPACE:
TOTAL ROOMS: 1ST FLR.: 4 2ND FLR.: 2 3RD FLR.: 0
BATHROOM(S): 1.0 TOILgT ROOM(S): 0.0 UTILITY ROOM(S):
PORCH TYPH: DSCR TYPH: PATIO TYPH:
BRHHZSiD\Y: PIRHPLACH: GARAGH:
DOMBSTIC HOTWATHR: YES TYPB HHATER: SUPER STORE AIRCONDITIONING:
TYPE HBAT: OIL WARM AIR: HOTWATHR: X
OTH61t:
ACCESSORY STRUCTURES:
GARAGH, TYPH OP CONST.: STORAGH, TYPH CONST.: 2 SMALL WOOD
SWIMMMG POOL: GUEST, TYPH CONST.:
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION ~ DESCRIPTION ~ ART ~ SEC
RHYaRYC- RE-I P CTED 8 18 03
INSPHCTED BY: DATR ON INSPECTION: 08/20/03
JOHN M BOUFIS TIlD; START: 9:30AM END: 1O:00AM
~5 c~ a ~s2-- '
- -
TOWN OF SOUTIIOLD ;,~orl'L
uUILU111O D~pnarllelir ~ ~ y
•rowN hnt,b G ~ . ,iU~ 3 ~ 2C03
' 7e;s-IBDZ I i
~ APPLICAT1bN FOR.CGRTLFICATE OF pCCUPANCY ~.,,_T`~..
1
A. Phis application must be filled in by tppeilriter OR lnk'and submitted to the buLldlhg
inspector with klre Eollowingt Enr net! building or tteW Use:
l: Final survey of property with decUrdta location of nil buildingst property liuest
streets, and UnUaUnl tta ttlrnl br topographic fvatUred: "
2: Final Approval froth Ilealtlt Uepti'oE Water supply and sewerage-disposdl(S-9 form):
J: Approval of electrical installation Erom tloard of Fird UnderWritersi
4: Sworn statement Erom plumber tettifying that the solder used itt system cohtalns
t. less than 2/10 of 17. lend. ~ `
5: Commercial bttildingt indus.ttial bu~ldingt multiple residences and sitailar bdlldingt
and installntionst a certificate of Code Compliance fram'nrchitect of engineer
responsible for the building,
6i Submit Planning tloard Approval of 4ompleted site plan requirements:
t,
Ui Por existing buildings (prior to April 9y 1957) non-conforming usest or buildings and
t'pre-existingtt labs usest
L+ Accurate survey of property showing ail property liuest streets, building and , ,
Unusual natural or topogtnpbic leatUrest
2:' A properly completed. application and a consent to inspect signed by the appllcnuti
1f a Certificate of Occupancy is sealed, the Building Inspector shall state the
, reasons therefor in Writing to the applicants
Oi Fees
' l: Certificatd of Occupancy - New dwelling 125.00, Additions to dwelli,hq ~25.OOt
' Alterations to dwelling ~25:OOt SWitmnlhg pool ~25:OOt Accessory building 125:UOi
Additions to accessory building X25:00: businesses50:00: '
2, Certificate of Occupancy on prt:-existing euildiug - X100:00
' 3: Copy of Certificate of Occupaucy - #5.00-aver 5 years - 110.00
4: Updated Certificatd of occupancy - DSO+OO ,
, 'Cemporary Certificate of Occupancy - ttesidenkldl $LS:OOt Commercial. $15.00
New Constructiort::.:~ii.::: Old Or Pce-exi7]sting DUilding:+::$i::~:.:::::::
Locptlolt of Property::isti95:.ii:i.:::-fi~ilftel~i1ii[i~i~~::++:iii::.:::+~Fle:PtTl)?4iYlti:i::::+.::~
house Na: Street Itutnlet
Onwer nr Ownecs of Property„ He~ent K.iil3aj~
ett~t:~4~er~~~+y++KQ~~+r+~llyy,iit}yx~tjK:i:++i,:+,
Dickerson
County Tax Hap IJO 1000, Section:ittUt,-yQ1QPi.i.BlockiiQ~rp+O+:+::+::.Lot:+:+012:.cQ00:.::t.:,
SUbdlvlsion::+iii.:i.i:a:it+i:i::rit:t::t.+ii.:Flled llapii:iiii:::::Lot..:...:::ii:r::a:ii
. .
Fermlt Iloiiii/ii:i+i'c,.i:bakd OE permit,,::iii,:tiiiitiAppllcaltt:+:i:i:i::iit:i:ttii.::::i,
Iledlth Dept, Approval:isiiitt:ti:::.:itittttri:Underwriters Apptovnli.i:+++:i.+i.li..+::t:.
planning Board Approval.;::::t::::i::::itti:.::. .
Request for; +temporary Certiflcnte:iitri:ii:, Final Cettlcdte::;~+iii:::
fee Submitted, U#.}QO~+Oiq~+++:i:+ii::::.~t::i
asap
AI'rt.lcnlrf '
William H. Price, Jr., as Agent'for
Owners
765-1802
BUILDING DEPT.
1 NS~ECTION
[ ] FOUNDATION iST [ ]ROUGH PLBG.
[ ] FOUNDATION 2ND ( ]INSULATION
[ ] FRAMING [ ]FINAL
[ ] FIREPLACE ~ CHIMNEY
REMARKS:c~irl0~ /~/d~7- Bhv ~'osia~
~~~ao/2 Oho ~p'L /~c..~Sirte S~Y~c.~~
m/~ ~
DATE ~ l/ INSPECTO
~ ~~~a~~~ ~
~j 765-1802
d~ d~ Sid -S=/ Z BUILDING DEPT.
~ I NS~ECTION
[ ] FOUNDATION 1ST [ ]ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSU ON
[ ] FRAMING INAL
[ ] F LACE A CHIMNEY
R ARKS:
DATE ~INSPECTO
Cerli/ications indicated hereon 5ignily that this plat of the hereon described property is o true and correct represen lalion of a recent
survey mode and plotted under my direction In accordance with the eKlsting Code o/ Practice for Lond Surveyors by the New York Slate
Association o/ Pro/essional Land Surveyors. Sold certiOcatlons shall run only to the person for whom the survey is prepared and on their
Deh ol/ to the title company, governmental agency and lending Institu clan listed hereon. This certi/icatlon is only for the lands described
hereon, its not o certiOcotlon o/ title, zoning or Ireedom 6om encumberances. Cerlilicatlons are not trans/arable to additional Institu lions
or subsequent owners.
LAND NOW OR FORMERLY OF
GARY C. & CARLA L. BLASKO
S 13~1'S3'20" E
CNAW LINK PIpE .70.13'
MAP FE FO.B EEX FOUND FE
. 0. 0.4'E t. E STO KADE FENCE IEE CLF
zo.oo' ~T,i "~ENC~- --L- o.rE _ _LINE
O b FE
a 0.6'S
0.7'W
M ~ P/O I LOT H° " rob e.t'
~ ' LOT I 5 SHED
n
O
r
O U
CONC. z
LIDS
r
1 0
W
P/O (V °a
LOT o LOT /
4 = ~ 6
N 3
FILL FE
.s^,I CooS MAS. 0.5'S ;i
19.8' ~YU O
rt~~ ' 30.1. U-14 r`yy.~~1
I` PA VT FE W
z. rN 1 1/2 STORY
Z ~ FRAME o ° z -
DWELLING H N
NO. 10
9.4' O < IIr^e
o i 21R O ~ V ! /
W' ' MAS. O '
' STEPS
Y I ~
i 3 a ~
m ~ ~ ~aa''o
°
z z
- _ P )vN - 30.00' 35JSy44' . '`D. -
MO OUNDNT N ~ 7'21 ~ w Otr rr M FOUNDNT
D.3•W 100.0T0'
MIDDLETON ROAD '
LM: SURVEY '
VIEW: SURVEY
The olfse is or dimensions shown from the structures to the property tin as are /or o specific purpose and use and th ere lore are not intended
to guide in the erection of /antes, retaining walls, pools. patios, planting areas, additions to buildings and any other construction. Subsw face
Conditions not shown. Easements, Rights-ol-Way of Record, it any, not shown. properly corner m ants were not placed os o purl of (his survey
~'1q!+ UNAII AIORl71 U t If R=1i Y, Jld
BaCreit, BOIIaCCI 8r V811 Wee~e, P.C. ADrnnaN Tn fhi SuRVET is a
CIV IL ENGINEERS/SURVEYORS/PLANNERS vloLnl7oN of sLC nuN /20o ui
' 175A Commerce Drive, Hauppauge, NY 11788 NEw nrRK S;ntE EnucA LION L.~w
TEL n31/435-1111 FAX 631/435-1022
WwW.bbvpacom ®2003 B.B.Y., P.C'.
LOT: 5 & P/O 4 BLOCK: 2 REVISIONS:
MAP OF: FLEETFIELD
FILED: FEBRUARY 6, 1942 NO. 1351 CO. SUFFOLK
SITUATED: GREENPORT TOWN OF SOUTHOLD coPlES or n-n:; ;urvrr Map Nor
BEARING THE LAND Sl1R VE YDR'ti
CERTIFIED TO: TITLE NO.: NY031161 EMBOSSED scAt nND sICNA7vae
91-IALL NOT BF. CUN SIDEh'f,D 10
COMMONWEALTH LAND TITLE INSURANCE COMPANY BE A TRUE AND vauD col=r.
LAWRENCE H. KOTIK JOB NO.: A030582
DATE: JUNE 5, 2003
DR. A. V.R. CH. W.J.B. SCALE: 1" = 30~ DIST. 1000 SEC. 40 BLK. S LOT 12
CONSENT
q•p .
1NSPS~C'1'lON
William H. Price, Jr., as agent for
Helen K. Barrett, Rosemary Konarsky, and Laura K. Ri file u derslgrted,
Owner(s) N.Imc(s)
do(es) hereby state:
the agent for
That the undersigned (is) L~ the owner(s) of the premises In the Totivrt
oCSoutholdlocated at 395 Middleton Road, Greenport, New York
u•}tich is shown and designated on the Suifoll,
Courtly tax map us District 1000, Section pq ,00, Block 05.00 , Lot 012.OOQ
That th¢ undersigned thas)~kh~xrc) filed, or caused to be tiled, an appllca-
lion in the Southold `Town Duildint; Inspector's Office for the Collowutg:
r
Application for Pre-Certificate of Occupancy
`Pilaf the undersigned do(es) hereby givt: consent to the Building inspectors
oC the 'Town oC Southold to enter upon the above described property, including
any and all huildings located thereon, to conduct such inspections as they may
deem necessary with respect to the aforesaid application, includutg inspections
1o determine that said premises comply with all oC the laws, ordinances, rules
and regulations oC the 'Town cC Southold,
The undersigned, in consenting to such inspeetions, do(es) so with the
ltnewlcd~e and under~stnnding that any irtCormation obtained In Ure conduct oC
such inspections may be used as e'vldence in subsequent prosecutions for vio-
lation- o[ the luws, ordinances, rules or rei,*ttlations of the 'Down of So d.
Dated; July I8, 2003 '
si nature)
William H. Price, Jr.
(pL'lnt n1r7iL•)
(ui~naluru)
(print name)