HomeMy WebLinkAboutZ-29989FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUP/%NCY
NO: Z- 29989 Date: 02/03/04
THIS CERTIFIES that the building DWELLING
Location of Property 4145 PEQUASH AVE CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map NO. 473889 Section 137 Block 0002 Lot 009
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- 29989 dated FEBRUARY 3, 2004
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 GEORGE CASSIMATIS & ANO
( OWNER )
of the aforesaid building.
SUFFOLK COUNT~DEPARTMENTOFHEALTHAPPRO~-~J~
ELE~-i~ICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DA'l~u
*PLEASE SEE ATTACHED INSPECTION REPORT.
~/A
N/A
N/A
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 4145 PEQUASH AVE CUTCROGUE
SUBDI~r~SION: ~ NO.:
N~ OF OW~ER (S): GEORGE CASSIMATIS & A-NO
OCCUPANCY: SINGLE FAMILY
GEORGE CASSIMATIS & ANO
DWELLING:
T~fPE OF CONSTRUCTION: WOOD FRAME
FOUNDATION: CEMENT BLOCK
STORIES:
C~: FULL
CP.A~LSPACE:
ACCESSORY STRUCTURES:
VIOLATIONS: CMAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
P~: BP~4357 ACCY GAR3%GE C0Z3717
DA~'E ON INSPECTION: 01/07/04
Form No. 6
TO~A~' O1~ ~OWFHOLD
BUILDING DEPARTMENT
TOV~N 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 ~ f,~l~
A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets,.anffunusual 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 $25.0/0, 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-eyi:,dng Building - $100.00
3. Copy of Certificate of Occupancy/- $.25
4. Updated Certificate ofOccupang'y - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date. /- ~C) ¢
New Construction:
Location of Property:
Old or Pre-existing Building:
House No. Street
Owner or Owners ofProperty: .~?_ 114, Gc_ r -ax?
Suffolk County Tax Map No 1000, Section /',~ 7
Subdivision
Permit No.
Date of Permit.
Health Dept. Approval:
(check one)
Block o,Q
Filed Map.
Applicant:
Underwriters Approval:
Hamlet
Lot
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $
Final Certificate: (check one)
ignature
UNION SQUARE
E. S. KALOGERAS,....
-; ~0~ ~-~--' ' ACEC Member
· 727 UNION AVENUE · RIVERHEAD, NY 11901
January 23, 2004
Town of Southold
Building Department
Main Road
Southold, New York 11971
Re: Gennaro Residence, 4145 Pequash Avenue, Cutchogue, NY
Gentlemen:
I have inspected the structural condition on the basement stairs and floor system at the above
referenced residence and certify that they are structurally sound and in compliance with the New
York State Building Code, latest edition.
lfyou have any questions concerning this matter, please call us at your convenience.
Very truly yours,
E.S. Kalogeras, P.E. ~ ~. .~ '
ESK:wpwinl0.0
cc: Mrs, Kelly Gennaro
TEL: (631) 722-4040 · FAX: (631) 722-4004 ° E-maih Lkalogeras@msn.com
CONSENT TO INSPECTION
Owner(s) Name(s)
, the undersigned, do(es) hereby state:
That the undersigned (is) (ar~ the owner(s) of the premises in the Town of
Southold, located at lTll l~ h~ D~at/~rk ~t x/ O-~cJw~je_
which is shown and designated on the ~uff~lk County Tax Map as D~strict 1000,
Section /5 '7 , Block Z- , 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 anv. 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: 1-- ~-6/c~/
(Signature)
(Print Name)
SURI~Y C~
AT CAITCHOGUE
TOVt4V OF ~THOLD
~UF~C~K COUNT~. N E
AuG ~ 20O3
03 ~ 236