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Home My WebLink AboutZ-30101FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 30101 Date: 03/19/04 THIS CERTIFIES that the buildln~ DWELLING Location of Property 3455 LITTLE NECK RD (HOUSE NO.) County Tax Map No. 473889 Section 103 Subdivision CUTCHOGUE (STREET) (HAMLET) Block 0010 Lot 011.001 Filed Map No. __ LOt No. __ conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which C~KTIFICATE OF ~ANCYN~MB]~R Z- 30101 dated ~4ARCH 19, 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 WITH ATTACHED GARAGE* The certificate is issued to JONATHAN C BROWNING ESTATE (OWNER) of the aforesaid building. Su~FOLKCO%~YDEPART~qTOFH~%L~{APPRO~rAL ELECTRICAL c~KTIFICATENO. pLUMBERS c~KTIFICATION DA'£~u *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A nature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT S(~JRCR OF R~: DAVID W. OLSEN, ATTY 3/9/04 DAT~: 03/19/04 DWELLING: TYPE OF C~STRU~I0~: WOOD FRAME FOL~TI~: CEMENT BLOCK PORCH TYPN: FRONT-ENCLOSED NP~ZEWAY: ENCLOSED ACCESSORY STRUCTURES: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. DATE (~ INSPECTI(~: 03/17/04 TI~ START: 9:55 AM ~/]3: 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, street's, 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. Temporar~CeRi.ficate of Occupancy - Residential $15.00, Commercial $15.00 Date. March 9, 2004 New Construction: Old or Pre-existing Building: X (check one) Location of Property: 3455 Little Neck Rd. House No. Street Hamlet Owner or Owners ofProperty: R~ruro at: .lnnn/-hnn l~re~*,,i~g by li-"-d~- ¥.a!c:ki aa Ex:c'.:grix Suffolk County Tax Map No 1000, Section 103 Block 10 Lot 11.01 Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ 100.00 C¢o_c. {05 7/(, Id l Final Certificate: (check one) Applicant Signature '~ N 88'27'00" W 224,46' SURVEY OF PROPERTY SITUATED AT CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-103-10-11.1 SCALE 1"=30' FEBRUARY 4, 2004 AREA = 50,016.56 sq. ft. 0.689 ac. CERTIFIED TO: FIDELITY NATIONAL TITLE INSURANCE COMPANY OF NEW YOJ JACK idICHALAK KATARZYNA MICHALAX PECONIC ABSTRACT INC. Josepl Lane A. Ingegno Surveyor CONSENT TO INSPECTION David Worthington Olsen as Attorney' for the Emtatm of i, the undersigned, Owner(s) Name(s) Jonathan Browning do(es) hereby stat(;: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at 3455 L~trl~ N~rk RH.: c,,t~-h,~g,,,% M-v · which is shown and deslgnated on the Suffolk County tax map as District 1000, Section 103 , Block 10 0 Lot 11.01 That the undersigned (has) (have) filed, 'or caused robe filed, an applica- tion in'th,, Southold Town L$uxicling lnsp~u~u~ .~ o~£~oo ro,~ +~ Fnllnwin~: (Two story frame house and garage That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southoldto 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, includind'inspections to determine that said premises comply with all of the laws. ordinances, rules and regulations of the Town of Southold. Thc undersigned· in consenting to such inspections· do(es) so with the knowledge and understanding that any information obtained in the conduct of such knspectlons may'be used as evidence in subsequent prosecutions for vio- lations of the laws· ordinances, rules or regulations of the Town of Southold. Dated: (signature) David Worthington Olsen (print name) (signature) (print name)