The URL can be used to link to this page

Home My WebLink AboutZ-30103FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 30103 Date: 03/20/04 I~{IS CERTIFIES ttu~t the building DWELLING Location of Property 795 KOUROS RD (HOUSE NO.) County Tax Map No. 473889 Section 117 subdivision NEW SUFFOLK (STREET) (HAMLET) Block 0006 Lot 008 Filed Map No. Lot No. -- conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursv~-t to w~lich CERTIFICATE OF OCCUPANCY NUMBER Z- 30103 dated MARCH 20, 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 ACCESSORY GARAGE & BARN* The certificate is issued to NEBOYSHA & CATHERINE BRASICH (OWNER) of the aforesaid building. SUFFOLK COUNT~DEPART~4ENTOFHEALTHAPPRO~rAL Er.Rt-i~ICAL CERTIFICATE NO. PL~]~BERS CERTIFICATION DA'£~U3 *PLEASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 N/A N/A N/A BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 795 KOUROS RD NEW SUFFOLK SUBDI'UISION: MAP NO.: I~ (S) NAME OF O~ (S): NEBOYSHA & CATHERINE BP~ASICH OCC[]PANCY: SINGLE FAMILY DWELLING NEBOYSHA & CATHERINE BPJkSICH AD~k'i-r~ BY: NEBOYSHA BRASICH ACC(~PAMI]~D BY: SAME SO[~CH OF P. EQDF. ST: NEBOYSHA R. HRASHICH 3/11/04 DA~IE: 03/22/04 VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. DATE ON INSPECTIOn: 03/19/04 TIldE START: 9:30 AM ]~D: 10:30 AM This A. Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY .~ ~ ~ application must be filled in by typewriter or ink and submitted to the Buildh~g Department with the following: For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual uatural 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" laud uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a 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. Co Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimtrfing 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- $25.00 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. 3/11/04 New Construction: Old or Pre-existing Building: x (check one) Location of Property: 795 Kouro$ Rd (aka 7300 blow Suffolk Road)~ Iqow Suffolk House No. Street Owner or Owners of Property: Neboysha Ranko Brash±ch 8, Cat:her±neBrash±ch Sufl'olk County Tax Map No 1000, Section 117.00 Subdivision Permit No. Iq/A Date of Permit. Health Dept. Approval: N/A Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ 100,00 Hamlet Block 06.00 Filed Map. Applicant: Underwriters Approval: _ N/A Lot 008.000 Lot: Final Certificate: x (check one) pplicant- ~ignature CONSENT TO INSPECTION Neboysha Ranko Brashich & Catherine Brashich Owner(s) Name(s) , the undersigned, do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold, located at 795 Kouros Rd {aka 7300 New Suffolk Rd), New Suffolk which is shown and designated on the Suffolk County Tax Map as District 1000, Section 117.00, Block 06.00 , Lot 008.000. That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: Certificate of Occupancy on Pre-Existing Buildings 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 ali 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: 3/11/04 (Signature) ' Nebo~$ha Ranko Brash±ch (Print Name) (Signature) (Print Name) / ! 12ALJIZO M. FS~.~.5'klICLI 5CALF= 50~: 1" m = MOMLIM.~t4T .~T ldF=\V TOWu OF 5OUTUOL~f, iTL.E LI-~:'O7-45z69 A[;Z.[;;A'= 5.367 ~ d~U,~D..A~JT~F=D TO TN.r= c-~ub.m&UT~=C---.D TITLF= DIV'I'~IOM - AME. E.I/.&M TtTL& IM,~u[z.&Uce CO