HomeMy WebLinkAboutZ-46004 SUF p o{ Town of Southold 2/28/2025
jo Gyp 53095 Main Rd
N Southold,New York 11971
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 46004 Date: 2/28/2025
THIS CERTIFIES that the structure(s) located at: 5535 Old North Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 51.-3-6.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the requirements for a built prior to
APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 46004
dated 2/28/2025 was issued and conforms to all the requriements of the applicable provisions of the law.
The occupancy for which this certificate is issued is:
wood frame single family dwelling with unfinished basement.*
The certificate is issued to Sawicki,Albina
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
Au on ed i ature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 5535 Old North Rd,Southold
SUFF.CO.TAX MAP NO.: 51.-3-6.2 SUBDIVISION:
NAME OF OWNER(S): Sawicki,Albina
OCCUPANCY:
ADMITTED BY:
SOURCE OF REQUEST: Sawicki,Albina DATE: 2/28/2025
DWELLING:
#STORIES: 2 #EXITS: 2
FOUNDATION: cement block CELLAR: full CRAWL SPACE:
BATHROOM(S): 1 TOILET ROOM(S): UTILITY ROOM(S):
PORCH TYPE: DECK TYPE: PATIO TYPE:
BREEZEWAY: yes FIREPLACE: GARAGE:
DOMESTIC HOTWATER: yes TYPE HEATER: AIR CONDITIONING:
TYPE HEAT: gas WARM AIR: HOT WATER:
#BEDROOMS: 3 #KITCHENS: I BASEMENT TYPE: unfinished
OTHER:
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST:.
SWIMMING POOL: GUEST,TYPE OF CONST:
OTHER:
VIOLATIONS:
REMARKS:
INSPECTED BY: JOHNJ DATE OF INSPECTION: 1/29/2025
TIME START: 9:30am END: 10:00am
Authentisign ID:OFD343DF-23D4-EF11-88CF-002248299057 '<�a f�d�I�\
VVV"'J p ECEOWE
TOWN OF SOUTHOLD—BUILDING DEPARTMENT JA N 17 2025
Town Hall Annex 54375 Main Road P. O.Box 1179 Southold,NY 11971-0959
Building Department
Telephone (631) 765-1802 Fax(631) 765-9502 https://www.southoldtownny-SR-•vn of Southold
APPLICATION FOR PRE-EXISTING CERTIFICATE OF OCCUPANCY
OWNER(S)OF PROPERTY:
Name:Walter Sawicki as Executor Date: 1/15/2025
Physical Address:5535 Old North Rd, Southold, NY SCTM#1000- 51-3N-K o
Phone#: 612-414-3100 Email: waltersawicki@comcast.net
Mailing Address: Walter Sawicki
CONTACT PERSON:
Name: Tom Scalia -Albertson Realty
Mailing Address: 54280 Main Rd, PO Box 598, Southold, NY 11971
Phone#: 631-786-6920 Email: tscalia@albertsonrealty.com
To apply for a Pre C.O.for an existing building(prior to April 9, 1957) provide the following:
Accurate Survey
• Floor Plan
• $200 Fee
CONSENT TO INSPECTION
That the undersigned does hereby give consent to the Building Inspector 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.
[Authentaw
wW�ef SGtWI��f 01/17/25
Owner's Signature Date
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
Walter Sawicki
I, residing at the above address, do hereby authorize
Tom Scalia -Albertson Realty to apply on my behalf to the Town of Southold Building Department for
approval as described herein.
iAuthC�f1tiSIGN'lter fAwick 01/17/25
Owner's Signature Date
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As f 'fiSIGN" I Certificate Page 1 of 3
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s; Signing Information:
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Signing Name:Application for Pre-CO
- s
r;
ID:OFD343DF-23D4-EF11-88CF-002248299057
Start Date:Jan 16,2025 11:06:48 AM EST End Date: Jan 17,2025 07:20:08 AM EST
7
#Signers: 1 #Reviewers: 0 #CC:0
w Creator:Thomas Scalia Email: tscalia@albertsonrealty.com
1Y
k Document Information:
Document Name:Application for PRE CO
H
� ry
ID:02EA6309-24D4-EF 11-88CF-002248299057
tt Pages: 1 #Signature Blocks: 2 #Initial Blocks: 0
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Participant Activity:
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Name:Walter Sawicki Type: Email:
Email:waltersawicki@comcast.net
s �
TOS/STAESP/CCD:Accepted:Jan 17,2025 07:18:46 AM EST[98.97.51.50]
EULA/TOS Version:hftps://secure.authentisign.com/assets/files/Authentisign_TOS_202106.pdf
STAESP Version:hftps://secure.authentisign.com/assets/files/Authentisign_STAESP_202106.pdf
CCD Version:hftps://secure.authentisign.com/assets/files/Authentisign_CCD_202106.pdf
Document:Signed And Accepted: Jan 17,2025 07:20:04 AM EST[98.97.51.50]
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# : TOWN OF SOUTHOLD BUILD NG DEPT.
com, 631-765-1802
4NSPECTION
[ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] 'FIREPLACE & CHIMNEY [. ] FIRE SAFETY INSPECTION
[ ] FIRE-RESISTANT CONSTRUCTION [ ] FIR RESISTANT�PENETRATION-
[ ] ELECTRICAL (R GH) [ ] LECTRICAL (FINAL)
[ ] CODE VIOLAT N [ PRE C/O [ ] RENTAL
REMARKS:
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DATE INSPECTOR
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x 4'0
BEDROOM BEDROOM
9'8"x 17'11" 13'7"x 17'11"
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FLOOR 2
HE
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PRIMARY BEDROOM EAT-IN KITCHEN
9'8"x 14'6" 11'6"x 12'0" UND
'8"x 510"
LL
57 3'5" ,; SCREENED PORCH
12'6"x 147
it
ROOM
7'8"x 12'11"
LIVING ROOM '
BEDROOM 17'1"x 12'11"
9'8"x 10'4"
F R
FLOOR 1
TOTAL: 1207 sq.ft
FLOOR 1: 865 sq. It, FLOOR 2: 342 sq.ft
EXCLUDED AREAS: SCREENED PORCH: 176 sq.It,LOW CEILING: 68 sq.It
FLOOR PLAN CREATED BY CUBICASA APR.MEASUREMENTS DEEMED HIGHLY RELIABLE BUT NOT GUARANTEED.
LOT 3 N CLUSTER MNOR SUSDNISON&LOT LINE CHANGE FOR FRANK PURITA AT SOUIHOLD. FWj 11299. FILED SEP 07,7005
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OLD NORTH ROAD
SURVEY OF
DESCRIBED PROPERTY
SITUATE
SOUTHOLD, TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
SURVEYED FOR: ALBINA SAWICKI
TM# 1000-051-03-006.2
GUARANTEED TO: SURVEYED: 13 APRIL 2009
ALRINA SAWII'ICI
SCALE 1"= 20'
AREA = 26,860 S.F.
OR
0.617 ACRES
GUARANTEES INDICATED HERE EYV SHALL RUN
ONLY 70 7HE PERSON FOR MOM THE SURVEY SURVEYED BY
1s IR A`?fD.AND OH s BEHALF To 717LE COMPANY.GOVERNM£NJAL AGENCY,E STANLEY J. ISAKSEN, JR.
AND
TO LENOTHE ASSIGNEES OF THE LENDINGEINSD1U➢N.. P.O. BOX 294
GUARANTEE$ARE NOT TRANSFERABLE TU NEWS FOLK. N.Y. 1 1956
AODIDONAL LNSRNIIIONS OR SUB$EOVENT OWNERS.
631-714-5635
UNAUTNORIIED ALTERATION OR ADDITION TO THIS
SURVEI IS A WOLADON OF SECTION 7209 OF
THE HEN YORK STATE EDWWON LAW.
LOPLEs( THIS SURVEY MAP ITOF BEARING CENSE ND RVEYOR
THE LAND SURVEIOQ ENDOSSED SEAL SHALL.
N07 DI CONSTOERED TO-RE A VALID TRUE NYS Lic. No. 49273 09R 17'18
DOPY
' BULKHEAD HOUSE/LOT �Jgo(,owc
JYOWL . OF 5®UT'H®LD PR®PAR CARD
M1 OWNER STREET 17 `5 VILLAGE DIST. SUB. LOT
FORMER OWNER /� N � E ACR. l
i SLY t7i1 r/t r�`�= /�J'Y£ p i ,�,� rsa>b^� - � � T�a1
# ` U S W TYPE OF BUILDING,,
i RES. 2 O SEAS. VL. FARM COMM. CB. MICS. Mkt. Value
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NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value
Acre
Tillable .FRONTAGE ON.WATER
Woodland FRONTAGE ON ROAD
Mead
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House.Plot BULKHEAD
Total DOCK
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Type Roof Rooms Ist F
PREIC/O INSPECTION SURVEY
LOCATION: � SCTM#:1000-
SUBDIVISION: MAP #: LOT(S):
NAME OF OWNER(S):
OCCUPANCY TYPE: r 0
ADMITTED BY: OMPANIED BY:
KEY AVAILABLE: SOURCE OF REQUEST: DATE:
STRUCTURE: -
TYPE OF CONSTRUCTIO #STORIES ��/a C?i # EXITS:
FOUNDATION: (qjn� BASEMEN , CRAWL SPACE:
1,71# OF BEDROOM& 15T FLOOR: 2ND FLOOR: 3RD FLOOR:
BATHROOM(S): TOILET ROOM(S): UTILITY ROOM:
PORCH, TYPE: DECK, TYPE: PATIO, TYPE:
BREEZEWA FIREPLACE: GARAGE:
DOMESTIC HOT ATER: �, TYPE HEATER: A/C: )$-1bP
TYPE HEAT: WARM AIR: HOT WATER:-6�
#OF KITCHENS. FINISHED BASEMENT:
OTHER: 6
ACCESSOR 3TR'CTURE: y%
GARAGE,TYPE OF CONST: STORAGE, TYPE OF CONST:
SWIMMING POOL: GUEST, TYPE OF CONST:
OTHER:
VIOLATIONS:.CHAPTER444&_NYS UNIFORM'CODE:
LOCATION: DESCRIPTION: ARTICLE/SECTION:
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REMARKS:
INSPECTORS: J py J• J DATE:I 01,ir
TIME START:q.�V TIME END: ����