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Home My WebLink AboutZ-30418FOP~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPD~TME~T Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 30418 Date: 09/13/04 T~IS CEI~TIFIEE t~t the building Location of Property 45295 ~AIN RD (HOUSE NO.) County Tan(Map No. 473889 Section 075 DWELLING SOUTHOLD (STREET) (~L~LET) Block 0002 Lot 005 Su~divlsion Filed Map No. __ Lot No. __ conforms substantially to the Requirements fo~ a ONE F~ILY DWELLI~IG built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCuu~AI~CY NUMBER Z- 30418 dated SEPTEMBER 13, 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 F~ILY DWELLING WITH ACCESSORY TWO CAR G.~d~AGE * The certificate is issued to BAP2~Ey OVISINAK & ORS. ( OWNER ) of the aforesaid building_ ~I/FFOLK COUN~f DEP~TMENT OF ~EALTE ADPROV~J~ N/A E~C'~I~ C~TIFI~ NO. N/A PL~ C~TIFI~TION D~ *PLEASE SEE ATTACHED INSPECTION REPORT. Authorized Si~ture Rev. 1/81 SUBDI%~SION: MA~ NO.: LOT (S) OCCUPANCY: RESIDENTIAL ADNi£'I~ BY: TOMASZ MEJSAK K~Y AVA~LA~I~E: S~FF. CO. TAX ~A~ NO.: 75.-2-5 SODRCE OF P~QUE~T: A/gTHONY B. TOHILL, D.C. 8/13/04 BARNEY 0VISII~AK a ORS. DATE: 09/13/04 YES INSPECTION: 09/07/04 APPLICATION FOR CERTIFICATE OF OCCUPANCY Form No. ,~ TOWN OF SOUTHOLD BUILDING DEPARTM£NT TO~:N ItALL 765-1802 This application mttst be filled m by typewriter or Lrflc and submitted to the Building Department with the following: For new building or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Einai Approval fi'om Health Dept. ofwatersupplyandsexverage-disposal(S-9fom:0. 3. Approval o f electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber cert,'lng that the solder used in ~-stern contains less than 2/10 of l% lead. 5. Commercial bttilding, indus=iai binlding, multiple residences and similar buildings and installations, a certificate of Code Compliance from ar6hitect or engineer responsible for ~he building. 6. Submit planrLmg Boai-d Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) nan-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all propeR' lines, streets, building and unusual natural or ropograpkic features. 2_ A properly completed application and a conseag m inspect signed by rhe applicant. If a Certificate of Occupancy is den/ed, the Building Inspector shall state the reasons therefor in writing [o the applicant. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additious to dry eLling $25.00. Alterations to dwelling $25.00, Swimming pool $25.00, Accessory bdilding $25.00, Additions to accessory' building $25.00, Businesses $50.00. 2. Ce~ificate of Occupancy on Pre-cx~sfing Building - $ i00.00 Copy of` Certificate of Occupancy - $25.00 4. Updated Certificate of'Occupancy- $50.00 5. Tempora~ Certificate of`Occupancy- Residential $15.00, Commercial $~5.00 Date. Auqust 16, 2004 New Construction: Location of Property: Old or Pre-existing Building: 45295 Main Road X (check one) Peconic House No. Owner orOwners of Property: Barrier] V. Suffolk Coun~, Tax Map No 1000, Section 7 5 Subdivision Permit No_ Da~e of Permit. Health Dept Approval: Harming Board Approval: Request- for: ~ Temporary ~ercificate Street Hamlet Ovisinak, Joan D. Butler and David A. Block 02 Lot Filed Map. Lot: Applicant: Underwriters Approval: 005 Final certificate: X (check one) Oates Fee Subrmtted: $ Applicant Signature Anthony B. Tohill, As Agent CONSENT TO INSPECTION .. BARNEY V. OVISINAK 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, locatedat 45295 Main Road, Peconi~ which is shown mid designated on the Suffolk County Tax Map as District 1000, Section 75 ,Block 02 ,Lot 005 That the undersigned (ha~) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: CEU That the undersigned do(es) hereby gtve consent to the Building Inspectors 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 aforesa!fl application, including inspections to determin~ that said premises comply with all of th ~ laws, ordinances, roles 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 Soutliold. Dmed: August 24, 2004 BARNEY V. OVISINAK (Print Nmne) (Signature) (Print Name) N SO.O' SURV'LYED: 50 JUL'r 2904 SCALE 1'- 50' APEA = ~4,37~7£ S.F. OF 0.35 AC~ES ,.,o: ~ co.._~,c~Eo ~o ~E ~ ~..o ~,oE DESCRIBED PROPERT~ PECONIC, TOWN OF SOUTHOLD SUFFOLK COUN'F~, N.Y. SURVEYED FOR: TOMASZ MEJSAK BARBARA ivlEJSAK T' ~: ~,5£,£'-07E-C,2_-C,,25 2_000,0~r~L ESTZTE SERVICES,