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Home My WebLink AboutZ-30592FORM IIO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 30592 Date: 11!29!04 THIS CERTIFIES that the building DWELLING Location of Property 1450 MILL CREEP DR SOUTHOLD (HOUSE PIO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 051 Block 0006 Lot 027 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- 30592 dated NOVEMBER 29, 2004 was issued, and conforms to all of the requirements of the applicable pro%,inions of the law. The occupancy for which this certificate is issued is OISE FP24ILY DWELLING WITH PATIO. The certificate is issued to MARGARET R PAWLIK OWITER ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. ' thorized Signature Re 1!81 BUILDIi1G DEP.'.FTNEI]Y TOWN OF _OUTHOLD HOUSIUC CODE IIISPE2TICI1 REPORT LOCATION: 14S0 MILL CREEK DR SOUTHOLD SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S): 14.4RCAF.ET R. P-WLIK OCCUPANCY: SINGLEF: JdI LY H RGAREL R P:WLIK ADMITTED BY: CR-' WELLS ACCOMPANIED BY: SAIF KEY AVAILABLE: SUFF. CO. TAX MAP NO.: S1. -e<1 SOURCE OF REQUEST: PIP.P.GAEET PLWLIK DATE: 11'-5%J4 DWELLIII" : TYPE OF CONSTRUCTION: WOOD FR.LAE # STORIES: 1.0 # EXITS: FOUNDATION: CONCRETE BLOCK CELLAR: YES CRAWL SPACE: 110 TOTAL ROOMS: 1ST FLR.: 2ND FLR.: 0 3RD FLR.: 0 BATHROOM(S): 2.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S): 1 PORCH TYPE: DECK TYPE: PATIO TYPE: COISCRETE s SL -7= BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: BASEROAP.D TYPE HEATER: OIL BUREER. AIRCONDITIONING: TYPE BEAT: OIL' WARM AIR: HOTWATER: YES OTHER: -HOT WATER ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SWIMMING POOL: OTHER: STORAGE, TYPE CONST.: GUEST, TYPE CONST.: `,IOL.'' ICUS: CHAPIER 4c II.'i. SIATE UVIFORM FIRE PREVE111101I & BUILDIIIG CODE REMARKS- BF1137 ADD CGZ81s BP3553 A.DD:ALT COZ28 i8 (shed removed) INSPECTED BY: / o/x� f� _ A YL_ DATE ON INSPECTION: 11'Z2'04 GEORGE 3ILLEII 4�TIME START: y:40?J4 END: 10:15?Sd Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TORN 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, streets, 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. .u:ill llli'.1'..-.0 CC1 L Ij 1i:.` tt.,i: Lh1 _-Glial U.,_'J R 5_ .`a; ll] Ll... t l.0-. 1•_, l;l:!.l' PJOfl':o 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 - $100.0^. 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.J0, Commercial $15.00 Date. t I I / 2-1 Oy New Construction: 1 Old or Pre-existing Building: V/ _ (check one) a Location of Property: _ `( �(� / r // �l C�' i� a%/ �{ �OGIf%lvl House No. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Permit No. Health Dept. Approval: Planning Board Approval: Date of Permit. Request for: Temporary Certificate t'et P14kJ/I Block Lot _ Filed Map. _ Lot: Applicant: Underwriters Approval: Final Certificate: (check one) Fee Submitted: $ r 00 -C)C) -Q(c C (-0 -2 -�)o5q a % G (F,� __�) 5 3 Applicant Signature r'z / TOWN OF SOUTHOLD PROPERTY RECORD CARD _ J OWNER — , 4 STREET VILLAGE DIST. SUB. LOT FOitIMER OWNER N, -,E (. V,. (� ACR.. � OQ rnl/� c� �l f S A�� W _� TYPE OF BUILDING- RES. ID LAND SEAS. IMP. VL. TOTAL FARM DATE COMM. CB. Mks. i REMARKS t. Value //00 �00 �0 G G o 02 0-7- z f 9 5- -rmP7 &reowd - JZ< AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE _ FARM Acre Value Per Acre Value Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland DEPTH House Plot BULKHEAD Total DOCK OWNER STREET VILLAGE DISTRICT SUB. LOT FORMER OWNER N E ACREAGE n. S W TYPE OF BUILDING RES. I SEAS. VL. FARM COMM. IND. C I MISC. LAND IMP. TOTAL DATE REMARKS 1137 Z 1�Q 31366 v a O =` ' O v av 3 o , �S/a !ti3 GfJl:ti.: ,,. G• ,9.fS3; /z y ,%..; 7 Fix . s << �9 - T �B¢d IL I C O NEW NORMA BELOW ABOVE ?�F,-�, ,. ;" Farm Acre Value Per Acre Value Tillable 1 Tillable 2 Z ;:.y,�;Y• 1 Z o fad% /� /G /F f� Tillable 3 t' 5�,-71 S� a�; r Woodland Swampland Brushland House Plot Total 1 M. Bldg. Ji 5 B� v p,2 p d/Foundation Bath Extension %v : �� Basement 1�, Floors Extension 5 t. Walls J Interior Finish GV Extension y 0 ; L g Fire Place p Heart %5'D;2 _ Porch Attic 6 43 O Porch Rooms 1st Floor Breezeway Patio Rooms 2nd Floor Garage X/ y = u� , j d� n n PVlDriveway 0. B. t. I ®l CONSENT TO INSPECTION r/ P/ef 0atdk ' the undersigned, do(es) hereby state: L/ Owner(s) Name(s) That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold, located at /W Mill wWWk 6 Ve— which is shown and designated on the Suffolk County Tax Map as District 1000, rV Section __� Block _�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: Pre C 0 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 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: l // i 110 % (S' ature) 0/k a w /—/k (P int Name) (Signature) (Print Name) Nov 10 04 05:19p Hill Wiley JV a gtS1od n� cWlr.✓. eeM..IMxul ICI�'[C• .I.NC¢IX .IY •vn wrR Y WY,";JMpY qM qqV Jq2 [p/CnMW lnM 4e(J V Fl T.PY�� uY�Mt r tM'64K0 rP•(r 4N Ytf 51687:35364 TM] IMO -001-06-027 5~r OF DESCRIBED PROPERTY SRW1[ SOUTHOLD, TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. SURVEYED FOR: WILLIAM T. WILEY KAREN A. WILEY CUMANTEEO TO! WILLUM r. mLE. R REN A. WILEY FIRST NAERICM TITLE INS. CO LMO OWNERS ABSTRACT CORP.. (L15370-54103912) PRINCIPAL RESIOEN71 L MORTWE. INC. . p.2 SURVEYED: 22 OCTOBER 2004 SCALE- 30' AREA - 29.M5.88 SJ. OR 0.684 4CRES SUR✓EYED BY STANLEY J. I5AKSEN. JR. P.O. Box 294 NEW SUFFOLK. N.Y 11956 631-7 —57335 _I NSE SUR OR S Lic. o. a9273 04R 1361 TO 39t7d OS3 NVHVNVHS i8MOd Z9LL91>L915 WEI OOOZ/60/11 O� OG �aN J OA �N •� C alf y6 Ids $$a, 5 ST `1DIo6M 196.6 N > L.M.wCL z W 1 >• 1J' �y 1 GARACEq""M _ A U P q O 6�0 y� 40 TM] IMO -001-06-027 5~r OF DESCRIBED PROPERTY SRW1[ SOUTHOLD, TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. SURVEYED FOR: WILLIAM T. WILEY KAREN A. WILEY CUMANTEEO TO! WILLUM r. mLE. R REN A. WILEY FIRST NAERICM TITLE INS. CO LMO OWNERS ABSTRACT CORP.. (L15370-54103912) PRINCIPAL RESIOEN71 L MORTWE. INC. . p.2 SURVEYED: 22 OCTOBER 2004 SCALE- 30' AREA - 29.M5.88 SJ. OR 0.684 4CRES SUR✓EYED BY STANLEY J. I5AKSEN. JR. P.O. Box 294 NEW SUFFOLK. N.Y 11956 631-7 —57335 _I NSE SUR OR S Lic. o. a9273 04R 1361 TO 39t7d OS3 NVHVNVHS i8MOd Z9LL91>L915 WEI OOOZ/60/11 LOCATION: PfS0 /-vl / L L (number & street) SUBDIVISION: NAME OF OWNER(S): OCCUPANCY: cW&Fk- D iC I V F, Sa CC7- f f® L. b (municipality) MAP NO.: _ T YOi41N LOT(S): (type) (owner -tenant) ADMITTED BY: C/KA W FL L -S ACCOMPANIED BY: -S MF e< -d C KEY AVAILABLE: 01 LTo/ SUFF. CO. TAX MAP NO. 1009 -',Yl — 6 v27 SOURCE OF REQUEST: I' fI 4SAf t T P,g w L ► K DATE: DWELLING: TYPE OF CONSTRUCTION: W o o D F/e"E # STORIES: I # EXITS: 9 FOUNDATION: C ONC9 E'% CELLAR: ES CRAWL SPACE: 4/0 TOTAL ROOMS: 1ST FLR: S 2ND FLR: 3RD FLR: BATHROOM(S): a TOILET ROOM(S): UTILITY ROOM: PORCH TYPE: DECK, TYPE: PATIO, TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER:BAfE/AoAMTYPE HEATER: #/I- 64RNE/QAIRCONDITIONING: TYPE HEAT: oll- Nor WARM AIR: HOTWATER: YFS OTHER: ACCESSORY STRAJCTURES: GARAGE, TYPE OF CONST.: SWIMMING POOL: AloN E STORAGE, TYPE CONST.: GUEST, TYPE CONST: _ VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFOFM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION'- ART. SEC. 109 c FNTR17 L ,g/ coy l T101V nfG O N I T *eO S S k l L D/ n! G tL- Vve f T L -/e -S REMARKS: INSPECTED BY: o0L 5 KED EYn0/—I syiF-�� r i , DATE OF INSPECTION: TIME START: � Ko lfl� END: