HomeMy WebLinkAboutZ-31048FORM N0. 4
TOM! OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
SouEhold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 31048
Date: 07/20/05
T~IS CERTIFIES that the building
Location of Property 57685 MAIN RD
(HOUSE NO.)
County Tax ~4ap No. 473889 Section 063
DWELLING
SOUTHOLD
(STREET) (PLAMLET)
Block 0003 Lot 025
Subdivision Filed Map No. __ Lot No. __
conforms su]~stantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
£~2C~3PAMCY ~L~4BER Z 31048 dated JULY 20, 2005
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, 2 ACCESSORY GAR-AGES, 3 STORAGE SHEDS, 1 BARN
ACCESSORY COTTAGE.*
%~ne certificate is issued to HELEN KRUKOWSKI
(OWNER)
of the aforesaid building.
SUFFOLK COUNT"f DEPARTMENT OF H~.~LTHAPPROVAL
ELEC'~RICAL CERTIFICATE NO.
PL~BERS CERTIFICATION DA~D
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
Rev. 1/81
SOUTEOLD
NO.; LOT (S)
HELSN KRUKOWSKI
PORCH TYPg: DECK ~"fPE: PATIO TYPg:
ACCESSORY STRUCTURES:
C~E, ~PE OF CONST.: 2 WOOD FR~E STORAGE, ~PE CONST.: 3 SHEDS-1 BARN WOOD FRAHE
SWI~4ING POOL: ~3EST, TY~E CONST.:
f~L-~: *FOUND.CEMENT 1 STY WOOD FP~E 3 ROOMS-1 EATH,PROP~IE HEATER,ELEC.HW
VIOLATIONS: CEAPTEP. 45 [I.Y. STATE UI4IFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART . SEC .
TO~H OF 50UTIIoLD
BUILDIHO OEP^~THEtir
'[ot4N IIaLb
765-[fl02
· APPLic^TU3N FOR.CERT,TFTCATE: OF OCCUP~IIC¥
1'ITiS app~ication'must be filled iii by typewriter OK ink'and subm[ '6'~he ba£Jdlt~g
inspector with tile followingf for ne~ building or new use~
Ftna~ sUrvoy of property yith dec,rata location of ail bui[dtngst property
2~ Final Approval fvotd Healkh Dep~' of ~akar sapply attd a~werage-disposal(S-9
3~ Approval of electrical lnstallatiott [rom Board of Fire Underwrite~s~
41 Sworn ska~mhent from plumber eerti[ying tha~ the solder used in system
less than 2/IO of 1% lead. ,'
5~ Co~nerciai buildtng~ tttdus, kttul bQtlding~ mdittpie resldeacea and shuiiar buddings
attd inskallationst a 'certificabe of Code Compliance Erom~archtteek or
responsible for kbe buildtmg~
6~ Submit Planning Board Approval of completed site plan requirements.
For ~-xisting buildings (prior to April 91 1957) non-conforming usei~ or buildings nnd
"pre-e×isting" land uses~
l~ Accurate survey of property sho~ing all proper~y [lues~ streaks~ building and.,
uu~sual t~a~urai or ~opographi¢ fea~a~ea~ ;"
2. A properly completed appkicatton and a consent ~o inapeck stgued by' the apptteant~
if a Certificate aC Occupancy is deuied~ the Building Inspector shall skate the
reasons bherefo~ in writing ~o kh~ applicanb~
Qi Fees
li Certificate of Oe¢~paacy - New d~eiling $~5.00, Additions to dwelling
Aiternkiona to dwelling ~2~;O0~ Swttmnimg pout $25100~ Accessory b~ildlng
~ddittot~s to accessory building $25~00~ B~stnassea $50.OO~
2, Cartiftcat~ of Occupancy on Pre-existing Building -
3t Copy of Certificate of OccUpancy - $5.OO-6ver 5 years - }10.OO
/~ Updated Certificate of Oce~pa~tey -
5i Temporary Certificate of Occ~patte~ - Residential ~lS.OO~ Commercial
. June 7, 2005
%{ew Co~skrUctio~***~,~.,; Old Or Pr~-exis~i.g 8uildieg.,,~,~ ....... ~.
House No. Stree~ Ila~e~
Helen Krukowski
' ' 063.00
Cou~,ky ~ax Hap No 1000~ Seekto~l~,~,i~,,~,~nlock**qq~OC 025.000
'
Sub itt , 100.00 ·
' ~PLICMfr
~' / Willia~ H. Price, 'Jr. '
~/~. SCTM~1000-063.00-03.0~-025.000 (Krukowski)
Enclosed please find Application for Certificate of Occupancy, Consent to
Ins~.ection, Survey, and my check in the amount of $100.00 to cover your fee.
In order to obtain access, please contact either Fran Blakely (765-4938) or
Joe Krukowski (765-2628).
Thank you.
Town of Southold Building Dept.
TO P.O. Box 1179
Scuthold, New York 11971
WILLIAM H. PRICE JR.
ATTORNEY AT LAW
LOCATION: 57685 Main ~ Scuthold, N.Y.
(number & street)
(municipality)
SUBDIVISION:
NAME OF OWNER(S): HELEN KRUKO~/SKI
OCCUPANCY: $!~c-T v ~v~ v n~T r~c
(type)
ADMITTED BY: ~,.,d~ ~~
~Y AVAILABLE:
SOURCE OF REQUEST: ~. PR~C~, aTTY
MAP NO.: LOT(S):
(owner-tenant)
ACCOMPANIED BY: ~
SUFF. CO. TAX MAP NO. 1000-
DATE: 118/o5
63-3-25
DWELLING:
TYPE OF CONSTRUCTION:
FOUNDATION: CE~mIT m,ocK
TOTAL ROOMS: 1ST FLR:
BATHROOM(S): !
PORCH TYPE:
BREEZE~VAY:
DOMESTIC HOTWATER: Xx
TYPE HEAT: gEYSpA~I GAS-STRAH~ARM AIR:
OTHER: Stn~ER KITCHEN & PANTRY
i/OOO glLOm # STORIES: I-I/2 # EXITS: ~
CELLAR: ~ CRAWL SPACE:
.~-- 2ND FLR: ~.~ 3RD FLR: __
TOILET ROOM(S): I UTILITY ROOM:
DECK, TYPE: PATIO, TYPE:
FIREPLACE: GARAGE:
TYPE HEATER: KL~SPAN GAS AIRCONDITIONING:
HOTWATER:
ACCESSORY STRUCTURES:
GARS, GE, TYPE OF CONST.: 2;-~,J~rfl'-~nv~ STORAGE, TYPE CONST.: 3 STORA~ SHEDS & !
S~VIMMING POOL: ~-- -GUEST, TYPE CONST: COTTAGE ~ Khglt
OTHER: *FOUNDATION CENENT- I STORY ~'OOD FP, AI~ 3 ROOHS-I FULL BATH/PROPANE HEATER, ELEC. HI./
VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION
DESCRIPTION
REMARKS:
INSPECTED BY:
DATE OF INSPECTION:
TIME START:
END:
CONS]~NT
TO. :
INSI~DcTION
William H. Price, Jr., as agent for Edward Kruk~wski, Executor of the
Estate of Helen Kruowski the unders|~ned,
Owner(s)
doJes) hereb~ state:
of Southold located ~[ 57685 Main Road
, which [s sho%~ m~ld designated on lhe Suffolk
County ~ax map as D~g[rict 1000, Sec[ion 063.00, Block 03.00 , Lo~ 025.000
That lhe undersigned (h~s) (h~ve) filed, or c~used ~o be filed,
t[on in the Sou[hold Town Buildinl~ Inspector's Office for the followh~g:
Application' for Pre-Ceztificate cf Occupancy
q'h:~l the undersigned do(es) I]ereb3 ffive consent to the Build[nC inspectors
of [he To%vu of Soulhold to enler upon the above described property, iucludinff
any and att buildings located Lhereon. [o conduc[ such [nspcdt[ons ~s they
deem necessary wilh respect to the aforesaid application, ~cludblf Inspections
1o determine [hal said premises corn[)ly with all of the laws. ordinances, rules
and ref~ulations 9[ lite Towel of Southold.
The undersifned, in consentln~ to such ~spections, do(es) so with the
knowtedffe and unde~standinff that any h~rormation obtMned tn the conduct of
such h~spections rnay be used as evidence in subsequent prosecutions for
rations of the laws, ordhlances~ rules or re~lations of {he Town of Southotd.
Dated~ ~une '7~ 2005
' ' ~ {si~naturu} .
William H. Price, Jr.
(print nam~)
(print nan;e)
I~OA9
SURVEY OF PROPERTY
AT SOUTHOLD
TO'tN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
1000-63-03-B5
SCALE: 1~#0'
MA Y J, 2005
CERTIFIED TO'
R/CHARD ~IBB,~
dENNIKER STACK GIBBS
ZB£ RROPERTIES LLC
AREA=8.2288 ACRES
OR J58, 445 SO. FT.
71 7¸
piP[