HomeMy WebLinkAboutZ-31715
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
NO: Z-
31715
Date: 07/13/06
THIS CERTIFIES that the building
DWELLINGS
Location of Property 16500 MAIN ST
(HOUSE NO.)
County Tax Map No. 473889 Section 117
(STREET)
Block 0009
NEW SUFFOLK
(HAMLET)
Lot 013
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-
31715
dated JULY
13, 2006
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 MAIN DWELLING WITH THREE APARTMENTS & A TWO FAMILY DWELLING *
The certificate is issued to JOSEPH H & JOAN M. FUDJINSKI
(OWNER)
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.
~or~
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION:
16500 MAIN ST
NEW SUFFOLK
SIlBDIVISION ,
MAP BO.;
LOT IS)
RAME OF OWNER (S): JOSEPH H & JOAN M. FUDJINSKI
OCCUPANCY: MULTIPLE RESIDENCE
JOSEPH H & JOAN M. FUDJINSKI
~ITTED BY; MIKE FUDJINSKI
ACCOMPANIED BY: SAME
KEY AVAILABLE:
BUFF. CO. TAX MAP BO.: 117.-9-13
SOURCE OF REQUEST; JOAN FUDJINSKI 5/29/06
DATE, 07/13/06
DWELLING:
MAIN OOELLOC WIlli APARIMENrS
TYPE OF CONSTRUCTION: WOOD FRAME
I STORIES: ~ # EXITS: ~
FOUNDATION:
BRICK
CELLAR: PART
CRAWL SPACE:
TOTAL ROOMS: 1ST FLR.: 4
2ND FLR.: 2
3RD FLR.; ~
BATHROOM (5); ~
TOILET ROOM(S); ~
UTILITY ROOM(S);
PORCH TYPE: FRONT COVERED
DECK TYPE:
PATIO TYPE: YES CONCRETE
BREEZEWAY;
FIREPLACE: WOOD STOVE
GARAGE ,
NO
DOMESTIC HOTHATER.: YES
TYPE HEATER.: HOT AIR
AIRCONDITIONIHG:
TYPE HEAT: OIL
WARM AIR: YES
HOTHATER:
YES
OT'HHR. : *
ACCESSORY STRUCTURES, 2 FAillLY DWELLIN:: WOOD FRAME 2 STORY - 3 EXITS
GARAGE. TYPE OF CQUST.: STORAGE. TYPE CONST.;
SHIMMDlG POOL: GUEST. TYPE COBST.:
OTHER: **
DESCRIPTION
*3-1 ROOM APARTMENTS WITH BATHS (1 BATH,
FIXTURES REMOVED IN 2002) 1-2 ROOM APARTMENTS
WITH BATH.
**1ST FL. 4 ROOMS 1 BATH. 2ND FL. 4 ROOMS
1 BATH, CEMENT BLOCK FOUNDATION, BILeo DOOR &
CONCRETE PATIO.
REMARKS: SP #32196-Z-COZ-31714 (HEATING SYSTEM)
~
~ DATE OR
IBSPBCTIQR, 06/09/06
INSPECTED BY:
GEORGE GILLEN
TIME START: 9: 30 AM mID: 10: 30 AM
.
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
J
APPLICATION FOR CERTIFICATE OF oecup ANCY
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 (8-9 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.
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 - $100.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Conunercial $15.00
Date. 5' -;1-9 - ~k
,
New Construction:
Location of Property: 'u. ~ OD
Old or Pre-existing Building:
1"\ A I ~ S'TiU. Ed'
V'
( check one)
NeW SUfPo/.,K.
Hamlet
House No.
Owner or Owners of Property:
J()~tPH
Street
H. FUOJ;NSKi
III Block
q
Lot
l~
Suffolk County Tax Map No 1000, Section
Subdivision
Date of Permit.
Filed Map.
Applicant:
Underwriters Approval:
Lot:
Permit No,
Health Dep!. Approval:
Planning Board Approval:
Request for:
Temporary Certificate
Final Certificate:
/
(check one)
Fee Submitted: $
I C>D;~
r
~~~~
Applicant Signatur
~~. lOG K :?
(Jf\R.. Lo'C 317 /5
TOWN OF SOUTHOLD PROPERTY RECORD CARD
1'1 2
/tJOQ - //7 - 9 - /.3 -
OWNER STREET / t~ S OJ VILLAGE DISTRICT SUB. LOT
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FORMER OWNER N AId.. ,'" r~t _ 1- E 1"- JA H 1- ACREAGE ~y
"';jr'} <. ' t~:J- r"f.'rw"1' ';" I~~
Yv,'I/(~ ,.. /!-( ~ V,'.J. S 1...vlJ, l~ "lc Ke'r W TYPE OF BUILDING cR /;)iti f'
y./JA, G,j), Da ",i4;' Y-iIh. ~,,- / , " /
hl,/, [ ,j
RES. ~~ (: , I I I I ~st. Mkt. Value
J,.,..", S p VL. FARM t.-'COM~ IND. CB. MISC.
,- , j/~i"'\o. NK, c> t
LA~m f-.....-/ IMP. \ TOTAL DATE REMARKS . <\ --. - .L
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I 'I '7 th1 .("~S' dO (pA/"" .5atelf y fl~c; 7
~116 V '
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AGE BUILDING CONDITION oR!J./!r3 .BP~ I ~ /I - cons) fol.l./h Ja::f; 01') /,ln~AcL',!'LJj ~#7~,e-o
NEW NORMAL BELOW ABOVE FRONTAGE ON WATER Co ~97~ M uL, , illiCit
FRONT AGE ON ROAD / () () J)~ 0 il A4~. :.., 7.~
Farm Acre Value Per Acre Value .' ..);1,...( t/ ~ ..~
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fillable 3 1.<'7, 97 J T, Dep 71\ Ii ~"
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Extension 20 '( ) if' - b c cJ ' I Basement f f} Floars
Extension 1/A.....J:fl ~5\ .2.,~;;I-'I/J"V1 3"); I Ext, Walls !,~..4.J;'/l_ ,'nterior Finish
Extension [3L(fJ-{~'1' l/.lLrf? ! ,yVV, 111 ,'VtFire Place ! ~Heat
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CONSENT TO INSPECTION
Zh1,v -F:.tlxn'NSt:r <
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
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section 1/7 ' Block cr ,Lot /3. .
That the undersigned (has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following:
Cf.R""I~IC.ME. 0' OC.C.UPAloJC'( Dill PJl.e.-E.)(I<:'l'INu R.f.~IlH.NC'- H01l:.L.
WI1'\oi AC.C.e.~~OR,( APPAR1"Mf.."'-r~
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: S- eJ-? - tJ k
/
"
<
~igna
(Print Name)
,
Heating Plant
16500 Main Street
New Suffolk, N.Y. 11956
Unit- Trane XE 90 Model# TUCI00C960B5
90+ Efficiency
Upflow- Forced Hot Air
Furnace- Natural Gas, Single Pipe Exhaust, 100,000 btu, Hot Surface Igniter
'5 Supply Ducts- 7"
1 Central Return- 14"x 30"
Inspected by James Fogarty
Box # 102
New Suffolk, N. Y. 11956
Phone# 631-905-3252
,
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JOSEPH-H, ~ JOAN M, FUDJ I N5K!
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IBEGISIEUD ARCBm:crl
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15'-0"
11'-0"
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16'-0"
181_4R
Note:
All Dimension Indlcllted
aN Nom"" (+10 2")
9'-(1'
21'-0"
341.411
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