HomeMy WebLinkAboutZ-32356
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-
32356
Date: 05/18/07
THIS CERTIFIES that the building DWELLING
Location of Property 2635 HOBART
(HOUSE NO.)
County Tax Map No. 473889 Section 064
RD
(STREET)
Block 0005
SOUTHOLD
(HAMLET)
Lot 031
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-
32356
dated MAY
18, 2007
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 WITH ENCLOSED FRONT PORCH AND ACCESSORY SHED.*
The certificate is issued to ELEANOR W CELATKA
(OWNER)
of the aforesaid building.
N/A
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
N/A
N/A
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
SOUTHOLD
MAP NO. :
LOT (S)
LOCATION:
SUBDIVISION:
HAME OF OWHER (S): ELEANOR W CELATKA
OCCUPAHCY: SINGLE FAMILY
2635 HOBART RD
ADMITTED BY: FRED TAYLOR
ELEANOR W CELATKA
ACCOMPAHIED BY: SAME
KEY AVAILABLE:
SUFF. CO. TAX MAP NO.: 64. -5-31
SOURCE OF REQUEST: ABIGAIL WICKHAM, ATTY
DATE: 05/18/07
DWELLING:
TYPE OF CONSTRUCTION: WOOD FRAME
FOUNDATION: CEMENT BLOCK
TOTAL ROOMS:
BATHROOM (S) :
1ST FLR.: -2
1.0
2ND FLR.: 2
TOILET ROOM (S): ----2....:...Q
DECK TYPE:
# STORIES: ~ # EXITS: 2
CELLAR: 1/8 CRAIIL SPACE: 7/8
3RD FLR.: -!2.
UTILITY ROOM(S) :
PORCH TYPE: FRONT ENCLOSED
BREEZEWAY:
DOMESTIC HOTWATER: YES
PATIO TYPE:
FIREPLACE: GARAGE:
TYPE HEATER: KEYS PAN GAS AlRCONDITIONIHG:
TYPE HEAT: KEYS. GAS WARM AIR:
OTHER ,
HOTWATBR: X
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.: NONE
SWIMMING POOL:
OTHER: OUTHOUSE
STORAGE, TYPE CONST.: SHED
GUEST, TYPE CONST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION
DESCRIPTION
ART.
SEC.
REMARKS ,
DlSPRCTED BY:
DATE ON IRSPECTION: 05/16/07
TIME START: 9: 30AM
END: 9:45AM
Form No. 6
.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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APPLICATION FOR CERTIFICATE OF OCCUPANCY
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A. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: 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.
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 a 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 - ~ '4~;
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .1;!'!'l[ .~: .?99?...........................
New Construction........... Old Or Pre-existing Building..~.(oa~~lalniq.q~ei~hhalf sthorYa f)rame
we ng w t two s e s
Location of Property... J.6,3;>. .. . . .. . . . . .. .. J;I,?1;>~H .''?~(L . .. .. . . .. . . . . ..ql!~l}ql.cj .. .. .. .. . . . .. . . ..
House No. Street Hamlet
Onwer or Owners of property...;pp~~~.~:.!~y~'?r.~~4.~~r'?~~~747..~t~~~~~1...~R~~~~~~.q~X~&~~&....
under L W T or Eleanor W. Celatka
County Tax Map No 1000, Section... ?~........ .Block..-?........... .Lot.. .:n.................
Subdivision. .S,u.b,d,i,v.i.s.i,op. !'l.ap. .o!. !'.o!'?~!'!~.~!'H~~Ji~~d Map.I!~~~...... .Lot... .1.~~...............
Permit No............... .Date Of Permit............... .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Health Dept. ApprovaL........................ .Underwriters ApprovaL........................
Planning Board Approval........................
Request for: Temporary Certificate........... Final Certicate...~........
Fee
S~t;:d~~~O~~....................... d j~ I'/a ~tJ
(b c"1 d'S:; ~ . Abi;;!{ff' . . ;;Lft~A~~n:: 'Ag;;t . . . . . . . .
CONSENT
TO
INSPECTION
Thomas A. Taylor and Carolee
Owner(s) Name(s)
doles) hereby state:
*
A. Pi~ntal, specific devisee~ th~ undersigned,
*under the Last Wil and Testament of EleanorW. Celatka
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at 2635 Hobart Road, Southold, New York 11971
, which is shown and designated on the Suffolk
County tax map as District 1000, Section 64 ,Block 5
, Lot 31
That the undersigned (has) (have) filed,or caused to be filed. an applica-
tion in the Southold Town Building Inspector's Office for the following:
a
.
one and one-half story frame dwelling with two sheds
That the undersigned doles) 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. doles) so with the
knowledge and understanding that any information obtained in the conduct of
such inspections may be used as evidence in subsequent prosecutions for vio-
Dated: May 3, 2007
rules or regulations of the Town of Southold.
7.1ltt!ift,{};[
lations of the laws, ordinances,
Abigail A. Wickham, Agent
(print name)
(signature)
(print name)
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