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Home My WebLink AboutZ-33922FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPA=RTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 33922 I~ate: 08/27/09 THIS CERTIFIES that the building DWELLING l~Dcation of Property 4625 DEPOT LA (HOUSE NO.) Co~ty Tax Map No. 473889 Section 096 subdivision CUTCROGUE (STREET) (HAMLET) Block 0005 LOt 004.001 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 ~u~ANC"f ~B~ Z- 33922 dated AUGUST 27, 2009 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 PORCH* The certificate is issued to JOSEPH GROHOSKI (OWNER) of the aforesaid building. N/A N/A N/A Rev. 1/81 BUILDING DEPAR~ENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION P~EPORT ~ OF ~ (S}: JOSEPH GROHOSKI OCCUPANCY: OWE FAMILY DWELLING MAP NO.: LOT (S) JOSEPH GROHOSKI DWELLING: ~ OH CON~(~: WOOD FRAME FO~H~%TION: CEMENT BLOCK TOTAL R(X~S: 1ST FLR.: ~4 POH~ TYPE: ENCLOSED ACCESSORY STRUCTURES: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. BP 3924 addition C/OZ-3163: BP 22095 Demo. garage C/O NA BY: ~/~3t? _/~'2~ mk~-~ o~ z~-s~-:'rzcm,: o8/2v/o~ Form No. 6 TOWN oF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUP AUG 2 5 2009 BLDG. DEPI. TOWN OF SOUTHOLD 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 locatinn 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 Compliunce 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 ali 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 3. 4. 5. New Construction: Old or Pre-existing Building: Location of Property: ~Z~ c~bo4 L-~ Ho'use No. I Street O nerorOwner ofPrope y: Suffolk County Tax Map No 1000, Section C~ ~, Subdivision 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. Certificate of Occupancy on Pre-existing Building - $I00.00 Copy of Certificate of Occupancy - $.25 Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 / / '- V/ fcheek one) Permit No. Date of Permit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~X~ Blnek Filed Map. Lot: Applicant: Underwriters Approval: Final Certificate: ~ (checkone) CONSENT TO INSPECTION Owner(s) Name(s) , the undersigned, do(es) hereby state: That the undersilgned (is) (are) the owner(s) of the pl'emises in the Town of Southold, locatedat ~u~2.~ '~uape.-} ~/[~_._ (~_~x.~c.~oq~6_ which is shown and designated on th~ Suffolk County Tax Map as Distrt~ 1000, Section g{. , Block o~' ., Lot ~/./ That the undersignedit~ (have) filed, or cause to be filed, an application in the Southold Town Building Ins~Xe~t/or's Office for the following: ~'~.. - That the undersigned do(es) hereby giye 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, 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, roles or regulations of the Town of Southold. Dated: - v U(Print Name) (Signature) (Print Name) '~4~TOWNt OF $OUTflOLD PROPERTY RECORD CARD OWNER STREET~/(~ "'~.~ VILLAGE FORMER OWNER ~ S LAND IMP. TOTAL DATE ACR. W TYPE OF BUiLDiNG CO/'A~ CB. MIC$. Mkt. V~lue~ ~,,~ '-2'~ ~ ~ "':~ " , SUB. LOT- AGE DUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Volue Acre Tillable Woodland Meodowl,and House~Lpl.~ To~l FRONTAGE ON WATER FRONTAGE ON ROAD · DEPTH BULKHEAD DOCK M. BIdg. Extension Extension Extension Porch Porch Breezeway Garage Patio Total COLOR Found=fion ~' / ,.~- Basement · ' 'Ext. W~ls Fire Place Type Roof Recreotion Roam Dormer Heot Rooms 1st Floor Rooms 2nd Floor Driveway TRIM DURVt_=T' OF DROF~RTY .GITUA'I'~: C.4JT~ 5UF~OLK C, OUNTY, NY .SURVEYED' 06-22-200.5 SUFFOLK C. OUN"F'f TAX IOOO-q,6-5-4.1 AUG 2 5 2009 BLDG. DEPT. TOWN OF SOUTHOLD NOTE~: · MONUbdENT FOUN~ AREA = 15,0~0 5.F. or 0.50 AGRE ®t:;~-.APHIC~ SC. ALE I"= 20' 'd JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RI'v-B~AD, N.Y. 11901 369-8288 Fax 369-8287 REF.-\~-Ip scrver~lXPROS\05-233.pro