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Home My WebLink AboutZ-34492FORM NO. 4 TOWN OF SOLVfHOLD BUILDING DEP~RTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 34492 Date: 08/03/10 THIS C~KTIFIES that the building DWELLING AND ACCESSORIES Location of Property 6315 INDIAN NECK LA PECONIC (HOUSE NO.) (STREET) (HAMLET) County Tax F~ap NO. 473889 Section 086 Block 0006 Lot 020 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to whlchCERTIFICATE OF ~C~3PANC"/ ~E/~ Z- 34492 dated AUGUST 3, 2010 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 ACCESSORY GAR3kGE AND SHEDS.* (GA/~AGE AND SHEDS IN DISREPAIR) The certificate is issued to KATHERINE S WOLOSIK (OWNER) of the aforesaid building. SUFFOLK COUNTYDEPARTM]gNTOFHEALTHAPPROVAL ~'LR~ji-KICAL CERTIFICATE NO. PLIERS CERTIFICATION DA'r~u *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A ~a~hO ~ed/S~i~a t u r e Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT PECONIC NAP NO. = LOT (S) KATHERINE S WOLOSIK ACCESSORY STRUCTURES: C~, 7~ OF C~ST.: 2 CAR WOOD FRAME GAP. AGE S~, T%rPE C~ST.: 2 DEfJ~PIDATED SHEDS LOCATION SEC. CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE DESCRIPTION ART. ACCESSORY GARAGE ROOF IN NEED OF REPLACEMENT OR EXTENSIVE REPAIR DAT~ ~ IN$~I(]~: 07/22/10 START: ~: CONSENT TO INSPECTION Wolosik by David , the undersign, ed, do(es) hereby state: Owner(s) Name(s) Worth~ngtod Olsen, as Attorney- That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold, located at 6315 Indian Neck Lane, Peconic, l~/ 11958 which is shown and designated on the Suffolk County Tax Map as District 1000, Section 86 ,Block 6 Lot 20 That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: ~ fa~,~~ That the undersigned do(es) hereby give congent to ~he 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, rules or regulations of the Town of Southold. ~ Dated: July 14, 2010 (Signature) Wot ['hlngtOll Ols~n (Print Name) (Signature) (Print Name) OLSEN & OLSEN LLP 32495 MAIN ROAD PO BOX706 CUTOHOGUE, NY 11935 ?m~ _~'-~'-:~o TOWN OF SOUTHOLD PROPERTY. RECORD CARD FOR)AER OWNER VL FARM COMM. DISTRICT SUB. ? CB. MISC. LOT Est. Mkt. Value ~Es. SEAS. LAN D IMP. TOTAL DATE /.~"AGE( BUILDING CONDITION NEM/ NORA4AL Farm Acre Tilleble 1 Tillable 2 Tilleble, 3 Woodland Swampland BELOW Value Per Acre Brushland House Plot Total ABOVE Value FRONTAGE ON WATER FRONTAGE ON ROAD BULKHEAD DOCK Foundation ~ J ' 'Basement Extension ~;~: ~L ~J* ~.~o Extension ~ / ' Ext. Walls , ~b~ Interior Finish ~tension ~ ~[ ~ FirePlace , ,, Porch Porch Roo~ 1st Floor Breezeway v / ~ Patio Rooms 2nd Floor Driveway Dormer Form No. 6 TOWN OF SOUTHOLD ~1L Jif BUILDING DEPARTMENT 765-1802 JUL ] 9 2010 BtDG DEPT. TOWN OF SOUTHOED 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. 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-ex/sting BuildLng - $100.00 3. Copy of CertificateofOccupancy $.25 4. Updated Certificate of Occupancy_ $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. July 14, 2010 New Construction: Old or Pre-existing Building: X _ (check one) LoCation of Property:__ 6315 Indian Neck Lane, Peconic, I~Y 11958 House No. Street Owner or Owners of Property: Suffolk County Tax Map No 1000, Section 86 Hamlet Subdivision Permit No. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ _ Inn on :5_qq qk 7 Block 6 Filed Map. Applicant: Underwriters Approval: ck one) Applicant Signature Date of Permit. Final Certificate: OLSEN & OLSEN LLP 32495 MAIN ROAD PO BOX706 CUTCHOGUE, NY 11935 Lot 20 Lot: LOCATION: (number & street) SUBDIVISION: NAME OF OWNER(S): OCCUPANCY: MAP NO.: (municipality) LOT(S): (type) ADMITTED BY: KEY AVAILABLE: SOURCE OF REQUEST: (owner-tenant) ACCOMPANIED BY: SUFF. CO. TAX MAP NO. 1000- DATE: DWELLING: TYPE OF CONSTRUCTION: FOUNDATION: C~..,~,~F- TOTAL ROOMS: 1ST FLR: f'-- BATHROOM(S): PORCH TYPE: BREEZEWAY: DOMESTIC HOTWA~TER: TYPE HEAT: ~(~ OTHER: #STORIES: ~ #EXITS: .~ CELLAR: ~L.~( CRAWL SPACE: 2ND FLR: 3RD FLR: ~ TOILET ROOM(S): DECK, TYPE: FIREPLACE: TYPE HEATER: .WARM AIR: UTILITY ROOM: PATIO, TYPE: GARAGE: AIRCONDITIONING: HOTWATER: ACCESSORY STRUCTURES: GARAOE, TYPE or CONST.: ORAGE, TYPE SWIMMING POOL: ,"--- GUEST, TYPE CONST: OTHER: ~-~ VIOLATIONS: CHAPTER 144 & N.Y. STATE UNIFORM FIRE .PREVENTION & BUILDING CODE REMARKS: DATE OF iNSPECTION: TIME START: END: R ~CHMOt~ CREEK SURVEY OF PROPERTY AT INDIAN NECK TO,tN OF SOUTHOLD SUFFOLK COUNTY, N.Y. l O00-8~-OG-BO SCALE: 1'-40' JUt ~ ~2, 20~0 SLA~/CO~C. POLE CERTIFIED TO: BARRY ROOT FIDELI~' NA110NAL TIU..E INSURANCE COMPANY ~f, ZLLS FARGO BANK, NA. 156.60' ,~o'~ NECK INPI^N ANY ALTERA770N OR ADDI~tON TO 77'¢1S SURLY (S A ~ ~CBON 72~ ~ ~E NEW Y~K STA~ EDUCA~ LA~ EXCEPT AS ~R ~C~ON 7209-SUBDI~ Z ALL ~R~FICA~ONS HERE~ ARE VAED F~ ~IS M~ AND C~I~ SAID M~ ~ C~IES BEAR ~E IMPR~ ~AL ~ ~E SURfeR ~0~ ~A~RE APPEARS H~E~. · == MONUNENT / / 393' {651) 765-5020 FAX (631) 765-1797 P. O, BOX 909 soumo~o, ~.x .~ 110-165 OLSEN (~7 'OLSEN~ L.L.E ATTORNEYS AT LAW GARY FLANNER OLSEN ATTORNEY AT LAW DAVID WORTHINGTON OLSEN ATTORNEY AT LAW 32495 MAIN ROAD · EO. BOX 706 · CUTCHOGUE, NEWYORK 11935 0706 PHONE 631-734-7666 FAX 631 734-7712 olsenlaw@optonline.ner July 15, 2010 Re: Wolosik to Root Our File 9510 To Whom It May Concern: Enclosed herewith please find the following: 1. Application for pre-existing certificate of occupancy. 2. Consent to Inspect form. 3. Check in the amount of $100.00. 4. Survey. Please contact Erica at Andrew Stype Realty, Inc. (765-6085) to arrang~the inspectiofi. DAVID WORTHiNGTON OLSEN DWO:lmk Enclosures Southold Town Building Dept. P. O. Box 1179 Southold, NY 11971