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Home My WebLink AboutZ-34658FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 34658 I~te: 11/05/10 THIS C~KTIFIES that the building DWELLING Location of Property 26025 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 109 subdivision Filed Map No. __ CUTCHOGUE (STREET) (~L~MLET) Block 0002 Lot 010 LOt No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF ~o~;~Nt"f NO~B~ Z- 34658 d~ated NO%qEMBER 5, 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 CONCRETE PATIO AND REAR ENTRY.* The certificate is issued to EDWARD GROHOSKI (OWNER) of the aforesaid building. SuffOLK COI~T~Y DEPARTMENT OF ~ALTH APPROVAL ~.~c:£KICAL CERTIFICATE NO. PL~ c~KTIFICATION *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A Signature Rev. 1/81 BUILDING DEP~%RTMENT TOWN OF SOUT~OLD HOUSING CODE INSPECTION REPORT MAP NO.: LOT (S) EDWARD GROHOSKI # STOP/ES: (~: FULL 2.0 # ~O[ITS: 2 PATIO ~: CONCRETE ACCESSORY STRUCTURES: VIOLATIONS: C}~PTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. DA~ ON I~PECTION: 10/19/10 '~ ~'T;%]~T: 10:00 AM ~: 10:30 For~n No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPAN( This application must be filled in by typewriter or ink and submitted to the Building De A. For new building or new use: 1. BLDG. DEPT. 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. Sublrdt 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, Swirnnfing 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, Commercial $15.00 Date. October 7, 2010 New Construction: Old or Pre-existing Building: X Location of Property: 26025 Rain Road (checkone) for a two-story frame dwelling Cutchogue House No. Street Owner or Owners of Property: The Estate of Edward R. Grohoski, deceased Suffolk County Tax Map No 1000, Section 109.00 Block 02.00 Subdivision Filed Map. Permit No. Date of Permit. Applicant: Hamlet 010.000 Lot Lot: Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ 100. Underwriters Approval: Final Certificate: X (check one) CONSENT TO INSPECTION Ed~ward Grohoski, co-executor of ~f Edward R. -- the Estatethe,,~ __ ~ deceased, Owne~, mme~sign,~d, Grohoski, do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the T Southold, located at 26025 Hain Road wh,c.h ,s shown y?ue, ;i;55 ownof Section 109 m^.,. ~ n ~e Suffolk Count. Ta- ~ o,.~ ~, ~t 10 ~ ~ ~v~up as oisthct ~ .vu' ~ nnn~' That the undersized Cas) (have) filed, or cause to be filed, ~ application in the Southold Town Building Inspector's Office for the following: a Pre-existing '~r~c~e ~ ~ anc for a t~o stor frame dwellin . That ~e undersized do(es) hereby give consent to Town of Sou~old to enter upon ~e above deschbed prope~y, including ~y ~d all -* ommmg ~lspectors of~e buildings located ~ereon, to conduct such inspections as the ma respect to ~e afores~d application, includi.-; ....... . ~ Y deem necess~ wifh comply wi~ all of~e -6 ,-~p=cnons to ~ete~me that said p~emi~s laws, ordin~ces, roles ~d re~lations of the Town of Sou~old. ~e undersized, in consenting to such inspections, do(es) so with ~e ~owledge ~d underst~ding ~at ~y info~ation obtained in the conduct of such inspections may be used in subsequent prosecutions for ~olations of the laws, ordin~ces, roles re~lations of ~e Town of Southold, or Dated: October 7, 2010 LOCATION: (number & street) SUBDIVISION: NAME OF OWNER(S): OCCUPANCY: MAP NO.: (municipality) LOT(S): (type) ADMITTED BY: ~ Q~ KEY AVAH,ABLE: SOURCE OF REQUEST: (owner-tenant) ACCOMPANIED BY: SUFF. CO. TAX MAP NO. 1000- DATE: STORAGE, TYPE CONST.: GUEST, TYPE CONST: DWELLING: TYPE OF CONSTRUCTION: C~-~. ~,~_ # STORIES: ~2 # EXITS: ~ FOUNDATION: CELL~: ~/ C~ SPACE: TOTAL ROOMS: ~R:~ 2ND~LR: .~ 3~ FLR: ~ BATHROOM(S): ~ TOILET ROOM(S): ~. UTILITY ROOM: PORCH TYPE: ~ DEC~ TYPE: ~ ~ztwAv: - ~m~e[Ac~: ~¢ eAXIO, ~YP~: ~~ . GAUGE: -. DOMESTIC HOTWATER: W~ AIR: HOTWATER: ~ ACCESSORY STRUCTURES: ~ GAUGE, TYPE OF CONST.: SWlMM~G POOL: OTHER: VIOLATIONS: CHAPTER 144 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION ] DESCRIPTION ART. SEC. / ) REMARKS: TIME START: ,/~7 f,../L9 END: /~); ~ /o~o-/~ ~- o-/,, TOWN OF SOUTHOLD PROPERTY RECORD CARD STREW* ZbO~ w~ o,~. su~. ~o~ FORMER oWNER N E ACR. S~ ~ W. ~PE OF BUILDING ~$) ~/D S~S. VL. FAro COMM. CB. MISC. Mkt. Value ~N D IMP. TOTAL DATE R~ARKS AGE BUILDING CONDITION N~ NOeL BELOW ABOVE FA~ Acre Value Per Value Acre 'illable illable 2 illable /oodland ~ampland FRONTAGE ON WATER rushland FRONTAGE ON ROAD 7~ ~ ~ g ~ ~ ~ ~ ~ ~ ~ BULKH~D ot~l DOCK v~. Bldg. '~tension "xtension Foundation Ext. Walls ~xtension Fire Place Roof ~orch >,ecreotion Room )arch Breezeway ~oroge Patio Total Driveway c~ Bath Floors Interior Finish Heat Rooms I st Floor Rooms 2nd Floor ]nette LR. DR. BR. FIN. B. ERIC J. BRESSLER ABIGAIL A, WICKHAM LYNNE M. GORDON JANET GEASA LAW OFFICES WICKHAM, BRESSLER, GORDON & GEASA, P.C. 13015 MAIN ROAD, P.O. BOX 1424 MATT[TUCK, LONG ISLAND NEW YORK 11952 631-298-8353 TELEFAX NO. 631-298-8565 wwblaw~aol.com October 7, 2010 WILLIAM WICKHAM (06-02) 275 BROAD HOLLOW ROAD SUITE 111 MELVILLE, NEW YORK 11747 631-249-9480 TELEFAX NO. 631-24 9- 94@4 Attn: Ms. Connie Bunch Town of Southold Building Department P.O. Box 1179 Southold, New York 11971 Re: Property owned by the Estate of Edward R. Grohoski, deceased Pre-Existing Use C.O. Application - 26025 Main Road, Cutchogue, NY SCTM# 1000-109-2-10 Dear Connie: We represent the owner of the above referenced property. The following items are enclosed: 1. Application for Pre-Existing Use Certificate of Occupancy for two story frame dwelling; 2. Consent to Inspect; 3. Print of Survey prepared by Peconic Surveyors, P.C. dated 9/21/10 4. $100. application fee; and 5. Copy of Property Card. Please contact the broker, Bob Celic, at 298-6124 to arrange for the inspection. Very truly yours, Abigail A. Wickham ,4 ,4 W/dm encl. 30/shdbprecoapp cc: Bob Celic LOT I "MAP OF CROWN LAND ROAD' NO. 6289 F/LED AUGUST 27, 1975 SURVEY OF PROPERTY AT CUTCHOGUE TO,tN OF SOUTHOLD SUFFOLK COUNTY, N.Y. l O00-109--OB--l O SCALE: I'--30' SEPTEWBER 2~, 2010 S55'19'40',,, -_ , s=s=o,,, ",,o_.oo~ (ACnJAL) /o. oo ~v ~o~ (xa go) AREA=17,081 $O. FT. ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 72090F THE NEW YORK STATE EDUCATION LAW, EXCEPT AS PER SECTION ?209-SUBDIVISION 2. ALL CERTIFiCATiONS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR WHOSE SIGNA lURE APPEARS HEREON. CERTIFIED TO: DEBORAH LORENZO FIDELITY NATIONAL TITlt~ WELLS FARGO BANK, (6J1) 765-5020 P.O. BOX 909 12JO ~A ~LER S~EET