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Home My WebLink AboutZ-35103FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 35103 Date: 07/29/11 THIS CERTIFIES that the building DWELLING AND ACCESSORY Location of Property 2020 MARLENE LA (HOUSE NO.) County Tax Map NO. 473889 Section 144 subdivision LAUREL (STREET) (HAMLET) Block 0002 Lot 031 Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which C~KTIFICATE OF OC~u~ANC~f ~ Z- 35103 dated JULY 29, 2011 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 REAR BRICK PATIO & ACCESSORY TWO CAN GARAGE.* q~ne certificate is issued to MILDRED GLOWACKI (OWNER) of the aforesaid building. I=L~ERS C~TIFICATION DAT~U *PLEASE SEE ATTACHED INSPECTION REPORT. N/~ N/~ N/A -~t~r~i~ure Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT 2020 FaARLENE LA N~ OF (~ (S): MILDRED GLOWACKI G(2~ANCY: OWE FAMILY DWELLING LAUREL MAP NO.: LOT (S) MILDRED GLOWACKI DWELLING: ~ OF CO~STRUCTI(~: WOOD FRAME I~/(~: CEMENT BLOCK VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. P~: BP26593 ADD C0Z35102 II~ ON INSPE~I(]~: 07/27/11 START: 9:40AM I~: --- TOW SOtmIO BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 t % 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 $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, 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. New Construction: Old or Pre-existing Building: Location of Property: ~.0~to /~,t}~i~rls,2 /-,-,q~F House No. Street OwnerorOwnersofProperty: ~t'X~.~ ~-~ ~,~ ~:,~,ox.~ot,~, (check one) Hamlet Suffolk County Tax Map No 1000, Section Subdivision Permit No. Health Dept. Approval: Planning Board Approval: Date of Permit. Block Filed Map. Applicant: Underwriters Approval: Lot Lot: Request for: Temporary Certificate Fee Submitted: $ \~ ~, -- Final Certificate: (check one) CONSENT TO INSPECTION Owner(s) Name(s) the undersigned, do(es) hereby state: S , .T,h,at tho undersigned (is),(.are) the owner(s) of the pr.e~,?s in the town of oumom,~ocatedat .~.Ooo~ /l'M~e.~t /--/~L d4~d-~ta_~,L_ #~r. which is shown and designated on tho Suffolk County Tax Map aa District 1000, Section /¢4tf ,Block ~ ,Lot ~ X That the undt'rsigned (has) (have) filed, or muse to be filed, an application in the Southold Town Building Inspector's Office for.the following: That the undersigned do(es) hereby give consent 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 necessat3, with respect to the aforesaid application, including inspections to determine that said premises comply with ail of the laws, ordinances, rules and'regulations.of the Town of South61d. 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 8outhold. (Signature) (Print Name) '(Signature) (Print Name) TOWN OF SOUTHOLD PROPERTY RECORD CARD 1~ ,~o - t~-/4/-,~ -.~/ OWNER STREET ~ C)~) VILLAGE DIST ~' LOT S~ W , ~PE OF BUILDING ~ND IMP. TOTAL ... DATE REMARKS /00 /~rY~A4''/.. / AGE BUILDING CONDITION :iN~ NO~L BELOW ABOVE .FA~ Acre Value Per Value ' ~re ~-~illable 1 · illoble 3 S~ampl~d. FRONTAGE ON WATER Bt~tand FRONTAGE ON ROAD /~ ~ ~ ~ ~use Plot DEPTH / ~ ~ ~ BULKH~D Total DOCK I COLOR TRIM M. Bldg. Extension , Extension Exten~'~n Porch Porch Breezeway Garage Patio Total Foundation ~.,~, Basement /~' ~'/.._ Ext. Walls Fire Place Type Roof Recreation Roon Dormer Driveway Bath Floors Interior Finish Heat 0;/ Roams 1st Floor Rooms 2nd Floc LR. DR. BR. FIN. B. LOCATION: (number & street) (municipality) SUBDIVISION: NAME OF OWNER(S): OCCUPANCY: MAP NO.: LOT(S): (type) ADMITTED BY: Ct.~, KEY AVAILABLE: SOURCE OF REQUEST: (owner-tenant) ACCOMPANIED BY: k-J x~/'~4.~. SUFF. CO. TAX MAP NO. 1000- DATE: DWELLING TYPE OF CONSTRUCTION: FOUNDATION: O~_~a ~,/'~ # OF BEDROOMS: 1ST FLR: BATHROOM(S): ~ PORCH TYPE: BREEZEWAY: DOMESTIC HOTWATER: 7r-,J- TYPE HEAT: ~ # OF KITCHENS: (]'-/A..Ik.~ FINISHED BASEMENT: YES OTHER: ('~)d~ ~gq~W,,4/- #STORIES: BASEMENT: ~.j(, 2ND FLR: ~ TOILET ROOM(S): ~- "' DECK, TYPE: ~ FIREPLACE: -- TYPE HEATER: ,/'f/-~C ~ WARM AIR: NO J ~ #EXITS: --~ CRAWL SPACE: '- 3RD FLR: UTILITY ROOM: PATIO, TYPE: ~P~4r..~ GARAGE: ~ AIRCOND1TIONING: HOTWATER: ACCESSORY STRUCTURES GARAGE, TYPE OF CONST.: SWIMMING POOL: OTHER: [*'Z'-~ OO~GE, TYPE CONST.: GUEST, TYPE CONST: VIOI.ATIONS: CHAPTER 144 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: INSPECTED BY: TIMESTART:~ ~) //{ ~ END: O O 5O UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLA?ION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION lAW COPIES OF THIS SURVEY MAP NOT DEANINO [HE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED 10 BE A VALID TRUE COPY CERTIFICATIONS INBICATED HEREON SHAL~ RUN THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE NOT OUARANTEED. SURVEY OF PROPERTY SITUATE MATTITUCK TOWN OF $OUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-144-02-51 SCALE 1"--20' JULY 15, 2011 AREA = 14,500 sq. ff. 0.3330 ac. PREPARED IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR TITLE SURVEYS AS ESTABUSHED BY THE LIALS AND APPROVED AND ADOPTED FOR SUCH USE BY THE NEW YORK STATE LAND TITLE ASSOCIATION Nathan Taft Corwin III Land Surveyor Successor To: Stanley J. Isaksen, Jr. LS Joseph A Ingegno LS. T41e Surveys -- Subdivisions Site Plans Cons~rucffon Loyou~ PHONE (631)727-2090 Fox {631)727 1727 OFFICES LOCATED AT MAILING ADDRESS 1586 Maln Road PO Box 16 Jamesport, New York 11947 Jamesport, New York 11947 31-125