HomeMy WebLinkAboutZ-25571FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXIBTING
CERTIFICATE OF OCCUPANCY
No: Z- 25571 Date: 03/05/98
THIS CERTIFIES that the building DWELLING
Location of Property 57455 MAIN RD SOUTHOLD
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 063 Block 0003
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- 25571 dated MARCH 5, 1998
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 GARAGE *
{HAMLET)
Lot 021.003
The certificate is issued to ELIZABETH H BARNETT
( OWNER )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
N/A
N/A
N/A
Building ~or
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 57455 MAIN RD
SUBDIVISION:
NAME OF OWNER (S): ELIZABETH
OCCUPANCY: SINGLE FAMILY
ADMITTED BY: BILL BARNETT
SOUTHOLD
MAP NO.: -- LOT (S) __
KEY AVAILABLE: __ SUFF. CO. TAX MAP NO.: 63.-3-21.3
SOURCE OF REQUEST: ELIZABETH BAP. NETT 1/13/97 DATE: 03/05/98
TYPE OF CONSTRUCTION: WOOD FRAME
FOUNDATION: BRICK & STONE
TOTAL ROOMS: 1ST FLR.: _1 2ND FLR.: 6
BATHROOM(S): ~.0 TOILET ROOM(S): _ .
PORCH TYPE: COVERED PORCH FRONT DECK TYPE:
BREEZEWAY: FIREPLACE: YES
DOMESTIC HOTWATER: YES TYPE HEATER: OIL
TYPE HEAT: WAP~4 AIR: HOTWATER:
OTHER:
~ STORIES: 2,0 # EXITS: $
CELLAR: 2/3 CRAWL SPACE: 1/3
3RD FLR.: O
UTILITY ROOM(S): ~
PATIO TYPE:
C4%P. AGE, TYPE OF CONST.:
SWIPING POOL:
OTHER:
WOOD FRAME STORAGE, TYPE CONST.:
GUEST, TYPE CONST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFOP34 FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART.
SEE,
REMARKS: BP #24433-Z-CO Z-25569-(DECK ADD) BP ~24433-Z-CO Z-25570 (ACCY GAZEBO)
MICHAEL J. VERITY TIME START: 10:20 AM END: 11:20 AM
.-OWN OF $OUTHOLD
BUiLDiNG D E ?.~RTME~
TOWN [-h~ L L
BLDG D~:,~''-'° ~,.=,~ v
~^'~ O~h~ .... ~PPLZCAT!ON FOR CERTIFICATE OF
...... De .... ~_~n mUS: be filled ia ' - _.,p ....... OR ink and suomiuced no ~= ' ~'
inspec:or with :he following: for new building or ~ew use:
?inai survey of proper:y ~iah accurate iocaEion of all buildings, p~ou_... ±!nas.
Yinai Approval from Heai~h De?~. of ~a[er supo!7 and sewerage-disposal(S-? form).
Approval of electrical insta!!auion from Board o~ Fire Unde~ri~ers.
less ~han 2/!0 of [% lead.
Commercial building, indus~riai building, ~-~ ' '
anm =~m~,a~ buildings
and insnallauions, a cerzifica~a of Code Compliance from=r~n_~_c_- ~'~-o ~ or engineer
responsible for the >~iiding.
Submit Planning Board[Approval of completed site plan requirements.
for exlstins bui!din~s (prior to April 9 ~-7~
.... ~ , non-conforming uses, or buildings and
· Pr ~= land uses:
~ L .Accura~e--~ survey___ of property show,ag ail property lines, s~ree:s, bu"'ding and
¶ unusua~ natural or ~opographic feanuras.
Il. A prpperl7 ~_ompl___~m~=~ ?~!_~lcauion and a oonsan~ co insoec~ slzned by the aoo4~aant.''
if a uer:~i~=t= of Occunancy is denied Building insoec:or
. ~na±~ the
_ne ..... writing the aooiicans.
,. Yeas
_ A~m .... ns ro dwelling $25.00,
A!uaranlons ~o ~we_'~n~ $25.00. Swimming .~ooi $25.00, Accessory ' ,~ou__~_n~? $25.00,
Additions :o accessory building $25.00. Businesses S50.00.
=. ~e ..... ~an_ of Occupancy on .... x_s~=n~ ~uildin~ $10O.0O
5. Copy of Car:ificace of Occuoa~ .25~
=. Updated Carnlficata of Occupancy - $50.00
5. Temporary Ce=r==~ca~e of Occupancy - R.s_c~nn_a .... ~0, Co~ercmal S15.00
r i ........... Old Or Pre-existing Buildlng..~ ......... ..,.
. . ............ , ........ ~ ...... ) ......... ........ ~.~ ...... ) .........
~ouse No. S~ree~
7
-uo c ;v,_ s-_on .................................... Yi!ad Map ............ Lot ......................
'=-'m,- No, .Dane Of On ~-
..................... _'rn, .................. Auplicann...
lznc~ng 5oard Approval ........................
y/ 3/ ........ }.: . ....
(~()N:; li:NT
1 N.'q 1 )Ii:( :TI( )N
(')wner'(s) I'h~nl~!(.~O ........................................... ' the nndersil,~nud,
'l'h;,l the undevsign(:d (i:O (ilv~-;) lira owl'~al'(s) of tim i)uemises itl lira Town
~ ~._A~;~/_ ....................... .,,,,,,,,,, ,..,,.,,,,, ,,,,,, ,,,,~,,,,,,,,,,., .,, ,,,,:
~ (~¥~'~- ......................
(In'hd name)
(s i~.q mi tH'(:'i .............
STATE OF NEW YORK:
2SS
COUNTY OF ~ i/} (~3:
I, Rosemary Longworth, residing at 45 Tutor City Place, Apt. #720, New York,
New York 10017, being duly sworn, depose and say:
THAT I am the daughter of Stanley J. Poliwoda and Evelyn Poliwoda who
conveyed premises known as (no#) Main Road, Southold, NY 11971 (SCTM#1000-
063.00-03.00-021.003) to Louis B. Barnett and Elizabeth H. Barnett, his wife, by deed
dated April 20, 1961;
THAT prior to that time my parents had owned said premises for a period of
about 18 years;
THAT the premises were used as a two family dwelling prior to April, 1957 and
was continuously used as such.
Dated: April ~%997
BUILDING DEPARI~IENT
TOWN OF SOUTIIOLO
ltOUSING CODE INSPECTION REPORT
(number & street) (munlclpatlt¥
SDnOIVISION ~P NO, LOT (s)
N~ OF O~R (s) .~
KEY AVAILABLE
SOURCE OF REQUEST:
(o~ner-CenauC)
ACCOHPANIED BY: ~
SUFF..~. TAX HAP NO. //6)fO '~ ~, ~:,.-- ~ '- .~/~, ~.~
DWELLING:
TYPE OF CONSTR~TION
TOTAL ROOMS: I ST FI.R. F 2ND FLR.
STORIES # EXITS
3RD FLR.
BARROOM (s) / TOILET ROOM
PORCH TYPE
BREEZEWAY
FIREPLACE
DOMESTIC UOTWATER ~ TYPE HEATE
TYPE HEAT WARM AIR
OTHER:
· UTILITY ROOH
PATIO, TYPE
GARAGE
AIRCONDITIONING
HOTWATER
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. ~2~ STORAGE, TYPE CONST.
SWIMMING POOL '---'-'-' , GUEST, TYPE CONST. ~
OTHER: ~
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
INSPECTED BY: DATE ON INSPECTION
TIME START