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Home My WebLink AboutZ-27615FORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 27615 Date: 04/11/01 T~IS CERTIFIES that the building DWELLING Location of Property 1025 AKA 26 MIDDLETON RD. GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Ta~ Map No. 473889 Section 040 Block 0005 Lot 026 Subdivision Filed Map No. __ Lot NO. conforms substuntially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to w~zich u~TIFICATE OF OCCN3PANCY ~N3~B~ Z- 27615 dat~d APRIL 11, 2001 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 GAR3~GE * The certificate is issued to HARRY & MARIE ELLEN BONDARCHUK (OWNER) of the aforesaid building. SUFFOLK COUNT~DEPART~ENT OF~[EALT~APPRO~-AL EL~-£EICAL c~TIFICATENO. PLUMBERS CERTIFICATION *PLEASE SEE ATTACHED INSPECTION ~T.I Rev. 1/81 N/A N/A A~u'~t ~or~~t ure BUILDING DEPARTMENT TOWN OF SOUTEOLD HOUSING CODE INSPECTION REPORT LOCATIO{{: 1025 AKA 26 MIDDLETON RD. GREENPORT SIIBDIVISION: MAP NO.: ~OT (S) 1~ OF (3~ (S): PJkRRY & MARIE ELLEN BONDARCHUK OCCI}P~CY: SINGLE FAMILY DWELLING HARRY & MARIE ELLEN BONDARCNUK ~J]aql-l-rl~u BY: HARRY BONDARCHUCK ACC~PI%NI]~ BY: SAME SOURCE OF I~ST: HARRY BOND/LRCNUK, 3/23/01 DATE: 04/11/01 DWELLING: TirpE OF CO~S~UCTI(~: FOUNDATION: CEMENT WOOD FRAME VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. PJ~: BP #~C0Z-16240 (DECK ADDITION) fl~ .. BOUFIS Form No. 6 TOWN OF SOUTHOLD 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 inspector with the following: 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: i. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2., A properly completed application and a 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-existing Buildinm - $100.00 3. Copy of Certificate of Occupancy - ~ .251~ 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 Buildin~ .... ~. ......... J Location of Property....~.~ ........... .~...J~.~.~..~.~.' ...... . [~[ ~. ~. ~.~2..~/.~% .)//~ House No. He, et ~ Street ~ Onwer or O=ers of Property..~/~. ~2~ ~/~.~ ~".~. ~.~.~ ........ County T~ ~p N 1000, section ..7..~ . B~ock ..... ~ ..... Lot. ~.~..~{ ~ Subdivision.. ~ ~ J .~ ~ ~.~. ~J.~. ~Q ~ ~.~ Map...~ ~.~ ~...Lot ............. Permit No ................ Date Of Pe~it ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate .......... Final Certicate..~%.. ..... Fee Submitted: $ ...... ' ................ ................... (Y,"~ C o -~. ~"?(,, / 5 CONSENT TO INSPECTION / ~wner (s) Name(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of So thold located at County tax map as District 1000, Section , Block , Lot That the undersigned (has) (have) filed, or caused to be filed0 an applica- tion in the Southold Tom Building Inspector's Office for the following: · which is shoYrn and designated on the Suffolk That the undersigned do(es) hereby give 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,~rules 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 as evidence in subsequent prosecutions for lations of the laws, ordinances, rules or regulations of the Town of Southold. (signature) (print name) 0