HomeMy WebLinkAboutZ-22850FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-22850
Date JANUARY 26~ 1994
THIS CERTIFIES that the buildin~
Location of Property 1850 CARROLL AVE.
House No.
County Tax Map No. 1000 Section 74
Subdivision
ONE FAMILY DW~LnING
PECONICt N.Y.
Street Hamlet
Block 3 Lot 7
Filed Map No. Lot No.
conforms substantially to the Requirements for a One Family Dwelling built
Prior to: APRIL 9t 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-22850 dated JANUARY 26~ 1994
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 D~3.TNGWITHACCESSORYGARA~. WITH
ONE NON-HABITABLE STORAGE SHK~ "COTTAGE" N~'£ TO GAI~AGE & ACCR. RRORY
RAMSHACKLE BARN *
The certificate is issued to
ESTATE OF JOSEPH BUGDIN
of the aforesaid building.
(owner)
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
LOCATION:
BUILDINC DEI'ART~fENT
TOWN OF SOU]]IOLD
IIOUSINC CODE INSPECTION REPORT
SUBDIVISION
NAME OF OUNER (s)
OCCUPANCY
(type)
ADMITTED BY: ELIZABETH SHALVEY
]850 CARROLL AVE. PECONICg N Y.
(number & sUrcet) (munic~pali[y
MAp NO. LOT
ESTATE OF JOSEPH BUGDIN .
KEY AVAILABLE
SOUnd~ OF REQUEST:ELIZABETH SHALVEY/ANN LENCESKI
OWNER
(o--wne~-te.~t)'
ACCOMPANIED BY: Si5~ME
SUFF. CO. TAX MAP NO. 1000-74.03-07
DATE:NOV. 10, 1993
DWELLING:
T~PE OF CONSTRUCTION
FOUNDATION CEMENT
WOOD FRAME
TOTAL ROOMS: IST FLR. 3
2ND FLR.
{ STORIESi-1/2 { EXI3S 2
CELLAR FULL CRAWL- SPACE
3' 3RD FLR.
BATHROOM (s) ONE
PORCH TYPE
BREEZEWAY
DOMESTIC DOTWATER YES
TYPE IIEAT OIL
OTIlER:
TOILET ROOM (s)
DECK, TYPE
FIREP~%CE NONE
TYPE HEATER OFF BOILER
WARM AIR
UTILITY ROOM
PATIO, TYPE
GARAGE
AIRCONDITIONING
HO~qATER XX
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. WOOD FRAME
?~O GARAGE
OTIIER: ]~AM~HACKT,F, BAR~
STORAGE, TYPE CONST.ONE STORAGE SHED ATTACHE
- .'ONE STORAGE SHED "COTTAGE" NEX
TO GARAGE "NON-HABITABLE"
VIOlaTIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
RI'-'MA R~ S:
DA'I'E ON INSPECTION NOV. 24, 1993
TIME START 9:30 END 10:00
Form No. 6
TOWN OF SOUTIIOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
~PLICATION FOR CERTIFICATE OF OCCUPANCY
A. 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:
i. 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 i% 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-exxstzng 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 Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.O0
Date .....................................
New Construction .......... Old Or Pre-existing Building .... ~ ..... '
Location of Property.[ ../~...~. ....... ~'~- ~ ~ '
House No. Street Hamlet
Onwer or Owners of Property ..... ~~..~~~F.~~.] .............
County Tax Map No 1000, Sectio~....~.~ ...... Block .... ~ ......... Lot .... ~ .........
Permit No ........... e t .............. Applicant .~.~. ~ ~
Health Dept. Approval ....... .~ .............. Underwriters Approval..~ ..................
Planning Board Approval
Request for: Temporary Certificate ........... Final Certicate ......
tee Submitted: $..~..~.f-. ................
CONSENT
TO
do(es) hereby state:
· the undersigned,
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southotd located at
· which is shoxwn and designated on the Suffolk
County tax map as District 1000, Section· 7~z: , Block ~ _, Lot ~;~ .
That the undersigned (has) (have) filed, 'or caused to be filed, an applica-
tion in the South01d Tox~m Building Inspector's Office for the iollowing:
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 cf Southold.
Dated: .
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 vio-
lations of the laws, ordinances, rules or regulations of the Town of Southold.
(print name)
(print name)
~JO~EP~-4 ~I~-VtCTO~.tA E~UGOIN
MAP OF PR. OPEF~TY
_SUIIVEYED FO~.
,JOSEPt---t BUGDiN
2_'/'9 .? I
WOOD FENCE
,~; ,A.~VEYEI~ ~
r2OPEI'2~Y.. VAN TUYL~.~ -.
L, IC. LAND SNi2V EYOl"~