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Home My WebLink AboutZ-25871FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: z- 25871 Date: 08/03/98 THIS CERTIFIES that the building Location of Property 73175 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 045 Subdivision D~rELLING GREENPORT (STREET) (HAMLET) Block 0003 Lot 001 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- 25871 dated AUGUST 3, 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 ONE CAR GARAGE The certificate is issued to DAVID CICHANOWICZ (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION ~ ~. Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTBOLD HOUSING CODE INSPECTION REPORT LOCATION: 73175 MAIN RD GREENPORT SUBDIVISION: MAP NO.: __LOT (S) -- NAME OF OWNER (S): DAVID CICHANOWICZ OCCUPANCY: SINGLE FAMILY ADMITTED BY: DAVID CICE~kNOWICZ KEY AVAILABLE: SUFF. CO. TAX MAP NO.: ~,-~-] SOURCE OF REQUEST: DAVID CEICE~kNOWICZ - J~3LY 17. 1998 DAVID CIC~OWICZ ACCOMPANIED BY: SAME DATE: 08/03/98 DWELLING: TYPE OF CONSTRUCTION: WQQD FRAME FOUNDATION: STONE TOTAL ROOMS: 1ST FLR.: 5 BATHROOM(S): ~.O PORCH TYPE: FRONT BREEZEWAY: # STORIES: 2.0 # EXITS: ~ CELLAR: PART CRAWL SPACE: -- TOILET ROOM(S): Q,Q UTILITY ROOM(S): -- DECK TYPE: SIDE ENTRY PATIO TYPE: FIKEPLACE: C~kRAGE: TYPE HEATER: OFF BUR~ER AIRCONDITIONING: WARM AIR: HOTWATER: XX GARAGE, TYPE OF CONST.: SWID~ING POOL: OTHER: 1 CAR WOOD (POOR SHAPE) STORAGE, TYPE CONST.: GUEST, TYPE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: INSPECTED BY: BP ~18399-Z-CO Z-18533 (ALTHEATIOMI T END: 10:55 AM Form No. 6 mo TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY ~L~ ::"! !~ 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, 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 e-existing" land uses: , Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. k~. 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, ._~-~gckgiCions to accessory building $25.00. Businesses $50.00. --~.~ Certificate of Occupancy 0~ Pr&nexis~in~ Buiidin~ - $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...'.w'~.. .......... Location of Property..7.~.~7~'~....~ .~.~ ..~.. g ......................... .~..~.~.. ~.~... ........ House No. Street Hamlet Onwer or Owners of Property ................................................ County Tax Map No ~000, Section ..... .~.~. .... Bloe~ .... ¢..~. ....... Lot .... .~.~ ............... Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval ........... Underwriters Approval ..... Planning Board Approval ................ Request for: Temporary Certificate ........... Final Certicate ........... CONSENT TO INS rH?,CTION do(es) hereby st~te: Th~f the undersigned (is) (are) the owner'(s) of the premises in the orSoutholdlocatedat 7 3 i 7 . _ which is shown and designated on the Suffolk County tax map as District 1000, Section ~ ,Bioek ~ , Lot O That the undersigned (has) (have) filed, or caused to be filed, an appliea- tion in the Southold Tox~ Building lnspeetor'~ Office for the following= That the undersigned do(cs) hereby give consent to the ]3uilding Inspectors of Ihe Town of Southold to enter- upon Ihe above described property, ~ ~cludlng any and all buildhlgs located Ihereon, to conduct such inspections as they may deem necessary with respect to the aforesaid appllealion, including Inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Soul:hold. The undersigned, ineonaenting to such inspections, do(es) so with the knowledge and mclerstandlnil that any information obtained In the conduct of such inspections may be used as evidence in subsequent prosecutions for rations or the laws, ordinances, rules or regulations of the Town orSouthold. - (~ign~tu~ (print name) (signature) (print name) ~Y