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Home My WebLink AboutZ-27023FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 27023 Date: 04/06/00 THIS CERTIFIES that the building DWELLING Location of Property 670 GROVE RD (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 051 Block 0006 subdivision Filed Map No. -- Lot No. -- SOUTHOLD (HAMLET) Lot 026.001 conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 27023 dated APRIL 6, 2000 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 * The certificate is issued to ALBIN V CZELATKA & ORS. (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 REPO ~. Rev. 1/81 ~ BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: ~7Q GROVE RD SOUTHOLD SUBDIVISION: MAP NO.: -- LOT (S) -- ~"fPE OF CONSTRUCTION: WOOD FP~ ~ STORIES: 1.0 ~ EXITS: ~ FOUNDATION: CEMENT BLOCK CELLAR: PART. CRAWL SPACE: __ TOTAL ROOMS: 1ST FLR.: 6 2ND FLR.: ~ 3RD FLR.: O BATHROOM(S): 1.0 TOILET ROOM(S): l,O UTILITY ROOM(S): -- PORCH TYPE: FRONT & SIDE DECK TYPE: REAR PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC SOTWATER: XX TYPE HEATER: OIL AIRCONDITIONING: TYPE HEAT: OIL WARM AIR: ~ SOTWATER: OTBBR: SIDE OPEN WALK WAY (WOOD) DOES NOT CONSTITUTE BLDG.AI~EA GARAGE, TYPE OF CONST.: SWIPING POOL: OTHER: STORAGE, TYPE CONST.: GUEST, TYPE CONST.: ACCESSORY SHED VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION ~ DESCRIPTION ART. SEC. R~KS: Bp#2~Z2230 (ADDIBP~13321Z-COZ15549 (DECK) BP#26430Z-COZ27023 (ACCYI TIME START: 9:45 AM END: 10:15 AM -, t~Ul IH)lNG DEPART~EN'I TOWN HALL 765 I802 A. API'I. iCATION FOR CERTIFICATE 01" OCCUPANCY T'i~is application must be filled in by typewriter OR ink and submitted to the buildin inspector with the following: for new building or new use: 1. Fisal survey of property with accurate location of all buildings, property lines streets, asd unusual natural or topographic features. 2. Final Approval from Health Dept. oi water supply and sewerage-disposal(S-9 form~ 3. Approval of electrical instai]ation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system coutaina ]ess than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar bui]di and in~tallations, a certiii(ate oJ Code Complianco ~rom ar(hitecl or cngin~,e~ re:q)onsible for the bui]ding. 6. Submit Planning Board Approval ol completed sito plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings a "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 a consent to inspect signed by the applican 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 Buildin~ - $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....~.v~..~).....~.,~.~.. ~ ...?~?. ......................................... House No. Street Hamlet Onwer or Owners of Property. .~ .......... ~l .............. ' .......................... County Tax Map No 1000, Section.O~'OO .... Block... ~)~.OO .Lot. Subdivision .................................... Filed Map ............ Lot .................. Permit No ................ Date Of Permit ................ Applicant ......................... Health Dept. Approval ........ ~.1.~. .............. Underwriters Approval... Planning Board Approval. ~1~ Request for: Fee Submitted: Temporary Certificate ........... Final Certicate ........... APPLICANT CONSENT TO INSPECTION Owner(s) Name(s) do(es) hereby state: · the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at · which is shown and designated on the Suffolk County tax map as__D_District 1000, Section ~\.o0, Block (~.oO Lot That the undersigned (has) (have) filed, 'or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: 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 rio- lations of the laws, Dated: ,~\%~ oO ordinances, rules or regulat~ns of the Town of Southold. (signature) (print name) (signature) (print name) UP-.VE¥ OF 51TUATE: ~30UTHOLD TOINN OF 50UTHOLP 5UFt=OLK. COUNT1', NY 5UF~,VEYED MA~C~H 14, ;2000 SUFFOLK OOUNT¥ TAX ~ I000 - 51 - 6 - 2¢.1 E, ERTIFIED TO: %~'~ ~ BEVERLEY' ~OF:F JUDY L. BURN5 FIDELITY' NATIONAL TITLE INSURANf_,E COI'4PAN¥ OF N.Y'. NOTE~: e PIPE ~=OUND At~JEA = ID,qO3 S.F. or O.D2 QrqAPH I C SCALE S "=30 ' JOHN C. EHLERS LAND SURVEYOR N.Y.S. LIC. NO. 50202 6 EAST MAIN STREET RIVERHF-3,D~N.Y. ! 1901 369-8288 F~x 369-8287 REF. D:',JOBS.0-134 0 30 BO 90