HomeMy WebLinkAboutZ-22100FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-22100
Date JANUARY 12~ 1993
THIS CERTIFIES that the building ONE FAMILY DW~.TJ.ING
Location of Property 1875 HIAWATHAS PATH SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 78 Block 3 Lot 60
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 ~ER Z-22100 dated JANUARY 12~ 1993
was issued, and conforms to all of the requirements of the applicable
previsions of the law. The occupancy for which this certificate is
issued is ONE FAMILY DW~Lr. ING WITH ACCESSORY TWO CAR GARAGE *
The certificate is issued to JOSEPHINE DeMARIA
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
i'lding Inspector
Rev. 1/81
TC',,;I CF ZCUTXoLD, il. '£.
Location
Subdivision
Occupancy .
A~ ~ ~ed by:
Key available
HCUZiXC
1875 HIAWATHA PAT~
SOI/T~OLD, NEW YORK
?-Imp No. Lot(~)
JOSEPIiINE DeMARIA
A-I
(~nTpe)
JOl~l deReeder
OWNER
Accomp~nied by: SAME
guf£olk Co. Toe.: No. 78-3-60
Source of request.
JOSEPHINE DeMA~IA
__Date _SEPT.
i0, 1992
D':~LL!3~:
,Type of construction
Foundation CEMENT BLOC~
Total rooms, 1st. F1
Bathroom(s) 2
Porch, t~e, ENCLOSED
Breezeway~
Type Heat OIL & ELEC
Fireplace(s)' ONE
Dcmeatic ho~..;a~er
Other,
WOOD FRAME
5
Deck,
Garage
,~.S torl~s ONE
Cellar FULL Crawl space
2nd. Fl__ .Std. Fl.
Toilet room(s)
i-fpq
Utility
' Warm Air Ho ~.;
A.ircond~
~S T~ e h ~_ 2_. E~CTRIC
AC .... Ca_ STRUC~L~EE.
Garage, type const. 2 CAP. Storage, type Const.
Swir.~ing pool Guest, type const.
Other.
VT~T 8'PT 'J .
,_- ....... O: ,S.
Lncetion
.CIIAPTER 45--N.Y. STA'fE UNIFOI~I FIIU! PKEVENTION & BUILDING CODE
D . .c~ lo.,!on I Art,. [ Sec
~ ·
·
e , ~. BP ~3289Z for accy garage g BP ~3288Z
......... %mnclose4 Pat ~o1
BP ~4/~4Z-~O Z;3682 Accy Bldg., since removed. ., -
Inspected by: -~f' ~ . ' .D-a. te of Insp. Jan. 8, 1993
~qa~J. "Fish --
· Time start 9:30 end 9:45
FORM NO, 6
TOWN OF $OUTHOLD
· Building Deportment
Town Hall
Southoldo N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted ,,, ~ to the Building Inspec-
tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal)·
:3.Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5.Submit Planning Board approval of completed site plan requirements where applicable. '
B..For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or
topographic features·
2.Sworn statement of owner or previous owner' as to use, occupancy and condition of buildings.
3. Date of an,/ housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C, Fees:
1. Certificate of occupancy $25200 -- BUSINESS $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50. O0
3. Copy of certificate of occupancy $ 5,'00. over 5 years $10.00
4.Vacant Land C.O. $ 20.00
5. Updated C.O. $ "50. 00 Date ...S.ep,t.e.m,b.e.r. 10, 1.9,9,2
NewCons t, ruct, ion ...... Old or Pre-existing Building .X Vacant Land
Location of Property . .],8~7.5, .Ht~t~'.~ .P.~tA,..$.o.u.tAo.].d.,..N.Y .............................
Hou=a No. Srr~ur Hamlet
Owner or Owners of Property Oosephi ne DeMari a
county Tax Map No. mOO Section ..?. ........... mock. ? ............. Lo,.. ?.0 .......... . .
Subdivision ..............................
Permit No ........... Date of Permit .......
Health Dept Approval /
U nderwriters Approval .....................
Request for Temporary Certificate ............
Fee Submitted $ 100.00.
· .Filed Map No ........... Lot No ..............
· .Applicant ..................................
· .Labor Dept. Approval ........................
· .Planning Board Approval ......................
........ Final Certificate .......................
Construction on above described building and permit meets all applicable codes and regulations.
10-10.78
Applicant. .. .
Office of ~ar~ F]anne~ O]sen, Esq.
Main RS., P. O. Box 706
Cutchogue, NY 11935
CONSENT
TO
INSPECTION
Josephine DeMaria
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_ ]875 Hiawatha's Path, S0uthold, NY
· which is shown and designated on the Suffolk
County tax map as District 1000, Section 78 , Block 3 , Lot 60
That the undersigned (has) (have) filed, 'or caused to be filed, an applica-
tion in'th,~ Southold Town k~ullcling Inspect,...~ o.r£~o ~o.~ ,~ ~nllnwin~:
one family/ dwelling
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 vio-
lations of the laws, ordinances, rules or regulations of the Town of Southold.
Dated: September 10, 1992
(signature)
2osephine De Maria
(print name)
(signature) '~
(print name)
'170040 TITLE NO. (~L ~'OO~
LAND N/F ST, pATRICK'S ROMAN cATHOLIC CHURCH
FoRMERLY GORDON ~ r
d F-'-'--'~, /,~o'-. ~Es.
'~ ' ' · - ACTUAL
-~-.-----'"~'-'~'-- L~.~z~'r '"" "' "'-~'~'~' .....
4~./
~ -- X,,, 5~ 2/0.00'
HIA WA THA 8 PA
Barrett, Bonacci, Hyman & Van Weele, RC.
175A Commerce Drive, Hauppause, NY 117~
TEL. 5161435-1111 516/435-1022 FAX
MAP OF: DESCRIBED PROPERTY
SITUATED A~ LAUGHING WATER, NEAR SOUTHOLD
FI~EO: 00. SUFFOLK NO.
OERTIFIED TO:
RAY.ND N. MITCHEL
GLOBE ABSTRACT~~ DATE DEC. 16, 1992
DR. I~JD CH. JB SCALE 1" = 30' DIS~/WARD 1000 SEC. 78 BLK 3 LOT 60