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Home My WebLink AboutZ-28093FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP/LRTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPAIqCY No: Z- 28093 Date: 11/30/01 THIS ~KTIFIEE tl~at the building DWELLING & ACCESSORIES Location of Property 48720 MAIN RD (HOUSE NO.) County Tax Map NO. 473889 Section 070 SOUTHOLD subdivision (STREET) (HAMLET) Block 0007 Lot 011 Filed Map No. __ Lot No. __ conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which C~KTIFICATH OF OCCO~ANCYI~JMBER Z- 28093 dated NOVEMBER 30, 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 TWO CAR GAR3~GE A_ND TWO ACCESSORY FRAME SHEDS.* The certificate is issued to STEFNEY DOBEC of the aforesaid building. (OWNER) SUFFOLK COUNT"fDEPAI~TMENT OF HEALTHAPPROVAL ELEC"rKICAL CERTIFICATE NO. PLUMBI~RS CERTIFICATION DA'r~u3 *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD ROUSING CODE INSPECTION REPORT ]~OCATION: 48720 MAIN RD N3~ OF O~ (S): STEFNEY DOBEC MAP NO.: LOT (S) STEFNEY DOBEC ACCESSORY STRUCTURES: C~, ~"~PE OF CONST.: TWO CAR WOOD FRAME STOP~, ~"fPE CONST.: 2 WOOD FRAME SHEDS VIOLJ%TIONS: CHAPTER 45 N.Y. STATE DNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. 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 Department with the following: A. 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. B~ For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "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 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. Photocopy of Certificate of Occupancy- $ 0.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. 11'21, O / New Construction: Old or Pre-existing Building: X (check one) Location of Property: /"] ~)'7~--0 [~J[O,.L~ ~_..O(~ ~(_)~ House No. ~.. Street Hamlet OwnerorOwnersofProperty: ~ L ]')o[a.~z.;'~oio~re% ~/, [~tra.sndOtu~-~ld~_ ; C (i.,L~Lo~.~_ Suffolk County Tax Map No 1000, Section Subdivision Permit No. Health Dept. Approval: Planning Board Approval: Date of Permit. Block Filed Map. Applicant: Underwriters Approval: 7 Lot // Lot: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: (check one) CONSENT TO INSPECTION ~'~U-~z- ~ ~-~ ' . the undersigned, Owner(s) Name(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at , which is sho%m and designated on the Suffolk County tax map as District 1000, Section ~d , Block 7 , Lot // That the undersigned (has) (have) filed,"oc caused to be filed, an applica- tion in the Southold To~ Buildin~ Inspector's Office for the follow~: 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, irules 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: //'2/' ~/ ~-~-~ (print name) ~7'r)' ~ -, /;FF (signature) (print name) SURVEY OF PROPERTY SITUA TED A T SOUTHOLD TOWN OF SOUTHOLD SUFFOLK: COUNTY, NEW YORK: S.C. TAX No. 1000-70-07-11 SCALE 1"=.30' NOVEMBER 6, 2001 AREA = 18,704.67 sq. ff. 0.429 ac. CERTIFIED TO: COMMONWEALTH LAND TITLE INSURANCE COMPANY HSBC KATHY D. HARRINGTON NOTE: DEED REFERENCES ARE TO DEED LIBER 11137 PAGE 596. / / / / / / THE EXIST[NCE OF RIGHTS OF WAY ANO/O~ EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANT[£O. N.Y.S. LJc. No. 49668 Joseph A. Ingegno Land Surveyor ~tle Su~eys -- Subdivisions -- Site Plans -- Cor~fruction Layout PHONE (631)727-2090 Fax (651)727-1727 OFFICE~ LOCATED AT MAIUNG ADO~ESS 1580 ROANOKE AVENUE P.O. Box 1951 RIVERHEAD, New York 11901 Riverheod, New york 11901-0965 21 -54B