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Home My WebLink AboutZ-14178FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14~78 Date Jan. 23 198.6.. THIS CERTIFIES that the building ...O.n.e...f.a.m.i..1~..d. we 11 lng ............. Location of Property 1750 FECONIC BAY BLVD LAUREL h~s'e hiol ....................... 's't/e~i ....................... i~r~iei County Tax Map No. 1000 Section ... ] .~.~ ...... Block ...... .0.3. ...... Lot 016 Subdivision ............................... Filed Map No ......... Lot No .............. Requirements for aprivate one-family dwelling built prior conforms substantially to the .axl~al~a~mxforxB~ilfl~gxBexmit~e~ot~l~}ellxia~xtfffi~Sa~t~ ......... w'' .C. er.t~[ficate of Occupancy# t,q. A&p.~.~L..2.5 19 5.7. pursuant to mcn~lllIO;gl'l~l~gkq~ ...... - ....... Z.q .5.1.78. dated ...g.a.n....2.3 ................. 19 .8.6., 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...£aaily. ~l.;qe 1 ~.ng ....................................................... The certificate is issued to ..... JAbIES D DOROSKI ............ ...................... of the aforesaid building. Suffolk County Department of Health Approval N / ^ UNDERWRITERS CERTIFICATE NO. N / A SEE ATTACHED INSPECTION REPORT Building Inspector Rev. 1/81 BUILDING DEPARTI~ENT TOVN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location Subdivision 1750 Peconic Bay Blvd. (number & street) .Map No. Laurel (Municipality) Lot(s). Name of Owner(s) JAMES D. DOROSKI Occupancy R-1 (type) A~mitted by: MR. DOROSKI Key ~vailable OWNER (owner-tenant) Accompanied by:. SAME Suffolk Co. Tax No. 145-03-016 Source of request ~. Doroski ~ Date12/24/85 D¥~LLIMG: Type of constr~ction WOOD Foundation CEMENT B~0CK Total rooms, 1st. F1 5 Bathroom(s) 1 Porch, typ~ Breezeway Type Heat GAS FIRED Fireplace(s) Domestic hotwater YES Other FRAME #stories 1 ~ S:AB Crawl space, ikOns____ 2nd. F1 0 3rd. F1 0 Toilet room(s) 1 Deck, type. Garage One car Warm Air No. Exits ~atio, type Utility room Hotwater xxxx 2 Airconditioning ~ype heather GAS ~CCESSORY STRUCTURES: Garage, type const. Swimming pool Other Storage, type const. METAL Guest, type const. VIOLATIONS: Housing Code, Chapter 45 N.Y. Stat$.U~iform Fire Prevention ~, ~uzxa. lna co~o _Location Description I-Art. I Sec. ~NO VIOLATIONS WERE FOUND Remarks: nspected nsp. ~-' - ~ / ~: - '~"~Ti~e start ~.10 ~'~0 CURTIS W. HORTON · end FORM NO. 6 TOWN OF SOUTHOLD Building Depa, U~ent Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for pew buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic feature[ 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property 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 any 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 $5.00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 New Building ............. Old or Pre-existing Building .~ ......... Vacant Land ............. Locat,on of Prope . ........... ....... House No. ~ Street Hamlet Owner or Owners of Property .... ~ ../~. :~,~.. ~.. :..../~...O../~.. ~ .~...~../. .............. County T. ~ap ,o. ,~o Section .. ~S .... 9,oc~ ... ?...~ ...... ,or.. F..(~ ........ Subdivision ...... ' .Filed Map No ........... Lot No .............. Permit No ........ Date of Permit Applicant Health Dept. Approval ........................ Labor Dept. Approval ....................... . Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ..... ~ .............. Fee Submitted $....~... ...................... Construction on above described building and/l~mit meets al~:)pl~f~codes and r~ulation,. CONSENT TO INSPECTION do.es ." bireby ItlM~ ThAt tho uaderl~ned . ~ Crusty tu map ii Dlltrint 1000, Section ,/~.~ , BlOCk ~ the owner...., uf t~o premhe8 in the TQ~II which is shown and designated ~n the Suffolk o Lot o/~ , That tho underAifnod' has , filed, or caasqd to be riled, Au apptica- tion in the Southoid Tolm Building Inspector,s Office tar the Cert~ficate of Pre-ex~stin~ Use That the undersigned do,es, hereby give col~ent to tho Bulld~ Inspectors of the Town of -qouthold to enter upas tim above described property° including any and all buLldinp located thereon, to conduct such lnapectim8 as they may deem neceAaary with respect to the aforeaahl application, hcludin~ inspections to determine that said premises comply wAth all or the laws, ordinances, ruleA and regulatinn8 of the Town of Southoid. The undersigned* In OQnMnting to such inApecti0ns, does so with the knowledge and underalandinf that any information obtained in the conduct of such inspections may be used as evMence in sutmequ, ent ~rosecutinns for rio- lath)no ot the lawA~ ordinauceAo rulee or rA&a~lations .or tho ?own o! -qouthold. . """ ' (me,hat'are) ~ ( tnt nmnm)