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Home My WebLink AboutZ-16830FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. ..Z-16830......... Date ....April 28, 1988 .............. THIS CERTIFIES that the buildingONE FAMILY DWELLING ................................................ Location of Property... ,?55 FouStreet Path Southold, New York House No. ........................ . Street Haa m/et County Tax Map No. 1000 Section ...64 .......Block ....? ..........Lot ....32 ........... Subdivision...............................Filed Map No. ........Lot No. ............. requirements for a private one -family dwelling built prior to conforms substantially to the dated Certificate of Occupancy April 23, 1957 pursuant to which l Z ] 6830 dated .April 22, 1988 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 ATTACHED GARAGE ....................................................................... The certificate is issued to JEROME F. HOLUB, JR. , ADMINISTRATOR OF EST. OF GLADYS L. HOLUB (owner, �$iiEij9X% .................. . of the aforesaid building. Suffolk County Department of Health Approval ..............N/A UNDERWRITERS CERTIFICATE NO......................N/A ......................... PLUMBERS CERTIFICATION DATED: 4-7 - -e Building Inspector Rev. 1/81 BUILDIING DEPART i��iT T0;i'N OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location 255 Founders Path Southold, New York number & street Nunicipaiity) Subdivision Map No. Lot(s) Name of Owner(s) JEROME F. HOLUB Occupancy 'A' Residential Agricultural (type) owner -tenant) Admitted by: Gloria Shirvell Accompanied by:Gloria Shirvell Key available Source of request ' Suffolk Co. Tax No. 64-2-32 Richard F. Lark, Esq'. Date 4/22/88 D'I ELLING: Type of construction WOOD FRAMEfistories 2 Foundation CEMENT BLOCK Cellar FULL Crawl space Total rooms, lst. F1 3 2nd. F1 4 3rd. Fl Bathroom(s) 1 Toilet room(s) Porch, type 1 Deck, type Patio, type Breeze:•iay Garage 1 attached Utility room Type Heat oil Warm Air Hotwater X Fireplace(s) 1 No. Exits 3 Airconditionng Domestic hotwater GAS Type heater Other ACCESSORY STRUCTURES: Garage, type const._ Swimming pool Other Storage, type const. Guest, type const. VIOLATIONS: Housing Code, Chapter 45 N.Y. State Uniform Fire Prevention r Buildina cndP Lncation Description JArt.1 Sec. 2nd Floor Smoke detector outside bedrooms 2nd floor EJ Remarks: Inspected by: Date of Insp. 4/28/88 Gary Fis Time start 2:00 PM end 2:20 PM FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 — 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted n Iasi• 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 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 New Dwelling, $25.00, Accessory, 10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00 , over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Undated C.O. $ 50.00 Date . Pllarch . a , 19138 , . _... , NewCons truction. , , , , , Old or Pre-existing Building .... ....... Vacant Land Location of Property .255 Founders Path Southold .. ........ . .. . . ..... House No. I Street Hamlet Owner or Owners of Property Jerane F; Holub, Jr. , administrator of Estate of G) aLdys L. Holub ...... . ... .. . . County Tax Map No. 1000 Section .,.064._.0.0 ..... Block „02.00....,,, Lot.. 032:000,,,_, Subdivisionrl0P. of, Founders Estate,,_ Inc., , , , ,Filed Map No. ..?3A ....Lot No. 52 & P/O, 51 Permit No. ....... Date of Permit ..........Applicant .................................. Health Dept. Approval ........................Labor Dept. Approval ........................ Underwriters Approval ........................Planning Board Approval ...................... Request for Temporary Certificate .....................Final Certificate ........ X.............. Fee Submitted $ ,50; 0,0 .... . ........... . .. . . . Construction on above described building and p rmit meets all laapp iile codes and regulations. Applicant lt?y/. ...... erome F. Holubadministrat........... r Rev. 10-10-78 3u4(I . 9r9. I✓0 ?- 16 ( 3V CONSENT TO INSPECTION Jerome F. Holub, Jr., administrator of Estate of Gladys L. the undersigned, Owner(YD) Name(h) ° do(es) hereby state: That the undersigned (is) (&W the owner(n) of the premises in the Town of Southold located at 255 Founders Path, Southold, New York which is shown and designated on the Suffolk County tax map as District 1000, Section 064 , Block 02 , Lot 032 That the undersigned tkarsr) (have) filed, 'or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: Certificate of Occupancy on pre-existing 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. _ f Dated: March a, 1988 C (signature Jerome F. Holub, Jr. , administrator (print name) (signature) (print name) I C-1 I. ren t2V 'Fu'"wA ❑ ., r..' _-. I \- j. " -.- . I 1 , IFJ THE JF1 ; CO, C -LE -f '5 GrriCE A5 MAP NG, E 34 -2.5JFF M :TAY MAP ✓ATA; ll:�X -a c K _ 'arlfSi �.7rGA��S �i'�{L �, -R::..x. ^.,y is nviclaoen� C.At'iT�l;✓.Sf '_ _ _._ iF�S. :,in7Wnc'the Nw VW, 5•:. �LehCR UfN. AGR.1 i;l� A_ ZQRVEEP .- .. - � tcex . or thi .,h Y mare t rear-- .he la.x itlR'9.Y L 1N[ed se, C. - J{^f\/�j L. l y •...�.. PC - I1f •.. 1 4/ 99tiJaLaE Lea, shall nor 6e GnP61 e.eG 1 �.r++I ��. t.�[I �••� ! �•• - y --'---_"' , �� o I &."he RUe WpY. GuaranteesytoI ersontea he eon ne sR -. to the im-ca for he.,o t!IB S M' - -- ! I le premweo, am an h13 to -half to tht Y:ia company, governmental eaenq, nn - 4e.d:ng inttnutlon finett herenn at e W itw assignees of the lem!tr inch- Li :.:ion. Guarelneas are not tranL 111. L LtiEitionil institubm, or aubw;uQM A eCl:" 0" z -� z. TOWN OF SOUTHOLD PROPERTY RECORD CARD -z9 OWNER STREET VILLAGE DISTRICT SUB. LOT's I IND. I CB. I MISC. I Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS FARMER OWNER IN d o E ACREAGE S W TYPE OF BUILDING _RES. y,� SEAS. VL. FARM COMM. I IND. I CB. I MISC. I Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS d o 00 7a AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD Tillable 1 - s BULKHEAD Tillable 2 DOCK Tillable 3 Woodland Swampland Brushland House Plot } Total /G h on ° ,. .1 �_p � f ✓ M. Bldg. x 4o - s-& a I Foundation G Bath ,-- - - Extension �{ �j = / p = Basement Floors I Extension2 Extension oaD iso 27 v Ext. Walls Fire Place Porch) --nterior ' -' Finish Heat Roof Type ' WP L 4- a v i----- -- -- - e I Porch Rooms 1st Floor Breezeway Garage Patio Driveway R Eta Rooms 2nd Floor Dormer j O. B. 11._J ..J BUILDI?.TG DEPART711E T TOJINT OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location J'y number & street Municipality Subdivision- /® Map No.- �1 Lot (s) ja Name of Owner(s) Occupancy �type)_ owner -tenant) Admitted by: �;� L � ccom anied b Y � � `�C/ �2,��-s� n, P --�iL� Key available ' Suffolk Co. Tax No. Source of request Date DWELLING: Type of construction #stories Foundation _Cellar_,&Crawl space Total rooms, 1st. Fl 3 2nd. Fl 3rd. F1 Bathrooms) / Toilet room(s) Porch, type / Deck, type Patio, type Breezeway Garage/ app/ Utility room Type Heat _warm Air Hotwater Fireplace(s)—/ No. Exits 3 Airconditioning Domestic hotwaterJ Type heater Other ACCESSORY STRUCTURES: Garage, type const. Storage, type const. Swimming pool Guest, type const. Other TTTr)T AmTn,Tn _ •r g Code, Chapter 45 N.Y. State Uniform Fire Prevention vivv. ilvu�_11 & B u i ldina Code Location Description Art.' Sec. v2 . Remarks: Inspected by: Date of Insp. �p Time start ;" end of B as Oi�