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Home My WebLink AboutZ-26360FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 26360 Date: 04/09/99 THIS CERTIFIES that the building DWELLING Location of Property 1740 VILLAGE LA ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 024 Block 0002 Lot 018 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 NUMBER Z- 26360 dated APRIL 9, 1999 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 AN ACCESSORY ONE CAR GARAGE The certificate is issued to GLADYS JAWORECKI (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 INSPECTI Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD LOCATION: 1740 VILLAGE LA ORIENT SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S): GLADYS JAWORECKI OCCUPANCY: SINGLE FAMILY DWELLING GLADYS JAWORECKI ADMITTED BY: CLAIRE CLEW ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 24.-2-18 SOURCE OF REQUEST: GLADYS JAWORECKI - APRIL 1. 1999 DATE: 04/09/99 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 2.0 # EXITS: 2 FOUNDATION: BLOCK & STONE CELLAR: CRAWL SPACE: PART TOTAL ROOMS: 1ST FLR.: 2ND FLR.: 3RD FLR.: 0 BATHROOM(S): 1.0 TOILET ROOM (S) 0.0 UTILITY ROOM(S): PORCH TYPE: ENCLOSED FRONT DECK TYPE: BREEZEWAY: FIREPLACE: GARAGE: PATIO TYPE: DOMESTIC HOTWATER: XX TYPE HEATER: L.P.GAS AIRCONDITIONING: TYPE HEAT: L.P.GAS WARM AIR: SPACE HEATER HOTWATER: • :�Y ; �l � ;••u GARAGE, TYPE OF CONST.: 1 CAR WOOD WITH TR7 STORAGE, TYPE CONST.: SWIMMING POOL: OTHER: GUEST, TYPE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE REMARKS: INSPECTED BY: Ar -k - DATE ON INSPECTION: 04/08/99 M. BOUFIS r TIME START: 10:30 AM END: 11:00 AM l� BLDG. DEPT. Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - .25e,. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ............y/.!�, .....r ................... New Construction ........J.. Old Or Pre-existing Building .. . Location of Property...!.. �o .................Y.Cf1..K ..4:dr1....... ..... House No. StreeTTj�Hamlet Onwer or Owners of Property ........... (..G.C:��i//................ . County Tax Map No 1000, Section .... .....Block......Z...... Lot../..il................. Subdivision....................................Filed Map ............ Lot ...................... Permit No................Date Of Permit ................ Applicant ............................. Health Dept. Approval..........................Underwriters Approval......................... Planning Board Approval ........................ Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $............................ _ ........... CO a 6 �pQ APPLICANT . CONSENT TO INSPECTION (adzyS , the undersigned, er(s) N me(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at'] (% 6 (�l � 616 bit t /VTf �"L S / , which is shown and designated on the Suffolk County tax map as District 1000, Section Z-�, Block 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: r 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; � �(� 2-e /l p (signature) e (print name) Unautnodzed altentlo, c• andar,� to this survey H a violatWm of Section 72M of The New York Sta!^ Eduuoon taw CopiN 01 d!le Sir%" map not bo_.--_ the IW4unwe m inked seal or not be eonsidwr !o be a %aW ma copy. Guammli" indicated hereon vail run only b tno Dotson Ar svnorn :he survey Is preparod. and on No oenad to ow We mmpeny govemmental agency and lending bUftidon sated hereon and 10 the usfgnees of the lerairq 4Wtua0n. GuaMMI a are not tr m*uWe to additlonal insalutions or subsequent pwmem JdRYEYF�L>= • G/CH/9�� !• �NO.�E}J/�02CTyYPOGcs/ �`�''V�^'"" n"ccyc�irir�vr+ amici /,yyO�1PYdr1�.2 LcG9Tic.yO2iE,y7fjow,v o c�oarl�ocy .c/ }� P, o•AaV 4/-sie f' OlJT.SGtO N•J! Gu.9ti??.9.t/; �rE.� 'e • �/Gy.9R_ O� AND.?EJS/�DD,Po7yS/�4.rcS%.�O�YW/�i91/GY✓AG/1%ielGhZ�E�diNS9N,7 OATS /.1�.acyz9�/yff� z4 -oz -/46 BUILDING DEPARTMENT TOWN OF SOUTHOLD ING CODE INSPECTION REPORT LOCATION: / 7 '10 er 4 Areet SUBDIVISION NAME OF OWNER (s) OCCUPANCY _04911� I municipality MAP NO. LOT (s) (type) (owner -tenant) ADMITTED BY:ai rt d.2' a� ACCOMPANIED BY:— L KEY AVAILABLE AVAILABLE SUFF . CO. TAX MAP NO.1.2 SOURCE OF REQUEST: � � DATE: !Kl_ � DWELLING: TYPE OF CONSTRUCTION / # STORIES # EXITS FOUNDATION / �/ pL �j� fm,�... CELLAR CRAWL SPACE TOTAL ROOMS: IST FI.R. 2ND FLR._ _3_ 3RD PLR. BATHROOM ( s ) L��n'e� TOILET ROOM (s) UTILITY ROOM; PORCH TYPE i/,yDECR, TYPE PATIO, TYPE BREEZEWAY r-- FIREPLACE DOMESTIC HOTWATER TYPE HEATER TYPE HEAT WARM AIR OTHER: ACCESSORY STRUCTURES: "--- GARAGE AIRCONDITIONING HOTWATER GARAGE, TYPE OF CONST TORAGE, TYPE CONST. SWIMMING POOL GUEST, TYPE CONST. OTHER: ---------------------------------------------------------------------------------------- VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION b BUILDING CODE, REMARKS: INSPECTED BY: DATE ON INSPECTION T/d/T �7 TIME START TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST SUB. LOT lard s 5 c�re.c-�C i ✓ v �se O EW OW�o ( e E '+ ACR. !02 G � 0 C i G cc I F f� 1 S %4, F, i� � W �,�d v A�Jo TYPE OF BUILDING RES. )1� SEAS. VL. FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS ?n D o- n G / D --O ✓ �Z 4` 7 15 — S W R d l AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Acre Value Tillable 1 Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD House Plot DEPTH BULKHEAD Total DOCK , NONE ON ONESSONSEENESONEENE NONE MOEN No mom Basement tenor Fi h Extension- Fire Place