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Home My WebLink AboutZ-28058 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 28058 Date: 11/13/01 THIS CERTIFIES that the building DWELLING & ACCESSORY Location of Property 6685 OREGON RD CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 095 Block 0001 Lot 006 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- 28058 dated NOVEMBER 13, 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 GARAGE.* The certificate is issued to SEAMON T KELESKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPR0~7AL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. 7 c I r A or' ed Si nature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 6685 OREGON RD CUTCHOGUE SUBDIVISION: NAP NO.: LOT (S) NA1~ OP OWNHR (S): SEAMON T KELESKI OCCUPANCY: SINGLE FAMILY SEAMON T KELESKI ADNITTHD BY: SEAMON KELESKI ACCONPANIHD BY: RSY AVAILABLH: SUPP. CO. TA% NAP NO.: 95.-1-6 SOURCE OF RHQUHST: SEAMON KELESKI DATH: 11 13 O1 DWELLING: TYPH OP CONSTRUCTION: WOOD FRAME # STORIHS: 1.5 # SKITS: 2 FOUNDATION: CEMENT HLOCK CHLLAR: FULL CRAWL SPACE: TOTAL ROONS: 1ST FLR.: 5 2ND PLR.: 0 3RD FLR.: 0 BATBROON (S): 1.0 TOILHT ROON (S): 0.0 UTILITY ROON (S): - PORCH TYPH: DHCR TYPH: PATIO TYPH: HRHHZHWAY: FIRHPLACH: GARAGH: DOMHSTIC HOTWATHR: YES TYPH H'HATHR: OFF BOILER AIRCONDITIONING: TYPH HHAT: OIL WARN AIR: HOTNATHR: X OTHHR: ACCESSORY STRUCTURES: GARAGH, TYPH OF CONST.: TWO CAR WOOD FRAME STORAGH, TYPH CONST.: SWIlDIING POOL: GUEST, TYPH CONST.: OTHHR: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION ~ DESCRIPTION ART. ~ SEC. RRMARRR: LNSPHCTHD BY:. DATB ON INSPECTION: 11 O1 O1 GARY J ISH TIMH START: 9:45AM SWD: 10:15AM • ~ ~ Form No. 6 ~2 R 15 l5 . TOWN OF SOUTHOLD D BUILDING DEPARTMENT .~^T 2 9 TOWN HALL ~ 765-1802 1'OMVNLDG. pL r?~o 0 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-4 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 1X 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, S~.*~~+~+~+~ng 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. Copy of Certificate of Occupancy - .25¢. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy _ Residential $15.00, Commercial $15.00 Date ...~.U. ~ ` . New Construction...... t.... Old Or Pre-existing Buildia Location of Property.~t.+t.T1:~............Q1~1~'.~'4:~...~~ House No. r~v~ Street[ 1 p Ham~letf ;;;111Y , Onwer or Owners of Property.~.~~.! ~1~. ~.t.I.K•:1.~-S 11`'.~:../~~'..~.r.~~.~4•:..~,`!,G/!_!~~1l~~,--1• .Lot. County Tax Map No 1000, Section.~Cl a~.:Q~.Block. ~ l : Q.l•7.... .~~J! Subdivision ....................................Filed Map............Lot...................... Permit No ................Date Of Permit.................Applicant............................. Health Dept. Approval .........................:Underwriters Approval..........//~~....... j....... Planning Board Approval ~ 3 ~ - ls/+~ Request for: Temporary Certificate........... Final Certicate........... Fee Sub fitted: $..~o.~...•.•..••••••••••• CC ~ ~ d ~ 5 ~ ' . ' . I G l0 v ~ ...APPLICANT.. 6/2001 10:02 5157511671 D SMITH CONSULTING ~ G~/Q'/ PAGE b. I Q (Q ov.vc s.C. TAX MAt NO. D1bT, iioo SECT, sf.f kOCK LOT__ G FILE NO. 9° y PR0.1. 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CtR1'Iftl~ OIILr TOi ALL CpMIERS 1111 Qanttrs ittrury ~eatpaay Sri s ~a.r'~~ s-~ ~ _ Ttw~ M~ LrIIA f rY wis rr... - ice.!" 4 ~.1~at /l.~. N-t~ ia. ~s.cettr r_.~rs~r ~d ~~Z~ t Erl..e Mie ~/i n L~ s! i ~ ~ ~ ~a11?11aN. Nr 117r rMr; (g117H-1M /rr. (tl1) 70bM71 _r~-L iii ~.e..- /e. ~ i.vr !lJRbEY DATff: - a d o i AREA: +E,~sr~d .S: f O . Rarle E. NartMarm, PL3, NYS LIC 040867 F1lHD MAP t4Q DATE FILED: DESIGNED AYVN BY: CKD FIELD BOOKS; _~s~T r~ DATA DISC: FND.,__ LIPID. CONST FINAL CONSENT TO ~ ~ / INSPECTION ~i ml~ l 1Ci1~+~~` ~ the undersigned, ~ Owner(s) Name(s) ~ r do(es) hereby state: That the undersigned (is1 care) the owner(s)o,~fythye~ p~remi~seas,in t/he~,To~w,~n . p of Southold located at~ fiL9~C ®IIk~G f C3-C[.[ _ ll~l/I1~7 ~}~1~-~- which is shown and designated on the Suffolk County tax map as District 1000, Section~~l~, Block~~~, Lot~f~l That the undersigned (has) (have) flied, 'or caused to be Piled, an applica- tion/y~i'./n~~ the Southold Town~/B~u~ilding Inspect/~o+r^'~sy Office for the following: 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 Por vio- lations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: ~~-~~i'c~~ signature) print name (signature) (print name)