The URL can be used to link to this page

Home My WebLink AboutZ-25685FORM NO. 4 TOWN OF 8OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 25685 Date: 04/17/98 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 11360 MAIN RD (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 031 Block 0013 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- 25685 dated APRIL 17, 1998 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 BARN AND BOATHOUSE* EAST MARION (HAMLET) Lot 010.001 The certificate is issued to DEBORAH A KUSA of the aforesaid building. (OWNER) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. ~/~~Inspector Rev. 1/81 LOCATION: SUBDIVISION: 11360 MAIN RD NAME OF OWNER (S) : DEBORAH A KUSA OCCUPANCY: A-1 RESIDENTIAL ADMITTED BY: DEBORAH A KUSA BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT EAST MARION MAP NO.: __ LOT (S) -- DEBORAH A KUSA ACCOMPANIED BY: DEBORAH A KUSA KEY AVAILJ%BLE: -- SUFF. CO. TAX MAP NO.: 31.-13-10.1 SOURCE OF REQUEST: DEBORAH A KUSA DATE: 04/17/98 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAblE FOUNDATION: CINDER BLOCK TOTAL ROOMS: 1ST FLR.: ._~ 2ND FLR.: _~ BATHROOM(S): 3-O TOILET ROOM(S): . PORCH TYPE: ENCLOSED(WATER SIDE) DECK TYPE: BREEZEWAY: FIREPLACE: ONE DOMESTIC HOTWATER: YES TYPE HEATER: QIL TYPE HEAT: QIL WARM AIR: OTHER: *TQWER ATTACHED TO GARAGE # STORIES: ~.O # EXITS: ~ CELLAR: PA=RT. CRAWL SPACE: PART. 3RD FLR.: ._~ UTILITY ROOM(S): W/DRY PATIO TYPE: WEST SIDE OF HOUSE GARAGE: ATTACHED* AIRCONDITIONING: & STEAM HOTWATER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SWIMMING POOL: OTHER: ~QATHOUSE (WOOD FRAME) STORAGE, TYPE CONST.: WOOD FRAME (BARN) GUEST, TYPE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS: BP#8323Z-ADD - CO Z7016 DATE ON INSPECTION: 04/24/98 TIME START: 10:00 END: 10:30 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 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. 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 Buildinm - $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 ......................... New Construction ........... Old Or Pre-existing Building ........ .... i ............... House No. Street Hamlet Onwer or of ^ O--... .... .................................. . County T~ ~p ~o 1000, Section ~l ..Bloc~. /"~ .~ot.. I0- I Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate....~. ..... do(es) hereby state: CONSENT TO SPEC I ION · the undersigned· of Southold located at That the undersigned (is) (are) the owner(s) of ti~e premises in the Town , which is shown and designated on the Suffolk Co,,n,..~ fa× ma, ~ ~,~,ooo, ~¢,,,n ~} . ~,o~,~ I ~ . ,.o~ I.O. I' That the undersigned (has) (have) filed, or caused robe filed, an applica- tion in the Southold Toxin Building ln.qpector's Office for the followina: That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southo].d to enter upon t:he above described property, inclndln~ 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 con~entin~ to such inspections, do(es) so with the knowledge a,d understanding that any information obtained tn the conduct o[ such inspections may he used us evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or re~gations of the Town of Southold. (print (si¢nature)