HomeMy WebLinkAboutZ-29091FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 29091
Date: 11/19/02
THIS CERTIFIES that the building
Location of Property 6300 MAIN RD
(HOUSE NO.)
County Tax Map No. 473889 Section 038
Sutx~ivision Filed Map No. __
DWELLING AND ACCESSORIES
EAST 5LARION
(STREET) (HA~MLET)
Block 0001 Lot 001.007
Lot No.
conforms substantially to the Requirements for a ONE FARILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCYNUMBER Z- 29091 dated NOVEMBER 19, 2002
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 AND SHED.*
The certificate is issued to JOSEPH A CHEREPOWICH & ORS
(OWNER)
of the aforesaid building.
SUFFOLK CO~ DEPARTMENT OF HEALTH kPPROVAL
ELEt-£KICAL CERTIFICAT~ NO.
PLUMBERS CERTIFICATION DATKD
N/A
N/A
N/A
*PLEASE SEE ATTACHED INSPECT~ ~~
Authorized~ignature
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
L(~-ATIOR: 6300 MAIN RD EAST MARION
SUBDIVISION: MAP NO.: LOT (S)
NAME OF OWNER (S): JOSEPH A CEEREPOWICH & ORS
OCCI/PANCY: SINGLE FAMILY JOSEPH A CHEREPOWICH & ORS
ADMI'I-rKU BY: MARION SA/~TACROCE ACCOMPANIED BY: SAME
KA"fA%~_II~%BI~E: St]FF. CO. TAX W2~PNO.: 38.-1-1.7
SOURCE OF P~EQUEST: JOSEPH CHEREPOWICH DATE: 11/19/02
DWELLING:
· "fPE OF C~NS~UCTION: WOOD FRAME # ~'rORIES: 1.0 # ~YITS: 2
7X)TAL RO(OS: 1ST FI~.: 6 2ND FI~{.: 0 3P~D FI=H.: 0
]~A~O(~(S): 2. 0 ~)II~ R(~(S): 0.0 DTILI~"f RO(O(S): *
~STIC HOTWA'r~K: X TYPE H~J¥£~K: NAT GAS AIRCO~DITIONING:
~£~K: *REAR MUD ROOM
ACCESSORY STRUCTURES:
C4~D~%GE, TYPE OF CONST.: TWO CAR WOOD FRAME ~TORA~E, TTI~E CONST.: LARGE METAL BARN & SHED
SWI~4ING~3OL: GUEST, TYPE CONST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
P.~%RKS: BP#2893~ C0Z-29090
DATE ON INSPECTION: 11/19/02
TIME START: ERD:
CONSENT TO INSPECTION
· 0wndr{s)Name(s)/~,~t~-~c-~.,~
That the undersigned (is)l[~tre) the~kwner(s) of the premi,ses in the Town of
Southold, located at ~9.~/~-r~ ilJl A~t.0 ~,-~ ~" ,ti s-r-/~,~a ~,~0 ,
which is shown and designated ~n the Su{'f~ll~ Co{m'iy'-T~x Map as Df~rict 1000,
Section ~' , Block / , Lot ./~.7
That the undersigned (has) (have) filed, or cause to be filed, an~application in the
Southold Town Building Inspectgr's Office for the following: ~-~ t FT~ ~ ~
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, roles 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 in subsequent prosecutions for violations of the laws, ordinances, roles or
regulations of the Town of Southold.
Dated:
(Signature)
(Print Name)
Form No. 6
TOWN OF SOUTHOLD
BU~D~G
DEPARTMENT
APPLICATION
FOR
CERTIFICATE
This application must be filled in by typewriter or i~ and submitted to the Building
Ao
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 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.
Fees
1. Certificate of Occupancy - New ~twelling $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 Building - $100.00
3. Copy of Certificate of Occupancy - $25.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date.
Old or Pre-existing Building: ~ (check one),
House No. Street
New Construction:
Location of Property:
Owner or Owners of Property: · ~ 4~,.,t,~6 /~ ~'/' ~'~O, age2/~/~ ,Zf~,o
Suffolk County Tax Map No 1000, Section/~,~,~ ~'.~-/-/. 7 Block
Subdivision
Permit No.
Health Dept. Approval:
Planning Board Approval:
Date of Permit.
Filed Map.
Applicant:
Underwriters Approval:
Request for: Temporary Certificate
Final Certificate: /
Fee Submitted: $
Hamlet
Lot
Lot:
(check one)
'A"~'~ [icanffS~'gnatur e
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
DATE
/'/
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