HomeMy WebLinkAboutZ-24534FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-24534 Date JULY 30, 1996
THIS CERTIFIES that the building ONS FAMILY DWELLING
Location of Property 1095 HYATT ROAD SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 50 Block 1
Subdivision
Filed Map No
Lot 14
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-24534 dated JULY 30, 1996
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 *
The certificate is issued to
of the aforesaid building.
VERA NESLAGE
(owner)
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
DI; rnn
3 3 ; JUL
,
�gLDG. DEPT.
TOWN OF SOUTHOLD
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1.802
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 17. 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 - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00-, Commercial $15.00
Date........................
New Construction........... Old Or Pre-existing Building .... x............
Location of Property..NO, .4........ ........... HXatt Road Southold
House No. Street Hamlet
Onwer or Owners of Property.E�tte'r o;� sUe>_.Neslace
050.00 O1 00 Lot 014.000
ounty Tax Map No 1000, Section..............I;11)ck....'... .
5ubdivisi.on.................................... F.H ed Piny ............ Lot ......................
'ermit No................Date Of permit ................ Applicant .............................
lealLh Dept. Approval..........................Underwriters Approval.........................
'lanning Board Approval ........................
tequest for: Temporary Certificate........... Fii 1 rt
.ee Submitted: $..$10,0.00 ...................
ti!x � �5 3
231M
BLDG. DEPT.
i TOWN OF SOUTHOLD
CON ;LN9'
'I'll
I INS P I;: C.' f I O IV
Estate of Vera Neslage by William C. Goggins
the underslgne(I,
does) Iles-elly stele;
'I'bal the undersif;ned (t;l) 011.0 the owilov(s) of lho Ilremisc:s In Ill() `Town
of S0ulhol(1 locale(I at No # Hyatt Road, Southold,—New York
which la "hewn and (Ir.sllmatt.-(I oo llm Suffolk
Colmly tax mill its f)Isll•Ic•l to()(t, Section 050.0,0 1:310(,1( 01.00 t,ot 014.000
---- -
'That the lulclec•sillfle(I (has) (� ) !'ilecl, ov causecl to be filed, an appliea-
lion In the S0111110l(1 'l'own BiIII(Ilu1, lospeclol•'s Office for the followlnl;;
Certificate'+of Occupancy -on Pre -Existing Building
That the un(lersigne(I tick(es)
hereby
(jive conselll to the I.11lilcilllg
lnspeclol'S
of the '1•oxvn of Southold to enlur
111)011 the
llhove deserlbed I)voperty,
inclu(Ilnf,
any (iud all butldlngs locc(tecl thereon,
to
conduct swell Inspections as
llley nlay
(leen, necessary with 1-espect to
lilt, afor•esclld
npl,licalion, Incl11diclf;
Inspections
to (lelermine ilial snld premises
cofnl:ly
wilb all -of Ilia laws, ordlnanees,
rules
and relmlaltous of lilt, 'l uwfl of soulhol(I.
The wl(lersl8necl, lu ecrosentilll, to such luspecllons, do(es) so with the
Inu:wleclip, mid undel•sl m(liull lbal any Infurinatiofl ublalfled In lbe (:uflchicl of
such lll:apecllolls iuny be flst,(I ns evidence in subsequent pl-oseccll(ons fur vlo-
1,lliou: of Ilia laws, ordinancoti, rulers or rei'lli plows of the Tow of Soulbuld,
Dillt,d: July 18, 1996
re
C__GOGGINS
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SURVEYED 6 JULY, 19:
SCALE- I"= 40'
AREA= 93,68706 S.F
or
2.1507 Acres
TM #11000-50-0/-14
SURVEY OF
DESCRIBED PROPERTY
S/TUAT£
SOUTHOL D, TOWN OF SOUTHOL D
SUFFOLK COUNTY, N Y.
SURVEYED FOR THOMAS ✓. SADOWSKI
GUARANTEED TO
329.061 I 1L
7-3 THOMAS ✓. SADOWSKI
N 77026r30"W GR££NPOINT BANK
FIDELITY
N/F MACK 20.32' TOWN OF SOUTOHOLD NAL TITLE INS. CO
Cm, antees irtdkated here an "If run Unauthorized alteration or addition to 1Ms
only b the person for whom the survey Survey Is a violafian of Section 7109 of
is prepared, and on his behalf to the the New York Stott Education Low.
title company, C. vermeMal Agency,
lending instin;tion, if listed hereon, end
is tF._ ,sjgnee% of the lending kMitutien or._: cr IM'r.i v.; t N
SURVEYED BY:
STANLEY J. /SAKS£N, J-
P.O.BOX 294
NEW SUFFOLK, N.Y., 1195,
1516) 734-5835
.4, 12 - jj/
Il(lll.DING, 1)I?PAI('I'MIiNT
TOWN 01? SOU PI'IIOLD
HOUSING CODE INSPECTION IMPORT
LOCATION:
number b slr�eel) (munict all Y3
SUBDIVISION —iV MAL' NO. LOT( 13 )
NAME OF OWNEIt--
000IIPARCY
«'pe.i. r (owner.-LennnL) ----
ADMITTED By: e,ILACCOMPANIED BY!
KEY AVAI LAIN,I?- - —_
__SUrF, . (,0.—TAX HAP NO _�19196—
00111W.11? OF RE(2uEST:__%����/ DATE:
DWELLING: —
TYPE OF CQNSTRUCTION
TOTAL ROOMS: IST FI.R.
IIATIIROOM (a)
1'OltCll 'I'YL'E
IME- EM"WAY DOMESTIC 110TWATER
TYPE HEAT
0.1.111's It :
��v _�rt��% "'�-- / 5'l'OIiiCS � ► IiX).'I', "'-___.
CRAWL SI'ACE
TOILET ROOM (s) UTILITY ROOM
DECK, TYPE PATIO
FIREPLACE GARAGE_
TYPE if CATER - f,�--- AIRCONDITI.ONI.NG _---
WARM Aili 110TWATER
ACCESSORY STRUCTURES:
GAI(AGL', 'TYPE OF CONS'i'. STORAGE, TYPE CONST.
SWIMMING POOL '� GIIIiS'I', 'IYI'1. CONST'_ ----
VIOLATIONS: CHAPTF,Lt 45 N.Y. S'PAT'E I1NI.FO1(M 17IItE I'MWENTION 6 BUILDING CODE
LOCATION
REMARKS
INSPECTIiD By
DESCRIPTION
AIU sEc.
DAPI, OF INSPECT 1 , �2-f7�� — —
T'IMi START �� ENI) 1�.c