HomeMy WebLinkAboutZ-25652FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 25652
Date: 04/16/98
THIS CERTIFIES that the building BUSINESS STRUCTURE
Location of Property 35315 MAIN RD CUTCHOGUE
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 097 Block 0001 Lot 014
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a BUSINESS STRUCTURE
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 25652 dated APRIL 16, 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 C-3 CARPENTERS SHOP
The certificate is issued to CHESTER P ORLOWSKI
(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 INSPECTION REPORT.
Inspector
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
LOCATION: 35315 NAIN RD CUTCHOGUE
SUBDIVISION:
MAP NO.: LOT (S)
NAME OF OWNER (S): CHESTER P ORLOWSKI
OCCUPANCY: C-3 CARPENTERS SHOP CHESTER P ORLOWSKI
ADMITTED BY: CHESTER ORLOWSKI ACCOMPANIED BY: CHESTER ORLOWSKI
KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 97.-i-14
SOURCE OF REQUEST: CHESTER ORLOWSKT-2/27/98 DATE: 04/16/98
TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: _1.0 # EXITS: _2
FOUNDATION: POSTS AND CEMENT CELLAR:
TOTAL ROOMS: 1ST FLR.: 2
BATHROOM(S): 0.0
PORCH TYPE:
BREEZEWAY:
2ND FLR.: 2
TOILET ROOM(S): 1.0
DECK TYPE:
FIREPLACE:
DOMESTIC HOTWATER: TYPE HEATER:
TYPE HEAT: NONE WARM AIR:
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.:
SWIMMING POOL:
OTHER: NO ACCESSORY STRUCTURES
HOTWATER:
CRAWL SPACE:
3RD FLR.: 0
UTILITY ROOM(S):
PATIO TYPE:
GARAGE:
AIRCONDITIONING:
STORAGE, TYPE CONST.:
GUEST, TYPE CONST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION 1 ART. 1 SEC.
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REMARKS: BP#24809Z COZ25651 (ALT)
INSPECTED BY:
GARY FISH
DATE ON INSPECTION: 03/12/98
TIME START: 10:10 END: 10:30
Form No. 6
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 Undefwriters.
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 nate a5. 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.
Feas
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-existin Buildine -(V100-001
3. Copy of Certificate of Occupancy - .25-C
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date
onstruction........... Old Or Pre-existing Building......... .......
ion of Property... 353.1........ .Q o`...... .. 1. n ,L(.......
House No. Street Hamlet_
orOwners of Property..0 .�................................
y Tax Map No 1000, Section. I .:.�1:..Block. ..1 ............ Lot.. l../ .................
vision....................................Filed Map ............ Lot ......................
tNo................Date Of Permit ................ Applicant .............................
hDept. Approval..........................Underwriters Approval.........................
ing Board Approval ........................
st for: Temporary Certificate........... Final Certicate...........
ubmitted: $.............................
....................... .
APPLICANT
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CONSENT
,1.0
INSPECTION
s) Names
do(es) hereby state:
, the undersigned,
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at 2 S 2 I <�- � ta.
which is shown and designated on the Suffolk
Comity tax rnap as District 1000, Section _- J_, 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: J_
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
w
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:_�Tjj)- _
%��,, (,signature)
y�sTc-r LJyLoLo
(print name)
signature
TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER
STREET '1 �� �.5
VILLAGE
DIST.'
SUB. LOT
' �,<�c•":�/ �c �'
/�Id ! n lea a d�b
�4/
FORMER OWNER
N ,p
E
T W Yt °
ACR.
S
W
TYPE OF BUILDING
RES. SEAS.
VL.
FARM
COMM--, CB. MICS. Mkt. Value
LAND IMP.
TOTAL
DATE
REMARKS
c� Yd 6
BS c
b
/YQD
366
AGE
BUILDING CONDITION G6
NEW
NORMAL
BELOW ABOVE
FARM
Acre
Value Per
Acre
Value
Tillable
FRONTAGE ON WATER
Woodland
i
FRONTAGE ON ROAD
/ o U 60-1t, a f x N346
Meadowland
i
DEPTH
House Plot
i
BULKHEAD
Total .d "'�
J
DOCK
IMF!
MAIN MJ
Wpm
LOCATION: d
SUBDIVISION
NAME OF OWNER (s)
OCCUPANCY
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
6 street
(muni�pallty
MAP NO. LOT (s)
ADMITTED BY: C.��t�%LC.Zt� ACCOMPANIED BY: - - -
KEY AVAILABLE SUFF. CO. TAX MAP NO. f� Q/
SOURCE OF REQUEST: w DATE:
DWELLING:
TYPE OF CONST" U.�_ CTTION ��j"(% %L � # STORIES C # E%ITS p�
FOUNDATION CELLAR T- CRAWL SPACE
TOTAL ROOMS: IST FLR. pZ 2ND FLR. 3RD FLR.
BATHROOM (s)
PORCH TYPE
BREEZEWAY
TOILET ROOM (s) (fk-Q. UTILITY ROOM
DECK, TYPE PATIO, TYPE
FIREPLACE
GARAGE
DOMESTIC HOTWATER TYPE HEATER AIRCONDITIONING
TYPE HEAT pT/�f WARM AIR HOTWATER
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. STORAGE, TYPE CONST.
SWIMMING POOL GUEST, TYPE CONST.
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
INSPECTED BY: DATE ON INSPECTION .3l/
TIME START END /d► , jo