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HomeMy WebLinkAboutZ-23876FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-23876 Date SEPTEMBER 15, 1995 THIS CERTIFIES that the building. Location of Propert~ 1050 ~BTI~uT RD. House No. County Tax Map No. 1000 Section 59 Subdivision ONE FAMILY DWELLING SOuT~OLD, N.Y. Block 3 Filed Map No. Street Lot 2 Lot No. Hamlet conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-23876 dated SEP£~4BER 15, 1995 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 AT~C OSTROSKI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PT.~.~E SEE ATTAc~u INSP~CTIONRE~~ Rev. 1/81 N/A N/A N/A Buildi'ng In~ 1,OCATION: 1050 CI~$TI~IT RD. (number & street') SUIII) IVIS ION NAME OF {)14Nl~,R (s) ALEC OSTROSKI BI! ILDI NG DEPARTHENT TOUN OF SOUTilOLD IIOUSING CODE INSPECTION REPORT SOUTHOLD, N.Y. HAP NO. (municipality) Lo'r(s) OCCDPANCY SINGLE FAMILY (type) (owner-tenant) SALVE ADH[TTED BY: SUSAN I~OTT ACCOHPANIED BY: KEY AVAII,ABI,I'; SUFF.CO. TAX HAP NO. ]000-59-3-Z S()[JRCE OF REQ.I. IEST: i~iiLLiA_.nl (X}C_.~II~IS (AGENT) DATE: AUG. 31, 1995 DIdELI.. I NG: TYPE OF CONSTRDCTION FOUNI)AT ION TOTAL ROOMS: BATUROOM (s) PORCll TYPE CEI~I~IT BLOCK IST FLR. 6 ONE BREEZEI~AY DOHESTIC I1OT~4ATER YES TYPE llEATER TYPE IIEAT OIL UARH AIR OTIIER: FRONT & REAR EI~ITR¥ I/AY BLOCK & BRICK ~ STORIES I ~ EXITS 2 CEI.1.AR PART CRAWL S~ACE 2NI) FLR. - - 3RI) FLR. TOILET ROOH (s) UTILITY ROOH BECK~ TYPE PATIO SMALL REAR CEMENT F I REPLACE GAILAGE OIL FIRED AIRCON1) ITIONING YES IIo'rI4ATER ACCESSORY STRDCTURES: GARAGE, TYPE OF CONST. STORAGE, TYPE CONST. SI4IHHING POOL , GUEST, TYPE CONST. OTI1ER: REAR GRAPE ARBOR VIOLATIONS: CIIAPTER 45 N.Y. STATE UNIFOI~ FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-t802 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 ali 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/IO 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. ,' 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 ail 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. 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-existin~ Buildin~ - $lO0.OO 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.O0-, Commercial $15.OO Date . . . A~9s t.,.~t,. ~95 .................... New Construction. Old Om Pre-existing Bu ................ Location of Property./z .... {'~9~.Qb¢~R~. R~.a4,. ~.qu~bp).4,. Nm.~ .Yor~.. l/g%l .............. House No. Street tlamlet ~ ....... Estate of Alec Ostroski .......... Onwer or Owners of ~v=~7 ..................................................... :ounty Tax Hap No 1000, Sectio,..0.5.9.'.Q©. ...... Bluclc..p.3...QO ........ Lot.002...O00 ............. Subdivision .................................... F:i t ed Hap ............ Lot ...................... Per,nit No ................ Date Of Permit ................ Applicant..W. illia.m.C,..Gogg.i.5s.as..agent :lealth Dept. Approval .......................... Underwriters Approval ......................... 'lan.ing Board Approval ........................ Temporary Certificate ........... F£ al Cer ' ate ......... 5Ol3 ................. '~'~,[jO ~'~"~ WILLIAM C. GO~-I~S,- as Agent 0B/0B/199S 18:44 5162984214 WILLIAM C GOGGINS PAGE 02 :. STATE OF NEW YORK ) )SS: COUNTY OF SUFFOLK) SUSAN MOTT, being duly swom deposes and says: ONE: I am the Executrix of the Estate of Alex Ostroski, and I am the oldest daughter of my late father, Alex Ostroski. TWO: At the time of my father's death, he owned property located at 1050 Chesmut Road, Southold, New York and further described as SCTM No. 1000-059.00-03.00-002.000. THREE: My father bought the aforesaid property on February 28, 1953, and built a house thereon a short time thereafter. SUSAN MOTT SwOrn to before me this v, POBLtC RUG 10 '95 07;56 P,4/4 CONSENT TO INSP~.CTION Estate of Alec 0stroski by William C. Goggins as Agent , the undcrsigned, '. ' O~ner(s) Name(s) do(es) ihereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southoldlocatedat 1050 Chestnut Road Southold, N~w York · which is shown and designated o,'~ the Suffolk County iax map as District 1000, Section 059 . O[131ock 03 . O~]]Lot 002. 000. Thai the qndersigned (has) (have) filed, or caused to be filec[, an applica- tion inlthe Southold Town Building Inspector's Office for the following: Certificate of Occupancy for Pre-existing use That the undersigned do(es)hereby give consent to the Build/hz 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 ~ecessa~ry with respect to the aforesaid application, including inspec+.ions to determine that said premises comply with all of the laws. nrd~nancos, rules and ~'egulations of the Town of Southold, The unde~'signed, in consenting to such iuspections, do(es) so w/th the knowledge and under.4tanding that any information obta/ned in the conduct of such inspections may be used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or re f Dated, August 31, 1995 ', 0GGINS, as Agent (print name) (siRnature) (print name)