HomeMy WebLinkAboutZ-20457FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-20457 Date JANUARY 8, 1991
THIS CERTIFIES that the building AGRICULTURAL
Location of Property 22600 COUNTY RD. #48 & 5450 COX LANE CUTCHOGUE,NY
House No. Street Hamlet
County Tax Map No. 1000 Section 84 Block 4 Lot 1
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a Agricultural structure
built prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-20457 dated JANUARY 8, 1992
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 FOUR AGRICULTURAL FARM BUILDINGS, TWO WITH LIVING QUARTERS
FOR FARM HELP *
The certificate is issued to ALBIN PIETREWICZ
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
A'Ie�-4 *10 Y.4� uilding Inspector
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 22600 COUNTY RD. #48 6 5450 COX LANE CDTCHOGDE, N.Y.
number & street 141-micipa ity
Subdivision Map No. Lot(s)
Name of Owner(s) ALBIN PIETREWICZ
Occupancy
(type) owner-•-tenar_t
Admitted. by: OAR Accompanied by: OWNER
Key available Suffolk Co. Tax No. 84-4-1
Source of request.
ALBIN PIETREWICZ Date DEC. 6, 199
DWELLING•
Type of construction #stories
Foundation Cellar Crawl space
Total rooms, lst. Fl 2nd. Fl 3rd. Fl
Bathroom(s) Toilet room(s)
Porch, type Deck, type Patio, type
Breezeway Garage Utility room
Type Heat Warm Air Hotwater
Fireplace(s) No. Exits Airconditioning
Domestic hotwater
Other
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other
Type heater
Storage, type const.
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
Location
Description JArt.
Sec.
1.
Large 2 story barn, "wood framed" attached shed
BP #83362 - CO Z-6948)
2.
2 small wood framed buildings.
3.
3 Car wood framed garage with living quarters
3 rooms and bath. Farm Help Occupied.
4.
Small wood storage building with living quarters
2 rooms and bath, farm help occupied.
Remarks: All buildings are in good shape.
Inspected by: ,vl,in�/ v ate of Insp. Dec. 20, 1991
CDRTIS W. HORTON Time start 2:30 end 3:00
E C E I V E
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Liu •' �"�..-11L'�_•
Form No. 6
T014N OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
1. 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.
3. 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 Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ..� ?/....................
New Construction........... Old O/,) r``Pre-existing Build�iing.. p
Location of Property. .�QLS4�4Caxs-a-
House No& Qyj� �S�s vect-fes ��J �o Hamlet
Unwer or Owners of Property.. � �1�.....%. �. ��✓. , r�J I�J.�L r ................. .
,.ounty Tax Map No 1000, Section..9.Z/ ...... Block ...... .......Lot.....1 ...............
:;ubdivision....................................Filed Map ............ Lot ......................
Permit No................Date Of Permit ................ Applicant .............................
:?ealth Dept. Approval..........................Underwriters Approval.........................
:Tanning Board Approval ........................
i,equest for: Temporary Certificate........... Final Certicate....!�....•
:ee Submitted: $.............................
y3��7
�v� co X20 Lfs 7
APPLJ.................. ......
MNT
CONSENT
TO
INSPECTION
_::/ Zj Y� vV /t -- , the undersigned,
Owner(s) Ndmc(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at .-2-Z( dl) e' ,-) 1" K -"j) k' .%-
which is shown and designated on the Suffolk
County tax map as District 1000, Section , Block , Lot 11
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in the Southcld Totem Building Inspector's Office for the following:
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, rules
and regulations of the Town cf 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: Zz- J - 9/
(signatu
(print )
sionat
,a.' 1 , � t r �✓
(print n me)
C
BUILDI::G DEP:;RT;IE;iT
T01'11\1 OF SOUTHOLD, N. Y.
HOUSI ,M CODE INSPECTION REPORT
Location ' " O � Afd
knUMD do street
Subdivision Map No.
r Alt" A
Name of Owner(s) /"�
r
icipa-Lity)
—Lot(s)__
Occupancy
(type) (owner -tenant)
Admitted by: Accompanied by:
Key available
Suffolk Co. Tax No.,`f ,1 7 •--
r I�
Source of request Date /224e 6
D4MLIMG
Type of construction #stories
Foundation Cellar Crawl space
Total rooms, lst. F1 2nd. F1 3rd. F1
Bathroom(s) Toilet room(s)
Porch, type Deck, type Patio, type_
Breezeway Garage Utility room
Type Heat Warm Air Hotwater
Fireplace(s) No. Exits Airconditioning
Domestic hotwater Type heater
Other
ACCESSORY STRUCTURES:
Garage, type const. Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS:- CHAPTER 45--N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
Inspected by:,�. Date of Insp.
_'�--
Time start.,;Z/ end
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Af
v ME
TOWN OF SOUTHOLD PROPERTY RECORD CARD;;''"
OWNER STREET VILLAGE DIST. SUB. LOT .r
FORMER OWNER N .. ACq.
S W ' TYPE OF BUILDING
s ,
6 / of e / LU. Gk
RES. �O SEAS. VL. ARMS COMM. CB. MISC. Mkt. Value4
LAND IMP. TOTAL DATE REMARKS y V17 / P i eWed. G !
G6 ov' ao
ad d C2 $
DDD .2 t
ao 3,� 3
1600 AGE ,. • .: �d G,.,a °x• BUIL ING. C ND 10
7
N EW '{ . NO L B V1d`" AB E
s ► s' �9 �2 Q d ,�9Ltedt Pxf,�
F t cre.. varui Per alu
d..0 Acre 704 3� l `�1� �7� ��D„ �� R, 3 3(, Z, u�J,D %e �J ,M 40. C oo
2j r
Iva
Tillable 3 �n gra'lr7
. c...... ,,.. see
Woodlond `.•� o�30,2AC/ A�alaz
Swampia d U FRONTAGE ON WATER -'l3 a 112 .. �'�U e B
Brushla FRONTAGE ON ROAD �"�,���P3 Q*f•u�
House PlotDEPTH
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Total DOCK ���/ ;M y. !.s'a�v
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