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HomeMy WebLinkAboutZ-29147FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP/LRTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 29147 Date: 12/26/02 THIS CERTIFIES that the building DWELLING AiqD ACCESSORIES Location of Property 57995 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 055 SOUTHOLD (STREET) (HAMLET) Block 0006 Lot 034 subdivision Filed Map No. __ Lot No. __ confor~ substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 29147 dated DECEMBER 26, 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 FRONT & REAR PORCHES & REAR CONCRETE PATIO WITH ACCESSORY 1 1/2 CAR GD=RAGE WITH LEAlq-TO AND FARM STAND WITH METAL SHED.* The certificate is issued to JOSEPH F KRUKOWSKI & ANO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF ~AL'r~ APPROVAL ELECTRICAL CERTIFICA~ NO. PLI~MBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECT~PORTI Rev. 1/81 N/A N/A N/A Authorized ~gnature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 57995 MAIN RD SOUTEOLD SUBDIVISION: MAP NO.: LOT (S) NAME OF O~ (S): JOSEPH F KRUKOWSKI & ANO OCCUPANC"f: SINGLE FDR4ILY ADMI'I-rMO BY: JOHN NICKLES ACC~3~pANI]~D BY: SAME KEY A%rAII~%BLE: SUFF. CO. T~2f ~ NO.: 55,-6 34 SOURCE OF P,~QL'EST: JOHN J NICKLES (AGENT) DAT~: 12/26/02 JOSEPH F KRUKOWSKI & /kN0 DWELLING: TYPE OF CONSTRUCTION: WOOD FRA34E # STORIES: FO~ATION: CONCRETE BLOCK C~'~J.~: FULL ~Y)TAL ROO~S: 1ST FLR.: 3 2ND FI~R.: 3 BAT~(~(S): 2.0 ~)II~ RO(~($): 0.0 PORCH T"fPE: FRONT & REAR BP, EEZ ~T;AY: DOMESTIC HOTWATER: X T~fPN }H~AT: OIL OTHER: DECK~"fPE: FIREPLACE: TYPE HF~k~R: OFF BOILER ~,RMAIR: HOTWi%TER: X CP~%WLSPACE: EP.D FLR.: 0 UTILITY ROOM(S): PANTRY PATIO ~"fPg: CONCRETE REAR GA~N: ACCESSORY STRUCTURES: GARAGE, T"fPE OF CONST.: WOOD 1 1/2 CAR W/LEAN-TO STOP=~GE, ~fPg CONST.: SWIPING POOL: ~EEST, ~"fPN CONST.: OTHER: OLD FARM STAND WITH METAL STORAGE BUILDING VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. Form No. 6 - TOWN OF SOUTHOLD BUILDING DEPARTMENT 765-1802 ~' - APPLICATION FOR CERTIFICATE OF OCCUPANC.Y This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. 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. 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 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, Swinrming 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 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. December 3~ 2002 New Construction: Location of Property: Old or Pre-existing Building: X . (check one) 57995 Main Road (Roul:e 25) Soul:hold House No. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No I000, Section Subdivision Permit No. Date of Permit. 055 Block 06 Lot Filed Map. Lot: Applicant: 034 Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ 100. O0 Underwriters Approval: Final Certificate: X (check one) ~plicant Signat~/ r 765-~.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE ([ CHIMNEY REMARKS: ..~~ ~~~__~ DATE INSPECT~ CONSENT TO INSPECTION Estate of Lillian Krukowski _, the undersigned, do(es) hereby state: Owner(s) Name(s) That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold, locatedat 57995 Main Road, Southold which is shown and designated on the Suffolk County Tax Map as District 1000, Section 055 ,Block 06 ,Lot 034 That the undersigned (has) (have) filed, or cause to be filed, an application in the Southold Town Building Inspector's Office for the following: Certificate of 10z~cupancy (Pre-existing) 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, rules or regulations of the Town of Southold. Dated: -(Signature)' ~ (Print Name) (Signature) (Print Name) FouND RE-ROD w/CAP N 4.9'~ W 9.5' 453,21' TO RAIL MON. LONG ISLAND RAiL ROAD (MTA) ..... =~"W 140.50' --~' ' MON. (DRWEN VERT.) .>< SOD NIP KRUKOWSKi P&ANTED ~ // "' FRAME / GARAGE / CARDINAL FENCE 0.7' SURVEY OF DESCRIBED PROPERTY SITUATE SOUTHOLD, TO N OF SOUTHOLD SUFFOLK COUN' , N.Y. SURVEYED FOR: JOHN ROMANELLI TM# 1000-055-06-054 GUARANTEED TO: JOHN ROMANELLI SAFE HARBOR TITLE AGENCY FD CM S GUARANTEES IND/CA17~O HERE ON SHALL RUN ONLY rO THE PERSON FOR WHOM THE SURVEY IS c~EPARED, AND ON HIS BEHALF TO ~g CDP'ES OF THIS SURVEY MAP NOT BEARING T~E LAND SURVEYORS EMBOSSED SEAL SHALL ~,©T BE CONSIDERED TO BE A VALID TRUE CONC .5.0' 0,6' SURVEYED: 19 NOVEMBER 2002 SCALE 1"= 60' AREA = 99.483.68 S.F. OR 2.284 ACRES SURVEYED BY STANLEY d. ISAKSEN, dR. P.O. BOX 294 NEW SUFFOLK. N.Y. 1 1 95,,~ 631 --,734~-5855~ /_ /// NYS L/c. No. 4927Z 02R?~94