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Home My WebLink AboutZ-23864FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-23864 Date SEPTEMBER 12, 1995 THIS CERTIFIES that the buildin~ Location of Property 27585 MAIN ROAD House No. County Tax Map No. 1000 Section 102 Subdivision ONE FAMILY DWELLING uu-rCHOGUE, N. Y. Street Hamlet Block 1 Lot 15 Filed Map No. 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-23864 dated SE~r~MBER 12, 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 (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *P?.~SE SEE ATTAu~D INSPECTION REPORT. Rev. 1/81 STANLEY M. & BARBA~A~ICZ N/A N/A N/A Bu~ lding Inspector BIJ I I.I) 1 tic DI';PAIUI'HI'~NT TOWN OF SOUTIIOLO IIOtJS1N(; COI)E INSPECTION REPORT I.OCAI'ION: 27585 HAIN ROAD (m~ml)er & street) SUBI) I V IS ION flAP NO. NAHE (}F O~NEI{ (n) STORY M. ~OWICZ CUTCHOGUE, NEW YORK (muniCipality) LOT ( s ) OCCUrt'ANCY A- I RES . Ol,HqER t~-} (owner-tenant) ADHITTEI} BY: STANLEY M. ILAKOWICZ ACCOHI'ANIED BY: SAI~ KEY AVAII.ABI.I,~ SIJFF.CO. TAX HAP NO. IOoo-IO2-OlC]~ S()UI{CF~ OF REq.IJEST: STANLEY lq. RAKOWICZ I)ATE: AUG. 3, 1995 I)WEI.I.I NG: 'I'YPE OF CONSTRUCTION I:OUNI)AT I ON TOTAl. ROOMS: IST FLR. RATIIROOH (s) TWO PORCII TYPE BRF~EZEWAY I)OHIr. ST IC [IOTWATER YES TYPE IIEAT LILCO GAS OTIIER: CEMENT BLOCK WOOD FRAIqE I STOl{lES 2 CEI.1.AR FULL CRAWl. SI;ACE 4 2ND FLR. 4 3RI) FI.R. TOILET ROOM (s) ONE UTILITY ROOH BECK, TYPE PATIO FIIIEPLACE NOBLE GARA(;E TYPE llEATER LILCO GAS AIRCOND1T1ONING WARH Ail{ IIO'i~dATER STEAl4 EXITS ACCESSORY S'I'RIICTURES: CARACE, TYPE OF CONST. SW IMf'Il NG I'OO1. Ol'llE R: STORAGE, TYPE CONST. · CUEs'r, TYPE CONST. ~T~ S~D ....................................................................................... ,,Z£~ VIOLATIONS: CIIAWFER 45 N.Y. STATE IJNIFORH FIRE PREVENTION & BUILDING CODE I.OCATiON DESCRIPTION ART. SEC . REMARKS: BP ff4881Z-CO Z-3995 (ACCY SHED), BP ffTO96z-co Z-6413(SWINMING POOL & DECK) BP tf20929-Z-CO Z-22037 (ADDITION) I NLI'~CTEI) BY_. ' ~' I)ATE OF INSI'Ir~CTION AUG. 17, 1995 TIME START 9:30 At{ END 10:00 Fo~m No. 6 TOWN OF SOUTtlOLD BUILDING DEPARTNENT TOWN tlALL 765-1802 jM~PLICATION 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 lihes, 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. 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 Buildin~ - $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 $15.00 ...................... New Construction ........... Old Or Pre-existing Building..~ ........... Location of Property ....... ............................................................... House No. Street Hamlet Onwer or Owners of Property..,~.~,A['r;-.t.:J-£~-~V ' County Tax Map No 1000, Section...[ ......... Block .... [ ........... Lot .................... Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant .......... ' ................... llealth Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... o } I __ A ,.ICAN' _ '" ................. . .co 4 s6q 'Ox~mer(s) Name(s) do(es) hereby state: CON$I~NT TO IN~q P~CTION the undersigned, That the undersigned (is) (are) the owner(s) of thc premises in [he Tovm · which is shown and designated on the Suffolk County tax map as District 1000, Section lO'~-: , Block t , Lot ~% That the undersigned (has) (have) filed, 'or caused to be filed· an applica- tion in the Southold Toxwn Building Inspector's O£fice for the [ollowing: __ That the u~derstgned 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 ~here0n~ 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 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 rio- Dated:_ lations of the laws, Ordinances, rules or regulations of the Town of Southold. (si~{atuge) 2- (print name) (signature) (print name)