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HomeMy WebLinkAboutZ-28357FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 28357 Date: 04/24/02 THIS CERTIFIES that the building DWELLING 80 FIDDLER LANE & Location of Property 2740 MANHA/qSET AVE. GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 043 Block 0001 Lot 001 Subdivision 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 NL~WBER Z- 28357 dated APRIL 24, 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 ACCESSORY GD2~AGE & SMALL SHED * ·"ne certificate is issued to MARRY ANNE & ALBERT SHIVICKAS ( OWNER ) of the aforesaid building. SUFFOLK COU1FrYDEPARTMENTOF~R~J~'£~APPRO~-AL ELBt-rKICAL c~TIFICATENO. PL~ c~TIFI~TION DAI~ *PLEASE SEE ATTACHED INSPECTION ~. ; Rev. 1/81 N/A N/A N/A Authorized S~ t u-r e 80 F~ LANE & LOCATION: 2740 MANHANSET AVE. BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT GREENPORT SUBDI~q[SION: ~ NO.: N~4E OF ONNER (S): MARY ANNE & ALBERT SHIVICKAS nOT (S) O~CUPA~C"f: SINGLE FAMILY DWELLING MARY ~NNE & ALBERT SHIVICKAS ~/)MI'l-£~ BY: MARY MCTIGUE ACC~R~P~I~DB¥: S~kME KEY A~-AII~BLE: SUFF. CO. T~X ~AP NO.: 43.-1-1 SOURCE OF REQUEST: JENNIFER B. GOULD, ATTY 8/31/01 DAT~: 04/24/02 DWELLING: · ~fPE OF CONS~R~UCTION: WOOD FRAME # S~DRIES: 1.5 # EXITS: 3 FOUNDATION: CEMENT BLOCK CEIJ~AR: FULL CR~J~L SPACE: · ~)~;%~ ROO~: i~T FIAt.: 4 2ND F~.: 2 3P, D PI~.: 0 ~£~O(O (S): 2.0 T~I~ RO(]~(S): 0.0 IF~ILI~"f ROOM(S): ACCESSORY STRUCTURES: ~E, ~"fPE OF CON~.: ONE CAR WITH ELECTRIC SMALL SHED VIO~ATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. N~S: BP #28273~C0Z-28356 (NEW HEATING SYSTEM) I1_,_. /2 .< 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 Underwriters. 4. Sworn statement from plumbar 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 Buildinm - $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 ...~.'.~..~7.O.J .............................. New Construction ........... Old Or Pre-existing Building...~.. ........... Location of Property ................................ .................... ~,~ ............ House No .... _Street__ Hamlet Onwer or Owners of Property...f'~P.~.% .~.~.d.¢...,.~..~.,'~j'(~..5..~'-O.¢'t..~f..,,,.j .~f'.~,.5."~. ~ ............................ County Tax Map No 1000, Section..~ .......... Block....~ ............ Lot...J .................. Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: ........................... .............. 11/04/i992 20:SB 718-424-9508 MER PRODUCTS PAGE 02 CONSENT TO INSPECTION · the undersigned, Owner(s) Name(s) do(es) hereby state: That the undersigned (is) (are) the o,,~Tc,~r(s) of the premises in the Town of Southold located at -.~TC/D gg}av~M~4~ ~t~. ~Ytt:P~4. ~ . which is shox~ and designated on the Suffolk County tax map as District 1000, Section ~% , Block [ , Lot That the undersigned (has) (have) filed, 'or caused to be filed, an applica- tion in the Southold To~ Building Inspector's Office for the follow,g: ~ 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 of Southold. The undersigned, ~n 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 lations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: ~o %[-01 ~ ~t~u ~'r (print name) (si~nafdre) (print name) NOTES: AREA = 5URV~-r' OF-pp.,opL~R~ ....... ~ 5UFFoL~ COUN-P,¢ TAx # fC'EI~TIFiED TO: C, ANDAc, E KURTZ 'C" OMHONI"~AL TH LAN INSURANCE GOPiPAN~D TITLE -5 = OLK C, OUN'Ty, 5URVE'KED O~-Oq-oI LAND NOPI OR FOP. i'~EP-.L¥ OF ALICE T~AKOS a. CHP-.I5 TSAKOE~ N84o$0'J0"E, ~ 100.00' / 1'4ONuN1EN T FOUND PIPE FOUND JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET RIVERI~EAD, N.Y. 11901 N.Y.S. LIC. NO. 50202 369-8288 Fax 369-8287 REF.\~Hp server\dLPROS\01_250.pro I"= u::K >© > Z