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Home My WebLink AboutZ-19150FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19150 Date JUNE 15, 1990 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 43750 MAIN ROAD PECONIC, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 75 Block 6 Lot 12 Subdivision Filed Map No. Lot No. conforms substantially to the requirements for a private one family dwelling built prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCC. #Z-19150 dated JUNE 15, 1990 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 2 CAR WOOD FRAME GARAGE & ACCESSORY WOOD FRAME STORAGE BUILDING. The certificate is issued to ROSE SOBOTKA (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NO RECORD PRE EXISTING UNDERWRITERS CERTIFICATE NO. NO RECORD PRE EXISTING PLUMBERS CERTIFICATION DATED NO RECORD PRE EXISTING *PLEASE SEE ATTACHED INSPECTION REPORT. Building Inspector Rev. 1/81 BUILDI's:G DEPART.•IE iT T0:'111\1 OF SOUTHOLD, N. Y. HOUSIZZG CODE INSPECTION REPORT Location 43750 MAIN ROAD PECONIC, N.Y. (numoer & street) Municipality) Subdivision Map No. Lot(s) Name of Owner (s) ROSE SOBOTKA Occupancy R-80 OWNER (type) owner -tenant) Admitted by: ROSE SOBOTKAAccompanied by: SAM Key available, Source of request DWELLING: ROSE SOBOTKA Suffolk Co. Tax No. 75-6-12 Date 6/12/1990 Type of construction WOOD FRAME #stories 1 STORY Foundation CONCRETE CellarPART' Crawl space P—RTTW— Total rooms, lst. F1 5 2nd. F1 - - 3rd. F1 - - Bathroom(s) ONE FULL Toilet room(s) Porch, type FRONT ENCLOSED Deck, type - - Patio, type_ - - Breezeway - - Garage - - Utility room Type Heat OIL 'alarm Air - - Hotwater xx Fireplace(s) No. Exits 2 Airconditioning Domestic hotwaterOFF THE BOILER Type heater Other REAR EBTRT WAY ACCESSORY STRUCTURES: Garage, type const. 2 CAR -WOW FRAZE Storage, type const. WOOD .FRAME Swimming pool Guest, type const. Other VIOLATIONS: .CHAPTER 45—N.Y. STATE UNIFORM FIRE PREVENTION 6 BUILDING CODE Remarks: Inspected by: �_Date of Insp. June 14, 1990 Gary J. Fish ' Time start 9:30 amend 9:55 am FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 IL /990 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal—(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non -conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling UsX*9 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 Date . , ,June 12 , 19.9.0 New Building ............. Old or Pre-existing Building ... 1�........ Vacant Land ............. Location of Property ............. C� ........Main......Road. Rt. 25 , , , Peconic Nouse No. Street Hamlet Owner or Owners of Property ..ROSE SOBOTIZA ....................... . ... . County Tax Map No. 1000 Section 075.......... Block .....6......... Lot ..... 12........ . Subdivision .................................Filed Map No. ..........Lot No. ............. Permit No. .......... Date of Permit ..........Applicant .................................. Health Dept. Approval ........................Labor Dept. Approval ........................ Underwriters Approval ........................Planning Board Approval ...................... Request for Temporary Certificate .....................Final Certificate ....................... Fee Submitted $ .1O.M9..................... Construction on above described building and per it meets all 7ic cable code and regulations. Applicant .. ... .. ....................... . (Rose Sobotka) Rev. 10-10-78 pc.3g8," c c + 9ls01 t �i `' ZWO CONSENT BLDG. DEPT. TO TOWN of souTHOLo___. INSPECTION , the undersigned, Owner(s) Name do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of SouId located at /Q which is shown and designated on the Suffolk- County uffolkCounty 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 Town 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 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 vio- lations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: (signature) / 0 S E sCc; R ,5222 (print name) (signature) (print name) Cori 1 z- 5 N RTE 2 jUN 12wo ROA p ti -7 s 144.74' Q Z8.1• tA� kd� 4 4 T TAX MAP Ab. /000 -075- 6 -/2 Z-5 �ro 'lf.ss 1 a C• 6A . 6405 054 3O •'W C/ -7- e %77 vJ SURVEYED S JUNE /990 SCALE I"t 30, Unauthorized alteration or addition to fhb SURVEY OF 4 E» Nov York State Education Law. DESCRIBED PROPERTY 2Ca.- PECON/C • TOWN OF SOUTNOLD a � SUFFOLK COUNTY • NEW YORK � Coro /s•9' Capia'af 06 uftW 00 net b*aft NGA T. N. HO k 0 N "M be tafttide►ed h be a Valid true ft ri 4 r • 3� . Jr F DIEP 0. HO only on + tun STANLE'f'-.✓ is.,wesEN, WR - * the Person for wh" �- 0 ki h. BQX �c'91 ^ •.�' : s • 6405 054 3O •'W C/ -7- e %77 vJ SURVEYED S JUNE /990 SCALE I"t 30, Unauthorized alteration or addition to fhb SURVEY OF armY is a violation of Section 7209 of E» Nov York State Education Law. DESCRIBED PROPERTY S1 MATE PECON/C • TOWN OF SOUTNOLD SUFFOLK COUNTY • NEW YORK SURVEYED FOR - DIEP Q, HO Capia'af 06 uftW 00 net b*aft NGA T. N. HO 00 Law embaaed foal shalt "M be tafttide►ed h be a Valid true ft ri 4 r • CUARANTfrED TO • GuaranteesSURVEYED BY kO1ed hens . Jr F DIEP 0. HO only on + tun STANLE'f'-.✓ is.,wesEN, WR - * the Person for wh" �- the movay NCA T. N. NO b prepared, and an /6 behalf to $9 P. 0 BQX �c'91 ^ •.�' : s • F/RST AMENICAN TITLE INSURANCE CO. we company, GosemeMel Apeney, N ` S PFOLK, N.Y. //9d ARCS MA4TCACE INC. lending ko'fh ti'a►. A listed he and TOWN OF SOUTHOLO to the assignees of the w ng k lending �hMan Guarantees on not transferable to L/Ceti D";Z44W., VEYO• additional lnstltuliar or wbsequent owner, N.Y. LIG MD;� X'3 00/941 � T C � F? �QZZ"' Q N 0- �%oPan <inot_ STATE OF NEW YORK ) ) SS: COUNTY OF SUFFOLK ) , ON 1 21990 ROSE SOBOTKA, being duly sworn, deposes and says that she is the applicant for a pre-existing Certificate of Occupancy; that deponent knows of her own knowledge that the dwelling house on said premises was constructed and occupied long prior to 1957; that no changes have been made subsequent to the enactment of the zoning ordinance; that premises are occupied as a one family residence, Subscribed and sworn to before me this /,z L` day of June, 1990. Notary Pu ALICE J. KRAMER NOTARY PUBLIC, State of New York Residing in Suffolk County No. 52-4822133 "k r'oTm ssior; Etpues - j/- 9/ �,�--0- (Rose Sobotka) /ftn7r- TOWN OF SOUTHOLD PROPERTY RECORD CARD �N, M,f/9i., r OWNER STREET V LAGE DIIjST. SUB. LOT 01, 2j FORMER OWNER N E C, SL l i/O /t/l' ACR. 0:6 o s e p!, Kms, lLe.as i S Ir- S -C o W s. YSc a 7 TYPE OF BUILDING RES. 714 SEAS. VL. FARM COMM. CB. MISC: Mkt. Value LAND IMP. TOTAL DATE REMARKS ;5 Q .Z 60 a 3 r 2 m.0 VS f 3 Z Y Z2 I 1-42V6 — So� /So D e2 o c 0 s 3D j'.LAda Awu,�;Iz &L4 -e— 40 anf-g 1),11117 o o 0 0 2 Sod v n J /0//7/.7 AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Acre Value Tillable 1 =- Tillable 2 Tillable 3 M ,v Woodland Swampland FRONTAGE ON WATER '014 AA44-� Brushland FRONTAGE ON ROAD 7 House Plot. - _ DEPTH D BULKHEAD Total IDOCK v �, . -.00 v • •• ■■■■■■ ■■■■■■■ ■■■■■■■NNE ■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ - ' ■■■■■ ■■■■■■ ■■■■■■■■■■■■■■■■■■■ ■A■■■■■■■■■■■■■■■■■■ ■■■■■��1�■■■■■■■■■■■■■■■■ ,., , . . ■■■■■ ■ iiia&I-ER■■■■■■■■■■■■■■ ■■■■■�■ ■■SErNSl■■■■■■■■■■■■■■ MEMEMMMEMEMS NNE ME ■■■■■■■■■■BSEM■■■■■■■■■■■■■■ MMMMMMMJEMSMMMMM ENOMMEMMEME Foundation Extension iExt. Walls Interior Finish ' sem■ - - .. ■■rte .. Porch Porch Dormer Breezeway Driveway Garage BUILDI_,;G DEPART,NENT T0:1111 OF SOUTHOLD, N. Y. HOUSI173G CODE INSPECTION REPORT Location knumoer & -street 1,1unic ip 1-ty ) Subdivision clap No. Lot(s) Name of Owner(s) Occupancy_ K- P 0 qty e) Ad.-,itted by•, _,Accompanied owner -t anti) by: Key available Suffolk Co. Tax No.��"'/ /%i Source of request �c� Date . a Z O DWELLING • Type of construction w #stories Foundation_ �ii�cL, P� Cellar - Crawl space Total rooms, lst. F1 2nd. F1 3rd. Fl -� Bathroom(s) Toilet room(s) Porch, type eck,"type Patio, type_ Breezeway Garage Utility room Type Heat • darm Air r- Hotwater Fireplace(s) No. Exits Z Airconditioni ng Domestic hotwater �� Type heater - Other ACCESSORY STRUCTURE'S/ � Garage, type const. for e, type const. (re Swi�-aming pool Guest, type const. Other VIOLATIONS: CHAPTER, 45—N.Y. STATE UNIFORM FIRE PREVENTION 6 BUILDING CODE - Remarks: Inspected by: Date of Insp, t Time start p end SSS