HomeMy WebLinkAboutZ-21003FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-21003 Date SEPTEMBER 11, 1992
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 35950 MAIN ROAD CUTCHOGUE, N.Y.
House No. Street Hamlet
County 'Pax Map No. 1000 Section 97 Block 2 Lot 23
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 NUMBER Z-21003
dated SEPTEMBER 11, 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 NON -HABITABLE UNSAFE ONE FAMILY DWELLING *
The certificate is issued to WALTER A. STEPNOSKI & JOAN A. EICKHOFF
(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.
Ag MZV 0
ildin Inspector
Rev. 1/81
BUI
TO'. L1 CF ZCUT;iOLD, N. Y.
EGU_ZI::G COLE- INSPECTION iZ�. 0"T
Location 35950 MAIN ROAD CUTCHOGUE, N.Y.
�r:c:.oer uc �;zreer) lclu:.1cipail Gy)
Subdivision slap No. Lot( )_
Name of owner(z) JOAN A. EICKHOFF &'ANO
Occupancy UNSAFE BUILDING ( ONE FAMILY) VACANT
(type) (owner -
Admitted by: NO ENTRY Accompanied by: N/A.
Key available
Suffolk Co. Tax No. 97-2-23
Source of request GARY OLSEN, ATTY Date 3! z
FOR STEPNOSKI
DI: ELLING :
Type of construction WOOD FRAME !stories
Foundation Cellar Crawl space
Total rooms, lst. Fl 2nd. Fl 3rd. Fl
Bathroom(s) Toilet rooms)
Porch, type Deck, type Patio, type_
Breezeway Garage Utility room
Type Heat 'alarm Air Hot:•rater
Fireplaces) No. Exits A.ircor_ditionirg
Domestic hotwater Type heater
Other
ACC^SS071 Y STRUCTURES:
Garage, type const._
Swimming pool
Other
(NONE REMAINING)
Storage, type const.
Guest, type const._
V_OLATIONS: C11APTER 45--N.Y. STATE UNIFORM TIKE PREVENTION & JSUILDING CODE
Lnration
Descrirtion IArt.1
Sec.
BUILDING HAS HOLES IN EXTERIOR WALLS,
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PORCH FLOOR lr ROOF DECAYED- U
NON HABITABLE (UNSAFE BUILDING)
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Remar'.cs:
Inspected by j" G, Date of Insp. SEPT. 4, 192
THO AS J. F H R -Time start 9:30 A14nd 10:00 AM
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FORM NO. 6
TOWN OF SOUTHOLD
Building Dopartmont
Town Hall
Southold, N.Y. 11971
765 — 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted m smww. w 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.
h. 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), Nonconforming 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 $25:00 -- BUSINESS $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5 . 0 0 , over 5 years $10.00
4.Vacant Land C.O. $20.00
5. Updated C.O. $"50.00 Date .August •31, 1992 , • , , , • , , • •
r
NeWConstruction ,,,,,, Old orPre-existing Building ,X.......... Vacant Land ......6......
Location of Property Main Road, Cutchogue, NY. ,.
. ............ ....
.. .... .. . ......
House No. Street hfandur
Owner or Owners of Property . , , Walter A. Stepnoski ,and Joan A. Eickhoff as
Co-Execuf o'r's' of 'Che Estate 'of 'Wats i'e 'G: 'St'epridsKi'
County Tax Map No. 1000 Section , , 097:00 ... , , , , Block 02 .0 ... .. • , , Lot . , 023. 000. . .
Subdivision .................................Filed Map No. ..........Lot No. .............
PermitNo. .......... Date of Permit ..........Applicant ..................................
r
Health Dept. Approval ................... ....Labor Dept. Approval ........................
Underwriters Approval ..................... ..Planning Board Approval ......................
Request for Temporary Certificate .....................Final Ccrti(" to . ...................
Fee Submitted $ . IQQ.QQ .......................
Construction on above described building and permit meets all , Is de nd regulations.
Applicant... ... . . .............. ..........
Gary Flanner 01se
nev.10.1o•7e P. 0. Box 706
Cutchogue, NY 11935
e,lkLa-?'216.3
CONSENT
TO f
INSPECTION
Gary Flanner Olsen, Esq., as Attorney
the undersigned,
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at Main Road, Cutchogue, NY
, which is shown and designated on the Suffolk
County tax map as District 1000, Section 097.00, Block 02.00 , Lot 023.000.
That the undersigned (has) (have) filed, 'or caused to be filed, an applica-
tion in -the Southold Town Building inspecLw, orri�� ro. ♦ho fnllowing:
Pre-existing Certificate of Occupancy for a,one family dwelling
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 pros ti ns for vio-
lations of the laws, ordinances, rules or regulations of t e�Tow of Southold.
Dated: August 31, 1992
(signature)
Gary Flanner Olsen, Esq.
(print name)
(signature)
(print name)
L'Ui:.D7.... J� L 1 .JT
TO:�I OF SCUT;iOLD, N. Y.
hC)USI::G CODS IiiSPECTION R-: CRT
Location JS'V, -0
�r;UZIID�r �c �greec) <iiu:.-clpal I)
Subdivision Man 1`Io. Lots)
Name of O�-jner(o )
Occupancy B,
ypeJ o�:�ner- �enunz J
Admitted by: Accompanied by:
Key available Suffolk Co. Ta:c No, '9
Source of request
Date
D!,r-'-LLTNG :
'Type of construction
— „stories
Foundation Cellar Crawl space_
Total rooms, 1st. Fl 2nd. Fl
3rd. Fl
Bathroom(s) Toilet room(s)
Porch, type Toilet
type Patio, type_
Breezeway G ram•- Utility room
a _
I=
Type Heat Warm Air
Ido tuwater
Fireplaces) No. Exits
A.ircor_diticn i rg�
Domestic hotwater Type heater
Otter
ACCESSORY STRUCTURES:
Garage, type const.
Storage, type const.
Sr,i;,,,-�ina pool Guest type const.
Other
VIOLATIONS CIIAPTER 45--N.Y. STATE UNIFORM FIRE PREVENTION h BUILDING CODE
Remarks:
In,;pccted by
Date of In -p. Z ---
Tine star ' end l0 fWV
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