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Home My WebLink AboutZ-27679 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. .PRE EXISTING CERTIFICATE OF 'OCCUPANCY No: Z- 27679 Date: 04/27/01 THIS CERTIFIES that the building DWELLING Location of Property 50575 CR 48 SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 051 Block 0003 Lot 011 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRI.L 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 27679 dated APRIL 27, 2001 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 GARAGE The certificate is issued to TELESPHORE & HELEN WOLANSKI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REP Authorized Sig ture Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 50575 CR 48 SOUTHOLD SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S) : TELESPHORE & HELEN WOLANSKI OCCUPANCY: SINGLE FAMILY TELESPHORE & HELEN WOLANSKI ADMITTED BY: SHELLY FASZCZEWSKI ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 51.-3-11 SOURCE OF REQUEST: HELEN WOLANSKI, 4/20/01 DATE: 04/27/01 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 3 FOUNDATION: CEMENT BLOCK CELLAR: FULL CRAWL SPACE: TOTAL ROOMS: 1ST FLR.: 6 2ND FLR.: 0 3RD FLR.: 0 BATHROOM(S): 0.0 TOILET ROOM(S) : 0.0 UTILITY ROOM(S): PORCH TYPE: UNHEATED REAR ENCLOSED DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: XX TYPE HEATER: NATURAL GAS AIRCONDITIONING: TYPE BEAT: OIL WARM AIR: HOTHATER: OTHER: NON-HABITABLE ATTICE ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: WOOD GARAGE STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION I DESCRIPTION I ART. I SEC. REMARKS. BP#19 49- -COZ-19337 (ADDITION) INSPECTED BY: DATE ON INSPECTION: 04 27/01 J HN M. BOUFIS TIME START: 9:30 AM END: 10:15 AM Form No. 6 R �j _ ,� TOWN OF SOUTHOLD _ ._.,. .._...._ . ... 11BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR.CERTIFICATE OF OCCUPANCY A. 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 o� 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 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 Building - $100.00 3. Copy of Certificate of Occupancy - -2%p 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . IZ a.�o �. . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . Old Or Pre-existing Building. . .X. . .'!��TE. r Location of Property.SW 5 . .N� l l�41�.�. � �.�?. . . . . . . . . . . . . . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . rJ. l. . . . . . . . .Block. .-i . . . . . . . . . . . .Lot. . .Li. . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . .. . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary C/e�rrttifi7cate. . . . . . . . . . . Final Certicate. . . . . . . . . . . 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C> G.4c c - R c�2T5: 3-15-0� 120-d l0/10'd 991-1 _wo�� WLIE:8d ld-8l-+Jdd CONSENT TO INSPECTION M4}ELEt�I wplf}NSK.I , 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 which is shown and designated on the Suffolk County tax map as District 1000, Section Block 3 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: �rL 15rl CO - FOR TflcttF� �, 2AG- UNLESS A-Vf AE� W WuubEb CA06E* PI&AsE Re59qec4 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: _ Re fe/v InlOL/}�USK� (signature) (print name) (signature) (print name)