HomeMy WebLinkAboutZ-22908 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-22908 Date MARCH 17, 1994
THIS CERTIFIES that the building ONE FAMILY DWELLING.
Location of Property 9915 OREGON ROAD CUTCHOGUE, N.Y.
House .No. Street Hamlet
County Tax Map No. 1000 Section 83 Block 2 Lot 20.1
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-22908 dated MARCH 17, 1994
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 3 CAR GARAGE WITH
STORAGE SHED ATTACHED
The certificate is issued to. JEAN D. ZUHOSRI
(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 RE
Building Inspec or
Rev. 1/81
t" BUILDING DEPARTMENT
TOWN OF SOUTIIOLD
HOUSING CODE INSPECTION ItEPORT
LOCATION: 9915 OREGON ROAD CUTCHOGUE, NEW YORK
number 5 street municipality
SUBDIVISION MAP NO.
LOT (;)
NAME OF OWNER (s) JEAN D. ZUHOSKI
OCCUPANCY SINGLE FAMILY
(type)
(owner—tenant)
ADMITTED BY: . BERTHA HARRIS ACCO.IPANIED QY.BERTHA .HARRIS
KEY AVAILABLE SUPF. CO. TAX MAP NO. 1000- 83-2-20. 1
Sour.:: OF REQUEST: JEAN ZUHOSKI DATE: MARCH 2, 1994 `
DWELLING:
TYPE OF CONSTRUCTION WOOD FRAME 0 STORIES 1 EXITS 2
FOUNDATION CONCRETE BLOCK CELLAR FULL CRAWL. SPACE
TOTAL ROOMS: 1ST FLR. 5 2ND FLR. 3RD FLR.
BATUROOM (s)" ONE TOILET ROOM (s) NO UTILITY ROOM ' NO
PORCH TYPE FRONT COVERED DECK,' TYPE NO PATIO, TYPE NO
BREEZEWAY NO FIREPLACE ONE GARAGE NO
DOMESTIC HOTWATER YES TYPE HEATER OFF BOILER AIRCONDITIONING NO
TYPE HEAT OIL WARM AIR OTHER: HOTWATER YES _OTHER: N; REAR FOYE t_2_ qA UTS`fBE-VESTIBULU --_
f C ULLi {7('fJ�(tp �
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. WOOD — 3 CAR STORAGE, TYPE CONST. STORAGE SHED ATTACHED TO
SWI11MING POOL GUEST,. TYPE CONST. GARAGE.
OTHER:
VIOIATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC_
REMARKS.
INSPECTIiD BY: / " DATE ON INSPECTION MARCH 14, 1994
OHN M. 0 IS
TIME START 9:50 AM ENU 10: 10 AM
' Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802 l ', 3
APPLICATION FOR CERTIFICATE OF OCCUPANCX
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 of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1Z 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 - $5.00 over 5 years $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Ilia
Date . .. . . ctirV .ii, ./ . . . . . . . . . . . . . . . . .
New Construction. .. . . . . . . Old Or Pre-existing Building. . :. . ./. . . . .
Location of Property. . . .Nd, . . . . . . . . . 0�C400 oaC. . . . . . . . .&/Choe C,. . . . . . . .
J . . . . . JJ
House No, Street Hamlet
Onwer or Owners of Property. icar) Zuhos�Cl . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. 0.03..00 . . . . .Block. 9.2_: 06. . . , . . . ,Lot.02.0,,OD , . . .
Subdivision. N6. . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit NO. . . . . . . . . . . . . . . .Date Of .Permit.... . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:Iealth Dept. Approval. . . . . . . . . . . . . .. , , . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . .. . . . . . ... . . . . . .
'equest for: Temporary Certificate. . . . . . ... . . Final Certicate. . . .
fee Submitted: $, .�00 00 . . . . .. .. . . .. . . . . . .
. . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cp �� �QQ' .APPLICA.NT
2,
n
• c0NSI-7NT {i ;
TO
INSPECTION`
Ull'nerts) Name(s) the undersigned.
do(es) herebv'state;
That the undersigned (is) (are) the owner(s) of the premises in the Town '
of Southold located at NO # Ore-co/'J RoQ'G(� �L[1C`70QLl�
which is shown and designated on the Suffoll:
County tax map as District loon, Section 083.OG Block 0oQ.00
, Lot Oo20.001
That the undersigned (has) (have) filed.••or caused to be filed, an applica-
tion in the Southold Town B//uilding /Inspector's Office for the following;
pie-ex�sl�n (�e/TI l�'Q�Q D OCC'le ' r/e
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 inspectiohs
to determine that said premises comply with all of the laws, ordinances, rules
and regulations of the Town cf Southold.
The undersigned, in consenting to such inspections, do(es) so with the
knov:ledge and understanding that any information obtained in the conduct of
such inspections may be used as evidence in subsequent prosecutions for vio-
lation_ of,the laws, ordinances, rules or regulations of the Town of Southold.
- Dated-
(signature)
Jean zahoski
(print name)
(signature) •
(print name)
"Unauthorized alteration or addition to survey
map bearing■licensed land surveyor's seal is a
violation of section 7209.sub-division 2,of the
Now York State Education Low.'"Only copies
N/F WAL TERS from the original of this survey marked with an
original of the land su,t c.-s embossed seal
shall be considered to t_ Aid true copies."
"Certifications indicated'--_n signify that this
survey was prepared it'. , _;..rdance with the
existing Code of Practice [or Land Surveys
S 39 0 00 00 _E adopted by the New York State Association of
Professional Land Surveyors.
238. 00 '
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�o
[0.4' U1
.m
�y SCALE - 30
w
48. 0 ' s' 9' v
FrSrGar. No 32.4' 47.2 O j CERTIFIED TO:
N N Covered Brick
�L1 24.6 Stoop 3
N/F N 112 Sly. N o o BERTHA HARRIS
MAUCOTEL Covered
h Fr. Res. In _ 2
Conc.
Strap e7 O
CO
01 32.4
47.6 ' Z
Z C.E.
3
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to
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DESCRIBED PROPERTY
N 39000 '00 -W
238. 00 ' S i t u o t e
HAMLET of CUTCHOGUE. TOWN of SOUTHOLD.
DUCK POND ROAD SUFFOLK COUNTY. NEW YORK
49.5 ' R. 0. W. BITUMINOUS SURFACE
SURVEYED FEBRUARY 20. 1994 BY:
TECHNICAD LAND SURVEYING
THE EXISTENCE OF WETLANDS. RIGHTS OF WAY, AND/OR SUFFOLK COUNTY TAX MAP NUMBER
PAUL W. WERLER. L . S. NYS L lC 049875
EASEMENTS. IF ANY NOT SHOWN. ARE NOT GUARANTEED. GUARANTEES OR CERTIFICATIONS INDICATED 1000-083-04-20. 1
HEREON SHALL RUN ONLY TO THE PERSON FOR 126 UNION AVENUE'',
WHOM THE SURVEY IS PREPARED&ON HIS BE. '
HALF TO THE TITLE COMPANY GOVERNMENTAL CENTER 'MOR i CHEo. NEW YORK 11934
ZONING - AGENCY & LENDING INSTRUTIONS LISTED
DATUM -
HEREON&TO THE ASSIGNEES OF THE LENDING (516_) ' 878-2847 -_INSTITUTION GUARANTEES OR CERTIFICATIONS
L 0 T AREA - 40000. 57 S.F. OR 0.9183 ACRES ARE NOT TRANSFERABLE TO ADDITIONAL INSTI• JOB # 94105
TUTIONS OR SUBSEQUENT OWNERS FAX (516) 874-4164
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3,
M. Bldg. 3. �: oundation Bath
Extension ; . : . Basement Floors
`Extension Ext. Walls woo Interior Finish
.F, Extension Fire Place Heat
Porch Attic
Porch Rooms 1 st Floor "
.113reeieway Patio Rooms 2nd Floor ,
Garage , i D 0 Driveway
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T.M. �F 5®UT�®L PROPERTY RECORD CAR®
OWNER - - ST�EET C101,g VILLAGE DISTRICT SUB. . LOT y
FORMER OWNER N E J ACREAGE
WALre)?S , 919
S � �'�-G , � W . ��JC %��lt�'�.�� .TYPE OF BUILDING - I
RES: �� SEAS. VL. ARM comm. I IND. I CB. I MISC.
" LAND IMP. TOTAL DATE REMARKS
r:
AA-� ; `"�i '1%(�U � - _ 'Y4 3 ��r(�o l cl �• t ��'(N {-�ceu vc:t s .i
o 4 oI/i �8 h' n f'(arres s rr c��a� f� ►car �c
Wi I.I
�my/7J/ -1 l - L- l z toAc) 7ril1 as(� Fe s
AGE BUILDING CONDITION j
`.NEW NORMAL BELOW ABOVE }
Farm Acre Value Ter Acre . Value
V E
Tillable 1
i y
Tillable - 2 ;
y ?i
Tillable, ' 3 . .
Woodland 4
Swampland
Brushland' ,
r
House Plot; f 33t
:• -`�" r{ b.!' h � fi-. 'k4 I .nr zap' t' F.- � J
Total