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Home My WebLink AboutZ-34492 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- 34492 Date: 08/03/10 THIS CERTIFIES that the building DWELLING AND ACCESSORIES Location of Property 6315 INDIAN NECK LA PECONIC (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 413889 Section 086 Block 0006 Lot 020 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- 34492 dated AUGUST 3, 2010 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 AND SHEDS.* (GARAGE AND SHEDS IN DISREPAIR) The certificate is issued to KATHERINE S WOLOSIK (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 REPORT. � 1 A hor' ed Si ature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 6315 INDIAN NECK LA PECONIC SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S): KATHERINE S WOLOSIK OCCUPANCY: SINGLE FAMILY DWELLING KATHERINE S WOLOSIK ADMITTED BY: ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 86.-6-20 SOURCE OF REQUEST: DAVID W OLSEN, ATTY DATE: 08/03 10 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 3 FOUNDATION: CEMENT BLOCK CELLAR: FULL CRAWL SPACE: TOTAL ROOMS: 1ST FLR.: 5 2ND FLR.: 0 3RD FLR.: 0 BATHROOM(S) : 1.0 TOILET ROOM(S) : 0.0 UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: BREEZEFIDY: FIREPLACE: 1 GARAGE: DOMESTIC HOTSwATEaZ: YES TYPE HEATER: AIRCONDITIONING: TYPE HEAT: OIL WARM AIR: HOTWATER: X OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: 2 CAR WOOD FRAME GARAGE STORAGE, TYPE CONST.: 2 DELAPIDATED SHEDS SW324MIDIG POOL: GUEST, TYPE CONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION I DESCRIPTION I ART. SEC. ACCESSORY GARAGE ROOF IN NEED OF REPLACEMENT OR EXTENSIVE REPAIR REMARKS: INSPECTED BY: , DATE ON INSPECTION: 07/22/10 GARY J F SH TIME START: END: - r .J ® - TOWN OF SOUTHOL POP RTY - RECORD CARD OWNER STREET VIL DISTRICT SUB. LOT I'0,41 neel mil c FORMER OWNER E ACREAGE C Sys o yi /" uo S TYPE OF BUILDING /RES. / SEAS. VL. FARM COMM. I IND. I CB. I MISC. I Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS o 6 S� 0 iD o � 7300 4- 0l �- r- r AGE( BUILDING CONDITION NEW NORMAL BELOW ABOVE FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD Tillable 1 BULKHEAD Z � Tillable DOCK ' Tillable, 3 Woodland Swampland Brushland 4 'i House Plot Total r, k d", LIP, r M. Bldg. 3 _ 3. 0 0 0. p Foundation e2c,�us Bath / Extension 3 3 o V? o Basement ao Floors Extension Ext. Walls Interior Finish v-r- Extension Fire Place Heat Porch Roof Type _ Porch Rooms 1 st Floor Breezeway Patio Rooms'2nd Floor Garage 03 0 g p _ qD�0 4(h Driveway Dormer O: B. Form No.6 F710 TOWN OF SOUTHOLD UILDING DEPARTMENT TOWN HA t76s->soa APPLICATIO FOR CERTIFICATE OF OCCUPTO This application must be filled in by typewrite or ink and submitted to the Building Department with the following: -A. For new building or new use: 1. Final survey of property with accurate location of all buildings, topographic features. Property lines, streets, and unusual natural or 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation fro Board of 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, 957) non-conforming uses,or buildings and"pre-existing" land uses: 1. Accurate survey of property showing a 1 property lines, streets,building and unusual natural or topographic features_ 2. A properly completed application and onsent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall sta e the reasons therefor in writing t6 the applicant. C. Fees 1_ Certificate of Occupancy-New dwell' g$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-existirilg Building- $I00.00 3. Copy of Certificate of Occupancy-$.25 - 4. Updated Certificate of Occupancy- $Sb_00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial $15.00 / Date. July 14, 2010 New Construction: Old or Pre existing d g Building:g� g (check one) Location of Property: 6315 Indian Neck Lane Peconic NY 11958 House No. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section 86 Block 6 Lot 20 Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: .Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ �nn nn 1� OLSE & OLSEN LLP 32195 MAIN ROAD Applicant Signature PO BOX 706 CUTCHOGUE,NY 11935 LOCATION: (number& street) (municipality) SUBDIVISION: MAP NO.: LOT(S): NAME OF OWNER(S): OCCUPANCY: (type) (owner-tenant) ADMITTED BY: I ACCOMPA NIED BY: KEY AVAILABLE: I SUFF. CO. TAX MAP NO. 1000- SOURCE OF REQUEST: I DATE: DWELLING: TYPE OF CONSTRUCTION: r # STORIES: #EXITS: FOUNDATION: CELLAR: .'_CRAW, SPACE: -- TOTAL ROOMS: 1ST FLR: 5-1 2ND FLR: 3RD FLR: r- - BATHROOM(S): _gyp TOILET ROOM(S): UTILITY ROOM-- PORCH TYPE: DEC'k, TYPE: PATIO, TYPE: BREEZEWAY: FIREPLACE: 6%t-e- _ GARAGE: DOMESTIC HOTW TER: 7`-- TYPE HEATER: AIRCONDITIONING: TYPE HEAT: WARM AIR: HOTWATER: OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: G✓ — L STORAGE, TYPE CONST.: �)� SWIMMING POOL: GUEST, TYPE CONST: OTHER: VIOLATIONS: CHAPTER 144 &N.Y. STATE.UNIFORM FIRE PREVENTION &BUILDING CODE LOCATION DESCRIPTION ART. SEC. ilk I , I . I I . I REMARKS: I I 1 INSPECTED BY: I DATE OF INSPECTION: ' TIME START: END: tea= L73 ACRES (to tie line) SURVEY OF PROPERTY ry o , R icNMorvo AT INDIAN NECK h. REEK TOWN OF SOUTHOLD ,v N78040 E S74 34�0; SUFFOLK COUNTY, N. Y. tk , � 45.Z6 • E ro�8 , 1000-86-06-20 of L►NE 4 SCALE. 1 —40 END FIE �. JUL Y 12, 2010 0.4'E. �► CONC.& STONE RAMP - -- ^N IN DIISREPAIR gw 38? 7 9 1 STY FRAME 14.0 6.4. +YOZy'FR VI HOUSE f END N FE.t.M 2a6' SZ1' O/CONc m CONCRETE � 3 o � cd to COHC-& FR. O GARAGE 2a 1 OLE O 9LOI POLE I 1 w Lu !_ x END O FE.0.3SE 1 X 1 Lai I) o w Um k � � w $55 D1LAFnDATED 0 Z SHEDS \ \ Z !P.4 w. m � I • 17.9' p,y.W. )- O.N.W. POLE � 3 W o I CER77FIED TO. �--p H W. POLEi BARRY ROOT FE. a FIDELITY NA77ONAL 777ZE INSURANCE COMPANY 0.1'w ;� WELLS FARGO BANK, NA. ? I e sW 5LJ 2 Z O I W Q�� P� v /�Z4PO 0.6'N 393' 156.60 OF END FE ts • 0 6' E 76 56�+0"W R p A D � � INDIANJ �w LRA IC. NO. 49618 ANY ALTERA77ON OR ADDI77ON TO THIS SURVEY IS A VIOLATION ECONIC P.C. OF SEC77ON 7209 OF THE NEW YORK STATE EDUCA77ON LAW. (631) 765-5020 FAX (631) 765-1797 EXCEPT AS PER SECTION 7209—SUBDIVISION 2 ALL CER77FICA77ONS P.O. BOX 909 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR ■ = MONUNENT 1230 TRAVELER STREET 0-165 WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N.Y. 11971