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HomeMy WebLinkAboutZ-25685 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- 25685 Date: 04/17/98 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 11360 MAIN RD EAST MARION (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 031 Block 0013 Lot 010.001 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- 25685 dated APRIL 17, 1998 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 BARN AND BOATHOUSE* The certificate is issued to DEBORAH A KUSA (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. /11 wilding Inspector Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 11360 MAIN RD EAST MARION SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S) : DEBORAH A KUSA OCCUPANCY: A-1 RESIDENTIAL DEBORAH A KUSA ADMITTED BY: DEBORAH A KUSA ACCOMPANIED BY: DEBORAH A KUSA KEY AVAILABLE: SUFF. CO. TAX MAP NO. : 31 -13-10 1 SOURCE OF REQUEST: DEBORAH A KUSA DATE: 04/17/98 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 2.0 # EXITS: 2 FOUNDATION: CINDER BLOCK CELLAR: PART. CRAWL SPACE: PART. TOTAL ROOMS: 1ST FLR.: 2ND FLR. : 4 3RD FLR.: 0 BATHROOM(S) : 3.0 TOILET ROOM(S) : 0.0 UTILITY ROOM(S) DRY PORCH TYPE: FNCLOSED(WATER SIDE) DECK TYPE: PATIO TYPE: WEST SIDE OF HOUSE BREEZEWAY: FIREPLACE: ONE GARAGE: ATTACHED* DOMESTIC HOTWATER: YES TYPE HEATER: OIL AIRCONDITIONING: TYPE HEAT: OIL WARM AIR: HOTWATER: & STEAM OTHER: *TOWER ATTACHED TO GARAGE ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. : STORAGE, TYPE CONST.: WOOD FRAME (BARN) SWIMMING POOL: GUEST, TYPE CONST.: 'OTHER: BOATHOUSE (WOOD FRAME) VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION i DESCRIPTION ART i SEC. i i i i i i I i REMARKS: BP#8323Z-ADD CO Z7016 INSPECTED BY: �' DATE ON INSPECTION: 04/24/98 GARY F SH TIME START: 10:00 END: 10:30 Form No. 6�945[p� �gto ' �iZ L� Y I ' 1 3 TOWN OF SOUTHOLD BUILDING 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 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, 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 - _ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy -c Residential j$15.00cc}}, Commercial $15.00 Date . . .Vl 6/. J y... . . . . . . . . . . . . . . . . . . . . . . . . New Construction. .. . .. . . Old Or Pre-pexisting B�uuildiing. . . .11. . . Location of Property.. . .3 U. q61�. House No. I� 1 Street Hamlet Onwer or Owners of Property.. . �!�:!! .A .�\.U. �`... . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . . . . . . . . ...Block. .. .. '.... . . . . .Lot. . . . . . . . ®:�•f • • . • • • • . Subdivision. :. . . . .. . . . . . . . . . . . . . . .. .. . . . .. . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . .. . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . .. . . . . .. . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . .. . . . . . . . . . . . . . . . . / Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . .Y . . . . . . Fee Submitted: $. . . . . 00..... . . . . . . . . . . . . . - . . . . . . . . . . . . P, . o " � S701�5 ki — C . . .APT �'�_3 S� t CONSENT TO INSPECTION the undersigned, � \ g , Owner(s) Names) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at �j O «hir_.h is shown and designated on the Suffolk County tax map as District 1000, Section � I , Block � Lot 1 ® m That the undersigned (has) (leave) filed, or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following- A2�0_1 A.- F. 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 re ulations of the Town of Southold. Dated: (signature) (print name) (signature) (print name) BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: MA-),J kcl M4,/Z/ /0 number & street municipality SUBDIVISION MAP NO. LOT (s) NAME OF OWNER (s) OCCUPANCY A + S (type) (owner-tenant() ADMITTED BY � �Q� F{ �"f t�(S� ACCOMPANIED BY: KEY AVAILABLE SUFF. CO. TAX MAP NO. j 1 —1 SOURCE OF REQUEST: }40 kq E} DATE• T� DWELLING: A TYPE OF CONSTRUCTION 004 # STORIES # EXITS FOUNDATION (g, CELLAR 7 CRAWL SPACE TOTAL ROOMS: 1ST FLR. 2ND FLR. _ 3RD FLR. BATHROOM (s) F TOILET ROOM (s) UTILITY ROOM (�1 PORCH TYPE / � '�" DECK, TYPE PATIO, TYPE BREEZEWAY FIREPLACE 0'2_� GARAGE DOMESTIC HOTWATER TYPE HEATER AIRCONDITIONING TYPE HEAT 621/6 WARM AIR HOTWATER OTHER: `(ow ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. STORAGE, TYPE CONST. Oat9X F:A4­�e SWIMMING POOL GUEST, TYPE CONST. OTHER: ------------------------------------------------------------------=---------------------- ----------------------------------------------------------------------------------------- VIOLATIONS: CHAPTER 45 N-Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REMARKS 0 �' j� C-0 INSPECTED BY: DATE ON INSPECTION TIME START 167r &-f;' END ©.� 13 , TOWN OF SOUTH.OLD PROPERTY RECORD CARD OWNER STREET �d VILLAGE DIST. SUB. LOT FO�MER O' VNER E ACR. ThePoi E:.�a,�l�er (�uSf N� i�:c� //' .� S W TYPE OF BUILDING /a PQ ��P✓ f Ong 4a, 26 Is is t+Pc= Ha his L U- 2-1�5o SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS zOle 41 96P aP'9 wt^ /S Doo ftc u a e 5 re 269 ' 8 Off? ��. '+��0 ' S i"1' '�9 r a� a-L illooZ•Z �!9 -{�i✓k�r PQ`���� -(rust NIA 194—L �61— arknr,Tu sf -n i� Sa f/./C, 5d ") < AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE 1 FARM Acre Value Per Value Acre 3ldc C-4/00 Tillable FRONTAGE ON WATER " Woodland ,'p�. .a ``. / s7_ >�Q FRONTAGE ON ROAD '1 -- l G,74 Mead DEPTH '4v�v see House Plot BULKHEAD i f 9�h .4 Total I Dock Oki MEN ■■■ ■■iiY■©11!!■�■!!!■!!�!■�Ti�1!ONE ■■■MI■■■■■!■■■■■M■11MONNUl.!■BI®■®■ ■■■■■■■!■■■■■■■■■11■l�,I�i■�1■■■■ . ■■■■■■■vMv■M■■■■■N■®�o!Basement ■■■■ • nterfor 7 ;o77, 'to "7' A4 'T j7KNJ, nj J . Mn,z too w v -Va JU ------- ...... z­ ........................ 77� g, lilt; two -YON, VAN on is A, AQ4 "Not r ;�Otil 04,A; A L'L M M 'sit ABU'-4. -0a Vol , "P002". � 'o SOME NO "'NoWn"Ay A W 4_1 My, WOO ...... man Woo A old a �1� 4 Ton", r,,-, 0 sow, do O�:: _;A;�r4 V- '4' N 7!" lux .,VIA >0 00; n out W"Awd. 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