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HomeMy WebLinkAbout9250-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPD~i'~D ~TIFI~ATE OF O~uu~ANCY No Z-22934 Date APRIL 5, 1994 THIS CERTIFIES that the building Location of Property 4150 ALDRICH LANE House No. County Tax Map No. 1000 Section 120 ADDITION & ALTERATION Street Block 3 LAUREL~ N.Y. Hamlet Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 18, 1977 ~ursuant to which Building Permit No. 9250--Z dated MAY 18~ 1977 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 FIREPLACH~ PATIO & BAT~KOOMADDITION & KITteN ALTERATION TO EXISTING ONE FAMILY DW~T.T, ING * The certificate is issued to BARBARA KUJAWSKI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *NOTE: THIS UPDATES CO Z-8097 D~~28,~j,~ ~/~ ~~-'7'1977' ~ Rev. 1/81 // Building In~pe~or ' FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CTHIS?ERMIT MUST BE KEPT ON THE PREMI-~E5 UNTIL FUL~ CO~ETION OF THE WORK'AUTHORIZED) ~ ~ 9250 Z at p/~mises located at/....~/.~. .... , ............................... ~. ............ Building lnsp~tor. , FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy ........... ~c_ ..~ ., No. ~°c° ? 7 Date .......................... THIS CERTIFIES that the building located at ...................... Street ...... ....... eonfor~ substantially to the Application for B~lding Permit heretofore fried in t~s office dated .. ~ / ¢ .... , 19~ Y. pursuit to which Building Pemit No. da~ed ..... ~.~ ~. ..... , lg~., was issued, ~d conforms ~ ments of the a~plieable provisions of tho law. The oee~ey for which ~i~~te ~ issued is ~~~ ~.~ ~~ The certificate is ~sued t~~ ~'' :~~esseL' Lr 't~'i '2~ ......... of ~e aforesad building. S~olk County Department of Heal~ Approval ~ ' ~ U~ERWmT~as C~aT~m~TE ~o...N ~. ~ ................ Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to t~' buzlding 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. Submzt Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildzngs 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, Alteragions 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 $15.00 Date ......................... New Construction.~ ......... Old Or Pre-existing Building ................. Location of Property.. 4J50 ^Idrich bane, ta~reI, New York I1948 House No. Street Hamlet Onwer or Owners of Property. Barbara Kujawski County Tax ~ap No 1000, Section..l~? .......... Block.~ ..............not. J~ ................... Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters App~ ......... __ ............. Planning Board Approval ........................ ~ ~~.~ Request for: Temporary Certificate ........... Fi~n~l Cer~c~. ..... Fee Sa itted: UUy r~muner utsen, tsq. APPLICANT J&Cu~o~/ - P.O. Box 706, Cutchogue, NY 11935 JOYCE M. WILKIN$ Notary Public, State of New York No. ¢952246, Suffolk Courlty_~ Term Expires June 12, 19..~% FOl'{,~l 1'~O. 6 TOWN OF ~SOUTHOLD Building Department Town Clerks Office ~outhold, N. Y. 11971  CERTIFICAT.E OF OCCUPANCY Instructions A. Th~s application must be filled in typewriter OR ~nk, and submitted ~n DUPLICATE to the Building inspector w~th the following; for new buildings or new use 1. Final survey of property with accurate location of all bu,ld,ngs, property lines, streets, and unusual natural or topograph,c features· ~. Final approval of Health Dept. of water supply and sewerage d~sposal--(S-9 form or equal). 3. Approval of electrical installation from Board of F~re Underwriters. 4. Com)mercial buildings, Industrial buddings, Mulhple Residences and similar buddings ahd installations, a cert,ficate of Code compliance from the Architect or Eng,neer respons,ble for the building. ~. Submit Planning Board approval of completed s,te plan requirements where applicable· B For existing buddings (prior to Aprd 1957), Non-conforming uses, ar buddings and "pre-existing" land uses: 1. Accurate survey of property showing all property hnes, streets, budd,ngs 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 inspectJon of buddings or premises, or other pertinent in- formation required to prepare a certificate Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelhng or land use $5.00 3 Copy of certificate of occupancy $1.00 blew Building ................ Addition ................ Old or Pre-ex~sting Building ................ Vocant Lond .............. / v Subdiv,sion ................................................................ Lot No ............. Block No..: .......... House No,:J...~...).., Underwriters Approval ........... ...~/..,!..~ ........................ Planning Board Approval ................. ..~.....,1~. ...... Request For Temporary Cerhficate ....................................... Final Certificate .......~..~..~.. ......................... Fee Subm,tted $ .... ~..'.~ .......... Construction on above described building and permit meets all apphcable codes and regular,ans. ~~r ~ W 0 m t ' D '