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Home My WebLink AboutZ-22935FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OC~umANCY No Z-22935 Date APRIL 5, 1994 THIS CERTIFIES that the buildin~ Location of Property 4150 ~?.~RI~H LANE House No. Street County Tax Map No. 1000 Section 120 Block 3 Subdivision Filed Map No. ONE FAMILY DWELLING LAUREL, N.Y. Lot 13 Lot No. Hamlet conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-22935 dated APRIL 5, 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 ON~ FAMILY DWELLING WITH ATTAu~u~D GARAGE * The certificate is issued to BARBA~AKuJAWEKI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 N/A N/A SEE ATTA~:HK~, INSPECTION REPORT. BUILDING DEPARTNENT TONN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 4]50 ALDRICH LANE (number & street) SUBDIVISION HAP NO. NANE OF ONNER (s) BARBARA J. KUJAWSKI MATTITUCK, ~ YORK (municipality) LOT(s) OCCHFANCY A-I SINGIi FAMILY DWELLING (type) (o~ner-tenant) ADHITTED BY: BARBARA KU2AWSK! ACCOMPANIED BY: SANE KEY AVAILABLE SUFF.CO. TAX IqAP NO. 1000-120-3-13 ,~ SOURCE OF REQUEST: GARY FLANNER OLSEN, ATTY DATE: HARCH 22, 1994 DNELLING: T~FE OF CONSTRUCTION FOUNDATION ROCK TOTAL ROOHS: BATItROOM (s) PORCH TYPE BREEZEWAY WOOD FRAt~ CELLAR ~ STORIES I-I/2 [ EXITS PARTIAL CRAI~L SPACE PARTIAL IST FLR. 3 2ND FLR. 3 3RD FLR. TI~O TOILET R00H (s) ONE UTILITY R00H NONE COVERED ENTRY PORCH DECK, TYPE ~ATIO RAISED REAR SLATE NONE FIREPLACE ONE GARAGE 2 CAR DOHESTIC HOT~ATER ES TYPE HEATER OFF BOILER AIRCONDITIONING NONE TYPE HEAT OIL WARM AIR - - HOT~/ATER BASEBOARD 0TILER: SIDE ENTKYWAY - FRONT FOYER - REAR FOYER ~/ITlt WASHER & DRYER - EXIT FROM BASEI~NT ACCESSORY STRUCTURES: NONE GARAGE, TYPE OF CONST. SWII~IING POOL OYm~R: STORAGE, TYPE CONST. ,.GUEST, TYPE CONST. VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVgNTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. REHARKS: BP #9250- UPDATED CO Z-22934 ISSUED FOR FIREPLACE, KITCHEN ALTERATION & BATHROOM DATE OF INSPECTION IiIRCH 29, 1994 TIME START 9:30 END 10:00 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 TOWN OF $OUTHOLD 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 App~v~i 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 3/22/94 Date ......................................... New Construction ........... Old Or Pre-exis~ing Building..X. .............. 4150 Aldrich Lame, Laurel, New York ....... Location of Property. ................................................................. House No. Street Hamlet Barbara O. Kujawski · Onwer or Owners of Property. ' ............... County Tax Map No 1000, Section.. 120 Block. .3 ............. Lot. 13 Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... %lea[]icg f]~ard Approval ........................ q : Temporary Certificate ........... Final Cert~ate.?~"f7. ...... (~2~-, L{-~(~ _ "~ary F~lan/n~r~enZC, A~q--' ~ 60'~00 s~.ft. BLDG. DEPT. TOWN OF SOUTHOLE F.dith .yS. i te ReVi~,o~ · YOUNG & YOUNG D£~,~,/.97'6 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ~"~.~/a/~X~ ALDEN W, YOUNG HOWARD W. SURV~ FOE: " I~ '~'~' - :: ~' I i u m ~0 ~ [ . . , CONSENT TO INSPECTION Barbara J. Kujawski ~' Owner(s) Name(s) do(es) hereby state: · the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at 4150 Aldrich Lane, [aurel, NV · which is shown and designated on the Suffolk County tax map as District 1000, Section 120 , Block 3 , Lot 13 . That the undersigned (has) (have) filed, 'or caused to be filed· an applica- tion in'~ Southold Town Bullc~ing xnspec~,, .,. or.~:~,o to, +~,,~ tr~llo,vin~: One family dwelling with att. ached garage That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, incl.uding .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 w£th 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: _~//¥'/~/ Barbara J. ICujawski (print name) (signature) (print name)