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Home My WebLink AboutZ-23611FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PI~ ~XISTING C~RTIFICAT~OFOCCUPANCY No Z-23611 Date APRIL 27, 1995 THIS CERTIFIES that the building. Location of Property. 3100 SKu~fK LANE House No. Street County Tax Map No. 1000 Section 97 8 Lot Subdivision Lot No. 01~ FAMILY DWELLING Block Filed Map No. Hamlet 13 conforms substantially to the Requirements for a One Family Dwelling built Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z--23611 dated APRIL 27, 1995 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 A ONE FAMILY DWR~.ING WITH AN ACCESSORY TWO CAR GARAGE* The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *Pr.~ASE SEE ATTAu~usD INSPECTION REPORT. Rev. 1/81 BENJAMIN KUJAWSKI N/A N/A N/A ldin~ Inspector BUILDING DEPARTMENT TOWN OF S0U~UOLD HOUSING CODE INSPECTION REPORT 'LOCATION: 3100 SICu-NKLAI~ (number & street) SUBDIVISION NAME OF OI~qER (s) BENJANIN KUJAWSKI HAP NO. CUTCHOGu~ (municipality) LOT(s) OCCUPANCY A-l RES. (type) ADMI'rr[D BY: SCOTT RUSSELL KEY AVAILABLE SOURCE OF RE~UEST: SCOTT RUSSELL ONNER (o~mer-tenant) ACCOMPANIED BY: SAME SUFF.CO. TAX HAP NO. 1000-97-8-13 DATE: 1/23/95 DWELLING: TYPE OF CONSTRUCTION WOOD FRAME FOUNDATION LOCUST POSTS CELLARSHALL PIT TOTAL ROOMS: IST FLR. 4 2ND FLR. 2 3RD FLR. BATItROOM (s) ONE TOILET ROOM (s) PORCH TYPE FRONT ENTK~ & REAR ENTRY (ENCL.) BECK, TYPE BREEZEWAY FIREPLACE NO DOMESTIC ROT~ATER YES TYPE HEATER ELECTRIC T¥~E HEAT 2KEROSENEHEATERgdARMAIR OTifliR: SITTING ROOM 2ND FLOOR & PANTR~ OFF KITCHEN. STORIES CRANL SPACE UTILITY ROOM PATIO GARAGE AIRCONDITIONING HOT~ATER EXITS 2 ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. 2 CAR CENENT BLOCK STORAGE, TYPE CONST. SWIMMING POOL , GUEST, TYPE CONST. OTHER: WOODFRAME (NEED OF REPAIR) VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. fOP OF CHIHNEYS, SNOKESTACKS, FLUES, GAS VENTS, SMOKE PIPES AND 3HINNEY CONNECTORS SHALL BE HAINTAINED STRUC'£ugALLY SAFE AND SNOKE NYCRR 9(B) TIGHT, SO AS TO SAFKLY CONv~Y Tmi PRODUCTS OF CONBUSTION TO SEC. 1243. Tti~ OUTER AIR. ;ONE FLOOR BUILDINGS AND STRUCTURES SHALL BE HAINTAINED FREE OF INSECT, SEC. 1242.9 BEAHS VERHIN AND RODENT HARBORAGE AND IN~STATION: Cb) DATE OF INSPECTION 1/27/95 TI. HE START 9:40AM END 10:00AH Form No. 6 TOWN OF SOUTtIOLD BUILDING DEPARTMENT TOWN tIALL 765-1802 ~PLICATION 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 lihes, 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 I. 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. Certificate of Occupancy on Pre-existinR Buildin~ - $i00.00 3.Copy of Certificate of Occupancy - $20.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial 515.00 .............. ' New Construction ........... Old Or Pre-existing Building .... J ...................... Location of Property ~jO~ S~o~ ~.A4.. ............ ? ...... House No. Street Hamlet O,wer or Owners of Property ....... .~.~ .~.~.~ ~.~.~ ( County Tax Map No 1000, Section ..... ?..~. ..... Block ...... ~. ........ Lot ..... [..~. ............. ubdivision ............. /?. . . . i .......... '..,Filed ............ Lot ...................... Permit No ................ Date Of Permit. .Applicant. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temp~ry Certificate[ .......... Final Certicate ........... Fee Submitted: $.iil.~ ..................... o ........... CONSENT TO INSPECTION Owner(s) do(es) hereby state: Name(s) · the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at · which is shown and designated on the Suffolk County tax map as District 000, Section ??. Block ? ,Lot /3 That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: 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 regulations of the Town of Southold. (s~ghature) ~(print name) (signature) (print name)