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Home My WebLink AboutZ-24280FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING C~RTIFI~ATE OF OGt&UWANCY No Z-24280 Date APRIL 15, 1996 THIS CERTIFIES that the building ONE FAMILY DW~LIN~ Location of Property. 1300 GRA'£~WOHL ROAD NEW SUffOLK NY House No. Street Hamlet County Tax Map No. 1000 Section 117 Block 4 Lot 7 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-24280 dated APRIL 15, 1996 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 DW~Z.ING* The certificate is issued to --K,.~N ORLOWSKI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *P~-~%SE SEE ATTA~D INSPECTION REPORT. N/A N/A N/A Rev. 1/81 BIl I I.I)ING I)EPARTHI'~NT TOWN OF SOUTIIOLI} IIOIIS]NG COI}E INSPECTION REPORT I.OCATION: 1300 GRA'rHWOHL ROAD (number & street) SUBDIVISION NAME OF OWNER (s) HELEN OR~OSKI HAP NO. NEW SUFFOLK NY (munic|pal| ty) LOl'( s ) OCCUPAI~CY A- ! RESIDENTIAL (type) ADMIT'rED BY: BENNETT ORLOWSKI SR. KEY AVAILARLE SOIIECE OF RE(}[JEST: ~LEN O~I HELEN ORLO~SKI (owner-tenant) ACCOMPANIED BY: SUFF.CO. TAX MAP NO. I)AI'E: 4/10/96 DWELLING: TYPE OF CONSTRUCTION WOOD ~ FOBNDATION CEMENT BLOCK CEI.I,AR TOTAl, ROOMS: IST FLR. 4 2ND FLR. BATIIROOM (s) ! FuLL BATH TOILET ROOH POECII TYPE COVERED PORCH {REAR) BREEZEWAY F I REPI,ACE DOMESTIC IIOI~ATER YES TYPE IlEA'FEE TYPE IIEAT OIL WAR~! Ail{ OTIIER: FULL 31{I) FI,R. DECK· TYPE NO OFF BOILER # STORIES l CRAWl. SPACE UTII,ITY ROOM PAl!lO GARAGE I CAR ATTACHED AIRCONI)ITION [NO IIOTWA'FER YES EXITS 2 ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. SWIMMING POOL O'IIIER: STORAGE, TYPE CONST. · GUEST, TYPE CONST. VIOLATIONS: CIIAPTER 65 N.Y. STATE UN1FORH FlltE PREVENTION & BDII,DING CODE LOCATION DESCRIPTION ART. SEC . REHARKS: INSPECTED BY I)ATE OF INSPECTION 4/I 1/96 TIHE START 9:45 A~ END IO:OOAM Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 'ro v 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. 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 Buildin~ - $100.00 3. Copy of Certificate of Occupancy - ~ .25¢~. 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 .................. . .~.Z~.~. ~ Z. ~. ......... ~/~ ~..~. ~..~.~/.~ ..... House No. Street Hamlet Onwer or Owners of Property ................ ~../..~..~.~...~.f~.~4~...~[ ...................... County Tax Map No 1000, Section .... ZM.7. .... Block ...... .~. ....... Lot....7.. ................ Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate..~ ...... Fee Submitted: $ ...... /.~.~ ............... f~(~ ~'~ q~ APPLICANT CONSENT TO J N,q I~I~:CTION Owner(s) Name(s) do(es) hereby slat,.*: the andersigned, That the undersigned (is) (are) tile owner(s) of the premises in tim Town ,ffO~ . . ~ ~, which is shown and desif{nated on the Suffolk County tax ,nnp as District 1000, Section //7 , Block_ ~ , Lot 7 That the undersigned (has) (have) filed, or caused to be riled, an applica- tlon In tile Sou(hold rl'oxxq', l?mildin.q~ inspecto,-'s Office for tim following: ~ That tile undersigned do(es) hereby give consent to the Buildh~g Inspectors of the Town of Southold to enter- upon the above described property, iileluding any nnd all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that gnid premises comply with all.of the laws, ordinances, rules and re~lulations of the Town of Soutlmhl. The undersigned, in consenlh'~g to such insl)ecti(ms, do(es) so with the knowledge and un(let'standinl[ that any infm-mation obtained In tim conduct of such ir~speetions }nay be used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules m' regulations of the Town of Soulhold. l)ated: (sig,mture) (print name) (sit.mnlt, ve) (priut name)