HomeMy WebLinkAboutZ-24301 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-24301 Date APRIL 24, 1996
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 4355 ALDRICH LANE EXT. MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 112 Block 1 Lot 13
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-24301 dated APRIL 24, 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 ONE FAMILY DWELLING WITH ACCESSORY GARAGE
The certificate is issued to PHILIPPE L. & HELEN MAITREJEAN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
w
B lding Inspector
Rev. 1/81
BUfl..D1NG DEPARTMENT
TOWN OF SOUT11OLD
UOUSI:NG CODE INSPECTION REPORT
LOCATION: 4355 ALDRI'CH LANE EXT. MATTITUCK, N.Y.
number d street iiunicipali.ty
SUBDIVISION MAP NO. LO'I'(s)
NAME OF OWNER (s) PHILIPPE MAITREJEAN
OCCUPANCY A-1 RES. OWNER
typeT owner.-tenant
ADMITTED BY: PHILIPPE MAITREJEAN ACCOMPANIED BY, SAME
KEY AVAILABLE SUFF.CO. TAX MAP NO. 1000-112-1-13
SOURCE OF REOUEST:_ PHILIPPE MAITREJEAN DA'rE: 4/14/96
DWELLING: ---
TYPE OF CONSTRUCTION CEMENT BLOCK-(STUCCO) f STORIES ONE I EXITS FOUR
FOUNDATION CEMENT CELLAR PARTIAL CRAWL SPACE
'.TO'TAL. ROOMS: IST FLR. 7 2ND FLR. 3111) PLR.
BATUROOM (s) 2 FULL TOILET ROOM (s) UTILITY ROOM
PORCII 'TYPE DECK, 'TYPE PATIO CEMENT FRONT
BREEZEWAY FIREPLACE 2 GARAGE
DOMESTIC UO'lVATP.R YES TYPE IIEATER OIL AIRCONDITIONING
TYPE UEA'r OIL WARM Alit — IIOTWATER Xg
OTUER: ENCLOSED SUN ROOM
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONS'T. 3 CAR CEMENT BLOCK STORAGE, TYPE CONST.
WITH ATTACHED POTTING SHED. GUEST, TYPE CONSI'._
OTHER:
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VIOLATIONS: CIIAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION S BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
I
REMARKS: BP #20296Z-COZ-21140 (Addition) BP #4871 CO Z-4144 (Accessory)
INSPECTED BY _ _ DA'rii'. OF INSPECTION_ APRIL 23, 1996
GAR J. FISfl
TIME; START 10:45 AM END 11:05 AM
CONSENT
TO
l C'I'LU1\1
-IV/4 /? s�AAl the undc:rsignecl,
do(e,) herebv state;
That the underslf;ned (is) (are) [he o\vllc (s) of the premises tr► the Town
Of Southold loclltecl al
►� f' 'i`�[�G ��hir_h 1:I shc.�wn anti clr,sittnnled on lhc: Sclffcnik
County tax snap Its District lOOtl, Section I loc:lc Lot l
That the undersigned (has) (have) filecl, or caused to be filed, an applica-
tion in the Southold �l'o\��l l�lIllCllllf; Inspectol"s Office for the follo\virltJ;
That the urLclersignecl do(es) hereby give cousenC to the 1311ilding Llspectol's
Of the `1'owll of Southold to enter upon the flbOve described property, including '
any And all buildings locatedlhereon, to conduct such inspections as they Illlly
deerri necessary with respect to the aforesaid application, including inspections
to determine that saicl premises collll)13' With all of the laws, ordinances, rules
and ret;ulatlorls of the To\vr► of SOU11101c1.
The ► ndersigrled, lu consentint; to such ills pc:cliorls. do(es) so with the
knowledge and understallding that any i.nforulatic:)rl ohtairled hl the couclucl of
such ins pecllolls inay be used Its evidence in sllbsecluent prosecutions for vto-
lations of the la\vs, oi'dinance.9, rules oI. rel;lll,ltious of the '.l'o\vll of Southold.
(stsuatur-e)
(print nalllc:)
(print name)
Form No. 6 M
TOWN OF SOUTHOLD �1
BUILDING DEPARTMENT
TOWN HALL f
765-1802 7
TOWN LD
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.
Q
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
1.1pre-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.
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 - .251,',
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . . . . . . . . f. .6 . . . . . . . . . . . . . . . . . . . . . .
few Construction. . . . . . . . . . . Old Or Pre-existing Building. . .. . . . . .
-ocation of Property. : . t:4 .�,.�/�_. /.a. . . .f �1�. . . . . . . . . . . . .
House No. Street Hamlet
Dnwer or Owners of Property p//l� d,J'P�; . . �'0 1. , , .. . . . . . . . . . . . . . . . . . . . . . . . . . .
;ounty Tax Map No 1000, Section. A P?. . . . . . . .Block. . . . I . . . . . . .Lot. 12� . . . . . . . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
'Tanning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
:request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . .
Fee Submitted: $. . . Q Qe . . . . . . . . . . . . . . .
. . . . . . . . . .
��36 ` APPLICANT
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_ SURVEY Fd .
. RTH . ' f0 ( ).a ,r �. PH1LIPPE 't�' MAIT.REJ b'N; . 8,
N , 4,; ,. . a ,T
. .''Srt: ALA'::; ,�S ` MAITR JEAN
. 1 ,,,�, . - . .
s `' U.F 'CO 'I x Y. GUARANTEED' TO
.� t !., �hi° sdl a I+ 'PHILI PE- L. MAtTREJE:
MONUMENT it } . , �� ; ', ' 'STELCA K;. MAITREJE'
I f .: ' YI' ' SCAL =''•I, ;;i09 .;, -GUARANTEED TIT'L+E" DIV:
�;� MAY 11 .. ti. AMERICAN TITLE iNSURf
. ... r
., ;
;, LIEc idd%'�,
PROFESSION NOINE
BUH.DING DE,PARTHE'NT
TOWN OF SOUTHOLD
HOUSING CODE INSPECT lON REPORT'
LOCATION: �3SS" L/�P.1C&
number b street) municipality
SUBDIVISION MAP NO. LOT(s)
NAME OF OWNER (s) f`f(L/PP= -F4i��
OCCUPAVCY
type A� owner-tenant
1'
ADMITTED BY: 11fpP� M ACCOMPANIED BY:
KEY AVAILABLE SUFF.CO. TAX MAP NO.
SOURCE OF REQUEST: P��/L i,oio _ DATE:
DWELLING: ----
TYPE OF CONSTRUCTION STORIES_ I EXITS—
FOUNDATION �� CELLAR CRAWL SPACE �
'.TOTAL. ROOMS: IST FLR.—_2ND PLR. 3111) FI.R.
BATHROOM (s) �- Lc" TOILET ROOM (s) UTILITY ROOM "--'
PORCH TYPE HECK, 'TYPE PATIO
BREEZEWAY //YY//// FIREPLACES oZ GARAGE
DOMESTIC 110TWATE_R TYPE HEATER 4�tlG AIRCONDITI.ONING
TYPE 11EA'l' igfG�I���III������ WARM Alit I10TWATER
OTHER: /%vc1o,7'.E�
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. J C.4� C-6 Uj) STORAGE, TYPE&MIST.
SWIMMING POOL , GUEST, 'TYPE CONST._
OTHER:
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--------------------------------------=----------------------------------------------------
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION 6 BUII.DING CODE
LOCATION DESCRIPTION Alt'f. SEC.
REMARKS:
INSPECTED BY � --_--- DATE, OF INSPECTION
TIME START 162 END �� OI,
'N . ®�: U�°H®L® �' IPP RTY REC®R® .CAR® G/_ !�
'` OWNER A STREET ZI 2VILLAGE DISTRICT S LOT
�� ' f i rr f./�OL.• rr� k�=44 t`�J ..:�`+i7 �•L� J t ��f / Y �.��/ � G• .i/s%1. l:s CTRA
FO MER N" E ACREAGEjv
�' 00
S W TYPE OF BUILDING
..
-Le .�!` .�t_,. to �icy v �fJe <L .,
SEAS. VL. FARM comm. I IND. CB. I MISC. I ✓�
LAND IMP. TOTAL DATE REMARKS
/J o �J G oU lv �S"p r� e:P, �L f r
Nru �� otW �
/ao aQoi/ -3 �� z I_ ' Y z d w«�
iN4
N
oo ./0/2 ' 7`� laS 9� - I .;Zoa ea.fe 1 a
l0-1.. 8E 7 D o L AG ONDITI i� `�/ CO )I��
NEW NORMAL BELOW ABOVE
Farm Acre Value Per Acre Value
Tillable 1
;. Tillable 2
Tillable, 3
. Woodland ' --- —
Swampland ,
Brushland
ouvD
2oo 01y S G 600
yl. ,
c)4
r
:70 Pon
r.
i
M. Bldg, �G YS Foundation \ I Bath f y y
Extension p�3 R Floors T��
w X Z Z Basement
Cr
Extension ° X �`� ' °� v Ext. Walls ! Interior Finish
Extension S. /` �� Fire Place Heat
Porch Attic
Porch Rooms 1 st Floor
Breezeway Patio Rooms 2nd Floor -
Garage' r: G +� X N t%.OPS' R'� ,r`t! Driveway
3rEt3• k� �' ,
��_-�iyi7� �-