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Home My WebLink AboutZ-10067FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No ....g. 1. 99.6.7. ....... Date ........ gU. gUet;. 11,. 1 91t0 ........ 19... THIS CERTIFIES that the building ................................................ Location of Property ...2..6.2~...}/I~.l.1..L..a~..e. .......................... Pe.coaig, .N,Z, · House No. Street Hamlet County Tax Map No. 1000 Section .... ~.7 ...... Block ..... 6 ......... l,ot ...... .9 .......... Subdivision ...B.~..al3..°.h.e.. ?.,..D.~.c.ll:.l.~..~.o.zl. .... Filed Map No...~60...Lot No... 9. & · 10 .... ~equi~ementa fo~ a one family dwell .~ bul t p~i ~ conforms substantially to the ...... Cer~ifioa~e of Oooupa~cy .... ?p.~.i..1..2.~. ....... , 19 ~.7. pursuant to which ~ ........... Z.111067 .... dated ...... .~.u. gg..~.t;..0 ............ 19~0., 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 ......... ............ .?.v. ~. y.~., .o.n~ .p...m~..~r. D~..e. ll~ ................................... The certificate is issued to ............ P. g.~.~.t.o..k..I~.~1. {1~. ............................... of the aforesaid building. Suffolk County Department of Health Approval ............... .N/.~. ....................... UNDERWRITERS CERTIFICATE NO ....................... ~I/A ....................... to Rev 4/79 BUILDING DEPART~ZENT TO%fN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT 2625 Mill Lane Location Subdivision Blanche T. Dickinson Map No. (number & street) 860 Name of Owner(s) Patrick Walsh & wf. Peco~c, N.Y, (Municipality) Lot(s) 9 & 10 Occupancy Admitted by: R-1 (tYpe) Key available owner (6wner-tenant) Accompanied by: self Suffolk Co. Tax No. 1000-67-6-9 Source of request R. G. Terry, Jr.,' Esq. Date August 6, 1980 DWELLING: Type of construction Foundation cement block Total rooms, 1st. F1 Bathroom(s) Porch, type screened in Breezeway Type Heat gas Fireplace(s) X Domestic hotwater Other 6 Deck, type Garage. Warm Air X No. Exits yes wood #stories 1 Cellar Crawl space X 2nd. F1 3rd. F1 Toilet room(s) Patio, type. cement Utility room Hotwater Airconditioning Type heater ~as ACCESSORY STRUCTURES: Garage, type const. Wood/l' car Swimming pool Other Storage, type const. Guest, type const. VIOLATIONS: Housing Code, Chapter 52 Location Description Art. Sec. Kitchen Gas stove - no shut off V ~2-~2 E6 Utility tm: No ventilation V 52-53..G1 Outside Front steps . III 52-30 A ~rawi ......... ~pace More floor JoY,tn nemde8 III 52-32 A Remarks: & 2 Inspected by: ~~~/~ Date of Insp. August 7, 1980 Curtis Ho~ton Time start 10:15 end lo735 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings 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 inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 New Building ............. Old or Pre-existing Building ....~'. ..... Vacant Land ............. Location of PropertY9..."~?. '~---~.~.~-~ ~ ............. ~.. ~ ............ ~..~, House No. Street _ /3 ,, Ham/et' Owner or Owners of Property .~..~...~ ..... ~. County Tax Map No. 1000 Section ....... ; ....... Block ............... Lot...~.iii..~ Subdivision.~.'./~~..-~.'~..FiledMap,o. g.~...~....Lot,o...C~ .'i16'.. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations.