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Home My WebLink AboutZ-10743FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z10743 Date ....... Oct,~aber. THIS CERTIFIES that the building ................................................ Location or Property ... 1. .2.5.5...H.o.b.a.~. ~..R.o.a..d .......... ~..o.u.t.h.o..1.d.,..~.ey..g..o.r.k .......... House No. Street Ham/et County Tax Map No. 1000 Section ..... .6.4 ..... Block .......... 2. .... Lot ..... .9 ........... Subdivision...F..o..u.n.d.e.e..~..g.a. 17 .a.t.e.~. ......... Filed Map No. 9.3.4. .... Lot No.1 3...*..~...o.f..1.4. Requirements for a One Family Dwelling Built Prior to conforms substantially to the.A.pp~aS~o~.fos-B~141i~e-P, eam~t-hesetefe~-~t-ia-t.l~.-ef~iee-dat~-- April 23 ,19.5.7. pursuant ' ,Cer. tL~lca, te .O{'. Occupancy Z10743 ..................... Iow m c n..J~d4~J~t.q& .t'~0.1~. ~ ...................... dated .... .O.c. ~ o..b .e.r.. 2. .9 ............ 19..8.1, was issued, and conform s to all o f the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ..... e.r. ~..v.a.t.e., 9p.e.-..v.a.m3. Z..y.p.w.e..~.Z3.n.g., .w3.t.h., .~.c.c.e. ?.sp. cy., 9.t.~.u..c.t.u.r.e., .(.~..C..a.v..qa..rage ) The certificate is issued to .... C..a?.o.l.¥n...E.:. y9.]:.~s. .................................... {owner, I~ ~t~a~ X Z g of the aforesaid building. Suffolk County Department of Health Approval ..... bl/~ ................................. UNDERWRITERS CERTIFICATE NO ...... i~ ! ~ ......................................... Re~. 1/81 BUILDING DEPf~RTHENT T0%7~ OF SOUTHOLD, N. Y. Location.. Subdivision HOUSING CODE INSPECTION REPORT 1255 Hobart Road Southold, New York {number & street) (M~nicipality) Founders Estates Map No. 834 Lot(s) 13 + ½ Name of O;.,mer(s) Carolyn E. Wells Occupancy R-1 (type) Admitted by: Self {owner-tenm,t) AccSmpanied by: Same Key available Burt Lewis Realty Suffolk Co. Tax No.6.4-2-9 Source of request R. G. Terry, Jr. Date oct. 22/81 of 14 D~FELLILG. 1 Type of construction Wood Framed #stories Foundation Hollow Tile Cellar Full Crawl space Total rooms, 1st. Fi 6 2nd. Fi 3rd. FI Bathroom(s) 1 Toilet room(s). Porch, type Deck, type Patio, type.__ Breezeway. Garage. Utility room x . ~fpe Heat Oil Fired Warm Air Hotwater X Fireplace(s) 1 No. Exits 2 Airconditioning Domestic hotwater Yes ~ype }]eater Gas Other ACCeSSoRY S%RU~UR~S. Oarage, type const. Wood one car Swimming pool Other Storage, type const. Guest, type const. VIOLATIONS: Housing Code, Chapter 52 Lo. cation I Description Art. Sec. Kitchen Gas Stove, No shut off V 52-52-B Found water leaking reported same to Mr. Lewis Remarks: Inspected by: ~ .~_, ~/ .~~ Da'~e of Insp.. Oct, 2~/81 Curtis W. Horton Time sLar~:00 end 3:20 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Tbis 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 buildin§s, 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 PIanning 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 ali 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 Rev. 10,10-78 Date .......................... New Building ............. Old or Pre-existing Building ...~. ....... Vacant Land ............. House No. Street Hamlet .. ...... County Tax Map No. 1000 Section .... ~ ....... Block ..... ~ ........ Lot...~ ........... Subdivision . ~~.. ~ ..... Filed Map No. ~ .... Lot No. Health Dept. Approval ........................ Labor Dept, Approval .................. ~ .... U nde~r~]s tprov:l ........................ Planning Board Approval .~ ....... , .~. ~, Request o Te pora y Certificate ..................... Final Certificate ............ ~..~. ~:, . .~ bee buomitted S .... ~.,. ..................... ~,~ ¢~ Construction on above described building and permit meets all applicable codes and regulat~o' ns.