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HomeMy WebLinkAboutZ-10163FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y., Certificate Of Occupancy No..Z~016~ ........ THIS CERTIFIES that the building ................................................ Location of Property . .2.7. Q..B.a.y.g.v.~r~.e .................. East. Marion~. N. Y. ........ House No. Street Hamlet County Tax Map No, ]000 Section . . .0.3.'1 ...... Block . . .0.~ .......... Lot . . 0.06. ' Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the ~eo~m~-~'~m~O~h~f~we~l~l~e~i~-ri°r to Certificate of Occupancy .~Pril..2.~, .......... , 19 5.7. pursuant to which Bv, ikl4r~il4'4o, ........ ...... .Zfi. 0. ~.6.~. dated . .~ ept.elxlber. P. 9 ............ 1980., was issued, and conforms to all of the requirements oftheapplicableprovisionsofthelaw. Theoccupancyforw~chthiscertificateisissuedis ~¥~.~ One Family Dwelling with Accessory Garage-Side Yard Veriancc Appeal #.97J.~.Oct~ber. 6,..~966 ...................................................... The certificate is issued to ..... F. reeda. Wt.:~qger.t~r ................................... of the aforesaid building. Suffolk County Department of Health Approval ........ N/~ .............................. / UNDERWRITERS CERTIFICATE NO ................ ~/~ .......... .),~ ................. / // / / Building Inspector Rev 4/79 BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location ~,7<3 ~y' /~V~ (number & street) Subdivision ~ Map No. (Municipality) -- Lot(s) Name of Owner(s) Occupancy /~-- (type) Admitted Key available Source of request (owne~-tenant) Accompanied by: Suffolk Co. Tax Date ~F/~- ~..WELLING: Type of construction ~cl~/~JX~/~_ #stories Foundation 6~Z~,7-z~r~c~_ Cellar - Crawl space ~_~ Total rooms, 1st. F1 ~' ~'>~. nu. F1 3rd. F1 Bathroom(s) ~/~.. Toilet room(s) Porch, type Deck, type ~ Patio, type___ Breezeway Garag~ ~ Utility room Type Heat ~:~/:..~ Warm Air ~ Hotwater c3~ Fireplace(s) No. Exits-~ Airconditioning Domestic hotwater </~ Type heater Other ACCESSORY STRUCTURES: / C~ ~ Garage, type const.-~7~/~. ~, F~z. Storage, type const. Swimming pool Guest, type const. Other~i~K~?~= /~,o ~-~-__ .,/~r~/~- [/~/~(~ ~ VIOLATIONS: Housing Code, Chapter 52 Location Description Art. Sec. Inspected by,~Z~.¢¢~.~.~~ate of Insp.--:~, FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: ~i'~TZi&i:-'il. Final survey of property with accurate location of all buildings, property lines, streets, and ~ unusual natural or topographic features. .~. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). ~ O [8. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and S~zt?.b~-~-- installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. k Submit Planning Board approval of completed site plan requirements where applicable. 'q) ) B. or existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" and uses: BLOCK Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. ~ Date of housing code or safety inspection of buildings or premises, or other pertinent in- any formation required to prepare a certificate. C, es: LOT Certificate of occupancy $5.00 Certificate of occupancy on pre-existing dwelling or land use $§.00 ~, Copy of certificate of occupancy $1.00 \ \ New Building ................ Addition ................ 01~kor Pre-existing Building ....?...~. ...... ,Vacant Land .............. Location Of Property ..¢~.....~.O.g_...~....~....~........~....~....~....~...~...~ ........ ..~...,../~i..~_)/m~ ........................... Owner Or Owners Of Property-- \ Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No ..................... Dote Of Permit .................... Applicant .................................................................. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ................................. ~al Certificate ...C~ ................................. Fee Submitted $ ......... ~ ................. / ,//~////~//~////~. Sworn t~efore me th~ ~ __ / / GARY FLANNER OLSEN ..... of ..... .... No, y P,b, .................................... co,, y