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Home My WebLink AboutZ-9413NO. 4 TOWI~ OF SOUTHOLD BUrr.DING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z9/~.'l~ ..... Date ...J..a~..u.a..ry.. 3.0. ............, lg..7.9. THIS CERTIFIES that the building located at . 5.~5...(~.c., .h.a~d.. ,.S~.r.e..e~ ..... ~ Map No ............. Block No ........... Lot No .................................. kL.-,UIi~'~%~£S FOR ONE FAMILY DWELLING BUILT PRIOR TO conforms substantially to the ........ ,C.E~, TIF!?.TE OF OCCUPANCY dated .. AP. VI!... ~}..: ...... , 19.97, pursuant to which l~i~]it~t No. Z94.3.5 ·. dated .. ,Imausxly.. ~.0 ....... , 19..7.9., was issued, and conforms to an of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... .~..i.v.a.t..e..~..e...F.*~!%y..~..e.%l.i~..~ ............................... The certificate is issued to ........ .R.i.t..a..C.,..¥9i;]:o..m ............................... (owner, ]~l~a~ of the aforesaid building. Suffolk County Department of Health Approval ......... P. re~Exis.ting ............ UNDERWRITERS CERTIFICATE No ................... PI'.e-.Exill;$~ ........... HOUSE NUMBER .... .525 ...... Street ........... Or. chard .$~r. ee% .............. / ........................................... ~. <' .~?. Oxcl erzt, · ~e.~ i~prk ........... Buildin~ Inspector County Tax Number 1000-25-2-15 BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location C~~- O /?C/ff /q/'~D ,-~' ZU. 0 /~/z~ ^( ~- '~'~' (n~ber & street) (M~icipality) Subdivision ~ Map No. ~ Lot(s) Name of Owner(s) ~'~/'T~ C. Occupancy/F-/ (type) Admitted by:/~f//~Y[d/o~ZO]~ Key available -- Source of request4/~. (owner-tenant) Accompanied by: Suffolk Co. Tax No./dY&JO - ZD~ ~- /3 DYTELLING: Type of construction #stories i ~/~ Crawl space Total rooms, 1st. F1 ~*~ 2nd. F1 Bathroom( s ) /~///~__~/g~_~ -~oo~_~ Toilet room( s ) Porch, t~e~~Deck, t~e Breezeway -- Garage Type Heat ~~ Warm Air O~ Fireplace(~ ~. No. ~its Domestic hotwat er~/ Other 3rd. F1 Patio, type~O'~-~ Utility room Hotwater Airconditionin~ ~ Type heater ~ ~-/~/~ ACCESSORY STRUCTURES: Garage, type const. -~2~//~/w,~= Storage, type const. Swimming pool Guest, type const. Other VIOLATIONS: Housing Code, Chapter 52 Location Description Art. Sec. Remarks: Inspected by: Date of Insp. //~ /7~ Time start~.'$o~end ~.'~0 ~l~. FOEM NO. $ TOWN OF $OUTHOLD , Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLIGATION FOR GERTIFIGATE OF OCCUPANCY Insfructions 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. 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 disposel--(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 end installations, o 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings end "pre-existing" land uses: 1. Accurate survey.of property 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 in- formation required to prepare a certificate. C. Fees: ]. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 DGte 1/26/79 New Building ................ Addition ................ Old or Pre-existing Building ..... ~. ........ Vacant Land .............. ...... Tax MaD Desianation: Dist. 1000, Sec. 25, Lot 2, Blk. 13 ocatlon ~,~T rroperry ............. · ............. 4 ............. · .......................................................................................... Orchard Street, Orlent~ N.Y. (See attached survey) Rita Cooke Wo lom Owner Or Owners Of Property ............... ~ ................ .~. ................................................................................. ,.o..-..z..s Subdivision ................................................................ Lot No ............. Block No ............. House No ............ Permit No ..................... Date Of Permit .................... Applicant .................................................................. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fined Certificate X Fee - Construction on obove described buildin~On lotions. Sworn to before me this ~' ...~,(~Y~... day of. J.a~a~.y..,... 1.9.2~a. ........... {stamp or seal)~/~ Nota~ Public .~.~.~Qi~ .................. Coun~ ~, ~