HomeMy WebLinkAboutZ-9709FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No. Z9.7.09 ........... Date .-Oca~ober-.12 ................... 19.79
THIS CERTIFIES that the building ................................................
Location of Property . .6.7..5 .......... $11p. Se~. Lane .............. ~reenport.,..N
House No. Street
County Tax Map No. 1000 Section ...033 ...... Block . 04 ........... Lot . 0.55 ............
Subdivision ....... XXXX ................... Filed Map No. I(~X .... Lot No... X~ .......
Requirements for a one family dwelling built prd~or to
conforms substantially to the
Certificate of Occupancy
. . .April . 23., ........ , 1957. pursuant to which ~ No .......... Z970.9 ......
dated ..... Qq.t.o.b. el:. 12., ........... 19.7 9, 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 .........................................................
The certificate is issued to ... Fzank..J.. &. ~Toar~ .I ·. Zahra ...........................
(owner, ~e~)
of the aforesaid building.
Suffolk County Department of Health Approval .. N/~R ....................................
UNDERWRITERS CERTIFICATE NO ......... N/R .....................................
Building Inspector
Rev 4/79
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
Location
Subdivision
HOUSING CODE INSPECTION REPORT
(number & street) ' (Munidipality)t
--- Map No. Lot(s)
Name of Owner(s)
Occupancy /~--
(type)
Admitted by:
Key available
Source of request
(. owner-tenant
Accompanied by: ~--~
Suffolk Co. Tax No./orYo--~95~-~-~--
Date /0//0/7~
DWELLING:
Type of construction
Foundation
Total rooms,
Bathroom(s)
Porch, type
Breezeway
Type Heat ~r/d~
Fireplace(s)
Domestic hotwater
Other
/~/oo ~ F/~/~ #stories
C,~Y'-~- ~z.c~/~ Cellar'~ Crawl space
1st. FI~ ~ 2nd. F1 ~ -~ 3rd. F1
Toilet room(s)
Deck, t~e ~o~ ~z~ Patio,
Garage d~-- Utility room
Wa~ Air Hotwater
No. ~its ~ Airconditioning
~ T~e heater
type C~c. ~,~
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other
Storage, type const.
Guest, type const.
VIOLATIONS:
Location
Housing Code, Chapter 52
Description Art.
Sec.
Inspected bY:~4/~~4,Y<- Date of Insp. /0/,~17 ~
Time start~'~ ~Jq-end <~;o~- ~-~-
Premises: 49 Sunset Lane, Greenport, NY
AFFIDAVIT
STATE OF NEW YORK )
: SS.:
COUNTY OF SUFFOLK )
FRANK ZAHRA, being duly sworn,
I am over the age of 18 years
Laurel, New York.
deposes and says:
and reside at 1965 Bray Avenue,
I am making this affidavit in connection with the above
captioned property, of which I am one of the owners.
That I acquired title to said property in 1954 and title has
remained in my possession since then, either individually or jointly
with my former wife, Joan I. Zahra.
That the annexed survey is an accurate representation of the
premises as they existed prior to April, 1957, the effective date of
zoning in the Town of Southold. The only alteration made to said
premises was an addition made in April, 1966 for which a Certificate
of Occupancy was issued (see copy annexed hereto).
That the building on said premises up to and including the
date of this affidavit has been used as a one-family dwelling and
remains in an average condition subject to reasonable use, wear, tear
and natural deterioration.
This affidavit is made to induce the Town of Southold, through
its appropriate officials, boards or employees, to issue a certificate
of pre-existing use in reference to the premises herein referred to;
and knowing and intending that the said Town, its officials, boards o~
employees will rely upon and be induced to act by reason of the
representations made herein.
Sworn to before me this
/~ ~-~da~ of~_O~ctober, 1979.
~Notary Public
KARSN
NOTARY PUBLIC, Slat_/~,,f New
No. 52-4634869 - Suffolk County
Commi*$ion Expire~ Mamh 30~
Frank J~ ~hra
FORM NO. 6
TOWN OF SOUTHOLD
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 featu res.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safeW 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
October IQ, 1979
Date ..........................
New Building ............. Old or Pre-existing Building × Vacant Land
Location of Property ...4.9..S..~.~.s.e.~..~.a.~.e..~..G.~.e..e.~.~.o.~..~.~..~.e..~..Y. ork
House No. Street Hamlet
Owner or Owners of Property . ~',~e,~]~. ~,. ~3~3.ra. ~n.d,. JQ~q. ~[,..2~Q]3~'p, ....................
County Tax Map No. 1000 Section .. ~,~.~. ........ Block ...~..~ .......... Lot...O"..,~..5~. ........
Subdivision ................................. Filed Map No ........... Lot No ..............
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 $..5.00 .......................
Construction on above described building and permit meet~ all applicable codes and regulations.
Applicant.. i .~./~.~2~..~.-.~~, ........................
-- ~ F~nk ~. Zahra
Rev. 10-10-7R