Loading...
HomeMy WebLinkAboutZ-10775FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate 01: Occupancy Z10775 No .................. Date ....... .N.o?.e..m.b.e?.. 1..6 THIS CERTIFIES that the buildinga. ............................................... 160 Cottage Place, ....... .8.o.u.~.h.o.l.d.,. New Yor.k Location of Property ........................................... House No. Street Ham/et County Tax Map No. 1000 Section ...6.2. ....... Block .... 3 .Lot 13 ...... Subdivision Filed Map No . .. Lot No ..... Requirements for a One Family Dwell. lng Built Prior to conforms substantially to the ~l~ll'~tioff'fof~Itd'ing"Perm'it'treretoTo~n~d~- Certificate of Occupancygl0775 April 23 1957 pursuant to which dated.......N°vember ....... 1..............6 19 .8. ! , 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 ......... I One family dwelling - Non Habitable. A Accessory - One Family, Non Habitable, Non Conforming size dwelling. A A~cessory - Storage Building in poor condition. William S. Zebroski, Jr. and Mary w. The certificate is issued to ........................................................... [owner, ~rr~i~Et~ x x of the aforesaid building. Suffolk County Department of Health Approval N/R N/R UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev 4/79 .t BUILDING DEPART~ENT ~' TOt'~ OF SOUTHOLD, N. Y. ~l ~- HOUSING CODE INSPECTION REPORT (number & street) ~/ (Municipality) Subdivision ~ Map No. -- Lot(s) Ovmer(s) Occupancy ~-[/~'~,J~/ .~(.~; (~.~ ~z~ ) '~ ~'~'~ ..~{~'~ (typ~) (owner-tenant) Admitted by: Accompanied by: ~.olt/~ Key available Source of request Suffolk Co, Tax No. - D LING: Type of construction #stories Foundation ~77~t~ Cellar ~ Crawl space Total rooms, 1st. F1 3 2nd. Fi~ 3rd. F1 Bathroom(s) I ~, ~/~-~ Toilet room(s) ~-~ Porch~type Tm~ Deck, type ~- Patio, type. Breezeway ~ y, vz~l Garage. Utility room -- Type Heat,~-P~ ~arm Air -- Hotwater ~ Fireplace(s) ~o-~ No. Exit~ ~ Airconditi0ning' Domestic hotwater ~ Type heater ~- ~ ~_~/~v) Other ~ ,~ ct~ ~.~-~ ~ , ACCESSORY STRUCTURES: Garage, type const. Swimming pool Other ~ o~,/-- ~L~ Storage, type const. Guest, type const. VIOLATIONS: Housing Code, Chapter 52 Location I Description Art. Sec. Inspected by: ./~',d~ - Date of Insp. Time start ~ end ~.'oP b-- '~:" FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall 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 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 featu res. 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 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 Date ... ~.o.'~(~z~o.~'. ]-3,,..3,9~,],.. New Building ............. Old or Pre-existing Building ... X. ....... Vacant Land ............. Location of Property .. 16.Q .Co~-tage. ~.lacP-¢. So~tholclr .~Te~ .York .................... House No. Street Ham/et Owner or Owners of Property .. M~ry. ~, .ZeTo=oski ...................................... County Tax Map No. 1000 Section ... 62 ......... Block .... 3 .......... Lot ..... 3,3 ........ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant . ~LT.~'..W,, D.e,~O~;£ ............. Health Dept. Approval ........................ Labor Dept. Approval .................... ~.. Underwr ters Approva ...................... Planning Board Approval . ~.~ Request for Temporary Certificate ..................... Final Certificate ..... Fee Submitted $. 5.,00 ....................... ~ ~ \\~ ~/ Construction on above deser bed build ng and permit r~eets ~11 applicable~r~odes/and regulations Apphcant. ~, ~'. ~: ~~/. '/'.~/~.~_~.~'.. ,~.. ............ Ru~blph H.~'Bruer~Attorney for M~ry W. Zebroski Rev, I0-10-78 '