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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
U P- D A T E D
Certificate Of Occupancy
No.. Z,1 P......... Date April..... 1...........
, 19$5.
THIS CERTIFIES that theibuddiqF , ,Pro ert
Location of Property . ,64155 Rt 25 (Main Rd:) Greenport
Nouse No. Street
Hamlet
County Tax Map No. 1000 Section ,056. , , , ,Block . 04 ...........Lot . Part, of . 020. .
Subdivision X.................Filed Map No. ........Lot No.
conforms substantially tt>=the- a"acfcrr-+hdhiusg=PPxmit~xdnlmef&d=in=is=f'f=ddL9±
19 zat4aalduig~ewtut11.40 . .
1 eftel 19 wow+s@Wdgattd•ooe€*W.*4o-tdl<sOfbks irsmsnts
to
eltthe applicable provisions of the law. The occupancy for which this certificate is issued is
Property sub-divided in 6/81. It contains a storage building and
is situated the B-1 zone
..with access to Rt. 25 a state maintained
road.
The certificate is issued to ,RICHARDS_,, GENEVIEVE
/owner, ksseeaFterraAN
of the aforesaid building.
Suffolk County Department of Health Approval N/A
UNDERWRITERS CERTIFICATE NO N/A
Building Inspector
Rev. 1/81
FDC
FORM NO. 6
TOWN OF SOUTHOLD 5 Building Department Town Hall Southold, N.Y. 11971 OLD
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 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.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "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 informa-
tion required to prepare a certificate. _
C. Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling $15.00
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00 _
Date
New Building . . . . . . Old or Pre- xistin Building ~t... : Vacant Land
u`1I5~
Location of Property PD....n. . .
House No. Street ff Har /et
Owner or Owners of Property ?~1 Q v e ? ..4 c~q b5
County Tax Map No. 1000 Section Arfi Block V. ~ Lot LAO
Subdivision ?ft - 4 W.(.WIFiled Map No. ..........Lot No. ...Q o`(D
Permit No. Date of Permit .........Applicant
Health Dept. Approval .......................Labor Dept. Approval .
Underwriters Approval ..............Planning Board Approval Ii11
/
Request for Temporary Certificate .............Final Certificate
J
Fee Submitted
.
Construction on above described building and permit meets all applicable codes and regulations.
C(D;2, 1- in Z> n n p
1 Applicant ti /.~XZot . l `D. $11 CJ. ! .R-v-.9
s t ~
c4 sL~12 X100 b't
Rav. 10-10-78
19
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NOTARY POtiI_IC, State of Nero York nn
No. 4707878, Suffolk County AOe-b,W
Term Expires March 30, 19_Fr7 v/4/f 5
d TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET VILLAGE DIST. SUB. LOT
FORMER OWNER N; i.~ ACR.
S gyp/ 1 TYPE OF BUILDING
RES~ SEAS. VL. FARM COM14!.. CB. MISC. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
7~ a r F
0 00'/ O $ S-h/hwv/
AGE BUILDING CONDITION
NEW% NORMAL BELOW ABOVE
FAR Acre Value Per Value
Acre
Tillable 1
Tillable 2
-
Tillable 3
Woodland
Swampland FRONTAGE ON WATER
Brushland FRONTAGE ON ROAD
-House Plot - DEPTH 1,- y r
PULKUEAD
! I
Total , /
COLOR
se~~=~ ~ TRIM ~ /
Y,00
\ a I
2 S {
IL 1~-
I
i
I
M. Bldg. /7xY0 3yD ( 'Foundation $LF. Bath / Dinette
Extension ' Bement ms's Floors K.
Extension 9 s Ext. Walls Interior Finish LR.
Extension / yx I
i~ 1 z y' S !Fire Place o Heat H, u/, r,= DR.
Type Roof Rooms Ist Floor BR.
Porch Recreation Room Rooms 2nd Floor r! FIN. B.
Pore}r 2 Z r Dormer
Breezeway veway
Garage a .
Patio
_ O. B.
Total J 711
J
r
S6
__Tii
12
I4~, 6 lQ r. `i 1 u
I
J
I
_
i
I
II
Con +ic„, C~ nc~ ~S J6e S ~-p
e~o-I CLk
nn'' $Ilt-
r _ A25HsaM J(NaOUE 7.17
i
LACOL(_A a ¢ a
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i
F
O ~c? t
Q
ti 44, 144
M I
lC) ! SOuT-"OC_o Bay
Q N LOCArlON MAP - SOO m ( "
0 - - - _
t Q N r-., Suffolk Coum4wy Tax Mab' Designafion;
1 U "y Di sf /COD, Sra-1:056, 19;
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i'; { n/, 3'(5• M L J Z y Confrwr front Su ff rs. U.P. W. aeelal ;
Z 191.31 lV lli
h o _ Nei-Hier lof -to be fi»-Flier subdivided,
• wa4wr --"WY j sevxge di*O.$Olt sg,sAgerrs will
2 a ~ 3 J6! a f N j tort fort" +o Scf. Co. ksah% Deo slarrdards;
i E. _ _ b 3,i i i Bona"' is as rndica~ec/ on (occrh'on nrcr~,; -
' _ t , °B -Light BuSirteEs
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Towle oF' SouTT--X °0, Y.
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Aree o 'S, 34rj ft (-te tie linas) Mo d ~6. 2~ 1980
~ ~ a iff4nukf~*+
--f_ Ooof kick- VA(V TUYL, PC.
Lic&msed Lcind Surveyors
Greist'f~Crrf ~ tYew York