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Home My WebLink AboutZ-9676FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N;Y. CerlJficate Of Occupancy Z9676 Date .... .~.e.p~.e.~.b..e .~..3.7 .............. 19..79 THIS CERTIFIES that the building ................................................ ~..q V.~.n..a A~.r..e.eA .. Location of Property .. ............................ Hou~ tvo. Street Hamlet County Tax Map No. 1000 Section ...Q./4~.. ..... Block ....! .......... Lot ...... ~. ........ Subdivision ............................... Fried Map No ......... Lot No .............. Requtremen~cs for a one family dvelllr~ bullL~c__pr:l._or .'t;o conforms substantially to the - "' · '~' ' -- Cer~cificate off Occupancy .Z967.6.. · ...Al~.r. $.1...2.} ........,19 ~.7.. pursuant to which ~ No .................. dated . S epacember 17 19 7.9. , was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... One family I)well~ng The certificate is i~ued to Ron.~.. J~..ABRo. n..a ...................... ............... rowner,~° of the aforesaid building. N/R Suffolk County Department of Health Approval ......................................... UNDERWRITERS CERTIFICATE NO ..................... .N/.R. ......................... Building Inspector Location Subdivision Name of Owner(s) Occupancy Admitted by: Eey available TOWN OFSOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT 5~OWiggins Street (number & street) Ronald'J. An$ona R - 1 Mrs. Angona Map No. Greenport (Municipality) t(s) Owner owner-tenant Accompanied by: Mrs. Anl;;ona Suffolk Co. Tax No.1000-04~-~ O?-026 Source of request ' William H. Pr$cer i'Jr- .(.At~orney-atTLaw ) Date September 12, 1979 Type of construction Foundation Cement block Tote1 rooms, 1st. F1 Three ~athroom(s) One Porch, type Roof over Breezeway Type Heat oil fired Fireplace(s) ~ Domestic hot~ater Other Wood framed ~stortes one.* * Cellar FUll Crawl space 2nd. F1 ~rd. FI Toilet room(s) Garage 'Warm Air No. Exits yes Patio, type Utility room Hotwater X · w~ Airoonditioning Type heater Ta~kleas ACC ,ESSO~Y ~: Oarage, type const-.. Swimmingpool Other Storage, type const. Metal ....~uest, type const. VIOLATIONS: Housing Code, .Chapter 52 .Locat~n Description iArt- Sec. Kitc~ NO 'shUt-off Gas stove V 52-52 B- Front Rm. B~okenwindow III ~-~ c Outside Cellar door n~eds repairs III 52-~1B Remarks: Did not inspect cellar as door was locked ... Inspected by:~Date of Insp. Sept. 1~, 1979 Curtis Horton Time start_2:45 end ~:05 ,,. ~O~M NO. 6 TOWN OF SOUTHOLD , Building Department Town Clerks Office Soufhold, 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: 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 installations, 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 in- formation required to prepare a certificate. C. Fees: I. 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 Date ~.Z..~........./..~...~.... New Bqilding ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ....~...~..~.. ....... ~x~/'~'~'"'"" '~" '~:'--'T-~ ~'~"~"~/'"'""~" ......................... Owner Or Owners Of Property ..... .~.~.~.~.... ...... ~............~.~ ................................................. 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 ~ertificate ........................................ FinaJ Certificate .......~,~........; ........................ Fee Submitted $ ..~..~.... / Construction on above described building an ~~_~.~[&~l~ulations.permit meets Applicant ......../~~~ ............. ~. ................................. Sworn to before me__ ///,,-this ~~/~/~4: -~~~ -- .... ./..,~......'~.. d, ay of ...~.. '~_..~,~.~..~.~../..~../~ (stamp or 7-ow~ o~ ~ou'r~o~o, ~V.Y.