HomeMy WebLinkAboutZ-10836FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
$outhold, N.Y.
Certificate O[ Occupancy
No..Z. J 0.8.3.6 ......... Date ....... .D.e.c..e.m.b.e.v...3.0. ........... ,19 .8.1.
THIS CERTIFIES that the. buildings. ...............................................
Location of Property . .4;~.30 .............. .~.v.a..o.d..g.¥.e.n.u.e. ............ ~.a.t.~:i:..~.u.c.R .....
House No. Street Hamlet
County Tax Map No. 1000 Section . . .1.0.?. ...... Block .. 9~ ........... LetO..0.2 ..............
Subdivision ....... X. ....................... Filed Map No....X ..... Lot No...g. ........ :..
Requirements for a private one-family dwelling built prior to
conforms substantially to the
Certificate of 0ccupancyz
·..Apri-.l, .I~3 ......... ,19 .§ 7pursuant to which Betit'Oing-PermiI No .......... 1.0..8.3.6 .......
dated ...... De.cembe~. 3 0 ......... 19.8 ~, was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
· .~. 9. p.r.~, y .a.~.e.. 9.'.'.n.~:.: t..~.m3y, y....d.~.e.Z..~.~.n.~;~. ~, .~.n.d., .t.i.v.e...a.c.c.e..~.~p.v.y...~.t.v.u. 9 ?.u.v.~. ?.,..
The certificate is issued to R. 9.b.o.E ~ .&n.e.i. g .b.y....~.l.l. 1.. 9.f..0..t.go..A .nr.t$
(owner, fe'ig~ll~,) .............
of the aforesaid building.
Suffolk County Department of Health Approval .. Ibl/.R. ....................................
UNDERWRITERS CERTIFICATE NO .......... lIAR ....................................
/
Building Inspector
Rev. 1/81
BUiLDInG DEPARTS~NT
TOI~ OF SOUTHOLD, N. Y.
Location
Subdivision
oF O er(s)
Admitted by: ~,I.~
Key available ~tc~
HOUSING CODE INSPECTION REPORT
(number & street) / (Municipality)
Map No. ~ Lot(s)_. --
(~6;~- ten ant )
Accompanied by:
Suffolk Co~ Tax No. /07-- 3 - !
Source of request ~/~./~/~/~Z~y~' '~(¢~- Date
D%UELLING:
Type of construction ~/-- /Iz~ ~ D~#stories
Foundation ~~ Cellar ~ Crawl space-
Total rooms, let. F1'~ 2nd. F1 ~ 3rd. F1
Bathroom(s) ~u__ Toilet room(s)
Porch, typq { ~o/ Deck, typ~
Breezeway Garage
Type Heat ~ 'Warm Air
Fireplace(s) No. Exits ~-~'
Domestic hotwater
.Patio, type -
Utility room
Hotwater ~~
Airconditigning'
TyPe heater ,T~ ~/~' ~ t~w,
Other
ACCESSORY STRUCTURES:
Garage, type const. /-{/¢¢~)Storage, type const.
m~,ing pool Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
Location Description Art. Sec.
Inspected by:. ~7~ .~/~f~ Date of Insp.
~ ~ Time start
BUILDING. DEPARTmeNT
T0%'~ OF SOUTHOLD, N. Y.
Location
Subdivision
Name of O~mer(s) Y~'~- ~'
HOUSING CODE INSPECTION REPORT
(number & street) (Municipality)
~ Map No. Lot(s) ~
Occupancy ~c~3~--~
(type)
Admitted by: ~/~
Key available
Source of request
(owner-tenant)
Accompanied by: ~ ~
Suffolk Co; Tax No. ~7- ~-/
DYrELLING: ~r~
Type of construction
Foundation
Total rooms,
Bathroom(s)
Porch, type ~
Breezeway ~J)
Type Heat /~J
Fireplace(s) --
Domestic hotwater
~/~ #stories
~~ -~/~ Cellar ~ Crawl space
1st. F1 ~ 2nd. F1 3rd.. F1
~z-~/ Toilet room(s). --------~--
Deck, type ~ Patio, type
Garage. ~ Utility room
'Warm Air ~-- Hotwater
No. Exits ~ Airconditioning
Other
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other
Storage, type const.
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
Location Description tart. Sec.
Remarks:
Inspected by:
Date Insp.
Time start ~-~ end
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hail
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 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, Multipte 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 lin~s, streets, buildings and unusua~ 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.
C. Fees:
1. 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 December 22,. 1981
New Building ............ , QId or Pre-existing Building ..... .~. ..... Vacant Land .............
/,,~t,,n of Pr"~r*', ~ Grand Avenue, Mattztuck, New York
House No. Street Hamlet
/ ,
Owner or Owners of Property Estate of Otto L. Anrig (./.~;;iC'? =, ,~ )
....... ................. ........... .....
County Tax Map No. t000 Section 107.00 Block 03.00 . Lot 001.00 &...~[~
Subdivision .... ~../.a .......................... Filed Map No ........... Lot No ..............
Permit No ..... ~./.a... Date of Permit .......... Applicant ..................................
Health Dept. Approval ~/a ........... Labor Dept. Approval
Underwriters Approval . .N../.a. .................. Planning Board Approval ......................
Pre-existing
Request for Temporary Certificate ..................... Final/Certificate ...... .'les .............
Fee Submitted $.. ~,5...0..0 .....................
Construction on above described building and permit meets all applicable codes and regulations.
Applicant
.. '..' ' ..............
324.7'