HomeMy WebLinkAboutZ-10290FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No. Z10290
December 9 80
Date ................................. 19...
THIS CERTIFIES that the building ................................................
Location of Property ....~.~.~...~I.i.~..t~. ?.~.O.17..R.o.8.d. ! .............~.~.o.~..ll?.O.~.~. ..............
House No. Str~e~ 0'I ~ Ham/et
County Tax Map No. 1000 Section . .0.~).. ...... Block ............... Lot .................
Subdivision....1*.~.~.~.$ .~.i.~.~.~. ................ Filed Map No. !~..~.'1 .... Lot No.
re-~uirement for a One Family Dwelling Built Prior to
conforms substantially to the-PVpl~ee, ti~a-f~'-B~td~tg'Pern~'~m'f~lg'Yff'tl1~'Ol'ffC~'d~crff
TM
...................... 57 Certificate of Occupancy
April 25, 19... pursuant to which-ltq~44d~g,~ermit-Ne.--. ......... ....
dated Decamber 9 19 ~0, 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 Karl Askevold
[owner,/e~ji~,~jl~~
of the aforesaid building.
Suffolk County Department of Health Approval . .I~../.R. ....................................
UNDERWRITERS CERTIFICATE NO .... .~I[.R. ..........................................
Rev 4/79
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
nocation~.5-3~- /'~E~-~- ,~ ,,
(number & street) '(Municipality)
Subdivision~/~ Map No. /J~-/ Lot(s)
Name of Owner(s)
Occupancy /~--~ /
(type)
Admitted by:/7~
Key available
Source of request ~/?//~'/c~
DWELLING:
Type of construction //)~o~ ~-~/~
Foundation d~X~'~-~3z ~-~_ Cellar~__Crawl space~a-T'Z-
Total rooms, 1st. F1 ~ z,~ 2nd. F1 - 3rd. F1
Bathroom(s) ~-~. Toilet room(s)
Porch, type -- Deck, type
Breezeway ~ Garage
Type Heat~d~___Warm Air --
Fireplace(s) ~ No. Exits /~.,'~
Domestic hotwater
Other
Patio, type
Utility room
Airconditioning
Type heater -~x~ ~-~ ~
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other
Storage, type const.
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
.. Location Description Art. Sec.
Remarks:
Inspected by:
Time start/.'~g ~-/~' end~%-'O~ ? ~
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 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 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.
C. 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
December 2, 1980
Date ..........................
XX
New Building ............. Old or Pre-existing Building ............ Vacant Land .............
14 Middleton Road, Greenport
Location of Property ...................................................................
House No. Street Ham/et
Karoline Askevold
Owner or Owners of Property ............................................................
040 05 014
County Tax Map No. 1000 Section ............... Block ............... Lot ................
1351 . . 7
Subdivision Map of Fleetfield, ~2 .Filed Map No ........... -ot No.
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
XX
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ 5.00
Construction on above described building and permit meets all
Rev. 10-10-78
Applicant ~ regulations.
WTLLIAM H.~E, JR. as attorney