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Home My WebLink AboutZ-10511FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's office Southoid, N.Y. Certificate Of Occupancy No...~- ~ 0.5~ 1 ........ Date .......... ~.V0.e.'.3 ............... ,198 J. THIS CERTIFIES that the building ................................................ Location of Property ~/~t)s~ 3Jo: 78~. Ba ~Z~O. B~.a c b. Ro ad ~ ......... ~a ~.~ tuc~,. ~ ,.~ .... Street Hamlet County Tax ~ap No. ]000 Section .... 9.9 ..... B]oc~ ........ 3 ...... ~ot ....... 6 ......... Subdivision ............................... FQed ~ap No ......... lot No .............. · - ~or to g~.~ccupancy ..... ~ ....... , 1~.~. pursuant to w~ch~namgr~rNO ............... g'1'05 t ~ dated .. dg.aO. ~.~ .................. 19..8 ] was issued, and confoms to a~ of the requirements of the applicable provisions of the law. ~e occupancy for w~ch t~s ce~ificate is issued is ......... ..... ~c~y.~,. 9.a~,F~g~y..~,l~.~ng ........................................... ~e certificate is issued to ....... ~hYll.~. P....4~.~.~ ................................ (owner~ ~._. of the aforesaid building. Suffolk County Depa~ment of Health Approval ...... g. ZR. UNDERWRITERS CERTIFICATE NO ..... N / R .......................................... Building Inspector Rev 4/79 BUILDING DF_OAP. TI.~NT TO~;~.~ OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location 782 Bailie Beach Road, (number & street) Subdivision Map No. Name of Ov~er(s) Phyllis P. Austin Mattituck, New York (Municipality) Lot(s) Occupancy R-1 (type) Admitted by: Mr. Moore Unoccupied ( owner-ten~'~t Accompanied by:Mr. Moore Key available Suffolk Co. Tax No. 99-3-6 Source of request John L. Moore, Jr. Date 5/15/81 D¥~LING: Type of construction Foundation cement R]o~ Total rooms, let. F1 Wood framed 5 #stories Cellarp~t~] Crawl space 2nd. FI 5rd. FI Bathroom(s) Porch, type Breezeway. ~ype Heat Oil Fireplace(s) 1 Domestic hotwater Other 2 Toilet room(s). Deck, typq Patio, t]~p~ 2 Cement Garag~ Under Utility room 2 "Warm Air Hotwater x No. Exits ~ Airconditioning Yes Type heater Tank] e~ ACCESSORY STRUC?URES: .Garage, type const. Swimming pool Other NONE Sto~age, .type const. Guest, type Const. VIOLATIONS: Housing Code, Chapter 52 .Location Description Art. Sec. Garage Cement Block wall cracked badly two 52~31-A Rear Psti Rnn~n h~Jll~ (n n]=~o~ III 52-30-A Remarks: .Inspected by:~Date of Insp. May 29, 1981 Curtis W. Horton T~me star~l:12 end 11:.30 FORM NO. 6 TOWN OF SOUTHOLD Building Depa,b,ent 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 usa: 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. OFor existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land usus: 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 usa, 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: (~l)Certificate of occupancy $5.00 Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 ~,Date ...... ~.//..~./..~.~. ...... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Loc?t?on o~f Property .O~i.U~....~..'..o.~....~.~.j.e..~...~...E.~....~..el.: .... ~....~......~..'-,~- House No. -- ~reet Owner or Owners of Property.. ~. k.~l I.~ .... County Tax Map No. 1000 Section .. ?..~.I ....... Block . .~..~. .......... I-'ot~..~ ~ ............ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ....... > .............. Request for Temporary Certificate ..................... Final Certificate .................... Fee Submitted $ .~.. ................ Construction on above described building and permit meets all.applicable co~es an~ re~tulations.