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Home My WebLink AboutZ-9401NO. & TOWN OF SOUTHOLD BUrLDING DEPARTMENT Town Clerk's Office Southold, iN. Y. Certificete Of Occupency THIS CERTIFIES that the building located at .~.0.~)..~.a..~..R.~: ............ Map No ............. Block No ........... Lot No .................................. REQUIPd~4ENTS FOR ONE FAMILY DWELLIN~ BUILT PRIOR TO conforms substantially to the ~_-~ ' ' ' CERTIFICATE OF OCCUPANCY dated ...A.p..~.i.1.....2.~. ....... , 19..5.7. pursuant to which~ No..Z9~01 dated ...J..a/1..u..a~.....2.2. ....... , 19..7.9., wss issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which ~ certificate is issued is ....... P~iva.te. 0n~ .F~mJ.ly. D~elli~g. ~witk Det~he~t. g~ ....... The certificate is issued to ........... Sal]_y..Bm] i ts ............................... (owner, of the aforesaid building. Suffolk County Department of Health Approval ......... . .P~..e.--..E~.l..s.~.!n.g ............ UNDERWRITERS CERTIFICATE No ................... P..r.e.-..~..i.s.~.i.n. 6 ............ HOUSE NUMBER ....5.0.0. ....... Street .............Hy.a.~..t..R.d... ................... .................................................. .s.o.u. ,..N.e.w...Y.o.r.k. ........ Building Inspector County Tax Number 1000-051-001-013 Location BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT 500 Hyatt Rd. or Pvt. Rd. # 18 Southold (number & street) Subdivision Name of Owner(s) Occupancy Admitted by: R-1 (type) Mrs. Hyatt Map No. (Municipality) ~ot(s) Commissioner of Social Services Sally Balits (owner-tenant) Accompanied by: Mrs. Hyatt Key available Rudolph H. Bruer Source of request Suffolk Co. Rudolph H. Bruer Attorney At Law Tax No. 1000-051-001-013 Date January 19~ 1979 DWELLING: Type of construction Foundation Total rooms, Bathroom(s) Porch, type Breezeway Type Heat Oil Fired Fireplace(s) Domestic hotwater Other Wood 1st. F1 5 one Deck, Garage. Warm Air No. Exits #stories Cellar full Crawl space 2nd. F1 3rd. F1 Toilet room(s) type Patio, type Utility room X Hotwater X 2 Airconditioning one yes Type heater 0il Fired-storage tank ACCESSORY STRUCTURES: One Car Garage, type const, cement block Swimming pool Other Storage, type const. Guest, type const. VIOLATIONS: Housing Code, Chapter 52 .Location Description Art.. Sec. arage Garage door jambs rotten 52 31 - B Remarks: Inspected by: urals normon Date of Insp. January 22, 1979 Time start 2~on end 2:20 FORM NO. 6 TOWN OF $OUTHOLD Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instruction. A. This application must be filled in typewriter OR ink, and submitted in triplicate 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 o~ 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: 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 ...J..a...n..u...a..r. ~7....1...7..,.....1..9...7..9. ........ New Building .................... Old or Pre-existing Building ............X. ............... Vacant Land ............................ Location Of Property ~..H..~...r..t.~.~..n.~.s~.P.~.~..i.~.n..t..~.E..~.~.t..e.~.n..s.~.i..~...n.~.....S..~..u...t..h.~.~..~.~.d./~.N..*.~.Y.:. ..................................... Owner Or Owners Of Property ..... .S..a...1..1. y.....B..a..1...i..t...s. ..................................................................................... 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 Certificate ........................................ Final Certificate .......X.. ................................. Fee Submitted $ ...~.,.0.fl ........................ Construction on above described building~_~ a/~Jc~Jyc~.a,nd, regulations. Applicant ~~ .................... Sworn to before me this R~o~ph H. ~uer, attorney for Sally Balits .... · 7..t,,h.. day of ..... Jart~a r~......1 ,q.7.1~ ........ (stamp or seal) ~-~ 2k//,, Notary Public ...,S.~,f. fD3,k ............... County