HomeMy WebLinkAboutZ-10191FORM NO. 4
TOWN OF SOUTHOLD
BUILDING'DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
Date October 8, ~0
THIS CERTIFIES that the building ................................................
Locatior~ of Property 275 Sun .LenA, Southol.d., N.Y.
- -- ~ ~/o: ...................... ~r~i ...................... /~i.i
County Tax Map No, 1000 Section .. ,?.~ ....... Block ..... .1 ......... Lot, :1./4
requirements for a one-family dwelling built prior to
conforms substantially to ths-Aptd/~io~fo~-Buil4i~-iiem~-he~ef~C~i-i~-lt/s-offe~datedr--
~,, Certifi.ca~e of Occupancy Zq.0~9~
· . P4Xl~ll. 2~ ......... ,19 ~t. pursuant to ~aioh-Bu/td~~.--. ...................
dated ....0.O.~.O..b.e?..8. v ............. 19.8.0. , was issued, and conforms to all of the requirements
of the applicable prov/sions of the hw. The occupancy for which this certificate is issued is .........
Oc~_ ahoy issued 1/6/75 #Z6279 M.,~, ~.~.
The ceriif'lcate is issued to ..................... '[~.: !..¥TY.~.": Y .........................
of the aforesaid building.
Suffolk County Department of Health Approval ..... .N/.R. .................................
UNDERWRITERS CERTIFICATE NO ............. .N/.R. .................................
Bufldhig inspector
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 275 Sun Lane~
(number & street)
Subdivision West Creek Dev.
Map No.
Southold
(Municipality)
1236 Lot(s)
Name of Owner(s) Mary Basile
Occupancy R-1
(tYpe)
Admitted by: Self
Owner
(owner-tenant)
Accompanied by: Self
Key available
Suffolk Co. Tax No. 76-1-14
Source of request Mildred Koch
Date Oct. 2, 1980
5&6
DWl~LING:
Type of construction Wood
Foundation Cement Block
Total rooms, 1st. F1 8
Bathroom(s) 1
Porch, type
Breezeway
Type Heat Oil Fired
Fireplace(s)
Domestic hotwater ~es
Other
#stories
CellarPartial Crawl space
2nd. F1 3rd. F1
Toilet room(s)
Deck, type
Garage
'Warm Air Central
No. Exits 1
Patio, type
Utility room
Hotwater
Airconditioning
Type heater Electric
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other
None
Storage, type const.
Guest, type const.
One
Rest
VIOLATIONS: Housing Code, Chapter 52
...Location Description Art. Sec.
.~/.tchen Gas Stove NO Shut Off V 59_~9_w~
3utside ~me Windows Broken III~
,~._~..~ eme Electric Boxes Need Cover Plates v
~ltche~ KltcheD Door and Frame Bad
Remarks:
by:~ate of Insp. Oct. 8,
Inspected
Timestart2:00 end
1980
2:~OP.M?
FORM NO. 6
TOWN OF SOUTHOLD
Building Departnlent
Town Hall
Snuthold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instruction.
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 linas, streets, and unusual
natural or topographic feature,,
2. Final approval of Health Dept. of water supply and sawerage disposal-(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Undemtrlters.
4. Commercial buildings, Industrial buildirigs, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer reaponsible 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 usas, or buildings and "pre-existing"
land usas:
1. Accurate survm/ of peoperty showing ail property lines, streets, buildings and unusual natural or
topographic feature~
2. Sworn statement of owner or previous owner as to use, occupancy and condition of ~
3. Date of any housing code or safety inspection of buildings or premisas, or otherp~ informa-
tion required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on preexisting dwelling or land usa $5.00
3. Copy of certificate of occupancy $1.00
D.te .......
New Building ............. Old or Pre-existing Building ............ Vacant Land .............
Location of Property .~11//.~ · .'.~ ~..~. ~-,'~).~ · .'~. · ~.~. ~ .''' .................... '~'rd '~0 J~¢[ '$ ~'/~
House No. ~reet
Owner or Owners of Property..~..y...~ A~.~ L~ .............
.O.t
Co ntyTex Map lO00S on . ........ .... ....... .or .... tg. .........
Subdi¥ision ................................. Filed Map No ........... Lot No ..............
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dapt Approval Labor Dapt Approval .....
Underwriters Approval Planning Board Approval ..................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ .............................
Construction on above described building aqd permit meets all applicabJ~(i,~'~d~;~if_,~and rag~..l~t.i.o~s.'
Rev. 10-10-78