HomeMy WebLinkAboutZ-10455FORM NO, 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
Date ...... a. pr.~.z.' .1 .~., ................. 19 ..8.1
THIS CERTIFIES that the building ................................................
Lo ..... 505 Founders Path Southold~N~
cazlon oi rroper~y ..............................
House NO. Street
County Tax Map No. 1000 Section ...... 6.4. .... Block .... .~ .......... Lot .3.4. t..3.5. .........
Subdivision Founders Estates .Ffled Map No. 834 LotNo60 & 61
requirements for a one family dwellingbuilt prior to
Certificate of 0ccupanCYzl0455
81
dated ...A?.~..Z..,.*. ,. ............... l~..., was issued, ~d conforms to aU of the r~quirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
Private One-Family Dwelling with Acceaeory(2-Car Garage,Wood Utility
The certificate is issued to Rose C. Bennett Building)
of the aforesaid building.
Suffolk County Department of Health Approval ....N/.R. ...................................
UNDERWRITERS CERTIFICATE NO. N/R
Building Inspector
Rev. 1/81
Location
Subdivision
BUILDING DEPARTmeNT
T0I~ OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
505 Founders Fath Southold
(number & s~ree~)
Founders Estates 834
Map No.
N.Y.
(Municipality)
Lot(s). 60 & 61
Name of Ovmer(s) Rose C. Bennett
Occupancy R-1
(type)
Admitted by: Mrs.
Kerbs
Unoccupied
{ owner-ten~'~t)
Accompanied by:. Mrs. Kerbs
Key available__
Suffolk Co. Tax No..6~-2-34,35
Source of request R.G. Terry, Jr. ,-Atty.
DateApril 8, 1981
DVfELLING:
Type o£ construction
FoLmdation 12"Cement Block
Total rooms, 1st. F1 5
Bathroom(s)~ 1
Porch, typ~
Breezeway~
Type Heat Oil
Fireplace(s). No.
Domestic hotwater Yes
Cinder Block #stories
Cellar Partial Crawl space
2nd. F1 3rd. F1
Toilet room(s)
Patio, type.__
Utility room
Hotwater
1
Rest
Deck, type
Garage X
Warm Air x
Exits 'Airconditioning
Type heater Tankless
Other
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other 2 Car cement block garage
Storage, type const.
Guest, type const.
with a wood utility buildiqg
attached.
VIOLATIONS: Housing Code, Chapter 52
Location Description Art. Sec.
Wood Util:tv Bldb. Needs V~i~,,~ ~p~i~s Iii ~2-30-A.I
Remarks:
Inspected by:
Date of Insp. 4/14/81
Time start 10:00 end
10:20 A.M.
Curtis W. Horton
FORM NO. 6
TOWN OF SOUTHOLD
Building Depaf I~.ent
Town Hall
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 features.
2. Final approval of Health Dept. of water supply and sewerage disposel-(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.
Bo
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 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 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
~1 ct ~'3 ate .........
New Building ....... ;: .....Old or Pre-existing Building . ./~..~ ....... Vacant Land .............
Location of Prope .................................................
Owner or Owners of Property ....... .~ ................................
County*ax Map No. ~000 Section ..... ~.¥. ..... B~ock ..... ~ ....... Cot..2..'t-.~ .X..~. ....
Subdivision.. . ... ...... ....
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 $~.,..G~. ....................... l ~'
Construction on above described building and ~:)rmit meets al~3_ plicable codes and regulations. )~.~--
Applicant...///~/..~.'. ~.~.~ ..... ~ .... ~.~j~.,, ~