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Home My WebLink AboutZ-8934FORM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy. No.. Z893~ .... Date .. F-ebruery .... 16 .......... , 19..~8 THIS CERTIFIES that the building located at 29~. Sh-ipyard..L~ne ....... Street Map No ............ Block No ........... Lot No .................................. REQUIREMEI~T$ FOR ONE FAMILY DWELLING BUILT BEFORE conforms substantially to the ~' K~g4~ Certificate of 0ecupaney dated . .Apr.it. · 2-3 ......... , 19 .~7. pursuant to which ~ N.o o. 89.3~Z dated . .Febzamry..16 ........ , 19.78., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .Pt~I.VATE. OldE. F.AbitL¥ .D~LLII~G ...................................... The certificate is issued to ...Elc.hae]...Boket~ ..................................... (owner,~]~~ of the aforesaid building. Suffolk County Department of Health Approval .... p~e-..~.x.~.~;..~.g ................. UNDERWRITERS CERTIFICATE No .............. ~r.e.'E.X~S~..~..g ................. HOUSE NUMBER ...29~ ........ Street .... ~hipy. ard. ~al~e ....................... .......................................... E~.t..~er;[.cr~,. N.Y. .................... Building Inspector Housing Code Inspection February 15, 1978 295 Shipyard Lane R-1 East Marion, New York Tax Roll: occupied: Michael Boken Theresa Boken Upon receipt of an application for a Pre-Existing Certificate of Occupancy I made an inspection of this premises. I was admitted to dwelling by Mrs. Boken and began this inspection at approximately 2:10 P.M. The dwelling is a one story wood framed structure constructed on a cement block foundation. Building contains three bedrooms, a living room, dining room, front entry, vestibule, bathroom and kitchen. Heat is furnished to all rooms from an oil fired hotwater furnace located in full cellar. Accessory structure is a small wood frame storage shed located in rear yard area. I found no violations of the Housing Code, Chapter 52, Code of the Town of Southold, N.Y. Inspection completed at approximately 2:30 P.M. Re~ct~_ully/~bmitted,~ ~ Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Dejmttment Town Clerks Office Southold, N. ¥. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions 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. §. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 19.57), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of 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 o/~pre-existi__n~c~lling or land use 3. Copy of certificate of occupant/ -'- $1.00 $5.00 Date , 2-, /' f ~,,/,,,,,~,,,d~'---''' New Building .................... Old .r~re-e.xiSti,~Og/Building ............................ Vacant Land ............................ Owner Or Owners Of Property ,,.,,,~. ,,~.,.~;,;;'~.~,~,.~ ....... ~,,~,],~,,,/,,,.~,,..,;~,:,,c;.,,: ............................................ Subdivision ................................................................ Lot No~.~:£J.. Block No. ~..../..f..~... 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 .......................................... Fee Submitted $ .....~ ............................ Construction on above described building and permit meets all applicable cocles~regulatio~s. -. Sworn to before me this ~ ................ day of ............................................ (stamp or ~al) /~ ~ ~y Nota~ Public .................................... Coun~ ~,~./k~[ -' ~ ~-~