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Home My WebLink AboutZ-10880FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Date ....... ~9~qqrY,.!-~ ............. 1~.~. THIS CERTIFIES that the building s .... { 5 } ........................................ Location of Property .3.1. ? 5 ................ .C 9.x.. L..a.n9 ..... Cu tchosu.~. ........ House No. $~eet ........... : ..... Hamlet County Tax Map No. 1000 Section . .0.9(~ ....... Block . .0.3. ........... Lot..0.0.~. ............ Subdivision Z .Filed Map No. Z .Lot No. X Requirements for a private one.family dwelling built prior to conforms substantially to the-Al~ie~Rn-l~u~li~ .~...,~ :;z;z:ofe~e Certificate of Occupancy ...... A.~r .i.1' .2..3 ...... ,19.5.7. pursuant to whiclrt~ild~.~tmit No ........ $1 0.8.8~Q ....... dated ..... Y. ebrua, rAr..16. ......... 19 82., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is .. ~ ...... pr.~. v..a.~.e.. 9.n.e.-.t..~.m.x.~.r..d~e. x..Z.LR~,..a.n.a...~..c.a.r. ~.a.r.a. ~.e.,.. a..n.~..~..ar$.e' . .a.~?.a. $.e ..... structure, and one-room gUROt house, and wood pump house. The certificate is issued to ......... ~[.L.I~RH..C....~04~1~ ~[1~. ........................... (owner./eeme~mem*~ of the aforesaid building. Suffolk County Department of Health Approval .... n../.e ................................... UNDERWRITERS CERTIFICATE NO ............ n../.r ................................... Building Inspector Ret. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location 3175 Cox Lane (number & street) Subdivision x Map No. Cutchogue (Municipality) Lot(s) X Name of Owner(s) William C. Bolenius Occupancy R-1 Admitted by: (type) Ann Hemblo unoccupied (owner-tenant) Accompanied by: same Key available Suffolk Co. Tax No. 096-03-004 Source of request William Wickhsm Date 2/1/82 DWELLING: Type of construction Foundation cement block Total rooms, 1st. F1 3 Bathroom(s) 2 Porch, type roof over Breezeway Type Heat cji fired Fireplace(s) 1 Domestic hotwater yes wood framed. #stories Cellar partial Crawl space 2nd. F1 .~ 3rd. F1 Toilet room(s) Deck, type Patio, type Garage Utility room 'Warm Air x Hotwater No. Exits 2 Airconditioning Type heater ~as Other electric senerator in cellar ACCESSORY STRUCTURES: FOUR Garage, type const. 2 car wood SWtmm%ng pool garage Other wood pump ~ouse Storage, type const, large wood Guest, type const, wood, one room .V. IOLATIONS: Housing Code, Chapter 52 Location Description Art. Sec. kitchen gas stove, no shut off V 52-~2-E, llar sSeps no rail II 52-27-B r garaEe needs some repairs III 52-31-B od storase needs sills replaced ..... III 52-~0-A ce] 2 car 6 Remarks: Inspected by: Curtis W. Horton Time start 11:30end 12:15 FORM NO. 6 TOWN OF SOUTHOLD Building Department 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 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. B. 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 buildil3gs or premises, or other pertinent info~ma- 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 3. Copy of certificate of occupancy $1.00 $5.00 New Building ............. Old or Pre-existing Building 3{ Vacant Land Location of Property Cox T.q~e, . .(~..C..t~3~..,. ~ ¥cr~ House No. Street Hamlet Owner or Owners of Property ........ ~1 1~C.. ...... .( ? .e .[ : . .~ 7 .3 .4 7 .5 .~ .4 .5 .) ........... County Tax Map No. 1000 Section . D,9/~ .......... Block . _3. ............ Lot ..... 6~ .......... 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 ..... Z .......... Fee Submitted $..-%00. .................... ~ ' Construction on above described building and p,~~s all~/~~~s.