HomeMy WebLinkAboutZ-13404FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED PRE C.O.
Certificate Of Occupancy
No.Z.l-3t~ P.4 ........... Date .. fi.p.r..5.1..3..0 ..................... 19.8.5.
THIS CERTIFIES that the building ...~.p. $¥~. pjn.~. ~'ia/RS, ~ y..d.'q~ ~.~fi.r~ g. ~..~. b.c.q,..
structures
Location of P~operty 460 NORTH DRIVE MATTITUCK
h~ ~io: ....................... 'S'tr~i ....................... h~iei
County Tax Map No. 1000 Section .... 1.0.6. ..... Block .......... 9.6. . .Lot ........... 0.2..8...
Subdivision SHORE ACRES 41 L-2
............................... Filed Map No. .Lot
REQUIREMENTS FOR A PRIVATE ONE-FAMILY DWELLING BUILT PRIOR TO
conforms substantially to the Xa~pl~li~[~llX~lrll~l~iafltl~r~xC~g~l~a~ellilflll~Xffilldt~lllitlO~
CERTIFICATE OF OCCUPANCY
·..R?.I~ ~[~..~3 .......... 195.7. pursuant to which tl~aildal:l~erlll~boXlo ........ Z.1.3404 .......
dated .... ~.p..r .5.1..3. .0 ............... 198.5. . , was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
...~.l~r~-.v.q~..q~.-~'.~r0$~Ly..cl¥.e.l. 2L~g..~ .two ~gcessorx structures.
The certificate isissued to . MERLE JOAN BOURGUIGNON
.................... ...................
of the aforesaid building.
Suffolk County Department of Health Approval .... Iq. qT..~.P.P..L .I.C.A.B..L.E ...............
UNDERWRITERS CERTIFICATE NO ............. 3IQ .T. p,.E~ I~.I.C.~.B..L~ ....................
Building Inspector
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Zl1402 Date December 28 , 89
THIS CERTIFIES that the building ................................................
Location of Property ..'.~:~.0. ............... p.o.~..t'.n )).~.z.¥.e . Mat~ituck
House No. Streei ....... Hamle~
County Tax Map No. 1000 Section .. 1. vp ~ · ...... .Block ............... 06 Lot ................. 02.3
Subdivision 3',,~re~ Acre;~ ......
........................... Filed Map No. 4 1 . .Lot No...L ...........
Requirement~ for a private one-family dwelling built orior to
conforms substantially to the Al>~eafi~r~-fei'-t~aiidhag-Fe~mi*-~re, eff, er~-fil~l-i~t-t~fi~d~e&
Certificate of Occupancy
· ?je.r.i..1..2.3. .......... , 19.5. 7. pursuant to w~ch l~r~d~ng t}mmljt No.. ~ .1.1.4.0. 2. .............
dated ..... D.e.,c..eB.b.e.~...2.8. ..........19 ?.~ , 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 .........
a private one-family ~wellin~ & two accessory structures.
The certificate is issued to ME}qLF JO.tl!'~ ~OURGUIGNOIq
..................... i o;':'.',;, ' .....................
of the aforesaid building. ,.
Suffolk County Department of Health Approval not apf, licab!e
UNDERWRITERS CERTIFICATE NO. . not applicable
Building Inspector
Rev. 1/81
BUILDING DEPARTI,~ENT
T0%'$! OF SOUTHOLD, N. Y.
Location
HOUSING CODE INSPECTION REPORT
(numDer & street) / (Municipality)
(type);. ,
Ad,mitred by: o~'a~
Key available '
Source o£ request ~ ~/~' "~'--~
D%TELLIMG:
Type of co=etruction -~/~ ~stories
Foundation ~ - ~/~ Cetlar..~~z Crawl space ~-~
Total rooms, 1st. F1 ~v6~Jc~2nd. F1 / 3rd. F1
Bathroom(s) ~ Toilet room(s)
Porch, type. ~k_ Deck, typ~ ~ Patio, type..
Breezeway.. Garage Utility room --
Type Heat.. ~C~ ~ 'Warm Air Hotwater
Fireplace(s) / No. Exits 7 . Airconditioning.
Domestic hotwater ~~ Type heat'er
Other
_ACCESSORY STRUCTURES:
Garage, type const, td~_ ~ Storage, type const.
Swimming pool ~P '
Guest, type const.
Other
V_iOLATIONS: Housing Code, Chapter 52
_Location Description I Art. J Sec.
.,
Remarks:
Inspected by:
-Time start
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 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 installa-
tions,:~ 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 p:operty 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 $15.0 0
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00
Date .... ¥~..~/~ %~
New Building Old or Pre-existing Building ~/'
......................... Vacant Land .............
Location of Property ......
House No. Street Ham/et
Owner or Owners of ProperW ................................
County Tax Map No. 1000 Section .../. ?.~. ........ Block .,, ~.~ ......... Lot.. ~ ~
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 .......................
Fee Submitted $ .............................
Construction on above described building al~ permit me~ts[all applicable codes and regulations.