HomeMy WebLinkAboutZ-11300FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
Date ....lq. qr. ?.m.b.e.P.. J.7 ................. 198.~..
THIS CERTIFIES that the building ~... C ~ ) .........................................
Location of Property .3.}~ ......... P.r.~y.a.~.e.. ~.~.... !L~..o..r.r. ~a..~.n. ?.q.a.d ...... .S.o.u..~.hp.~fi..
House No. Street Hamlet
County Tax Map No. 1000 Section . .0.6..1 ....... Block . .Off. ........... Lot..p.a..x?..o.f.. 99.9...
Minor
Subdivision...P.h. 9.bP..~ :..~r..l.d.g.~. ......... .-F-,/le&M~p No..~.~..5 .... Lot No...1 ...........
Requirements for a private one-family dwelling built prior to
conforms substantially to the
Certificate of Occupancy
·..~p.e.J:..1. ~..3...: ...... ,19.5.~ pursuant to which-thfitdirg/%-rm/t-No. Z 11 300
dated .... !~.q v. 9 .ra.b.e.P...~:~ ........... 19 .8.2., 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-fatally dwelling and acceseory two-car garage.
Phebe ~. grid~e
The certificate is issued to .................... ~ ......................................
(own~r, lesme m-~mm~
of the aforesaid b~]ding.
Suffolk County Department of Health Approval ...... .~./, a. ................................
UNDERWRITERS CERTIFICATE NO .............. .n./..~ ................................
Building Inspector
Rw. 1/81
FORM NO. 8
TOWN OF SOUTHOLD
Buiiding Depar~men~
Town Hall
Southold, N.Y. 11B71
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This aoplication must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec-
tor ,.vita ~ne following; for new buiJdings or new use:
1. Final sunvey of property with accurate location of ali buildings, property lines, streets, and unusual
natural ,, ,ooo~,a,~h,~ features.
2. Final approval of Health Dept. of water SUPply and sewerage dispose --(S-9 form or equal).
3. Approval of electrical installation from Bo~'rd of Fire Underwriters.
4. Commercial buildings, Industrial buildinas, Multiple Residences and similar buitding~ and installa-
tions, a c~rtff~c~,e of Code comp!iance from the Architect or Engineer respons b e for the building.
5. Submit Planning Board apprcval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or build/nas and "pre-existing"
land uses: ~
1. Accurate surwey of peoperty showing all property lines, streets, buildinas and unusual natural or
topographic features. ~
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Dale of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate. /
FoBs:
1. Ce~ificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use
3. Copy of certificate of occupancy 21.00
S5.00
Date ..
New Bui!ding ............. Old or Pre-existing Building(:Z.) ........ = /Vacant Land ............
Location of Property ........ . ..............
(~'~ I ~ ~,rreer Ham/et
O'.vner or O oers of Property .. .. .......................
County Tax Mao No. 1000 Section O~ ~ Block ~).$
Permit ~]o ........... Date of P~rmit *-~ · --. , ~'~
Heahh Dept. Approval ........................ Labor Dept. Approval .........................
Unden,'/riters Approval
........................ Planning Board Approval ..................
Request for Temporary Certificate ................ Final Csrtificate' . ....... - .........
Construction on above described building and permit meets air aPp[(cabl~codes and regulations.
335 Private Road #2 off Main Road
Southold
Minor
c~.~s~.~-- Phebe H. Brid~e
Plo. 245
(Nunzcipaii~y)
Lot(s) 1
Name of Owner(s)
Phebe M. Bridge
Oc ~u.~ .... y R- ~
unoccupied
[iMpel
~,~m~Ltsd by: sel~
Key available
Source of request
Mr. Albertson
( owner-tenanv
Accompanied by: self
Su~zol:< Co. Tax No. 06~-04-p/o 009
Lynch
Date 11 10/82
Type of construction
Fo'ondation cement
Total rooms, !st. F1
Bathroom(s) 1
Porch, tire..roof over
Breezeway
~Mpe Heat oil fired
Fireplace(s) 1
Domestic hotwater yes
Other
wood framed
Pstories 2
block Cellar full Crawl space
4 2nd. F1 3 }rd. F1 large
Toilet room(s) 1
Deck, type Patio,
Garage Utility room
Warm Air Hotwater X
No. Exits 2 Airconditioning
electric
.T~rp e heater
type
attic
....... .~- STRUCTb~ES:
Garage, type const.
Swirming pool
Other
2-cap wood
Stora6e, tppe const.
Guest, tppe const.
~ ...... ,n c. HouslnS Code, C~p~er 52
......... - .......... Art. } Sec.
front porch[ brick porch needs repairs III 152-31-A
bathroom repairs needed to bathroom 52-32-D
cellar no rail cellar steps
II
throughou~ damp spots on walls III
152-27-B
I52-32-C
Remarks:
Curtis W. Hort~n Time start 4:20
11/15/82
end 4:40