The URL can be used to link to this page

Home My WebLink AboutZ-10238FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's O~ice Southold, N.Y. ~ Date .... .l.o.T.~ll..b.a..~' .6 ................,19.80 THIS CERTIFIES that the building ................................................ Location of. Propecty ,ou~amo."" 1. 1../~.0. ............................... Iol, th Sea Dz.ive steer ..... .S!~utel~o1R,. l~,~,..,amiet County Tax Map No. 1000 Section ...~J' ....... Block .... ~ .......... Lot ..... .1.1 .......... Subdlv~on...(.~..O.~..a...~.L~..O.d...8.1~..b~...v.i. qi...o~ed Map No ......... Lot No .............. ~,equimente fo~. · one feml~.7 aeell ~1} V~e= to confo~s subst~t~y to ~e ~~ 0e~i~°ate~ ......... ..... ~$~..~3 ....... 19 ~ p~s~nt to w~ch .... ~.~3~. of ~ app~cable prov~om of the ~w. ~e o~up~cy for w~ch t~s c~ificate ~ i~u~ is ......... ' ~iva~e One ~lly ~ J~es ~d Paranoia ~ . ~e ce~ficate is ~ued to ....................... ~ ................. of the ~or~d b~d~g. Suffo~ Co~ty Dep~m~t of He~th Appw~ ........... ~ ............................ ~ERWRITERS CERTIFICA~ NO ................... ~ ............................ Bu,tldinA Permit !o, ~89~.~ loaued go A. B~lam~to to add a oo~oon 0.~.~ificate o£ Oooupan.7 ilo. Z3989 Building Inspector Rev 4/79 BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Loc.tion I / 3 O ? (number & street) (Municipality) Subdivision ~~ ~. Map No. Lot(s). (o~er~ A~itted ~: ~ ~T~' Accomp~ied ~: K~ available ~ ~-~Suffolk Co. T~ No./~-~- ~- // 8o~ce of request ~ ~, ~'m~ Date Porch, type~Deck, type Breezeway ~- ~ Garage ~-- Type Heat ~,~Warm Air FirePlace(k) 'wv D'~w .T.~: Type of construction. , ,~ ~ · ~stories Foundation~:?~ ;~-~ ,~ C~~ Crawl space.. Tot~ roo~, 1st. F1 ~+ ~d. F1 ~ 3~. ~ ~ ~oom(s) ~ ~ ~ Toilet room(s) ~ Patio, ~e Utility ro~ Ho~at~ Domestic hotwater Other No. Exits ~x~- TYPe heater ~3~ - ACCE~SORY STRUCTt~;~: Garage, type const. Swtmming pool Other Storage, type const. Guest, type const. VIOLATIONS: Housing C~de, Chapter 52 Lgcation Description ;Ar,.t,. ,~,ec. Remarks: Inspected by: ~te of Insp. "~//~, /,fro Time start ~ --end FORM NO. 6 T(:WN OF 8OUTHOLD Town Hell Suuthold, N.Y. 11871 APPLICATION FOR CERTIFICATE OF OCCUPANCY In~motiom A. This application must be filled in typewriter OR ink, and ~ubmitted i~ d~pliCate to the Buildin~ Impec- tor with the following; for new buildin~ or new use: ~-- ' 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic feetur~L 2. Final approval of Health Dapt, 'of water a~pply an~ sewerage disposal-(S-9 form or equal). 3. Approval of electrical in~allation from Board of Fire Und~writers. 4. Commercial buildings, Industrial buildir~s, Multiple Residences and similar buildin~ and instel~- tion% a cartificate of Code compliance from the Architect or Er~linNr respon~bio fo~ th~ buildin~ 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Nonconforming uses, or buildings and "pre-existir~" lend uses: 1. Accurate aurvey of peoperty showing all property lines, streets, buildings and unusual natural or 2. Sworn statement of owner or previous owner as to u~e, occupancy and condition of buildin~L 3. Date of any housing code or ~afety inspection of buildings or pmml~es, or other pertimmt Informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of ..occupancy on pre~xistingdwelling or land use $5.00 3. Copy of certiflc~ of occupancy $1.00 Date .Uoz,a~e= ,'4,, .~3~i~0 ...... ...... ' ' ............. ~ Vacant Land New Building ............. 0 d or Prs-ex sting Bu~ drag ....................... I { ~ 0 Southold Location of Property . ~.~T.o.. t). ~q~h..,~gP..D.~. '.ly.e. ....................................... House No. St~et Hamlet .Ja,m.e.s .P/...a~..d.P..a.t.r.i.c.~.a .B.: Owner or Owners of Property .............................. County Tax Map No. 1000 Section ...0.0.5.4. ........ Block . .00..05 Lot..0..0.]..1. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant. George..C,. SY,,a~ke.v~ch,. ~Sqo.. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .5 · OD ................ Construction on above described building ~ Rw. 10-10-78 Applicant/. ..........