HomeMy WebLinkAboutZ-10808FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No..Zfi..O .~.0.8. ......... Date ...... .~.e.c.e..m.b.e.~.. 9 ............... 19 OJ.
THIS CERTIFIES that the building ................................................
Location of Property .. 39.60 ...... 01.e..Jul.o..ban.e. .............. [qRt, l~ll;~,Ck .........
House No. Street Hamlet
County Tax Map No. 1000 Section . 122 ........ Block .. z~ ............ Lot .g ~ r'.~;.. ~ ly. ~6 ....
Subdivision ..... 2( ......................... Filed Map No. X ....... Lot No .... ~ .........
~equiremen%s for a private one-family dwellin.~ built
conforms substantially to the .A.p.~lieel;ieR-fe~,-]~i~d,ias,-Pemd~,-her-etofer-e-filed. 4~l~~
Certil'lca%e of Occupancy
p .v .~ .o.r.. ~ 9..fi. P..v .i.1.. 2. .3.., 19.5. 7 pursuant to which tt~i~Oing' PermiV-No ........ .Z.1.Q ~ 0 ~ .......
dated ....D. qC em.b.q r. ~ ............. 19 .B'[, 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 .........
.... ~.. ~r.i.v.a..~.e..o.n.e.r.t'.a.~'.x3y.. ~.~.~.%~..n~.,. ........................................
The certificate is issued to .....~.qd.z) .ay..T.:..B.u.c..k .h.a.m. ..................................
(owner,.~;' Or't~)
of the aforesaid building.
Suffolk County Department of Health Approval ..... .N./.B. .................................
UNDERWRITERS CERTIFICATE NO ............. .N/. R. .................................
This lot was approved b~ tho Zoning Board of Appeals, ~127'1~ 8/21/69.
The Planning Board ~;ranted approval as a set off, 1t/10/81.
:.. ................
Building Inspector
Rev. 1/81
BUILDING DF~mAR T~lENT
T0¥,¢; OF SOUTHOLD, N. Y.
H~USI~,i'~ CODE _~o~~TIOL REPORT
Location
9960 Ole Jule 4ane
(number & s~ree~)
Subdivision X
Map No.
Mattituck
(~,]%micipality)
Lot(s) x
Name of Ovmer(s) Rodnev T. Buckham
Occupancy R-1
(type)
Admitted by: Mr. Buckham
owner
( owner-tenant )
Accompanied by:~ same
Key available__
Suffolk Co. Tax No. ~22-4-part of 26
Source of request
Date 11/23/81
DYfEI.LING:
Type of construction
Foundation cement block
To~al rooms, 1st. Fi 5
Bathroom(s) 1
Porch, type $creene~
Breezeway
Type Heat ni~ fired
Fireplace(s) 1
Domestic hotwater ¥~
Other
wQod
#stories
Crawl space
2nd. F1 3rd. F1
Toilet room(s)
Deck, type Patio, type . .
Garage. Utility room
Warm Air Hotwater x
No. Exits 2 Airconditioning~
Type }]eater tankless
Cellar full
ACC~SSO.,Y STRUCTURES:
Darage, type const.
Swimming pool
Other
NONE
Storage, type const.
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
Loca'2ion Description Art. Sec.
no violations, Chanter R2
Remarks:
Inspected by: ~~./~-z//--'-----/~z??~te of Insp. December 8, 1981
Curtis W. Horton T~me start .2:30 end 2:45
J
FO~M NO. 6
TOWN OF SOUTHOLD
Building Department
Town Clerks Office
Southold, N. Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted
Inspector with the following; for new buildings or new use:
1. Final survey of property with accurate location of all buildings,
in triplicate to the Building
property lines, streets, and
unusual natural or topographic features.
2. Final approval of Health Dept. of water supply and sewerage disposol--(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.
5. Submit Planning Board approval of completed site plan requirements where applicable.
For existing buildings (prior to April 1957), 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.
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
Date ......... . ./../X..'~.../....g../. .................
New Building ............. ~.~/~DI,~ or Pre-existing Building ...... ~ ............ Vacant Land ............................
Location Of Property" ~'~- "~- -- ~ ~' ' .."...f~/...e........~.~L~......~.,....~./~..~.....~..~.~'.: ..................
Owner Or ~ners Of Prope~ ........ L~a~.....~...~~.~ ...............................................
5u~ivision ................................................................ Lot No ............. Block No ............. Hou~ No .............
Permit No ..................... Date Of Pe~it .................... ~plicant ......................... ., ......................................
Health Dept. Approval ........................................... ~. Approval ................................................
.............................................. , ra .......
Request For Tempom~ Ce~ificate ........................................Final Ce~ificate ...... ~ ..........................
Fee Submitted $~.~ .........................
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