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Home My WebLink AboutZ-9486/O~,M NO. 4 TOWN OF SOUTHOLD BI~.DING DEPARTMk'~NT Town Clerk% Offiee Southold, N. Y. Certificate Of Occupancy No...Z..~..~.. .... Date ... A~':L~I. .... 2 ............ , 19. ~IS ~T~S ~at ~e b~ 1~ at . ~.O .~. ~ve ........ ~p No .... ~ ..... BI~ No ........... ~t No ....... J~ ....................... co~o~ sultrily ~ ~e ~ SPr~l .a}. 19t7. p~u~t ~ wM~ ~ . .A~Fll. ~ ............. , 19.79., was ~u~, ~d co~o~-~ ~ ~ of ~e ~ m~ of ~e app~cable pro~o~ of ~e law. ~e ~cup~ for wM~ thls ~ ~ ~ .......... Pr. ivata .~e..FamtlM ~elling.. ~$~..~9~!~9~. ~e ~ica~ ~ ~su~ ~ ......... Clai:e. L..~11 .............................. ( owner~~l~ o! the aforesaid but]ding. Su~o]k County Department o! Health Approval ...... P~,~-g,~c~.at~n~ ............... UNDERV~RHT_~S CERT~K~ATE ~o ............... L~.e-~x~at~n~ ............... HOUSE NUMBER .. 83.0 ........ Street ......... BaF~.i~. Ave..//. ................ ........................................... i .Yorlt .......... / Building Tn~,ctor Tax Ma~ Number 1000-I 06-1 --15, 16 BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT be~ & street) (Municipality) Map No.,,, 77g' Lot(s) /-~. Subdivision of 0 er(s) Occupancy ~- (type) Admitted by: (owner-tenant) Accompanied by: ~/_/~ Key available ~'z'z';/..,Z~ ..'~z'~,'~r,~<~ Suffolk Co. Source of request J~H~-~ / Tax No. -~Im~~ - ~7/~f Date ,-'~-,:::~ ~ - ~ DWELLING: Type of construction ~/~ /~/~ #stories O~ Foundation ~-~;~ ~/o~, Cellar ~7-~ Crawl space ~¢~ Total rooms, let. F1 ~ z~ 2nd. F1 ~/,,z~ 3rd. F1 -- Bathroom(~ O~/~ Toilet room(s) ~' Porch, type~~_~Deck, type ~ Breezeway Garage ~ Type Heat ~-Z~/-~C Warm Air Fir epl ac e (~) ?~EF_~No. Exits 7-~ -- Domestic hotwater ~_~_~~TYPe heater Other -- Patio, type Utility room Hotwater Airconditioning ACCESSORY STRUCTURES: Garage, type const. Swimming pool Other Storage, type const. U~'~ Guest, type const. VIOLATIONS: Housing Code, Chapter 52 Location Description Art. Sec. ' / Remarks: Inspected by: ~t~e of Insp. ,.,--'~ ~- 7~_ Time start/~:o~,~end/~:~,~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions JB. 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 featu res. 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, 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 peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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. 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.O0 Date .... ~.~,~ ,ob..2. Q,. ~L.~. 79 ..... New Building ............. Old or Pre-existing Building . .¢. ....... Vacant Land ............. Location of Property ..:..8.:~0.. ,~.&.M~'.3.¢.w..A. ¥C~u,e,. J~a,~;~;;~.t.t~ck~, ,Ne~'..~LQrk ................ House No. Street Ham/et Owner or Owners of Property ....... C..~.A,Z.~.~.. ~.g..~..L ........................................ Dist. 1000 015.000 County Tax Map No. 1000 Section . .~.0..~...0.0. ...... Block ...~.q '..0.0 ....... Lot ~...Ol~...Q00 .... Mattituck, Town of South01d "Map of Property of Mattituck Development Inc., Mattituck, L.I."Daniel R. Young, Surveyor, Lot No.a. .1. ~ .2 ..... Dated December 1922, filed 5/1/23, File No. 776. 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 $ .~.: .O.q ....................... Construction on above described building and permit meets all applicable codes and regulations. Applicant....c¢~.....~----~.. ~../~....~.... ....................... CLAIRE BULL Co, ~ - 4,o t~4ill Z ~M I TI4 · .~4,,~3T'TTT~~