HomeMy WebLinkAboutZ-10572FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
Date ......... ju.l.y · ~ .3.,. · 198'% ........19...
THIS CERTIFIES that the building ................................................
200 North Lane, 50 Sylvan Drive, East Marion, New York
Location of Property ...............................................................
Hou~o No. Street Hamlet
County Tax Map No. 1000 Section . .3.1 ........ Block .... ~.§ ......... Lot .... ~ ............
Subdivision.. ~q~.~. ~ ............. F~ed ~ap No...~...Lot No. ~. ~..~ .....
, reqq~rement~ ~or a one family dwellingbu~lt prior to
confo~s suostant~miy to the A~~-~~~-~d~g---
....... ~nv~ .~3 ..... , ~9 5.z p~r~t to w~~~q~R~.t9~7?...
dated ..... f.~. ~.~ t ............. 19 8..~. , was issued, and conforms to an of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
Private One-Pamily Dwelling
The certificate is issued to ......
of the aforesaid building.
(owner, lessee or tenant)
Suffolk County Department of Health Approval .... 1~/. I~ ...................................
UNDERWRITERS CERTIFICATE NO .... RZR ..........................................
Building Inspector
Rev. 1/81
BUILDI[,.~G DEPAP. T['!ENT
TO¥,~,~ OF SOUTHOLD, N. Y.
HOUSING CODE IHSPECTION REPORT
Location 200 North Lane, 50 Sylvan Drive, East Marion, New York
(number & street) (MLunicipality)
Subdivision Gardiners Bay Map No. 275 .Lot(s) 57 & 58
Name of O~rner(s)
Arthur Collier and Wf.
Occupancy ~-1
(type)
Admitted by: Mrs.
Owner
( owner-t enact )
Collier
Accompanied by: same
Key available__
Suffolk Co. Tax No. 31-15-5
Source of request R. G. Terry, J~.
Date July 6, 1981
D?FELLING:
Type of construction
Foundation
Total rooms,
Bathroom(s)
Porch, type
Breezeway,
Type Heat Oil Fired
Fireplace(s). ~
Domestic hotwater Yes
Other
Wood
Cement Block
1st. F1 6
1
Cellar
2nd. F1 1
Toilet room(s)
#stories 2
Crawl space All
3rd. F1
Deck, type Patio, typq
Garag% Utility room X
Warm Air Hotwater
No. ~xits 3 Airconditionin~
~YPe heater Tankless
Attached Tool Shed
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other
NONE
storage, type const.
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
Location Descriotion Art. Sec.
Kitchen No Shut off gas stove V 52-52-E6
Outside House Needs Paintin~ III 52-30-C
Remarks:
Inspected by:~'~X %,~ate of Insp. July 8, 1981
' Curtis W. 'Hor{on- T~me start ~i0~ end 1.1;15
FORM NO, 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southo~d, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
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-iS-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
$5.00
Date ..........................
New Building ............. Old or Pre-existing Building ...~',. ....... Vacant Land .............
Location of Property...,~ 0..~..¥ ./..Y'. ~.~1.. i~i,L~]~ .~.. '." ~J.'~-'cz;..'.~.~..'..'~'..' ........ ~--~. · .~
House No, '" ~ Street Ham/et
Owner or Owners of Property . ,.~..~.~..-r-.H..L). I.~. .... .~.0..JT.~' ~..E.I.~......~....~..~. ..................
...... F,, pNo. X .... L o.
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 and permit mee. t.s all app_licable codes and regulations.
Applicant. ..-'
...,o_,0_. /' ........