HomeMy WebLinkAboutZ-10664FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Buildin§ Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z10664
Date ..... .~.~.p. ~. 9.m.~.~.~...4 ............... 19..8.1
THIS CERTIFIES that the building ................................................
L~,,^-^~o ..... ,, 280 Mechanic Street - 355 Youngs Ave., Southold~ N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section . 9.6.1. ....... Block .... 0.~ ......... Lot ....0.3.5. ..........
Subdivision ............................... Filed Map No ......... Lot No ..............
. Rflqu~r~meBts ,for .~..Tw~-Fam~lY~ ~we]~ipg .~il~ Pr$or, to
conforms substantially ~o
Certificiate of Occupancy Z10664
.... ?.p.~..~.1. ?.3. ....... , 19 .5.7. pursuant to which-B~itdi~it44o ......................
dated ..... .~.~.p..~9.m.b.~. r..4 ..........198.?., 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 .........
... ??.o...r.~.~yy. ~. p~..~.x.x.~.~...~.%~?...&%c.~. ~..~.o?y...s.~?.~.c..Lu??.. ! .z..c.~..v. 97.r. ~..~?) .......
The certificate is issued to .... ~..n.~.h.c~n. y., 9.a.~. c..i.c.h..h.. ~.n.~o..i.n?.~. ~. ?..C.~.~..c~.c.h. ............
[owne~~
of the aforesaid building.
Suffolk County Department of Health Approval ~/R
Building Inspector
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location ~/~30 /~/~//c 0;-,~,~ --'~'~r~/~
(n~ber & street) (M~icipality)
Subdivision Map No. -- Lot(s)
Name of Owner(s)
Occupancy ,/~--~_
(type)
Admitted by?~x~/~.~
/
Key available
Source of request
!
DWELLING:
Type of construction ~7o0~ ~---/~,Ce',~.'
Total rooms, 1st. F1
Bathroom(s) ~ ~
Porch, typ~ ~
BreezewaL
#stories 7~ed~
Crawl space~'Z2_
2nd. F1 ~ 3rd. F1
Toilet room(s), '
Deck, type ~ Patio, type
Garage ---- Utility room ----
Type Heat~W~g-
Fireplace(s).
Domestic hotwater
Other
Warm Air Hotwater ~ ,,
No. ExitsT~o 7~ ~Airconditioning
T~e heater
ACCESSORY STRUCTURES: ~uo~m W~.
Garage, type const.-7-~ ~/C_
Swimming pool
Other
Storage, type Const.
Guest, type $onst.
VIOLATIONS: Housing Code, Chapter 52
Location Description Art. Sec.
Remarks: . ~ / ' '
Inspected by. ;/~d~/2~at e o f Insp.
Time
z7
start/o'~/o~,~/end ~.'OY- .~.. A~.
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, 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--(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 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 informa-
tion required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use $5.00
3. Copy of certificate of occupancy $1.00
Application is made for a Certificate of Occupa. ncy reciting that
the premises may be used as a two-family Date .AUgUSt. 28,. 19.81 .......
dwelling with accessory structure two car garoge.
New Building ............. Old or Pre-existing Building .. A ........ Vacant Land .............
Southwest corner of ¥oun~s Avenue and Hechanic Street
Location of Property ............. ~Ol, l.t~q~t.,..[~.. []~ ............................
Hou~e No. ~ ~ 0 ' ~"~;- ~>.~ o~r~e/~ Hamlet
Owner or Owners of Property ....Aly-..T?I..0..N~...C..A.~.C..[.C.H....a.n.~...ADI'..T~..~ .[~..T.~..E....C~..C.[..C.I-I. ..........
County Tax Map No. 10OO Section .. O.61. OD. ..... Block ..... 0A.00 .... Lot ..... ~35.0~0. ·
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No ........... Date of Permit .......... Applicant ......................... ,J~...~(...
Health Dept. Approval ........................ Labor Dept. Approval ............. ~\.~.
Underwriters Approval ........................ Planning Board Approval ..
Request for Temporary Certificate Final Certificate
Fee Submitted $ .~.00 ......... iiiiiiiiiiiiiii ......... '"' ' ~' ~ '~'~
Construction on above described building and permit meets all applicable codes and rqgulations.
Rev. 10-10-78