HomeMy WebLinkAboutZ-9472NO. 4
TOWN OF $OUTHOLD
BUH.DING DEPARTMENT
Town Clerk's Office
Southold, lq. Y.
Certificate Of Occupancy
Date Ma~'ch 23
............................ , 19..79..
THIS CERTIFIES that the building located at ...-~,800 · .Counter. Rd..
Map No...~Block No... ~xxx3m~ot No ..... x3ucxxxxx ...................
REOU~S FOR ONE FAMILY DW~.T.ING BUILT PRIOR
conforms substantially to the ' ' _ ' ' ' ~-- ' ~ '
~ C~TIFICATE OFFOCC"JPANCY
.... ApeS1-- 2-~ ....... , 19..57 pursuant to which3]~//~/l~oit No. Z9/k72..
dated .... Na~. ch.. 23 ........ , 1979., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is .......... Pr-~.vate .0~e..Fam.t.ly Dwel.~4,ng. ~,~;h. Accessory. Structures
The certificate is issued to ......... Doug2.as · & ~aro,l .Ca~e ........................
(owner, ~t)
of the aforesaid building.
Suffolk County Department of Health Approval ......... .~..~.-..~.~.s.~..~.g .............
UNDERWRITERS CERTIFICATE No. l~e-Ex~st/~g
HOUSE NUMBER . .~.,.800 ...... Street .... County. P~o~.d~ .... Z7 .................
.......................................... Pecon~o, .Ne~ .York .................
Building Inspector
County Tax Number
1000-75-1-1.1
Location
Subdivision
Name of Owner(s)
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
34,800 County Road 27 Peconic
(number & street) (Municipality)
xxxxxxxx Map No. xxxxx~ Lot(s) xxxxx
Occupancy R-1
(type)
Admitted by: Mr. &Mrs.
Douglas & Carol Case
Owner
Case
(owner-~)
Accompanied by: Mr. & Mrs. Case
Suffolk Co. Tax No.
Rudolph Bruer Date
Key available
Source of request
Attorney for Applicant
1000--75-1-1.1
March 19, 1979
DWELLING:
Type of construction
Foundation cement block
Total rooms, 1st. F1 6
Bathroom(s) 1
Porch, type
Breezeway~arage.
Type Heat 0il Ftr~d Warm Air
Fireplace(s)
Domestic hotwater
Wood framed
#stories
Cellar full Crawl space
2nd. F1 4 3rd. F1
Toilet room(s). 1
Deck, type xxxxxx Patio,
Utility room
Hotwater
Other
No. Exits
Yes ~ype heater
2
Yes
Airconditioning
Electric
ACCESSORY STRUCTURES:
Garage, type const. 2 Car-Wood Storage, type const.
Swimming pool Guest, type const.
Other Also a One Car Garage on propert~
VIOLATIONS Housing Code, Chapter 52
Location Description Art. Sec.
at Porch Steps need replacing III 52-30-~
,, Sills need to be replaced III 52-30-A
far Garage Broken door III 52-30-A
far Garage Broken window frame III 52-30-A
Fron
2
1
Remarks:
Inspected by: ~' ~_
CURTIS HORTON
Date of Insp. March 20, 1979
Time start._2~Oo__end 2:A5 ~M
FORM NO. 6
TOWN OF SOUTHOLD
, Building Depaftmeflt
Town Clerks Office
Southold, N. Y. 11971
APPLICATION FOR GERTIFIC:ATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building
Inspector 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
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.
B. 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.
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
New Bclilding ................ Addition ................ Old or Pre-existing Building ........~{ ...... Vacant Land ..............
Location Of Property ...S~,e...~.~'c,~.~j~.q~..~.~.z;..v..~. ....................................................................................
Owner Or Owners Of Property .....D..o...u.~..a..s.....a..n...~.....C..a...:..o...Z....C...a..s...e. ....... .?...6..5..T..3..5..Z.9' ....................................
Subdivision ................................................................ Lot No. ............ Block No ............. House No .............
Permit No ..................... Date Of Permit ~ ................... Applicant .~,p~,..~.Q~r.~,.~. ...................................
Health Dept. Approval ............................................ Labor Dept. Approval ................................................
Underwriters_Approval .............................................. Planning Board Approval ........................................
Request For Temporary Certificate ........................................ Fined Certificate ......... .X.. ..............................
Fee Submitted $ ....~.,.(~ .......................
on above described buildin~t/~ll~l~b.~,~ and regulations.
Construction
App I ica n t..~.~.~..~~. ..........................
.... 1,9.tb... day of ...... ~ch..1R.~.~. ............. (stamp or seal)
Notary Public ...~_~...~..,..~,.. .............. County
~IOTARY PUBLIC, State of New
No. 52-4655242, Suffolk
Commission Expires March 30,