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Home My WebLink AboutZ-9567 BFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No.. 7.9567 .......... Date .............. June .15., .......... 19.7.9 THIS CERTIFIES that the building ................................................ Location of Property ...1265 .Shore. Dr&.ve ..................... Greersport ......... House No. Street Ham/et County Tax Map No. lO00 Section . 4.7. ........ Block ..... 2 ......... ]Lot ....... 26 ....... Subdivision · GreexaLm>~ .Shores ........... Filed Map No. 17~9...Lot No..15,..1,6 ,. & -1~ ,Req¢i.~emant~ .f~r ~ One. Fa4a~l¥ ~well~nq ~uiLt~ nrior to conforms substantially to the ~R~~X Xg~eX~[e~X~~ ce=t' i c~ ~ ...... ...... April..23,. I . , 19 57. pursuan~ '~l~c ~~~. gg. S6 ? ......... dated ............. J34r~e. ,I.$, ..... 19.79, was issued, and c~nforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ............. ~.RI~ATE_,. DiNE .-FAMILY. DWELLING ................................. The certificate is issued to . . $~ephen .G.. Chaskc~ .................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .... P,ce-~E~£st:£n~j ....................... UNDERWRITERS CERTIFICATE NO ............ Pse~-Ex.J,a[£n~ ....................... ................ .... Building Inspector Rev 4/79 Location Subdivision BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT (number & street) '(Municipality) · ~ap No. _ Lot(s) Key available Suffolk Co. Tax No./~r~6-o<[7-~- oo~ Source of request /~L~J/~FJ~. ~[~L/Z~S~/-~Dato -/~- 77 DWELLING: Type of construction Foundation Total rooms, Bath~oom(/~ Porch, type Breezeway ------- Type Heat ~/O~/~- 1st. Fl~ ~s 2nd. F1 ~ ~-~// Toilet room(s) - ~ Deck, ~e Patio, Garage -- Utility room W~Air Ho~ater No. Airconditioning Fireplace~a0 O~ Exits ~ Domestic hotwate~.~~Type heater Other #stories_~2~j_~__ Crawl space 3rd. F1 ~ type ACCESSORY STRUCTURES: Garage, type const. Zz~-~ Swimming pool Other Storage, type const. ~-~;~ ~ ~/z~g~ Guest, type const. VIOLATIONS: Housing Code, Chapter 52 Location Description Art. Sec. Inspected by. . te of Insp. Time start F.'~end FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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 faatu 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 $§.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date ...~..u.n.e...[.~..,...[.9.7.9. ........ New Building ............. Old or Pre-existing Building X Vacant Land Location of Property 516 Sho~e D~±ve, Gzeenpo=t:, ~Tew ¥o=.k .................... House No. Steer Ham/et Owner or Owners of Property ]~st:at, e p.E.S..t,.e~.h.e.~ .G.....C.h.a.sk.o.& dece~se~ County Tax Map No. 1000 Section 47 Block 2 Lot... 26 . Subdivision..G.~..e.e.~.~.o. ~..t..$:h.o..~ .e.s ............. Map No .... .~.7.5.9. ...... Lot No... ~,5.,.. [~,..]."~ Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate X Fee Submitted $ 5.00 Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 COVE In the Matter of Certain Real Property Known as 516 Shore Drive, Greenport, New York AFFIDAVIT OF USE, OCCUPATION AND CONDITION STATE OF NEW YORK) COUNTY OF NASSAU ) the estate of Christine M. Palmeri, formerly known as Christine M. Chasko, being duly sworn, deposes and says: That she is the sole executrix of Dr. Chasko died on January 2, 1979. Stephen G. Chasko. That at the time of his death, Dr.. Chasko was the fee owner of the real property known as 516 Shore Drive, Greenport, New York 11944, which property is more fully described in schedule A annexed hereto. That this property contains the following structures only: a one story single family dwelling house, a two car garage, and a boat dock. ~ That all of said structures were erected prior to 1957. That this property and the structures hereinabove described have been occupied and used since their purchase and construction solely as a seasonal residence by the descedent and his immediate family, includ- ing your deponent, who is the daughter of decedent. The dock has been used solely to accommodate a family boat. That upon information and belief, cribed are and have been at all times sound, safe and suitable for the uses the structures hereinabove des- since construction, structurally indicated above, and substantially conform to all applicable codes and regulations. That upon information and belief, there has never been a safety or building inspection of these premises. That this affidavit is made to induce the Building Department of the town of Southold, New York, to issue a final pre-existing certificate of occupancy on the above described real .property. Sworn to before me this llth day ~f June, 1979. Ouallfied m ~ueens Coun~ ~m,~sJon Expires Match. 30. CHRISTINE M. PALMERI -2-