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Home My WebLink AboutZ-10827FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificnte Of Occupnncy No.. Z. 1.082.7 ......... Date .... D. ece~ber. 2.1 ................ 19~1. THIS CERTIFIES that the, building ~ ............................................... Location of Property . .59.4.0.5 ............ ;':;~:1.$~ .l~o~.d. ............... S.o.t~th.o.~cl ....... House No. Street Hamlet County Tax Map No. 1000 Section . .~56 ....... Block . .0.3 ........... Lot 0.0.5 ............. Subdivision ..... X .......................... Filed Map No. ~...:..Lot No... ~. ......... Requirements fo~' a private one-family dwe~1~g built prior conforms substant,ally to the Certificate of bccupancy ... tit ..q F r.-tl. 23 ...... 19 5.7. pursuant to which Rmildieg4~m~R- No .......... .Z.l.QS. 2. 7 ..... dated ....... Oecember. 2l ........ 19 8.1., 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 ...a ...... ·.. p.~.iva.t.e . on.e.-.£ gmA.13t. ¢.w.o.~ 1 j. la.g..wJ..kh. ~.e.~.a.c. ~.e.d..t.~p..qa..~..~.a.r..ag.e.: ........ The certificate is issued to .... QO[l~.~r~9o L.a. r3g Qo. gp.o.r' ................ (ownerJ~ or-t*nanO ........ of the aforesaid building. Suffolk County Department of Health Approval ........... N./~.. ........................... UNDERWRITERS CERTIFICATE NO ................... N./.~ ............................ Building Inspector Rev. 1/81 59405 Location Subdivision Name of O~er(s) BUILDING DEPARTMENT TOi~: OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Main Road Southold (number & s~ree~) Occupancy Admitted by: Key available Source of request R-1 (type) Mr. Na~v Constance L. RudolDb H. Map No. Cooper (Municipality) Lot(s). X {owner-ten~t) Accompanied by:~ same Suffolk Co. Tax No. ~56-03-005 Bruer Date 10/21/81 D%'fEI,LING: Type of construction Foundation brick & stone Total rooms, 1st. F1 7 Bathroom(s) 1 Porch, typ~ screened Breezeway wood ~ramed #stories 2 Cellar partiaErawl space rest 2nd. F1 4 3rd. F1 Toilet room(s) type Patio, type slate Utility room Type Heat oil fired Fireplace(s) 1 Domestic hotwater Other in Deck, Garage Warm Air Hotwater x No. Exits 2 Airconditioning yes Type heater gas ACCESSORY STRUCTURES: Garage, type const.2 car wood Swimming pool Other Storage, type const. Guest, type const. VIOLATIONS: Housing Code, Chapter 52 Location Description Art. Sec. ¢itchen gas stove--DO shut off V ~2-52-B~ ~pstairs signs of roof leaking ~II 52-31-C cellar no rail--cellar steps ~.I 52-~7-B Remarks: Inspected by: Curtis W. Horton Time start 10:20 end 10:~ FO~M 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. B. 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. C. 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 . .O.q ~9~p.e3;. :~ ;Lj.. ],c,)¢,L. ..... New Building ............. Old or Pre-existing Building ... ~ ....... Vacant Land ............. Location of Property ......... ~ti~ .RQ ~.c],.. SH.~hQ ~L.c~ ................................... House No. ~ ~. . Street Hem/et Owner or Owners of Property . .G .o.n.s.~a.~_~.e..~ qQ]p~,~. ................................... County Tax Map No. 1000 Section ...~. 5~ ........ Block ., .~.3 .......... Lot .~?.5. ........... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .. C.o~s.f;~I~q~. ~....C~PH~(t~ ......... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...... .Z ................ Fee Submitted $....5...qQ ..................... Construction on above described bu lid ing and~t~ee~,/~J~ap~cab~e~/~-,~nd regu lations. Applicant. J.,~~.~.~ ............. ~ ~ pn ~. ~ruer, ey forC~stance L.