HomeMy WebLinkAboutZ-10522FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
THIS CERTIFIES that the building ................................................
Location of Property ... 2/~0. Pa~.ad la.e. Shox:.e$. Rt~ad ~ ........ ~o~t ~,~c~ld~..1~, ~, .....
House No. Street Ham/et
County Tax Map No. 1000 Section .... 80. ..... Block ......... 1 ..... Lot . .7.. ] ............
Subdivision ............................... Filed Map bio ......... Lot No ..............
r i~eme ~ f. r' on -fa i 11 il lot ~o
conforms substantially to the ~E/twa-~ ~u:~ ~m~ J~r~ i(~e~. ~.~.in ~.~..J~__
fi ate Occupanc.y. ..........
..... Apr~..L .23 ....... , 195.7.. pursuant to whici~tm.$e--t-~e.. ........ Z10522
dated ......... d.u~e. ~ ............ 19..8.~ 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 .........
Private One-family Dwelling
The certificate is issued to ...... Alexander..~oud.ext .................................
(ownerJ~g or. tsIl~ot~__
of the aforesaid building.
Suffolk County Department of Health Approval .... II/P. ..................................
UNDERWRITERS CERTIFICATE NO ..... ~ / ~ ..........................................
Building Inspector
Rev. 1/81
BUILDING
TO~',%' OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 2460 Paradise Shores Road,
(number & street)
Subdivision Map
Ns_me of O%mer(s) Alexander Couden
Southold, New York
No.
(Municipality)
.Lot(s)
Occupancy R-1
(type)
Admitted by: Self
Owner
( owner-ten~',t )
Accompanied by: Self
Key available Key at site
Suffolk Co. Tax No.8Q-1-7'1
Source of request Anthony B. Tohill
Date May 15, 1981
DVP~[LING:
Type of construction Wood
Foundation Cement Block
Total rooms, 1st. F1
Bathroom(s) 1
Porch, type Wood
Breezeway
~,pe Heat
Fireplace(s)
Domestic hotwater Yes
framed #stories One
Cellar Partial Crawl space Rest
2nd. F1 3rd. F1
Toilet room(s)
Deck, typ~ Patio, typ~__
Garage Utility room
~arm Air Central Hotwater
No. Exits 2 Airconditioning
Type heater Electric
Other
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other
NONE
Sto~age, type const.
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
Location Description Art. Sec.
Outside Wood Gutters rear Of house and leaders
pipe bad III . .5. 2-30C
Kitchen Gas Stove no shut off V 52-52E6
~Outside House needs painting , III 52-30C
Remarks:
Curtis W. Horton T~me start3:30 'end3:45
Q
0
:I: ,
o' TOOL.~2
Scale: 30'= t"
FORM NO. 6
TOWN OF SOUTHOLD
Buildi~ Depo~mu~.
Town Clerks Office
Southold, N. Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted
Inspector with the following; for new buildings or new use:
1. Final survey of property with accurate location of all buildings,
in triplicate to the Building
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. Approva~ 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
3. Copy of certificate of occupancy $1o00
May 15, 1981
New Building .................... C~lcJsorZ~'e-exi~ting. BuiLding....Y~, ........... .~._. ...... Vacant Land ............................
~,~'~; / Przva:e l{oa(~ wzth E/~
Locaton Of PFope'rty ......... ~.a~.diae..~k~r~,s..~qoad.,...~o~th~l~.~..~¥ ..........................................
Owner Or Owners Of Property Alexander L. Couden
Subdivision ................................................................ Lot No ............. Block No ............. House No .............
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 $ ...5..:.9..0. ........................
Construction on above described building and permit meets all applicable codes and regulations.
Applicant ................................... ~..'~.. .........................................................
Sworn to before me this Anthony B. Tohill, as agent
· day of ......H...a...y. ....................... (stamp or seal)
Notary Public ......... ..S..u...~.~.o..~ ~ .......... County