HomeMy WebLinkAboutZ-9311TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's ORice
$outhold, N. Y.
Certificnte Of Occupnncy
No...Z. 9~J?. .... Date ..... N.o.v.e.~..be~....2J ......... ,19..7.6
THIS CERTIFIES that the building located at . .2.4?3.0..M.a.t.n..R. 9.a.d. ........
Map No... ~.7.35 ..... Block No ........... Lot No ...... 3J ..........................
REQUIREMENTS FOR ONE FAMILY DWELLING BUILT PRIOR TO
conforms substantially to the ~ ~ ^-~':' ~'~ ~ '
CERTIFICATE OF OCCUPANCY
dated ... ~.p.r.i..1 .... 2.3 ......., 19 .~.?. pursuant to which ~ No .... Z. 9~.1.1
dated ...~.oY.e.m~)9.r....2J ....... , 19.. 7.8, 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 .... P~.ivate. ONe .F~m~ ly. Ilwelling .witk .Accassor~..Structures ....
The certificate is issued to .......... Countr~ .Climb .Estates
( owner ,~:~g~ll~x
of the aforesaid building.
Suffolk County Department of Health Approval .......... Pr.e-.Existing ...........
UNDERWRITERS CERTIFICATE No ................... p.r.e.-.E~;~,~J~g ...........
HOUSE NUMBER .... 2~750 .... Street ........... ~Iair~ .Road. ...................
.................................................. Cu~chogu.e~ .Ne~ .York .......
County Tax Map #
1000-109-3-2. ~
Building Inspector
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location ~ ~//~'O /~./~) /(~ ~
(number & street)
Subdivision ~cJ,.,~.~'/~ -( a~ ~-F~ Map No
/
0~er(s) ~ - '
N~e
(type)
/
Occupancy
Admitted by:
Key available
Source of request~_Z_~
(Municipality
Lot(
DWELLING:
Type of construction ~,.,~-,
Foundation ~[~.,~,¢-'
Total
rooms, 1st. F&~TJz-
Bathroom(~
Porch, type?~x/-~,.wc~z-~Deck, type
Breezeway. Garage.
Type Heat o.,~- ~l/g~ Warm Air
Fireplace(s) No. Exits
Domestic hotwater z~// /~/j~<?
Other
~--~f/~ #stories ///~_-
Cellar~// Crawl space ....
2nd. F1~,77~ D~,,y2Srd. FI ....
Toilet room(s)
Patio, type.
Utility room
Aircondi%ioning
Type heater
ACCESSORY STRUCTURES:
Garage, type const. ~-- Storage, type const. F/,t ,~
Swimming pool ~ Guest, type const. --
Other
VIOLATIONS: Housing Code, Chapter 52
.Location Description Art. Sec.
Remarks: 'f , / /
Inspected by:/~j£ [~,//~/_>/, Y~/Y .//, ~,c,~Date
Time
of Insp.
start~.'~'~-/,~ end ~/, yL-,
FORM NO. 6
TOWN OF SOUTHOLD
Building Oepartment
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 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.
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....~,.~.~/~'. ?.~..~.. ...........
New Building .............
...... Vacant Land .............
Location of PropertyHouse' ' '¥' '~-~' ' ' '--~' '~'~' ' ~'No, .... '~' " ~'~ ' '~v"~ '~ 'L--~' '~ '~'~treet .......... 'J' ....... ~ ~'~e~ .....
Owner or Owners of Property ............................................................
County Tax Map No. 1000 Section ............... Block ............... Lot ................
Subdivision ................................. Map No...~. ,~'f~ ...... Lot No..'.~..[ .........
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary_Certificate ................ x,'2~nal Certificate ...,~, .................
Fee Su bmitted $ . . .~.....~L~...~ .............. /~
Con,ruction on above de~ribed building and pe~e~icable c~ulations.
Rev. 10-10-78 //~ ~