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Home My WebLink AboutZ-5662FORM NO. 4 TOWN OF SOUTHOLD BU~.DING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy Date ~ov .... .~. 19.73. THIS CERTIFIES that the building located at . .We~t .l~hor. e. Dmive ....... Street Map No. !l.eY.d. 9.n..S.h..ozBilck No....A. ...... Lot No.2.~. ~.. ...... S. 9.u.t.h.o. 1..~.. ?. :?.,. .... conforms substantially'to the re u&rementm for one famil dwel Lug & housLug code bu$1t Certificate of occupancy dated .b~.f.o. pe. ADP....2.3 ..... , 1957.. pursuant to which~oz~662... dated ........... .N.o~.. .... .2.3., 19..7.5, 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, iva.te · on~ · fam$1y. 6well.~u~ ..................................... The certificate is issued to . .R.e..r~..Z.d.o..D.p.r.d..o~...~..v.$.ff.e...o~..q.r.~. ..................... (owner, lessee or tenant) of the aforesaid building. ~ Suffolk County Department of Health Approval ..... p.r.e.-..e..x.;[.s.t..:~..g. ............... UNDERWRITERS CERTIFICATE No. .. p..~.-...e.x.~..s.t..~.g .......................... HOUSE NUMBER . .~.80. ........ Street . Jdest;..Shor~ .D~.v.e ..................... '1700 Oak Drive [/ ~-~, J ....... ......... Building ~pe~or [ HOUSING CODE INSPECTION November 23, 1973 #1700 Oak Drive & ~80 West Shore Drive R-1 Southold, New York Sub-Div: Occupied: Reydon Shores # 631 Section "A" Lots 25 & 26 R. Dordon & family Upon request of the Southold Town Building Department I made inspection of this one story framed dwelling and found no violations of Chapter 52, Housing Code, Town of Southold. I was admitted to Oak Drive entrance by Mrs. Dordon and began my inspection at approximately 1:25 P.M. Building consists of three bedrooms, living room, dinette kitchen and full bathroom. Heat is furnished to each room from furnace located in full cellar. Inspection completed at approximately 1:$0 P.M. lrOB3f NO. 6 TOWN OF SOUTHOLD Building Depar~ment 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 in triplicate 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 o~ 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 //~ Date .~~.(.~z...'~....~. ....... ./._~'~. New Building .................... Old pr Pr~-e~xisting Build lng ...~;~f.....¢.....~j~acant Land ..(. ................ Owner Or Owners, O,f Property ~, ......... .~..~,~C...~....:....~X~Z./,,~.. ...................................................... Subdivision .~C~...~....~....~.';..~'~.~..~.~.. ................. Lot N .o~'~...j[;.~.~Block No...~.~.~..'... House No..~./,~. Permit No ..................... Date Of Permit ..... ;;7;;.; ........ Applicant .... . .. Health Dept. Approval .... ./3.:J-.,..~.. ........................... Labor Dept. Approval ...... : ......... -. ............................. Underwriters Approval ...... ././.~'.....:./../7: .......................... Planning Board Approval ...~..~.../....~-~; ........................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ ../....-.~---...: ....................... Construction on above described building and ~T~ er~e~t~ all applicable codes and regulatic~s. Ann cant ~< ,...~...._.L../......"'~Z~/1 ,/~/~ ,~./~,~_~/ ~..~/.,/ · .................................... © ..... T"7"7/ ........ ............... Sworn ,o befaOre ,m,e this ~~' "~' ................ d y o ............................................ ' (stamp or sea0 Notary Public .................................... County ~ £,,~ '~"~"~./;-~ U.u FOR~I NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Southold, N. Y. 11~971 APPLICATION FOR CERTIFICATE 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), Nomconforming 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 Building ................ Addition ................ Old or Pre-existing Building ~ Vacant Land Location Of Property ~' ~ ~1~ ~ ~ Owner Or ~ners Of Properly ~0~ D~L Permit No ..................... Date Of Permit .................... Applicant Health Dept. Approval ..................~..~ ................ Labor Dept. Approval..............,..,.......~ ~ ....................... U der i e . ................... ................ . ................. Request For Temporary Ce~ificate ........................................ Final Certificate .......................................... Fee Submitted $ .................................... Construction on Gbove described building~ ~~it~eet~l regulations. JUDITH T. BOKEN