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HomeMy WebLinkAboutZ-10205FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No .... Z! 0 .05 ....... Date Ootob®e 16, 19 80 THIS CERTIFIES that the building ................................................ Location of Property .. 99.0.0. $9..uq.~..AY.~.n..~e.,. l~att:Ltalck, I[.Y. House No. Street Hamlet County Tax Map No. 1000 Section ..! .2.2 ....... Block ....0.~ .......... Lot ..... 9.7. ......... Subdivision.. ............................. Filed Map No ......... Lot No .............. ~e~u~nent~ fg~ a one-f~i~ d~el~nR built n~o~ to conforms substantially t6'tl~"3~!b~51l~'a'g~/i'r6r '~[ng 'l~Fm~'IT'~ereto~ore {~ed ~n this office dated ~p~'.i!. .2. 3. ,195.7 Cex, ttflcate of Ocoupano~' _ ............. pursuant to w[fich~T~d~l'~a~f'~&' ..... Z.~..0.2.0.~. ......... dated ....O.O~9.b~.ly...1.6., ............ 19..~. ,Owas issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Px. ivate One-Family Dwelling The certificate is issued to And~ l~mohuk ~ I~.~ ......... ..................... ioldn'er,~ .................... of the aforesaid building. Suffolk County Department of Health Approval I~/1R UNDERWRITERS CERTIFICATE NO. N/R Building Inspector Rev 4/79 FOBM NO. 6 TOWN OF SOUTNOLD , Building Depmtment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Jnsfructlons 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. DiS'7::~C~~' 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 ......... installations, (3 certificate of Code compliance from the Architect or Engineer responsible or ~ the building. SECTIC:~ ,~.~ Submit Planning Board approval of completed site plan requirements where applicable. B. Far existing buildings (prior to April 1957), Non-conforming uses, or buildings and 'pre-existir I~nd uses: /0'1 q Accurate survey.of property showing all property lines, streets, buildings and unusual nott 'ol ,I or topographic features. 2 Sworn statement of owner or previous owner as to use, occupancy and condition of buildinc Date of any housing code or safety inspection of buildings or premises, or other pertinent formation required to prepare a certificate. es: Certificate of occupancy $5.00 Certificate of occupancy on pre-existing dwelling or land use $5.00 Copy of certificate of occupancy $1.00 BLOCK z Building ................ Addition ................ Old or Pre-existing Building .....~;:~. ....... Vacant Land .............. ,tion Of Property ...... ~/~..~. ~..~......~...~.~.......~....~...~..~ ................................ er Or Owners Of Property ...~......~... ~%J~%/~...~.....~..~..~......~.~....~......~...~ ........................ Subdivision ................................................................ Lot No ............. BlocE No ............. House No ............. Permit No ..................... Date Of Permit .................... Applicant .................................................................. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Plonni~,~rd Approval ........................................ Request For Temporary Certificate ................................... ~. I',no~ Certificate ....... ~ ............................ Fee Submittod $ ..~: .............................. / // ................................................ Nota~ Public .................................... Coun~ BUILDING DEPARTMENT TO¥~ OF SOUTHOLD, N. Y. Location Subdivision Name of O~mer(s) Occupancy R-1 (type) Admitted by: Mr. Demchuk Key available Source of request HOUSING CODE INSPECTION REPORT 9900 Sound Avenue, Mattituckt (number & street) (Municipality) Map No. Lot(s) Andrew Demchuk Unoccupied (owner-tenant) Accompanied by: Mr. Demchuk Suffolk Co. Tax No. 122-02-07 Gary Flanner 01sen Date 10/16/80 DWELLING: Type of construction Foundatio~ement Block Total rooms, 1st. F1 Bathroom(s) Porch, type Roof Over Breezeway Type Heat 0il Fired Fireplace(s). Domestic hotwater Yes Other Wood #stories Full Crawl space One Cellar 2nd. F1 3rd. F1 Toilet room(s). 1 Deck, type Patio, type Garage Utility room X Warm Air Hotwater X No. Exits ~ Airconditioning Type heater Tankless ACCESSORY STRUCTURES: NONE Garage, type const. Swimming pool Other Storage, type const. Guest, type const. VIOLATIONS: Housing Code, Chapter 52 Location Description Ar .t,,,~ Sec. No Violations Housing Code, Chapter ~2 Town of Southold where found. Remarks: Inspected by:~~.' .~/?~/~. Date of Insp. Oct. 16, 1980 Curtis Horton Time start10:3© end 11:00