HomeMy WebLinkAboutZ-10216FORM NO, 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No...~..1..0.2J.~. ....... Date .... .0.~.t..o.~.e.~..~.g ............... 19 .~.0.
THIS CERTIFIES that the building ................................................
Location of Property 170 :~echamte Street I ~outhold
County Tax Map No. 1000 Section ...61 ....... Block ..... .~ ......... Lot ..... 1 ~ ..........
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to
..................... ,19... pursuant to which ~lle~ae,m~/~. ...... J:. 1023,6 ......
dated . . . ~).~.t. qb..e~-..~.~ ............. 19..8.0, was issued, and conforms to all of the requ/rements
of the applicable provisions of the law. The occupancy for wh/ch this certificate is issued is .........
The certificate is issued to .
.................... /o'~;~, ~ ........... .........
of the aforesaid building.
Suffolk County Department of Health Approval ...~..~. ....................................
UNDERWRITERS CERTIFICATE NO.. ~I/~ ............................................
Building Inspector
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 170 Mechanic Street,
(number & street)
Subdivision
Map No.
Southold
(Municipality)
...Lot(s)
Name of O~er(s) Mahlon Dickerson and wf.
Occupancy R-1
(type)
Admitted by: Mr. Baker
Key available
Source of request R.G.Terry~
Jr,
Unoccupied
(owner-tenant)
Accompanied by: Mr. Baker
Suffolk Co.
Tax No.6~-~-18
Oct. 25, 1980
Date
DWELLINGs.
Type of construction Wood
Foundation Brick
Total rooms, 1st. F1
Bathroom(s) 2
P~h
Porch, type Glassed in
Breezeway Garage
Type Heat Oil Fired
Fireplace(s)
Domestic hotwater Yes
Warm Air
No.
2
Other
#stories
CellarPartial Crawl space
2nd. F1 3 3rd. F1
Toilet room(s)
type Wood Patio,
~tility room
Hotwater
X
type
Exits 2 Airconditioning
Type heater Tankless
ACCESSORY STRUCTURES:
Garage, type const. Wood;
Swimming pool
Other
One Oar Storage, type const. Wood
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
Location Description Art. Sec.
~ath First Floor -Wall around tub-Bad III 52-~2-B
~ath Second. Floor-Floor-holes III ~P-3~-B
~t~ Ceiling Hallway-Hole in III 52-32-~
titchen 0a~ ~tov~ N~ ~b~t ~ff ¥ ~2-~2-E~
~utside ~eds Pa~nt~nC Rmdly · III .- ~-
p~reh Deck and Sills and Piers Need Renai~n~ 77T 52-31-A
B
Remarks:
Inspected
Curtis Morton
Date of Insp. Oct. 27, 1980
T~me startg:lO end 9:2~
FORM 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 disposel-(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commemial 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 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 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
pete o
New Building ............. Old or Pre-existing Building . .~. ........ Vacant Land .............
LocationofProperty }~...~.~ ....................... ~..
House No. Street Hamlet
OWner or Owners of Property . .~.. ~ .............................
County Tax Map No. 1000 Section ~C)\ Block ...... . .~.... Lot .... I ~.
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval . .. ~T~.~ ................. Labor Dept. Approval ........................
Underwriters Approval . ...~/.~ ................. Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate . Z. ....................
Fee Submitted $.. ~.,.QQ ......................
Construction on above described building and permit meets all applicable codes and reguJatiops,,~
Applicant . . .~ .~ ~. ~,~~.~.
Rev. 10-10-78