HomeMy WebLinkAboutZ-10169 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
210169 October 1 80
No . Date ................................,19...
THIS CERTIFIES that the building .
Location of Property ~6~5. Cedar Ave. & 560 Oak Ave. , Southold; . N•.Y,
House No. Street Hamlet
County Tax Map No. 1000 Section 0.7.7.....Block ..Ol ...........Lot ...001.......... .
Goose Bay Est. 11'76 .Lot No. ~~~-•5of 281
Subdivision ........................Filed Map No. .
re uirements for aone-family dwelling built prior to
conforms substantially to the Ap~siiaatton-for'BtdlCding'Rerntit heretofore fitezlZn-thts office dated -
April 23, , . , • , 19 57 pursuant to whic7i~iz~l~i£ft~rP'~T~i~it"~-8scupancy Z101b9
dated . • October 1 , 19 . was issued, and conforms to all of the requirements
of the applicable provisions of the ]aw. The occupancy for which this certificate is issued is .
••.One-Family Private Dwelling•.•.••.....•....•.....•..•.••.•••.••••....••
The certificate is issued to .....Elsie,Dowd,.._.......•,.••••••„••,•„•„••,•,.••,•,
(owner, les~B ~rXt~r
a~li~X
of the aforesaid building.
Suffolk County Depaztment of Health Approval .....N/R • ~ • • • • ~ • • ~ ~ • • • • •
UNDERWRITERS CERTIFICATE NO .............N/R .
i~~~~~ ~
Building Inspector
Rev 4/78
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-
torwith 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, acertificate 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 peoperty showing all property Tines, 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.
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 ..Sept~mber..24, ..1.9$0.. .
New Building .............Old or Pre-existing Building J{...... Vacant Land
Location of Property ...Oak..Drive,.. So.uthold,.. New .York .
House No. Street Hamlet
Owner or Owners of Property Elsia .Dowd .
County Tax Map No. 1000 Section ....77......... Block .....1 Lot .....1 .
Subdivision....Goose.Bay. .Estates.........FiledMapNo. .11.7.6 ....Lot No. .277,278,2.7.9, 280
and 1/2 of 281
Permit No. Date of Permit ..........Applicant ....Elsie .Aowd .
Health Dept. Approval ........................Labor Dept. Approval .
Underwriters Approval ........................Planning Board Approval .
Request for Temporary Certificate .....................Final Certificate X................... .
Fee Submitted$..96.. 5,QQ,,,,,,,,,,,,,,,
Construction on above described building and m/it meets/all applicabl cod~es~and/rfgulations.
Applicant . ?.<L CC I ~ . ~%t-e~U .
.....,.7~.......
olphI. Bruer, for El i Dowd O
Rev. 10.1OJ8 ~ CCC, 13
S
p,,~~~,~ o~bq
~~6~
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
r ~
Location~,~~S ~7A~ Nr'~~ ~
SAC) .~'VGc. ~ri~1Tf/oL/.~-,(>
-rnumber c street ~ icipali~y~- /
Subdivision~a.~F;;~r-, ~l Map No. T6 Lot(s)~~de`~('
Name of Owner(s) ~lsiC CJGU~ , /
Occupancy / I/,~0(~(J<i.1/
type owner- enan
Admitted by: ~,QL~ ~L~ts® Accompanied by: S~C_C
Key available Suffolk Co. Tax No, frann-p77 ~Q,~-Qc~ ~
Source of request,,(~~
/~ol iG~fj ~ -~Z .U~~f Date ~
DWELLING:
Type of construction ~ #stories f ~
Foundationf
fkla - Cellar ~ Crawl space
Total rooms, 1st. 2nd. Fl " Co 3rd. F1
Bathroom(s) a Nr Toilet rooms
Porch, type ~/.~~5 ~,(~CL-. Deck, type Patio, type
Breezeway Garage Utility room -
Type Heat CcA.r~,~o~. Warm Air ~ic_ ~irrc-~Hotwater
Fireplace(s) No. Exits Airconditioning
Domestic hotwater yF~ Type heater O i~ ¢j~~
Other
ACCESSORY STRUCTURES: ~j~,op t-~g,~{~
Garage, type const.%lud ~ Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS: Housing Code, Chapter 52
L cation Descri tion Art. Sec.
~-.c1 .S~-s~
- ~ - E!
Remarks•
Inspected by: ate of Insp.~% ,~O 'mod
Time startl~5'S`~Q(end /:tea f'.'