HomeMy WebLinkAboutZ-9803 FORM N0.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No. 29803........... Date Dsoaaber• • 26........., 19 79
THIS CERTIFIESthatthebuilding
Location of Property ...~$B...SOtl:th ~DTd.YO • & •C!lts10~ .Pith • • • • MtttituCk•
House l o. Meet Hamlet
County Tax Map No. 1000 Section ...10(......Block ...~.1 ..........Lot . 23 .
Subdivision . $}jprgpA~pe~ • • • .Filed Map No. . ~1~ ....Lot No. .pS; •Of• I,Ot A
conforms substantially-fo e ~ p~ PRIOR TO
April. , 195'7. pursuant
toiwlue'hA'~i'J~~O.~ •ZQ803 .
dated ...DeO~g}a~=+..$6............ 19']C~. ,was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .
P2~ivAlte .One..Fzami7y..Dw~tllir~g .
The certificate is issued to .....Jeaa•I.•Egi>7
owner, itl
of the aforesaid building.
Suffolk County Department of Health Approval ......At/R .
UNDERWRITERS CERTIFICATE NO ..............Iy/R..........................:..... .
Building Inspector
Rsv 4/79
BUILDING DEPARTMENT
TOVN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location
number & street Municipality
Subdivision Shore ACTPR Map No. 14 Lot(s) pArt of Lod A
Name of Owner(s) Jean I Eginton
Occupancy _
type owner-tenant
Admitted by: s 'If Accompanied by: GPif
Key availablew;nkham~c office Suffolk Co. Tax No. 1n~_~~_~~
Source of request w;ii;am Wickham Date 12,[7/7q
DS'IELLING •
-Type of construction wood framed #stories nnP -
Foundation Cellar„p~~
CCrawl space x
Total rooms, lst. Fl R 2nd. Fl 3rd. Fl
Bathroom(s) o.,P. Toilet room(s)
Porch, type~~,.Pe„e~; beck, type ~,nn~i Patio, type
Breezeway Garage Utility room -
steam
Type Heat n; ~ f i rer~ • `rearm Air ~RS~'
Fireplace(s) ~ No. Exits Airconditioning
Domestic hotwater 4ea Type heater i,A„kieGa
Other
ACCESSORY STRUCTURES:
Garage, type const. Storage, type const.- w^n~__iargP
Swimming pool Guest, type const.
Other
VIOLATIONS: Housing Code, Chapter 52
Location Descri tion Art. Sec.
a' al fir t ste
sm
to kitchen
st _ _ _ _C
cr
Remarks•
Inspected by:~~„~,7 f~~.~ Date of Insp. ~A 147A
Time start 1115 end 12;15
~ 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 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.
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
December 7 1979
Date
New Building .............Old or Pre-existing Building ....X Vacant Land .
Location of Property ....e/s ,South Drive, .Shore Acres, Mattituck
House No. Street Hamlet
Owner or Owners of Property ,Estate of Jean .Irving ,Eginton, .dec . , .EYank .B. Irving, Achninstrator
County Tax Map No. 1000 Section ,106...... , _ , Block ..11........... Lot ...23 .
Map of Shore Acres 14 Part of Lot A
Subdivision .................................Filed Map No. ..........Lot No. .
Permit No. Date of Permit ..........Applicant .
Health Dept. Approval ........................Labor Dept. Approval .
Underwriters Approval ........................Planning Board Approval .
Request for Temporary Certificate .....................Final Certificate % .
Fee Submitted $ ,5:00
Construction on above described building and pePmi a sal ap ica codes nd regulations.
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