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Home My WebLink AboutZ-12576 FORM N0.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. 2.1.25.76,,,,,,,,,, Date .,,June 25 84 ..........................19... THIS CERTIFIES that the building ....One..t:amz?.y.. dWe,~lin~, , , , , , , , , , , , , , , , , Location of Property ......375..Navy..StCee.>i,,,,,,,,,,,,,,,,,,,,,;Orient~,N; Y.,,,, House No. Street Hamlet County Tax Map No. 1000 Section . 2 6.........Block .......1........Lot ,1, 0 , , , , , , , , Subdivision XX ....................Filed Map No. XX...Lot No. XX . Requirements for a private one family dwelling built prior to conforms substantially to the }(lip]{gp~ig~gf'lpg;l3~}~~i~~}~~ig~tgg~ggf~peXA1~d71~C7tk1A7Sr~~QCXd~6tCC A ril 23 Certificate of Occupancy P . 195 7 . pursuant to which BS~i[d'ii4~ 11'8fi'iSt~I6CDQi~.-0t Z J 25.7.6............. . dated .....lune..25 1934 . ,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 . ....One..familx . dw.e.lling,.and..2 . ac.c.essDX'.y.. ¢}ai,ld inks , _ , . The certificate is issued to ISdpc„T,, Edwards .....owner,./ ~aacarxa~x~xt~ of the aforesaid building. Suffolk County Department of Health Approval N/.A . UNDERWRITERS CERTIFICATE NO........... N/.A . Please see attached housing code inspection report. Addition B.P,O/95542 C.O. /kZ12570 Enclosure B.P. ~k6398Z C.O. /kZ12571 Building Inspector Rev. 1/81 BUILDING DEPARTMENT T0~•7N OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location 375 Nav Street Orient number & street Municipality Subdivision X Map No. X Lot(s) X Flame of 0~•~ner(s) Isaac T. Edwards Occupancy owner type owner-tenant Admitted by: Mr. Edwards Accompanied by: same Key available ' Suffolk Co. Tax No. 26-1-10 Source of request Frederick J. Tecleschi Date 6/14j84 D4IELLIPIG Type of construction wood framed #stories 2 Foundation cement block Cellar full Crawl space 4'otal rooms, 1st. F1 3 2nd. Fl 2 3rd. F1 Bathroom(s) 2 Toilet room(s) Porch, type Deck, type wood-roof ovexpatio, type cement Breeze-,eay Garage Utility room X Type Heat oil fired ~rlarm Air Hotwater X Fireplace{s) No. Exits 3 Airconditioning Domestic hotwater ves Type heater oil fired Other haaamant mostly finished off ACCESSORY STRUCTURES: Garage, type const. Storage, type const.2 wood S~•~imming pool Guest, type const. Other VIOLATIONS: Housing Code, Chapter 52 Location Description Art. Sec. bath--1st floor not finished III 52-32-D B.P. 63972 & 63982 issued March 9 1973 for an alteration & fence. C.O. for same issued 6/22/84, # 212571. B.P. 95542 issued November 17, 1977, for an addition, alterations on existing building, & fencing. C.O. for same issued 6/22/84 # 212570. Remarks• w Inspected by: Date of Insp. June 15, 1984 Curtis w. Hortdn Time start 9:45 end 10:15 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-~dup4ieetato 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 !land use --Pre-Existing C . 0. $15.00 3. Copy of certificate of occupancy $1.00 111 Vac ant land C . 0. $ 5.00 Date New Building .............Old or Pre-exis/ting B~uil7d-ing ~ /Vacant La`njd` J./.... . Location of Property ..375....~~1¢:vJ ,~i°Fr.....Q.!~~~lU! ~./v/.. , . House No. '"7'-~ ,,],,4 Street A Hamlet Owner or Owners of Property ....Y.~j.?~!//. C..../..! ~~~~/~~aa~ . County Tax Map No. 1000 Section . ~K~.... Block Lot.. ~u......... Subdivision .................................Filed Map No. ..........Lot No. . Permit No. Date of Permit ..........Applicant . Health Dept. Approval .......................Labor Dept. Approval . Underwriters Approval ........................Planning Bo prevah---~,.. Request for Temporary Certificate .........Final Certifica~te /~7t/4t~ . Fee Submitted $ . /~C~~~ ~~c/ N~ ~ w~ ~ f~~~-"'°.J ~C~~ -G{~'Td ~ ~ 0 ~d_ Construction on above described building and rmit meets al Applicant . Ate. io-t ~a JJ,/'~~`s~~y/ ~ l r~ _ d /~T S~" ~ac,~ d~(3o ~ ~ ~ ~ CONSENT TO INSPECTION/~ the undersigned, a wner(s) Name(s) do(es) hereby state: That the undersigned (is) (e~e)`theLowner(s) of the pre/m°iJses in/the Town of Southold located at y/ C/ which is shown and design/aced on the Suffolk County tax map as District 1000, Section Block / Lot That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulations of the Town of Southold. n Dated: [ S / nature)/; _ C~/J (print name) (signature) (print name)