HomeMy WebLinkAboutZ-10445 T .
FORM N0.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspactor
Town Hall
Southold, N.Y.
Certificate OF Occupancy
No....Z10445....... Date ...........April.9 19a~.
THIS CERTIFIES that the building .
Location of Pro 2215 Indian Neck Lane, Peconic, New York
Ply Nooar INo .......................%/wm%st
County Tax Map No. 1000 Section ....13.6 ......Block .......5 .......Lot l D...... .
Subdivision ...............................Filed Map No. .Lot No. .
requirements for a private one Tamil dwelling Duilt prior
conforms substantially to the ~>;eslisa-firlf~msRll~Srslstereis•ydsoEllee•dled.___
Cert~ff c e Af opc upancyZ10445
b0. AA~cil..23......... , 19 .57pursuant to whtichPe~il3~v
. .
, , , , April , Q , , , , , , , , , , , , , , , 19 S ? ,was issued, and oonforms to atl of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .
....,..,...Private One Family..Dwe111nR
The certificate is issued to , H i 1 d a A . Egan r . E t al ,
/ownai airiiiinowret} .
of the aforesaid building.
Suffolk County Department of Health Approval N/ R „ .
UNDERWRITERS CERTIFICATE NO...Nl$ .
Building Inspector
Rw. 7d7
FORM NO.B
TOWN OF SOUTHOLD
Building Dspmmsnt
Town Hell
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 inapec
for 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
nature) or topographic features.
2. Final approval of Health Dept.. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval at electrical installation from Board of Fire Undsrwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences atld similar buildings and installa-
tans, acertificate of Code compliance from the ArchiUCt or Engihear responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
8. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accwrete survey of peperty 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 irrforma-
tion required to prepare a certificate.
C. Fee:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on preexisting dwelling or land use $5.00
3. Copy of certificate of occupancy $1.00
Date ..~ugttst .1a,,..198.L , .
New Building .............Old orPre-existing Building ....X....... Vacant Land .
Location of Property ...7.nda.att .1~11ac~c . I.aAe.. Paaonic.. ~ieart .York .
Hr~ar No. SYntet Hsmist
Owner or Owners of Property !7 ; .HargeY . .
County Tax Map No. 1000 Section ...$b.......... Block S Lot ...lQ .
Subdivision .................................Filed Map No. ..........Lot No. .
Permit No. Date of Permit ..........Applicant J~~ T~~:vl3Y
. . . . . . .
Health Dept. Approval ........................Labor t. A royal o-~~ ~
Dap pn
Underwriters Approval ......Planning Board Approval . ; .
Request for Tem b
porery Certificate .....................Final Certificate ~
Fee Submitted $ x.•.00 .
Construction on above described building and p i a li le rogulations.
Applicant . ,
1 S Br At't ey for ......e J. ~ ,Harvey
a«.~o-ro-~e
_
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPOaRT
Location ~ / ~
num er & str ~~Mun ipa ty
Subdivision Map No. Lot(s)
Name of Owner(s) _
Occupancy
type owner-tenant
Admitted by: Accompanied by:~
Key available Suffolk Co. Tax No. ~ !D
Source of request Date~~ ,,~7f' /
DWII.LIfaG
Type of construction #stories~_
Foundation CL~,~~~ Cel ar~,,,,,(,t Crawl space
Total rooms, lst. Fl,~_2nd. F1 T'~~3rd. F1
Bathroom(s) / Toilet room(s).
Porch, type ter,, Begs Patio, type
Breezeway Garage ility room
Type Heat .Ge-r~.Q 'darn Air ~s-1i,~ Hotwater _
Fireplace(s) No. Eycits Airconditioni~ng
Domestic hotwater_ Type heater~~L,t
Other t
ACCESSORY STRUCTURES: _
Garage, type const. Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS: Housing Code, Chapter 52
Location Descri tion Art. Sec.
-s~- 6
_,s /T
Remarks•
Inspected by: Date of Insp. - ~
~
~ Time st.art~-' end 3