HomeMy WebLinkAboutZ-12897 FORM N0.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. 212897,,,,,,,,, Date October 17 1984
THIS CERTIFIES that the building ..,One family dwelling
Location of Property Fishers Island
House No. ...4 Street ....1...............1 ...Hamlet
County Tax Map No. 1000 Section 4 ...........Block 2....Lot ] .
4 3 10
Subdivision ...............................Filed Map No. ........Lot No. .
Requirements for a private one-family dwelling built prior to
conforms substantially to the 7A>~iRdiaX~74ii~iCBXiRdiI(~~'I4df~K%lft3bi~X~d7IrY7f~:bYtSdirX$'ated
. A.P.r ~ 23 , 195 Z ,pursuant to which Building Permit No._ . _ . _ _ . , _ . _ . .
dated 19 .--,was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .
One family, dwell,ing
The certificate is issued to ..$~i,2a¢eth,Gei,st,El,y,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
/owner, /e,~~(QQgI${g(@q$
of the aforesaid building.
Suffolk County Department of Health Approval .......N / A .
9
UNDERWRITERS CERTIFICATE NO ...............N/A,...,,.,,.,.,,..,,,,.,.,,,,,,,,,
Property contains one family dwelling with two porches. Also
a cottage and fence enclosed inground swimming pool. Property
also includes two small islands. A physical inspection of
premises not made. _
•Building Inspec~ .
for
Rev. 1/81
FORM N0. 6
TOWN OF SOUTHOLD ~ '
building vepartment
Town Hall ~
Southold, N.'/. 1137 i ' . i'"~
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions ~ ~ , t t5~
A. This application must be filled in typewriter OR inlc, and submitted in duplicate to.the Building lnspa-~
for :vi;h the following; for ne~.v buildings or new use: ~ ~ -
1. Final survey of property with accurate location of all buildings, property lines, streets, and unuai_
na;url or tooccrachic fei+ ~•ras.
2. Final approval of Health Dept. of water supply and sewerage disposal-(S•9 fprm or equal). ` `"•r}
3. Approval of electrical installation from Board of Fire Underwriters. '°•'i;
4. Cammarcia' buildings, Industrial buildings, Multiple Residences and similar buildings and install;
bons, a certificate of Code compliance from the Architect or Enoineer responsible for the building
5. Submit Ptannine Board approval of completed site plan requirements where app'.icable. ;g,,<
•av,
B. For existing buildings (prior to April 1957), Nonconforming uses, or buildina5 and "pre•exjstinq'.
land uses: '
1. Accura[e wrvey of peoperty showing all property lines, streets, buildings and unusual naturaF 0
topographic features. ~ '
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. i'
3. D~ca of any housing code or safety inspection of buildings ar premises, or other pertinent inform.
lion required to prepare acertificate. / '
1. Certificate of occupancy S5.00
2. Certificate of occupancy onpre-existing dwelling or land use S5.44 ~:>:;tis
3. Cepy of certificate of occupancy S1:C4 •
Date 7/24/84.
> '
- Ne•.v Building .............Old orPre-existing Building(X) Vacant Land
Location of Property , , Fshers Island: New York _
House No. Sireer ~H~ml~~
Owner or Owners of Property , Elisabeth Ceis~t, EtX ; . . . . . . . . . , , , , , , , , , , , ,
- 4 1. .1. .
1
County Tax Mao No.-1000 Section . , Block 3 Lot • -1.0
4
Subcivisian .................................Filed MaPt~lo. ..........Lot No.
P^rmit No. Dare of Perini, .........Applicant
Health Dept. Approval ........................Labor Dept. Approval
Underwriters Approval . ......Planning Board Approval •
Request for Temporary Certificate . ................Final Certificate
Fee Submitted S 15: 00
Construction on above described building and permit meets all appGcabl~odes and regulations.
Applicant , .r.... ~
Robert W. Tasker
Re•. t0~~0~78 ~ '