HomeMy WebLinkAboutZ-9730 FORM N0.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Ctf Occupancy
No.....Z9730........ Date Actobex .26 ................19 79
THIS CERTIFIES that the building .
Location of Property ....6705...Gx.@8t. P.eCOnic .$ayy. B1Yd. .............Laurel . NI.Y.
House No. Street Irlamlet
County Tax Map No. 1000 Section ....126.....Block .....10.. • • . • ..Lot .....025•
Subdivision ...............................Filed Map No. ........Lot No. .
Requirements Yor a.oneTfamily dwellin~.built`.prior to
conforms substantially to the
Certificate of Occu~pancy
....Apx'il. 2~ ,1957. pursuant to which 3TDdddmap~btcaidd~x ~973Q....... .
dated QCt01?g~', 2C , , , , , , , , , ...197.9. ,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 .
Pz~iyate.One.Family. RwelLtng..................................
The certificate is issued to ........Florence . FitZpatx:iCk .
/owner,
of the aforesaid building.
Suffolk County Department of Health Approval N/R .
UNDERWRITERS CERTIFICATE NO N.~R .
~c . -n
i
'/rri~~ - ;~ra/li~L
Building Inspector
Rw 4/79
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location O ~ ~~r'
u~ ~Lyo • A
[1 yL /y-
number street Munici alit
Subdivision Map No. Lot(s)
Name of Owner( ~O.~.c/C~ ~TzT.4TJZrC~
Occupancyf / liacA~~
type owner
Admitted by: ,TF/k ~~c1.vcH Accompanied by: ~'Fcr=-
Key available Suffolk Co. Tax No.,~oo - /Z~- l0 -Qa~S
Source of request ,rQyo% ~~9 QLlilti~'2 Date ® i~ 7
DWELLING:
Type of construction GUaot'~ f=fZ,o~•t~ #stories oivc
Foundation - ~ /cc ~ Cellar~Craw1 space
Total rooms, 1st. F ~``"L 2nd. F1 3rd. F1 -
Bathroom(~f on/~ Toilet room(s)
Porch, type - Deck, type Patio, type
Breezeway Garage - Utility room ~ /L.oC
Type Heat C'F,vT2AL. 'Aarm Airo~~ ~~o Hotwater -
Fireplace(s) - No. Exits Tw o Airconditi9ning -
Domestic hotwater Y`~s Type heater ~~os ~iies,n
Other
ACCESSORY STRUCTURES: oNE CAK
Garage, type const.LUneo tsre.c.~ Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS: Housing Code, Chapter 52
Location Descri tion Art. Sec.
N - - /3
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Remarks•
Inspected by• GC.,P/l.Ll.~~--Date of Insp. /~~ZS~79
Time start3•'/~'9~end 3:~0 ~M-
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_ SURVEY FOR
FLORENCE FITZPATRICK
MATTITUCK
TOWN OF SOUTHOLD
SUFF: CO., N.Y. GUARANTEED T0~
SCALE° I11=401 $OUTMOLD SAYIN(i3 BANK
~ SECURITY TITLE 8 GUARANTY CO.
~ MAY 26, 1964
NOTE
•a MONUMENT
I,~ ~ _ Pi~~ ENGI ER AND
G, i'-, . ~ M ~ ~ ~ LAND SURVEYOR, N.Y.S. LIC. N0. 12848
nc . _ _ ;rc'.,°- RIVERHEAO, N.Y. - .r.--:-
~
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), Nonconforming 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
Date .Ocxgber.... ,19.7.Q .
New Building .............Old or Pre-existing Building ~C Vacant Land .
Location of Property ...Eeconic . Bay..Boulevartl Mattituck,. iZew. Yosk...... .
House No. Street Hamlet
Owner or Owners of Property ..F.lorenae••~i~z{tstrick•••••••••••••••••••••••••••••••••
County Tax Map No. 1000 Section . 12.b Block ...10.......... Lot ...25.......... .
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 permit meets all applicable cod~esanddregulations.
Applicant .~~a4'r•/~•
• .
Rav. 10-t0-78 U ~ ~U 1
STATE OF FLORIDA )
ss.:
COUNTY OF -17UVl+L
FLORENCE FITZPA'~RICK, being duly sworn, deposes and
says: I am the owner of the premises Peconic Bay Boulevard,
known as Section 126, Block 10, Lot 25 on the Suffolk County
Tax Map, and I make this Affidavit knowing that the town of
Southold will rely thereon to issue a Certificate of Existing
Uae.
I am familiar with the above property having owned
the same since 1964, purchasing the same :from CHRISTOPHER V.
FISHER and LILLIAN R. FISHER, and I was familiar with the fact
that said house was constructed prior to April of 1957 as a
one-family dwelling and has been used as a one-family dwelling
for a period prior to April of 1957 and continually used as a
one-family dwelling up to and including the present date.
The premises, as constructed prior to April of 1957,
have not been added to up to and including the present time
and are in the same structural condition as existed prior~-t-o~/~
1957. `~i~.~Qi1i4~ce-ey
iA?I~iiA a~ ~
' FLORENCE ~ ZPATRICK
Sworn to before me this ~rH
day of ®erogE~e,. 1979.
,d~!,lh~ ~ ~~ur~oa
NOTARY PUBLIC
NOTARY PUBLIC, STATE OF Fl.ORIDA AT LARGE
Pr!Y Cu^?.9h.iISSION ERW RES FEB. 2, 1982