HomeMy WebLinkAboutZ-11243 FORM N0.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate CAF Ckcupancy
No..Z1124.3......... Date ......OFt.4>?er..fi 1952.
THIS CERTIFIES that the building .
Location of Property S• Dogwood. Lane Southold
HouasNo. ~ Street .........FJem%M
County Tax Map No. 1000 Section ..054. ....Block ..05, , , , , , , . , , .Lot ...033 , .
Subdivision X
.........................Filed Map No. .X ......Lot No. X........... .
Requirements for a private one-family dwelling built prior to
conforms substantially to the •leppticstien-for~Beildina•P~ermititeeelofere-fNediirtlda~
Certificate of Occupancy
AA r i 1..23......... , 19 .5 T pursuant to which ~Baildins PenttitNo. Z 1.1 ~!+3........... .
dated .....OC t obey . 6 . . . 19 2 ,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 .
....a. pr.iuate..one-.family..dwe.13in3•
The certificate is issued to ,Verna P, Pitzpatrick
lownei, ~lsaiiaitirai~t}
of the aforesaid building.
Suffolk County Department of Health Approval .......n/. ~ .
UNDERWRITERS CERTIFICATE NO ...............Aid............................... .
Building Inspector
Hw. 1/81
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 wrvey of property with accurate location of all buildings, property lines, streets, and unuwal
natural or topographic features.
2. Final approval of Health Dept. of water wpply and sewerage disposal-(S-9 form or equall.
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 wrvey of peoperty showing all property lines, streets, buildings and unuwal 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 August 10, 1982 , ,
New Building BaS .Old orPre-existing Building(X) . _ ~ Vacant Land .
Location of Property ..Dogwood. S.BI18,..&outh4ld,. Neb'. Xoxk
House No. Street Hamlet
Owner or Owners of Property Verna. Fit2pc7ti'-a.Ck .
County Tax Map No. 1000 Section 54.......... Block 5, , , , , , , , , , , Lot .
Subdivision ......Y
...........................Filed Map No. ..........Lot No. .
Permit No. Date of Permit ..........Applicant Verna.Fitzpatrick... , .
Health Dept. Approval ........................Labor Dept. Approval .
Underwriters Approval ........................Planning Board Approval • -
Request for Temporary Certificate .....................Final Certificate X...-......... -
Fee Submitted $ ..`a.AO .
Construction on above described building a p rtm s a des and regulations.
Applican .....s....._..
7(c 1 olph H Bru r, Attorney for Verna Fitzpatrick
R~,.,o.,oas 7(PS' ~ aa~
c~(~~~ ~ ~or.LQ- ~ C o ~ t r a ~-3 ~ ,
_ _ _
BUILDI!
iG DEPAP.TI~iE:1T
TOt•ITi OF SOUTHOLD, N. Y.
HOUSIt`:G CODE INSPECTIOIQ R/JEPORT / ~~jj
Location n ~.~Ll'1~- . _~P.,C~G_ %L.
~rn.mo ~reeti ~aunic ality
Subdivision o iviap~r•No. Lot{s)
Name of 0:•merp(s)~~ivn,ai. ~iAA~
Occupancy /1 -
type owner-tenant
Ad,::itted by: ~ly,~~~~l.~, Accompanied by:
Key available ` Suffolk Co. Tax No.f ,•S
Source o£ request ~ Date Q ~
D?~IELLI~IG : / .
Type of construction_~.?~r~l ~_~rstories~
Foundation~,,t e'C llar„„„T~Crawl sp2ce~
Total rooms, 1st. Fl~_2nd. F1 3rd. F1
Bathroom(s) / Toilet room(s)
Porch, type Deck, type Patio, type
Breeze:vay Garage Utility room
Type Heat alarm Air Hotwater
Fireplace(s) No. E:cits AircQ,nning
Domestic hotwater ~„~~y Type heater_~L///~
Other
ACCESSORY STRUCTURES:
Garage, type const. Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS: Housing Code, Chapter ,2
Location Description ~Art.~ Sec.
a
i~
Remarks•
Inspected by: Date of Insp. lU~.S~~
Time start, l 'Ud end. _'/5
- .