HomeMy WebLinkAboutZ-11249FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No..g. 1..1.2.4.9. ......... Date ..... O..c.t,.o.b.e. ?..1.~. ...............,198..2.
THIS CERTIFIES that the building .a... I .2.) .........................................
Location of Property . .~.5 ........ ~ .e.a.r.o.~. ~.a.n..D..r~.v.e....(.~.v.t. :. ?.d. :..~;1.)... ~-~.~..~i::'..
House No. Street Hamlet
County Tax Map No. 1000 Section ...1.4.5. ...... Block ...O.a. .......... Lot .... 0.0..8 ..........
Subdivision Ei:Lz. Near'ob:Lan & NoPe,et ~ll~ec~apNo .1.381 . LotNoP&t~t .o.f. 8
conforms substantially to the
Ceetlficage of OccupanCy
..... ~.~. ~1..~3 ...... , l~.. p~rs~nt to which Boll~l~l~mtt No...Z.! .1 ?.~p. ............
dated .... ~)¢.~.o.~r..1.~ ............ l~.2. , was issued, and conforms to all ofth~ re~luiroments
o~ the applicable provisions of the law. ~e occupancy for which this certificate is issu~l is .........
The certificate is issued to V. Jane Kno~lea
********************************* ************************
of the aforesaid building.
Suffolk County Department of Health Approval ...... .n./.a. ................................
n/a
UNDBRWRITBRS CBRTIFICATB NO ................................................
eTh:l.a C.0. :Lncludaa an updata of B,F. 8835Z--C,O. ~.ssued Z7318,
It also /.ncludaa B.P. 9273Z,--C,0. issued Z7838,
Building Inspector
Rw.l~l
BUILDING DEPART~IT
TO%'~ OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 425 Mesrobian Dr~ve (Pvt. Rd. #1) Laurel
(number & street) (Municipality)
Subdivision Eliz. Mesrobian & Map No. 1381 Lot(s). 87
Forest Hills
Name of Owner(s) Marilyn Groff & another
Occupancy R-1
( pe)
A~mitted by:Silkworth Aggncy
Key available
unoccupied
(owner-tenanT)
Accompanied by:.. same
Suffolk Co. Tax No. 145-04-008
Source of request Gary Flanner Olseh, Esq. Date. 10/1/82
wood framed #stories..
Cellarpartial Crawl Space
2nd. Fi_ ~rd. F1
Toilet room(s)
Type of construction
Foundation cement block
Total rooms,' 1st. F1 4
Bathroom(s) 2
Porch, type Deck, type
Breezeway Garage
Type Heat oil fired 'Warm Air
Fireplace(s). No.
Domestic hotwater yes
Other wood burner stove,
Patio, type
'Utility room
Hotwater x
Exits 2 Airconditioning..
Type heater ~ankless
outside showers
one
rest
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other
Storage, type const.
Guest, type const.
wood
VIOLATIONS: Housing Code, Chapter 52
Location Description Art. Sec.
.. N9 violations of Housing Code, Ch. 52
where found.
This inspection report includes an update
of B.P. 8835Z--C.0. issued Z7318. It als
includes B.P. 9273Zi--C.0. issued Z7838.
Remarks:
Inspected by: _ _ _ Date of InsR. October 6~ 1982
Curtis W. Hort~n -Time start 3:30 end 4:00
· : :.' :::~i~.:::~:~ ::"~ '. ' ' . ' -
FORM NO. 6
TOWN OF SOUTHOLD
Building Depa,li,,ant
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-
tor with the following; for new buildings or new use:
1. Final survey of property with accurat~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, a certificate 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, s~reets, 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 usa $5.00
3. Copy of certificate of occupancy $1.00
New Building . .. .... >, .... ,. Old or Pre-existing Building()[). _.~ .... a/Vacant Land ~ ...........
L°cati°n °f Pr°~P ~H'~ ~ ;~,~{~r,~ .;~,~ i~,~ · · · J~).~ · · · - ......
Owner or OWners of Property ~, .-'~.(~..'~, . .%/%~,~..~.~._..4,; ~(~,0~.k~/~..~~ ............
CountT. Map.o. Lot .... ....
s-t,~,v~s,onO~.~.~r~ '~,.~,.:.F~..~.'H~.F,ed Map No. l.~'h. I...Lo~ ~o. '...~.~. .....
Permit No ........... D~te of Permit. ........ . Applicant ............................. .... .1~
Health Dept. Approval ........................ Labor Dept. Approval ................... ... ,..
Underwriters Approval ........................ Planning Board Approval ..................
Request for Temporary Certificat~ ............... .....Fi/pel'~ertificate .....~..*.
Construction on above described building and parmK'rJa~all s.
...... n' ' '