HomeMy WebLinkAboutZ-12010FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No..g..1.2.0.1..0 ......... Date ........ qq e. 9p.e.v...2.5 .............. 19 .8.2.
THIS CERTIFIES that the huila;,,,~--dwelling & accessory..b.u.~t.~.i.n.~
Location of Property 375 Sterling Place Greenport
[-d~Js'e ~/o: ....................... 'S't/e~ i ....................... h ~r~ iel
County Tax Map No. 1000 Section . . .0.3.~ ...... Block . 0..3 ............ Lot ....0.2.5. ..... /;..;
Subdivision .... .X. ......................... Filed Map No. X. ....... Lot No..X. ...........
Requirements for a private one-family dwelling built prior to
conforms substantially to the :~l~plicatiorr -for Buitdirr~ Pc-milt- her~Wfcrm--ffled-/n- this- ~ff'rc~-d-aterl
Certificate of Occupancy
.... ~..p.v.t.]:...2.3 ......... 195..7. pursuant to which Building-Permit No ..... Z. ! .2.0.1.0. ..........
dated . . .0. c..t .o.b.e.v...2.5 ..............19.8..3, 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. ?.r.i, y .a.~.e., ,o .n.e.-~r.a, .m.~Ay., .d.w.e.Z.Z..~ p.g., ,a .a.d..a, c..c,e.~,~, .ory' .~, .t ??.a.g.?..~.u. ~..~.~.~.n.g.: .~..
The certificate is issued to ESTATE OF JENNIE HABERLAND
..................... io¥.'o), '~d-~'~d.;O ......................
of the aforesaid building.
Suffolk County Department of Health Approval n o r e c o r d
UNDERWRITERS CERTIFICATE NO ........... .n.o.. v. e. 9.o.v.d. ............................
*See attached inspection report
Building Inspector
Rev. 1/81
BUILDI~.[G DEP.~%T~dEHT
TOW$I OF SOUTHOLD, N. Y.
,OUoL~G CODE I~'iSPECTIO~,[ REPORT
Locazicn
Subdivision X
N~me of Owner(s)
Occupancy R-1
(type)
375 Sterling Place
Qnmmoer ~ szreez)
Greenport
([,[unzcZpa±izy)
Map No. X Lot(s) X
Estate of Jennie Haberland
owner
( own er- ~ enan~ ~
Susan Roache Accompanied by: same
Suffolk Co. Tax No. 34-3-25
A~mitt ed by:
Key ~vailable
Source of request
Susan Roache
Date 10/19/83
D%~LLi~:
Type of construction
Foundation cement block
Total rooms, 1st. F1 5
Bathroom(s) 1
Porch, t~e
Breezeway
Type Heat gas
Fireplace(s)
Domestic hotwater
Other
wood frame #stories
Cellar partial Crawl space
2nd. Fi 3rd. FI
Toilet room(s)
Deck, type
Garage
'Warm Air
No. ~(its 2
yes
Patio, type
Utility room
Hotwater x
Airconditioning
Type heater gas
1
rest
ACCESSORY STRUCTURES:
Garage, type const.
Swim,ming pool
Other
Storage, type const.
Guest, type const.
me tal
VIOLATIONS: Housing Code, Chapter 52
Location
cellar
Descriotion Art. I Se'c.
isteps to cellar narrow and ,steep III $52-27-A&B
Remarks:
Inspected by: ~_~ .~, ate of Insp. October 24,
Curtis .W. Horton 'Time start 9:05 end 9:15
1983
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
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 accurate location of all buildings, property lines, streets, and unusual
natural or topographic featu res.
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.
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, streets, buildings and unusual natural or
topograph ic featu res.
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/landuse--?re-~;×±st±ng C.0. $15;00
3. Copy of certificate of occupancy $1.00 Vacant, land C.0. $ 5.00
Date ..... .~.("..'.--.Z'. ~. ;-. ~.~. ......
New Building ............. Old or Pre-existing Building .../~' ....... Vacant Land .............
Location of Property . ~ .... . .~./.~.~.-.~....~-~..~.~..~.../.'?.~"7.~..~.&~ ......... . .~..~.. ?.- .~..~..6/..~..~.
House No. Street Hamlet
Owner or Owners of Property . .~.~../~.. ?..~...../~..~..~_~...~.~..L..~../[/.~.: ..........................
County Tax Map No. 1000 Section ..... ,~.., ,~Z. ..... Block ....... ~ ...... Lot....~. ,-~. .......
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 $.. ,/.~.'~. ,~-.~ ....................
Construction on above described building and per~t meets all appli/c~le codes and ragu lations.
Applican~...,~--~...../~..~///~ ................ ' ....
Rev. 10-10-78