HomeMy WebLinkAboutZ-10444FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
Z10444 April 9,
No .................. Date ................................. 19...
THIS CERTIFIES that the building ................................................
L ..... 7~0 Pvt. ~d. ?~18 on ~{vatt Rd. ?ast, So,thold, N.Y.
ocanon o[ rroper[y ........................... 'i .........................
House No. Street ...... H~I~
County Tax Map No. 1000 Section 50 .Block .Lot
Subdivision ............................... Filed Map No ......... Lot No ..............
requirements for a one family dwellin~ built prior
confo~s substanti~ly to ~e-~ffp~Y~~f~e~Te~ffoT~FffeR]R't~~ff ....
57 Cer~~_9~_~upancyz 10444
A p r i 1 23, 19... pursuant to w~ch Building Pe~it No ......................
da~d A p r i 1 9, 19 81 , was ~ssu~d, and conforms ~o aH of ~he r~quir~men~s
of the applicable provisions of ~he law. ~e occupancy for w~ch t~s c~rti~ca~e ~s issued ~s .........
Private One-Family Dwelling wihh accessory structure(Utility BldK.)
Frank Halba,~er and Wf.
~e certi~ca~e is ~ssu~d ~o
of th~ aforesaid building.
Suffolk County Depa~men~ of HeaRh Approval N / R
UNDERWRITERS CERT~FICATE NO. ~ / ~
Building Inspector
Rev. 1/81
Location
Subdivision
BUILDING
TO%~: OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
7?0 Private Road #18 on Hyatt Rd. East,
{number & streeT)
Map No.
Southold
(Municipality)
Lot(s)
Name of O~n~er(s) Frank Halbauer and Wf.
Occupancy R-1
(type)
Admitted by: Self
Key available First Town Realty
Source of request
Unoccupied
(owner-ten~'~t)
Accompanied by: Self
Suffolk Co. Tax No.. 50-3-20
Rudolph H. Bruer' Date March 13, 1981
DVP.LING:
Type of construction Wood
Foundation Cement Block piers Cellar
Total rooms, 1st. F1
Bathroom(s) 1
Porch, type
Breezeway
Type Heat None
Fireplace(s)
Domestic hotwater
Other
3
Deck, type
Garage
'Warm Air
No. Exits
Yes
#stories
Crawl space
3rd. F1
2nd. F1
Toilet room(s)
Patio, type
Utility room
Hotwater
/ Airconditioning
Type heater Electric
One
ACCESSORY S2RUu~L~RES.
Darage, type const.
Swimming pool
Other
storage, type const.
Guest, type const.
Metal'
VIOLATIONS: Housing Code, Chapter 52
Location Description , Art. Sec.
Utility Bldg. Rusted Out 'IIi 52-31~B
Bedrooms Windows to small for second means of
egrees TI q?-?~-~
Remarks: No heat-Summer occupancy only
.Inspected by:
~Date of Insp. March 17, 1981
Curtis Horton Time start 9:30' end 10:00
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-
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 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.
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
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.
Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use
3. Copy of certificate of occupancy $1.00
$5.00
New Building ............. Old or Pre-existing Building ... ~ ....... Vacant Land .............
Location of Property .............. ~S.o.q~.~.J,e.~. ,~.e.~Q.e.,.. $~).~t,t~)~L~,..~ff.~..¥o~c~, .........
House No. Street Ham/et
Owner or Owners of Property .. ~.r~tTt]c .a~cl./~1ae. [-T,~[]~au.e~- ...............................
County Tax Map No. 1000 Section . .. ~5.0. ......... Block .... ~3 .......... Lot...20 ...........
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No ........... Date of Permit .......... Applicant . .I~'~T~ .&. ,,'v[a,(~. [-Ip,[t~g~.~ ........
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate ...... Z ................
Fee Submitted $ . . .5.., .0.0. .....................
Construction on above described bu ilding~t m,~ts~ ap~/~/c~x~ c/e~es and regulations.
Applican~~~ ............... ~},