HomeMy WebLinkAboutZ-10342FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No ..... Z 10.56,2 ......
Date .... O'.~RllU~T~..0, ................. 19.8.1.
· THIS CERTIFIES that the building ................................................
Location of Property ..... .gfl. 0...S~.g~. ~.o.~..R..O.a.~.~. .............. M.a.~.~. ~ .'~..¢.I~..~..~.,.Y.., .....
House No. Street oH~mlet
County Tax Map No. 1000 Section 16'3 .Block 01 .Lot 011,
Subdivision. ~lat.~,~.~tl2~..P.l?gp.~.~..~.~.9.~. ..... Filed Map.No. 801 .Lot No. 18 & 19
Re.quirements for a One Family Private DwellingBuilt
conforms substantially to the
· .P](~]l.~.~3, ......... 19...57pursuant to ~v~'~:lJ~ cratg ..... oft.~c_.e_upancy ......... .~.I.0..3.~ .2. ......
dated ... ~e.19. B.e.~...8~ ............. 19..8.1, 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 .........
......... Private One ~amily Dwelling with accessory (l~Car Garage) building.
The certificate is issued to Anna L. Hallock
..................... io¥,'~;,'/" ............................
of the aforesaid building.
Suffolk County Department of Health Approval ... ~1/]~ ...................................
UNDERWRITERS CERTIFICATE NO.
Building Inspector
Rev 4/79
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location
Subdivision Matt. Park Properties Map No.
910 Sigsbee Road,
(number & street)
Mattituck, N.Y.
(Municipality)
801 Lot(s) 18 & 19
Name of 0v~er(s) Anna L. Hallock
Occupancy R-1
(type)
Admitted by: Se].~
Unoccupied
(owner-tenant)
Accompanied by: Self
Key available N.F.B.& Trust Co. Suffolk Co. Tax No. 143-01-011.00
Source of request A. Wickham Date 1/2/81
DW~J,LING:
Type of construction Wood
Foundation Cement Block
Total rooms, let. FI ~
Bathroom(s) 1
Porch, typ~ Back, Closed ~Bck, type
Breezeway Garag~
Type Heat 0il Fired Warm Air X
Fireplace(s)
Domestic hotwater Yes
Other
No. Exits
Type heater
#stories
Cellar F~l Crawl space
2nd. F1 3rd. F1
Toilet room(s)
Patio, type__
Utility room
Hotwater
Airconditioning
Gas
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other
Wood-1½Car
Storage, type const.
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
L0catipn Description Art. Sec.
Garage Holes in roof, sills bad III .52-30-~r~
Outside Rear step to high II 52-27-A
Remarks:
Inspected by: ~~~. ~~,
Curtis Horton
Date of Insp. 1/8/81
T~me startll-~ pO end 11:40
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 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 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 or land use $5.00
3. Copy of certificate of occupancy $1.00
Date ..... ~/,2/.8.~ ...............
New Building ............. Old or Pre-existing Building × Vacant Land
Location of Property w/s Sigsbee Road, Mattituck, New York 11952
House No. Street Ham/et
THE NORTH FORK BANK & TRUST COMPANY as Executor of
Owner or Owners of Property .. ANNA. ~.- F~A.T~rOc~,. ~ ................................
County Tax Map No. 1000 Section ....... Block ....0.Z...0.0. ......Lot .... .....
Subdivision Mattituck Park Properties .Map No. 801 Lot No. 18 & 19
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted$ 5.00
Construction on above described building and permit meets a p cab~ cod s and e tjo
Applicant .......... ~.
Rev. 10-10-78 ~ _may .be_obtaLned frcxa, the Trust ~-; ,,~_nt of The North Fork Bank
anct 'lrust uompany, Mattituck, N.Y. - (tel. no. 298-8366)