HomeMy WebLinkAboutZ-13458FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No...zj .3fi. 5.8 ......... Date .... ~I.a.y..¢9 ...................... 1985.
THIS CERTIFIES that the building .0.n.e.. f..a.m.~.l. ¥..d?.e. 1..i3.n.g .........................
Location of Property MANSION HOUSE DRIVE FISHERS ISLAND
121~6~ HO: ................................................... Street
County Tax Map No. 1000 Section ... ~. ........ Block ...... .6 ........ Lot ..... .~ .8 ..........
Subdivision ............................... Filed Map No ......... Lot No ..............
R~equir~em~en,.ts, fpr.,a pri~va, te 9ne~-f..a. mil2f dwelling bu_il.t pFior~_to
comorms suos[annany [o me
,Certi_f_ic~te .o.f .O. ccupancy~.~/,=~
.g p~.J.%, g3 ............ 19 5.?. pursuant to wmctD~ql~P~[ [q~x ......... :r.~.'.°. 7 ~?....
dated .. M..a y..2. O. ................... 19 .8.5., 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 .........
...... Q~..f.~.y..~w.e.%~ ~g ...................................................
The certificate is issued to ......... C. 9 I~.I.N. ~J ~..S.....H 8~.D. ~. ...............................
(owner, I~s~j~ ]~ t~fj~ X X X
of the aforesaid building.
Suffolk County Department of Health Approval ............. .Iq./. ~. .........................
UNDERWRITERS CERTIFICATE NO ...................... Iq./. 6 .........................
Building Inspector
Rev. 1/81
Location
BUILDING
T0%'~ OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
MANSION HOUSE DRIVE
FISHERS ISLAND
(nu~oer & sZree~)
(Municipalizy)
Subdivision
Name of Owner(s)
Map No.
CORRINE S. HARDY
Lot(s)
Occupancy
A~mitted by:
R-1
(type)
MRS. HARDY
Key ~vailable
Source of request
OWNER
(owner-tenanz)
Accompanied by: SAME
~ Suffolk Co. Tax No. 6-6-18
CORRINE S. HARDY' ~ate MAY 14, 1985
D~,,~LLING:
Type of construction WOOD FRAMED
Foundation CEMENT BLOCK
Total rooms, 1st. FI 5
Bathroom(s)
Porch, type
Breezeway 1
TTpe Heat ntt. FTRED
Fireplace(s)
Domestic hotwater
Other
1
Deck, type
Garag~ 1 car
'Warm Air
No. F~its 3
YES
#stories 1
CellarFARTIAL Crawl space SLAB
2nd. F1 3rd. F1
Toilet room(s)
Patio, typ~
Utility room
Hotwater xx
Airconditionin~
~ype heat'er -TANKLE$5
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other
NONE
Storage, type const.
Guest, type const.
VIOLATIONS:
Location
Housing Code, Chapter 4.SN.Y. State Uniform Fire Prevention
& Building Code
Descriotion t Art. I Sec.
NOIISF, NEEDS PATNTYNG
REAR STEP NEEDS REPLACING
Remarks:
Inspected
by:~Date of Insp. 5/14/85
CURTIS W. HORTONz 'Time start10:30 end 10:50
Bo
FORM NO. 6
TOWN OF SOUTHOLD
Building Depari.~ent
Town Hall
~outhold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted~i~l~,~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
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. Certificateofoccupancyonpre-existingdwelling/landuse--?z-e-E×±st,±r~g C.0. $15.00
3. Copy of certificate of occupancy $1.00 Vac an~, !and C. 0. $ 5 o 00
Date ..;~'.;~4.~'...~.~../~./~..~..
New Building ...... '~; ..... Old or Pre-existing Building ......... /. Vacant Land .... ......... ~..
Location of ProperW ~: ~.~-~...~ ,,?~ .~.~. ;'~¢.~...~?...../'~...~.
House ~o. Ham/et
~ Street
Owner or Owners of Property .;..~..~.'~.~:4~,~.~. ~
County Tax Map No. 1000 Section ............... Block ............... Lot
Subdivision ................................. Filed Map No.~ .. Lot .N°' ..~/ ..........
,
Perm,t No ........... Date of Perm,t .......... Appl,ca~n ~-c~..; .~.-...~/ ~ · ~ ....
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate ..... . .~. ·. ............
Fee Submitted $ ..... ,,~. ,~.. ;. ~..~-.-~;~. .............
Construction applicable codes and regulations.
on above described building and ~?ermit mtets all