HomeMy WebLinkAboutZ-7270NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupanc
No. J~72?.Q ..... Date ..........
THIS CERTIFIES that the building located at (~k. Ave .~ ................. Street
Map N°. Goose. i~a.y. Block No ........... Lot No, 29h~29.~ .a. P-t..29~ .... Soti~ho.~c}
conf°rr~, substantially to.the
,. , c~r.t~fic&te ~.oc cupancy
b~i~ b..of.o.b.e., lip. I:.. 2~ ..... , 19.57. pursuant to ww. cn
dated ......... ~..Oct .... ~ ...., 19.76., was issued, and conforms to All of the require-
ments of the applicable provisions of the law. The occupancy for Which thi.~ certificate is
issued is .P.~lY. tte. Pie. f.ar~lly..dweLLint .........................
The cert~cate is i.~sued to Iterbor. t. Hexmana .... flwner.
(owner, lessee or tenant
~ the aforesaid building.
SkffoLk C~unty'Department of Health Approval . ,pre.-..exis.ting. '
UNDERWRITERS CEI~TIFICATE No...~re.-..exls.tlng. "
HOUSE NUMBER .. 9.10 ........ Street .. 0!lc .Ave.
Building Inspector
HOUSING CODE INSPECTION
Sub. Div.:
October 4, 1976
910 Oak Avenue R-1 Southold, N.Y.
Goose Bay Estates, Lots 294, 295, 296 and part of
293 and 297
Tax Roil: Herbert Hermanns
Upon receipt of a request for a Pre-existing Certificate of
Occupancy, I made an inspection of this one-family dwelling
which was built before Zoning. I was admitted to the house
by Mr. and Mrs. Hermanns and began this inspection at approxi-
mately 11:00 A.M.
I found no violations of the Housing Code, Chapter 52,
Town of Southold, New York.
The dwelling and attached garage appear to be in good
condition. There are no accessory buildings.
Respectfully submitted,
George H. Fisher
Building Inspector
GHF:med
FOKM NO. S
TOWN OF SOUTHOLD
, Building Department
Town Clerks Office
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
Inspector 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, ~v~ultiple Residences and similar buildings and
installations, 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 property 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 in-
formation 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
New B~ilding ................ Addition ........... ~... Old or Pre-existing Building ...,~ ....... ¥ocont Lend ..............
Location Of Property ..... .N...ti~..~...~...~..~~..~..~.~j~.~..~1 --A--~,-- ~'"-"'"~"~
_. ....... ...............
Subdivision ./.~...../~7....~ ............. Lot No...: ........ Block No ............. House No .............
Permit No ..................... Dote Of Permit .................... Applicont ..................................................................
Heolth Dept. Approvol ............................................ Lobor Dept. Approval ................................................
Underwriters Approvol .............................................. Plonning Boord Approvol ........ 7 .................
Request For Temporary Certificate ........................................ Fined Certificate ..........................................
Fee Submitted $ .~..L ...........................
Construction on above described building a,n~pe~ni,t~meets all applicable ~odes and regplations.
...................
Swo~n/~ ,fore me this . Y~'/ ~~~