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Home My WebLink AboutZ-10636FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate O[ Occupancy Z10636 No .................. Date .......... ~R$~Y..1.~ ............ l~J.. THIS CERTIFIES that the building ................................................ Location of Property 4055 Pvt. #10 ltallock Lane, Mattttuck, New York h~s'e Ho: ........................................................ Street Hamlet County Tax Map No. 1000 Section 112- .Block 01 .Lot 005, 006 Subdivision ............................... Filed Map No ......... Lot No .............. Requirements for a one-family Dwelling Built Prior to conforms substantially to the A'FFti~a'tlutt'ftrt'lS'tlll~lllf~-l~e?/~tt-lTe?~lSFo-fF'lTrg'd-i'~TF~2~Ga-- April 23 19 57 Certificate of Occupanc7 ~n~a~ ..................... , ... pursuant to which B't~lh~o'l~l%ffR ?qb'. '. ......... .'.'."//..~ .... $1, ' dated ................ Augusg 19 . ............ 19 .. 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-Family Dwelling with Accessory (2) Helene Holtz The certificate is issued to ..................... ii it iiii ................... of the aforesaid building. Suffolk County Department of Health Approval N UNDERWRITERS CERTIFICATE NO. N/R Building Inspector Rev. 1/81 Location BUILDING T0¥.~ OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION RE?ORT 4055 Pvt. #10 Hallock Lane, Mattituck, New York (number & s~ree~) (Municipality) Subdivi s ion Name of OYmer(s) Helene Holtz Map No. Lot(s) Occupancy Admitted by: R-1 (type) Mrs. Sandlands owner ~owner-tenamt) Accompanied by: Same Key available Suffolk Co. Tax No. ~12-01;005,006 Source of request Gillian Sandlands Date 6/26/81 DYfELLING: Type of construction Cement Block Foundation Total rooms, 1st. Fi 4 Bathroom(s) 2 Porch, type Breezeway ~/pe Heat oil fired Fireplace(s) 1 Wood Framed #stories 2 CellarPartial Crawl space 2nd. Fi 2 3rd. F1 Toilet room(s). Deck, type Garage Warm Air x No. Exits Domestic hotwater Other Patio, type__ Utility room Ho%water Airconditioning. Yes Type heater Electric ACCESSORY STRUCTURES: , . ~arage, type const. St'orage, type const. Swimming pool Guest, type consi. Other Toilet room_located in storage room 2 Wood VIOLATIONS: Housing Code, Chapter 52 Description Art. Sec. Loca-~ion Stair up Stairs very narrow and steep IT ~?-P7-~ Outside Cellar-Way Needs repairing III 152-31-A,B Remarks: Curtis W. Horton T~me s[ortl0:30 end 11:30 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 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 Date ..... ?./~././Z/ .......... Location of Property ....~.E..~..~c~...?..~..'~..~./.~... ~'~.//¢.~.~~...~~_~ Hou~ No.. ~ Street Hamlet Owner or Owners of Property . ~ ~. ,~Z ~ ................................ County Tax MapNo. 1000 Section ..~ ........ Block ...~/ ........ Lot.~~... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planmng' Board Approval ..................... · /' Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .~.~, ..·. ........................ Construction on above described building and permit meets all applicable codes and regulations. Applicant...C_.~ ~. '..~.....-~'.~...~'~Y..~ .~..r-'~.. } .-~. ....................... Rev. 10-10-78