HomeMy WebLinkAboutZ-10411FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No ....... 7.10441 .... Date ..... M&~ch. At .................. 19 R%
THIS CERTIFIES that the building ................................................
Location of Property ..... 6 .125. Pe.con ic..Bay..~llYd ~.e~{ ...haur.~.l, ~. N .... Y ...........
House No. Hamlet
County Tax Map No. 1000 Section ...1.26 ...... Block .... 1.0 ......... Lot . 2.~. .............
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
dated . ~Iul¥..10 .................. 1962., 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 .........
.............. ~t~i.v. ai;e. QneYF~il~r..DvelJ, lng ..................................
The certificate is issued to .. ~T. ohn. TngelJ. is .........................................
(owner, ~sae,o& ~aa~l. ,
of the aforesaid building.
Suffolk County Department of Health Approval It. D. a~pp~'oval July 10 ~ ~ 62 Robet'~
......................................... Villa
UNDERWRITERS CERTIFICATE NO ........ I~/1~. ......................................
Building Inspector
Rev. 1/81
Location
Subdivision
BUILDING DF-OAP. T['~NT
TOYS[ OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
6125 Feconic Bay Blvd.~ Laurel, N.Y.
(number & s~ree~) (Mu~nicipality)
Map No. Lot(s).
Ns~me of
John Ingellis
Occupancy
Admitted by:
R-1
(type)
Mr. Inmellis
Owner
(owner-ten~'~t)
Accompanied by: Mr. Ingellis
Key available
Suffolk Co. Tax No. !26-10-24
Source of request Richard F. Lark·
Date March 3, 1981
DVf~LING:
Type of construction Wood
Fobundation cement Block
Total rooms, 1st. F1 4
Cellar Full
2nd. F1 2
#stories 1½'
Crawl space
3rd. F1
Bathroom (s)
Porch, type
Breezeway.
Type Heat
Fireplace(s)
Domestic hotwater Yes
Other
2
¢ .... , ~ ~eg~k, type
Garage 1 Car
Oil F~red.__'Warm Air
1 No. Exits
Toilet room(s)
Patio, type__
Utility room
Hotwater
Airconditioning
.TYPe heater Tankless
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
~Other
NONE
Sto~age, ~ype const.
Guest, type Const.
VIOLATIONS: Housing Code, Chapter 52
Location Description Ar_t.. Sec.
_. No ~;"in'l~''innm - wh~n~ f'n~nd in the
Mnusin~ Code. Chapter .52
Remarks: This inspection was an update of Building Permit #1705Z issued
April 16, ~6~._-.~y ~;~ O./issued JUly 10, 1962-Z1395
Inspected by: ~ ~.~7.~ ~ .~~ate of Insp. March 4, ~981
Curtis W. Horton Time start ll:qn 'end ,.
FORM NO. 6
TOWN OF SOUTI'IOLD
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 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.
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 .... .Z ....... Vacant Land .............
Location of Property 6125 Peconic Bay Boulevard Laurel
House No. Street Ham/et
Owner or Owners of Property Lydia M. Ingellis
County Tax Map No. 1000 Section ...1.2.6. ......... Block ... ,~.0 .......... Lot... ,2,4, ..........
Subdivision ................................. Filed Map No .......... .Lot No ..............
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 all applicable codes and ragu lations.
Rev. 10-10-78