HomeMy WebLinkAboutZ-9630 FORM N0.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Cferk's Office
Southold, N.Y.
Certificate Of Occupancy
No.. L9Ej50 Date iu,~tz~t, ~ 19 .79
THIS CERTIFIES that the building
Location of Property ...1985, SKU1?l~ L~~s)~': Ct~`~C IQ~Ur.
House No. ~ ~ Street Hamlet
County Tax Map No. 1000 Section ......`~7....Block 4 .........Lot .......~Q........ .
Subdivision ...............................Filed Map No. .Lot No. .
I-tequirements for a one Tamil dwelling bui p io to
conforms substantially to the '
Certi'icate of Occu~arcy ZQ6~0 ,
Al?itZd, .2~........... , 19'7. .
dated ,~.Uu?JST .13,, ,1 ~~9 , , , , , , . 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 .
One fan>j_ly dwelling w% wood framed storage barn
The certificate is issued to ..Lois hassner , , , , , , , , , , , , , , , , , ,
(owner,~ss54B,'DgtBt&~t'!c
of the aforesaid building.
Suffolk County Department of Health Approval nT/?~
LINDERWRTTERS CERTIFICATE NO N~~.
Building Inspector
Rw 4/79
nUILDIi~G DEPARii•:r.i~T
TOt•;N OF SOUTHOLD, id. Y_
HOUSING CODE INSPECTION REPORT
Location 1 8 - Cutcho e Y
number & street I:unicipality -
Subdivision Ifap No. Lots}
Name of Owner(s) LOIS KASSNER
Occupancy R-1 Unoccupied
type o~rner- Levant
Aamitted by: self Accompanied by: self
Key availableGary•F7.anner Olsen Suffolk Ca. Tax ATO_ 97-4-10
Source. of request Gary Flanner Olsen, 'Esq. hy-Ee 7/31~7g •
Dj~IELLING c - . - - _ •
.Type of construction Wood frame Tstories 2 -
Foundation stone Cellar partial Crawl space
_
Total rooms, 1st. Fl 4 2nd.. Fl 2 3rd_ Fl
Bathroom(s) 2 Toilet roon(s) - - - - - - -
Porch, type open - Deck, type - - _ _ _ Patio, type
Breezeway - - - - Garage - _ _ - Utility room
Type Heat oil fired ' `rlarm Air X Hottrater
- Fireplace(s) - - ~ No. bcits 3 Aircondi.tioning
- Domestic hotwater yes Type heater
Other
ACCESSORY STRUCTURES:
Garage, type const. Storage, type corist_
Swimming pool Guest, type coast.
Other storage barn-wood framed -
VIOLATIONS: Housing Code, Chapter 52
Location Descri tion Art. Sec.
Kitchen no shut-off gas stove IV 52-52-6
frt.porch support posts -bad + III 52-30-A
$3.1•]x= bad - etc ~ 2- 0-A
~~ar i
Rcmarlcs-
Inspected by: Date of Insp_ August 10, 1979
•n;.,,., ,,,fi 2:00 2:30 p.m.
-f'i . CnC1
FORM NO. 6 ~ ~ -
TOWN OF SOUTHOLD
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 {nspec-
torwith 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, acertificate 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 peoperty showing all property lines, streets, buildings and unusua? 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 Certificate of occupancy on pre-existing dwelling or land use $5.00
,(opy of certificate of occupancy $1.00
'vv Date ...:~.~.`.~~~U...........
• New Building .........pp... Old orPre-existing Buildi/ng.......... Vacant`Land .
Location of Property .~(.~:s ...~P~!/:lti~~.... !~.d.%?~........~.`~°!~1~~-c-l.<:'~.•...-...... .
House No. Street Ham/et
Owner or Owners of Property ~ ~!U......~~-SJ.!~/~!
/ .
County Tax Map No. 1000 Section Block Y Lot ...~Q .
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 .
00
Fee Submitted $ .
Construction on above described building and permit meets all applicable codes and regulations.
Applicant
RaV. 10.10-78 ` . D. ~ / ~ ~ • / /
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