HomeMy WebLinkAboutZ-11017 FORM N0.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
NoZ.1,1017..... Date June. ~ . 19$?.
THIS CERTIFIES that the building 2.) .
Location of Property .145„;;,,,,,,,,,,,,,,,Or~i~ard.Road,,,,,,,,,,,,Sou,tholcl,,,,,
House No. Street Ham/et
County Tax Map No. 1000 Section ..9~~.......Block ..9?...........Lot .:.9?f~.......... .
Subdivision .$ei.xe.dOri. ~siiate.s , , , ....Filed Map No. 1.47~....Lot No. . 3.......... .
Requirec~ents for a private one-family dwelling built prior to
conforms substantially to the A~p~pliesEien-for~di}d1rig~'erneitfieretofere-1wileeF-in-this~rffiee-dated-
Certificate of Occupancy 219017
. Q.p,ri.l, ~3 , 19 .~'~pursuant to which~~i~g~er~mE-No . .
dated .....June, .1 , , , , , , , , , , , , , , 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-faz?ily ,d.rel,lin/';, ~rith_ ,accessory, ,4ara~~.
The certificate is issued to Huza~hr~y. Kennedy & ,his wife
(owner, lecsse•er-tenaat}~
of the aforesaid building.
Suffolk County Department of Health Approval n/r,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
UNDERWRITERS CERTIFICATE NO n/r.,,,,,,,,,,,,,.,,,,,,,,,,,,,,,,,
Building Inspector
Rey. vs~
BUILDING DEPARTMENT
T0~•lN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 145 Orchard Road outhold
num'oer & street Municipality
Subdivision RP;Xadon Estates Map No. 1472 Lot(s) 3
Name of Owner(s) Humphrey Kennedy & wife
Occupancy R-1 owner
type owner-tenant
Admitted by:_ Mrs. Kennedv Accompanied by: same
Key available " Suffolk Co. Tax No. 66-2-26
Source of request Edna Kennedy Date 5/7/82
D~r7ELLING
Type of construction wood framed #stories 2
Foundation concrete slab Cellar x Crawl space x
Total rooms, lst. F1 5 2nd. F1 4 3rd. Fl
Bathroom(s) ~ Toilet room(s)
Porch, type 2, cement Deck, type Patio, type slate
Breezeway Garage Utility room
Type Heat ~;1 fared '~Iarm Air g Hotwater
Fireplace(s) No. Exits ~ Airconditioning
Domestic hotwater yP~ Type heater electric
Other boiler room outis~:de shower
ACCESSORY STRUCTURES:
metal & wood
Garage, type const. combination--Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS: Housing Code, Chapter 52
Location Description Art. Sec.
stora e sh d sills need re laci - -
boiler rm, no air su 1 for he er V - 1 & 2
- ~PORM 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 Inspec-
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 instalta-
lions, 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 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 occupanc
. Certificate o occupancy on pre-existing dwelling or land use $5.00
`-3Z,op
o
certificate of occupancy 1.00 -
Date c; ~
New Building Old orPre-existing Building(X) . rVacant Land .
Location of Property ~.~~..._.Q.R..~. t~. .~.......~O f~;~. {.);.f , ~"dC--
House No. Street ~ ~Qf ~ Ham/et
. ~ t
Owner or Owners of Property ~ ~ f'J.J~" h !!l..~'..~0~ t/~r _ t ` .
County Tax-vMya~p No. 1000 Section .~P.~> Block L........ Lot .
Subdivision ~ ~ i? { x P~dgv~• • ~~3. _Filed Map No. ~.7. ~02....Lot No. .
Permit No. Date of Permit ..........Applicant .
Health Dept. Approval ........................Labor Dept. Approval
Underwriters Approval ........................Planning Board Approval • .
Request for Temporary Certificate .....................Final Certificate ; s
Fee Submitted$.~~~..•:/.•••••••••••••••
Construction on above described building and permirmeets all app!{c I~odes and/;regulations.
Applicant - t~2-~~~...1. .
~ aoQ~`7, r, l~ 1~~, sq3
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