HomeMy WebLinkAboutZ-9771FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No.Zg . ............
Date ....D.q.o.e.~.b.er. ~. ................. 1979.
THIS CERTIFIES that the building ................................................
Location of PropertyHouse ....'~'8~'0'No..~.1~ .ROa.~ .......................... Street Peo°ntc'%i Pe]f'
County Tax Map No. 1000 Section . .85 ........ Block .... 2 .......... Lot ..... .1.7. .........
Subdivision ............................... Filed Map No ......... Lot No ..............
requirement, for a one flmily dwellin~ built prior
conforms substantially to the ~~a~l~l~l~ _a~l~,~ ' ....
=,, Certi.fioate of ~Ocoup_anoy
·.. A~ril. 23 ........ ,19 :~t. pursuant to which l~ld'-~ ta~wL'kNo ........ Z97~.'l ........
.i
datefd ... D~t~mb~..2 ............. 19 7.~, 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. Family. I~elling. w/2 ..tor. y. Fa~. Labor. IMeellAng* ..................
The certificate is issued to .......... J~L~l~$. r~APSkl ................................
of the aforesaid building·
Suffolk County Department of Health Approval ........ ~I/R ..............................
UNDERWRITERS CERTIFICATE NO ................ ~/[~ ..............................
tO
Building Inspector
Rev 4/79
*Farm labor dwelling - non habitable
until approved by the Board of Health,
· to.
Location
Subdivision
BUILDING DE?ARTMENT
TO~ OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
58350 Main Road
(n,~mber & street)
Map No.
Peconic. N.Y.
(Municipality)
Lot(s)
N~me of Owner(s)
Occupancy R ' 1
(type)
Admitted by: Mrs.
Key available
Kru~ski
Julius Kruoski
Owner
(owner-tenant)
Accompanied by: Mrs. Kruoski
Suffolk Co. Tax No. 1000-85-2r17
Source of request. R. G. Terry, Jr. '
Date Nov. 27, 1979
D$~ING:
Type of construction Wood
Foundation cement block
.Tot~] rooms, let. F1
Bathroom(s)
Porch, type closed in
Breezeway
Type Heat 0il fired
Fireplace(s)
Domestic hotwater
Other
ACCESSORY STRUCTURES:
Garage, type const~ Wood/~ car
Swimming pool
Other
Deck, type
Garage
'Warm Air
No. Exits
ves
#stories
Cellar full Crawl space
2nd. F1 3rd. F1
Toilet room(s)
Patio, type
Utility room
Hotwater X
Airconditioning
Type heater tankless
Storage, type const.
Guest, type·'const.
two story/wood framed - Farm labOr dwellin~
2
Potatoe storage
barn'- wood
VIOLATIONS:
Location
3 car
garage
Housing Code, Chapter 52
Description
Roof - very bad
III
Sec.
52-30-C
Farm labor dwelling needs heat, hot
water, various reoairinE. It also must
have aporoval from the Board of Health
Remarks: The Farm labor dwelling is non-habitable.
Inspected by: ~_~' ~~o-L Date of Insp. Nov. 28. 1979
, Curtis Horton Time start 3:00 end 3:45
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 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 featu res.
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.
§. 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
Date...~..O...~'.. ~,~.~/..I.?.?.~...
New Building ............. Old or Pre-existing Building /~ ......... Vacant Land .............
Location of Property...~. ~..~...~'~.. ............ ~ .~ .............. .~~
House No. Street Ham/et
Owner or Owners of Property ..... .~.. ~...o~..~ ~~. ~ . .~t
County Tax Map No. 1000 Section .... ~",~. ....... Block .... ,~. ......... Lot .... 1.~'. .........
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 $
Construction on above described building andjDermit meets all applicable codes and regulations.
App icant .~'~ .~., .2-~_~ .~~'/ [. ~ ~,~~~~' ~-
Rev. 10-10-78
0
N,40-.-~O.50-V'L.
t~CONIC