HomeMy WebLinkAboutZ-9977FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No. Z9977
June 13 80
Date ................................. 19...
THIS CERTIFIES that the building ................................................
Location of Property 275 Sound View Avenue Extention, Southold
House No. Street Ham/et
County Tax Map No. 1000 Section .... .~.0 ......Block .. ?: ........... Lot ..... .5 ...........
Subdivision ............................... Filed Map No ......... Lot No ..............
requirementa for a one-family dwelling .~built prior to
conforms substantially to t~-,~l~ie~ion-for-B-aiMi'r~laermit-heretoft~re--fit~-i,n-this--ot,~dat~-
Certificate of Occupancy
....A.p.l~.~..1..2.~. ........, 19 .5.7. pursuant to which B~rrrrit %~o.--. ....................
dated .... .ff..u~.e...'l.~. ............... 19..8? 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 . .l~. ~y.a.t.e.
.(~..e.-.~.mn..~.]:.y., .I~..e.]:..~.i.n.g..~.i.~.h., .t.h.e., .f.o.l.l.o.w..i.n.g..~:.c.c~ssory Buildings-2 Car Garage,
Stg. Building & Cabana near beach.
The certificate is issued to ....................... .J..~.e...H:..L..a~..d.e.l~. ...................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval ........ .N./.R ..............................
UNDERWRITERS CERTIFICATE NO ................ .~./.R. ..............................
Building Inspector
Rev 4/79
Location
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
275 Sound View Avenue Extention, Southold
(number & street) (Municipality)
Subdivision
N~me of Owner(s) Jane H. Lander
Occupancy RI
(type)
Admitted by: Jane Lander
Key available
Source of request Jane H. Lander
Map No. Lot(s)
(owner-tenant)
Accompanied by: Jane Lander
Suffolk Co. Tax No. 50-2-5
Date 6/12/80
DWELLING:
Type of construction Wood Framed
Foundation Cement Cellar
Total rooms, 1st. F1 3 2nd. F1
#stories 1½
Crawl space x
3rd. F1
Bathroom(s) 1
Porch, type
Breezeway
Type Heat Gas
Fireplace(s) X
Domestic hotwater
Other
Toilet room(s)
Deck, typ~ Wood Patio, type. Slate
Garage Utility room
Warm Air Hotwater X
No. Exits 2 Airconditionin~
Yes Type heater Tankless
ACCESSORY STRUCTURES:
Garage, type const. Wood-2 Car
Swimming pool
Other Cabana near beach
Storage, type const. Small,wood
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
Location Description Art. Sec.
Kitchen No Shut Off Gas Stove V 52-52-B,~
Upstairs Stairs Narrow ect. II 52-27-A,~
Outside Needs Painting ect. .. III 52-3-LrB
~oilet Rm Gas Fired Heater V 52-53 G.'
Remarks:
,2
Inspected
Date of Insp. 6-13-80
Time start9:15 end 9:~0
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 unusua~ 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 ............ Vacant Land .............
Location of Property ....... .~..7 .~,'~. ........... -.~.0, ,O../~.~. ,~./, ~. ,u_l., ,&. ,~.,..~-,X'.~., ..~]0, .c]~., ,/~, ~
House No. Street Ham/et
Owner or Owners of Property ... i .~-.~..~ .~. ..... L...~r..~..~..~..~. .................................
County Tax Map No. 1000 Section . .~'.~..CT.~.b.~...[.~... Block .... ~ ........ Lot ..... .~... .......
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 am~Lf;~rmit meets all applicable codc~ions.
Applicant....~.~.'...~.~.~ .~ ..........................~~