Loading...
HomeMy WebLinkAboutZ-10286FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy Z ~0286 NO .................. December 5, 80 Date ................................ , 19... THIS CERTIFIES that the buildh]g ................................................ Location of Property .. ?./*.8.0...N.~.8.~.U...P.O.~.~?..R.O. 8..d., ............ ?.U.~.o.b.O.g~..e' ........... House No. ~ ~ 8 Stre~g 007 Hamlet County Tax Map No. 1000 Section ............ Block ............... Lot ................. Subdivision..N..8.~?.~.~...P.~....0..1.u.b..P.r..op.. ..... Filed Map No ......... Lot No. Requirements for a One F_amil¥ Dwellin$ _Built _Prior_to conforms substantially to the K'p-piS~SfftTo'h-f'o't"WJlTdTn~-P'eTr~T[ lge-fe~Td'r~T~gd-Tri TI~' ortTc~ h'%t'e-d- -- Certificate of Occupancy Z10286 · ~.p.r.i..1.._2.~ ~. ......... , 19 .~.7. pursuant to w'taetr1~~tt-Ntrr.-. ........ -:. .......... dated ...D.e.q .e.m.b.e.r...5, ............. 19 .8.0. , was issued, and conforms to all orthe requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... One Family Dwelling with Accessory Structure which includes t~o car Garage and Non-Conforming Living Unit to be used for Guest Occupancy The certificate is issued to ....W.8~..~.e.l~.. H.'..If.ey.e?.~.o..h...8~.d..A.n.o.: ........................ (owner, I~ae. OI.~ of the aforesaid building. Suffolk CountY Department of Health Approval .... N/.R ................................... UNDERWRITERS CERTIFICATE NO .... .N/.R .......................................... 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 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. 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 $5.00 Date . December. 2.,. ~LgBD ......... New Building ............. Old or Pre-existing Building ... ~( ........ Vacant Land ............. Location of Property . Nc-~$at~. Pp~rd;. R{;3~. ~. Ct]~-~]~ .................................... House No. Street Ham/et Owner or Owners of Property Walden H. I_eve. rich ~ Peter C. Leverich County Tax Map No. 1000 Section 118 Block 6 Lot 7 Subdivision ................................. Filed Map No..1.5.6. ...... Lot No. 91 Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate X Fee Submitted $...5...0.0 ....................... Construction on above described building and permit meets all applica_b, le codes and ~egulations. pp ica ~: ....................................... I, qX. LDEN H. LEVEl{ICH ,/I Rev. 10-10-78 BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location ?~0 /q/~~ /-~'~ ~'~ (number~~& stree~t) Subdivision//~ ~ ~:,~3~ Map No. (Municipality) Lot(s) 9/ Name of Owner(s) Occupancy (type)/ Admitted by: _~//~, Key available (owner~ ~.~ Accompanied by: Source of request DWELLING: Type of construction f~Yoo~ ~-~~ Foundat io~o~ ~~ Cellar ~-~ #storie~/~ Crawl space Total rooms, 1st. Fi~ 2nd. F1 3 ~D 3rd. Fi~LL_~Z~ Bathroom(s) om~ ~--~£~ Toilet room(s) ..... Porch, type~~c~. Deck, type ~Y~O00 Patio, typq__ Breezeway -~- Garage Utility room Type Heat~/g~ Warm Air ~c ~/~ Hotwater , Fireplace(s) o~'~ No. Exits ~ Airconditionin~ Domestic hotwater ~ ~ype heater~>~ ~,~ Other ACCESSORY STRUCTURES: ~Uo, o~ Garage, type const. 77/~ ~/~ Storage, type const. Swimming pool Guest, type const. Other VZOLATIONS: Housing Code, Chapter 52 Location Description Art. Sec. Inspected by: ~~~f~ '~ " Date of Insp.~. Time start/r~/~nd ~Q~ ~.~' c~Z