HomeMy WebLinkAboutZ-12388FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. ...Z12388....... Date ......... March..? .............. 1984.
THIS CERTIFIES that the building -. ;dwelling. .
Location of Property 2400 Park Avenue Mattituck
P Y House %Vo ........................ Street .......................Hamlet
County Tax Map No. 1000 Section ...12.3 .....Block .... PA ........ Lot .:.. , 012
Subdivision .... X ..........................Filed Map No. ... X....Lot No. . X ..........
Requirements for a private one—family dwelling built prior to
conforms substantially to the AVpliea4iax_f9r-4W}ding$eRR4t- iereWer$f-tled-4a4}is-offted
April 23Certificate of Occupancy
...................... 19 .5 7 pursuant to which Bt iiding Permit No. .. Z 1.2 3 8 8
..............
dated ....... Mdx:gh . 2.7............ 19 84 , 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 .........
.,,,a_private.one-family.dwelling.
The certificate is issued to ...... ANTHONY. LoCASTRO
(owner %sseter tenenrl......................
of the aforesaid building.
Suffolk County Department of Health Approval ...... n(?. record
..........................
UNDERWRITERS CERTIFICATE NO .............. no ...re.....cord
.........................
SEE ATTACHED HOUSING CODE INSPECTION REPORT.
,.4../K... ......................
Building Inspector
Rev. 1/81
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 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.
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 occupancy $5.00 /
2. Certificate of occupancy on pre-existing dwelling / land use --Pre-Existing C.O.
3. Copy of certificate of occupancy $1.00 ( Vacant land C.O.
Date ......k,3/.a a 9T .........
New Building ............. Old or Pre-existing Building .... :V�..... Vacant Land .............
Location of Property .Zzq-00................ P41r K . A.aevkue..........
House No. Q /Street Ham/et
Owner or Owners of Property ......./. (�1 ... l-:4.. (fo, v.............. I .....
County Tax Map No. 1000 Section .. L. l;3 ....... Block .......�). 9 .... Lot ...Q 1. .......
Subdivision .. ✓:C• ............................Filed Map No. . ':.......Lot No. .�C..........
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 a pe mit ets all applicable codes nd regulations.
PP ',Vn�l
Applicant ................ ...... ...................v.v:'�..
Rev. 10-10.79 J 2 7/J7
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 7-4,D d
number & street unicipa i y
Subdivision Map/No. — Lot(s) —
Name of Owners)
Occupancy
type owner- enant
Admitted. by: 0 j), -K`, Accompanied by:
Ke available
Y O �-c_r�/ Suffolk Co. Tax No.
Source of requestA, Date t3loLoL� ,L
DWELLING• /
Type of construction_ #stories ( IIZ
Foundation /-a�.� x �N Cellar_Fz.y=Crawl space
Total rooms, lst. Fl=_2nd. Fl r- 3rd, Fl
Bathroom(s) j Toilet room(s)
Porch, typeeck, type — _Patio, type
Breezeway Garage Utility room
Type Heat Lc � �,�, Warm !_t Hotwater -�•
Fireplaces) No. Exits Airconditionin
Domestic hotwater i=Lcc� Type heater
Crther
ACCESSORY STRUCTURES:
Garage, type const. Storage, type const. /Ooc?,E�
Swimming pool Guest, type const.
Other
VIOLATIONS: Housing Code, Chapter 52
)d
Time start/•(:�J end j! " /7-
1,900 - /. 3 -S,4 /Z
TOWN OF SOUTHOLD PROPERTY RECORD CARD
Ic
OWNER
STREET
VILLAGE
DISTRICT
SUB.
LOT
I misc.
LAND
IMP.
D,
DATE
FORMER OWNER
N l
E
ACRE, PE
A
$ 4 y y, r
W r
TYPE OF BUILDING
RES.4
;
SEAS.
VL.
FARM
comm.
IND. CB.
I misc.
LAND
IMP.
TOTAL
DATE
REMARKS
3Z 0 6/0
Fo,��
A
\-Y,__ ��-/ �l
do
AGE
BUILDING CONDITION
NEW
Form
Tillable I
Tillable 2
Tillable 3
Wcodland
NORMAL
Acre
BELOW
Value Per Acre
ABOVE
Value
Swampland
Brushland
House Plot
,tai
M. Bldg.
�
j
I
�o
Bath
i I
Floors
�16 K
—
Extension
V '
p, X 3 P 9(
0 O
7
--------
Basement
_�
Extension
Ext. Walls --_
�� t j rho i�
� 4
i
Extension
M. Bldg.
Z o X O = D
j
Foundation
�o
Bath
(
Floors
�16 K
—
Extension
V '
p, X 3 P 9(
0 O
7
--------
Basement
_�
Extension
Ext. Walls --_
�� t j rho i�
Interior Finish
Extension
Fire Place
——I
Heat
Attic
o
/ X / —
-7
Porch
—
Porch
--
--- ---
Rooms ) st FloorZ
Breezeway
Patio
Driveway
Rooms 2nd Floor
Garage
I
IV r- rt H � A
Lw') td c 0 0 AL'
m