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Home My WebLink AboutZ-14321FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupnncy Date .... .~.a..v .c.h..2..6, .................. 198.6.. THIS CERTIFIES that the building a.. 0~.e.. ~ O~J, ~ y..d.~ ¢ ¢ ~.i.q g ...................... Location of Property 35.9.95. M.aio./R.o.~t..(.Re. g5.) ............ qq .~.c.h. Qg~.e .............. House No. Street Hamlet County Tax Map No. ]000 Section ..... 9. ? ..... Block ....... ! ....... Lot ....... .2.1 ........ Subdivision ............................... Filed Map No ......... Lot No .............. Requirements for a private one-family dwelling built prior to con forms substantially to the ;¢lHdJ(qOl~i~l!X )fO[~(B F.J.t'~X ]~&~K li&g~d~-i~ ~Ffi~ tfl~ th~ Ifff~ ;~li~t~ X Certificate of Occupancy Z14321 .... .A p.p.S. 3:..2.3 ......... 195. .7. pursuant to which g~ig~r~FeX'~R No ...................... dated ..... B ~?.c.l~. ~.6 .............. 19 8. 6., 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'-Fam.i.~y. dwet Z.i~g. an<~ '2. a.oee s~-oPy. ~uAtd.i. ng8.. ..................... The certificate is issued to ....RICEA~D. &..ELIZA. BETH. ~IAC. ~.ISH ...................... (owner, ~Ke~oX of the aforesaid building. Suffolk County Department of Health Approval ...... ~ / fi ................................. UNDERWRITERS CERTIFICATE NO .............. ~ //~ ................................. Building Inspector Rev. 1/81 BUILDING DEPART~ENT TO%'~ OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location 35995 Main Rd. (Rt. 25) Cutchogue (numoer & streeT) Subdivision Map No. (Munioipality not(s) Name of Owner(s) RICHARD E. MAC NISH Occupancy A~mitted by: (type) Key ~vailable R-1 SAME (owner-tenanT) Accompanied by: 97-1-21 Suffolk Co. Tax No. Source of request Mr. Mac Nish pate 3/24/86 D~LLIMG: Type of construction Foundation Tight Total rooms, 1st. F1 Bathroom(s) Porch, type wood Breezewa~ Type Heat oil fired Fireplace(s) Domestic hotwater Other WOOD FRAMED Cellar full 3 2nd. F1 4 I Toilet room(s) Deck, type Garage 'Warm Air No. ~xits Yes Coal burner #stories Crawl space 3rd. F1 Patio, type Utility room Hotwater XX 2 Airconditioning ~ype heat'er -Oil fired ACCESSORY STRUCTURES: Garage, type const. Swimming pool Other 2 J Storage, type const..wood ~ metal Guest, type const. VIOLATIONS: Housing Code, Chapter 45N.Y. Stat~ Uniform Fire Prevention & Bu~ldin~ _Location Description l-Art. Sec. No violations Housio~ where found. Remarks: ~(~a~ Inspected by: Date of Insp. 3/24/86 CURTIS W. HORTON ~°'e'~·'Time startg:30 end lO:~O FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 76.5- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted I ~ 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 p~operty 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 $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 ~/_.; j/ 5. Updated C.O. $15.00 Date .~2.~.c~r. [./.,~ New Building ............. Old or Pre-existing Building ...~. ........ Vacant Land ............. Location of Property . ,.~0~.~.~'. ~ ......... ~.~:'.~...~.~/..~.,/V~..~.3.:~ .... . .~__~.~ ~.,,.o.~_ .~--.... House No. Street -- J ', Hamlet Owner or Owners of Property . ~.. ~(%c~J'."~...~..~. ,.~../~-~.~--~./7 ..... ~/.,~----_~...~!.~ ............ County Tax Map No. 1000 Section ....... .~..~' ..... Block ..... ~ ......... Lot....~../. ........ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Hea th Dept Approve ,:. ...... Labor Dept Approval ...... J~/y. i ?./ )cr.;z -~ .......................... Underwriters Approval . ..'.' ' .~.'/~ ./??. ?, ........ Planning Board Approval ... ,,-. ............. ~. ~.% (7~- '".'~/' Request for Temporary Certificate ..................... Final Certificate ....................... J'/ Fee Submitted/./..~., .~. ~. ................. Construction on above described building an_~ermit meets all applicable c~ regulations. Applicant ~. ~...~.-..~__~.. ....... 1. .................. Rev. 10-10-78 CONSENT TO INSPECTION Owner(s) Name(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at (~_ / ! · the undersigned, · xvhich is shown and designa%ed on the Suffolk County tax map as District 1000, Section ~'~, Block / , Lot ~. / That the undersigned (has) (have) filed, or caused to be filed· an applica- tion in the Southold Town Building Inspector's Office for the following: __ That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Southold. The undersigned· in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulations of the Town of Southold. (signature) (print name) (signature) (print name)