HomeMy WebLinkAboutZ-9980FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
Date Jlme 17 1~?.
THIS CERTIFIES that the building ................................................
895 Central Drive, Mattituck
Location of Property .. .... . ......................... ._ ........................... ....:.
.ou~e mo. 106 (~'~eet 026 Ham/et
County Tax Map No. 1000 Section ............ Block ............... I.ot .................
Subdivision Capt. Kidd Estates .Filed Map No1672 .Lot No.
Requirements for'a one-f~mil~ dwelling built prior to
~er~z~xca~e oz uccupancy
A~Nil
23,
1957 pursuant to whic~]~u~-Pgr~n~t-~.
dated June 17 19 80 was issued, and conforms to aU of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
Private One-Family Dwelling
Henry J. Molczan
The certificate is issued to
(owne~,')~ee or tenant)
of the aforesaid building.
N/R
Suffolk County Department of Health Approval ..........................................
UNDERWRITERS CERTIFICATE NO ..................................................
Rev 4/79
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location
Subdivision
895 Central Drive,
(number & street)
Capt. Kidd Estates
Mattituck
(Municipality)
Map No. 1672 Lot(s) 140
N~me of Owner(s) Henry J. Molczan
Occupancy R-1
(type)
Admitted by: Self
owner
(owner-tenant)
Accompanied by: Self
Key available
Suffolk Co. Tax No. 106-2-26
Source of request Celic Agency
Date 6-13-80
DWELLING:
Type of construction Wood Framed
FoundationCement Block Cellar Full
Total rooms, let. F1 5 2nd. F1
#stories One
Crawl space
3rd. F1
Bathroom(s) X
Porch, type
Breezewa~
Type Heat 0il Fired
Fireplace(s)
Domestic hotwater
Other
Toilet room(s)
Deck, type
Garage.
Warm Air
No. Exits
Yes
Patio, typ~__
Utility room
Hotwater X
Airconditionin~
Type heater Tankless
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other
NONE
Storage, type const.
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
Location Description Art. Sec.
No Violations Where Found
Remarks:
Inspected by:~Date of Insp.
6/16/80
Curtis Horton Time start 3:15 end 3:30
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-exis~ing"
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.
Co
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
$5.00
Date ..... '~..-~ .[
New Building ............. Old or Pre-existing Building .. ~.. ....... Vacant Land .............
Location of Property...~. Z.r~--.. ............... ~J/?~.¢'~2 ~--,',.. ~'~ .' ...... ~.~./.~~'~--.'.
House No, , ~ ~ , Street Ham/et
Owner or Owners of Property . . . .-~/j~. ~..~., . ...~. ~ .~..~.. ~.. ~.. ...................
County Tax Map No. 1000 Section .../.~. 2L~'. ....... Block ...~.'..)~.. ....... Lot...(~...~& .......
Subdivision...~..~..~.'i..~./..P..~...~..F,~. ~.~..~'. .....Filed Map No. /.~'.'~.~...Lot No .... /..~..~. ....
Permit No.~ .... Date of Permit .......... Applicant '~ -~
Health Dept. Approval .... ~/Z~,,/,,,~. · . ......... Labor Dept. Approval . .~//~ ..............
Underwriters Approval · · · /!¥'r? ' '/'('--~'' ......... Planning Board Approval ,/~//.~,~-. ..........
Request for Temporary Certificate ..................... Final Certificate . ~ .................
Fee Submitted$....~...~.. ...................
Construction on above described building and permit meets all applicable codes and regulations.
Applicant..~/~/~...~. ~ ., . .~....~..~ ...............
Rev. 10-10-78
., IV