HomeMy WebLinkAboutZ-9988FORM NO.4
TOWN OF SOUTHOL,D
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No. ..Z9W......... Date ...... Jun 9.18 .................. 1980.
THIS CERTIFIES that the building ................................................
Location of Property 4235 NIS Bayview Road, SOutholdt New York
ih; lsOAio* Street Hamlet
County Tax Map No. 1000 Section ... 78 ......Block ?............Lot .... 17 ..........
Subdivision ...............................Filed Map No. ........Lot No. .............
requirements for a one -family dwelling built prior to
conforms substantially to the A"1iw►Liew-feF &+i iRg ?or+»if Itersk> efe-filed tri 4hi9 off3oe dated -
April 23? Certificate of Occupancy
................ . 195.. pursuant to wkiek$t+iidinsFer"ik- m ...... 99. .........
dated ..June 18 19 -�9, 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 .........
Private One -Family Dwelling
The certificate is issued to ..ward J. & Kathleen Mullen
(owner, lessee or tenant%
of the aforesaid building.
Suffolk County Department of Health Approval ..... N/R
UNDERWRITERS CERTIFICATE NO ............. N%R.................................
Id
Raw 4fM
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 or land use $5.00
3. Copy of certificate of occupancy $1.00
Date ...June ,16,,,1980,,,,,,,,
New Building ............. Old or Pre-existing Building ... Y........ Vacant Land .............
.�/Z3S
Location of Property ...N/,S ,$4Y.V�QW. RoqLd,..SQuthQ10,..NQW. X4rk.................... .
House No. Street Ham/et
Owner or Owners of Property .... Edward .J...and. Kathlean .Mul-len.....................
County Tax Map No. 1000 Section ...7$........... Block ... 2........... Lot .. 17........... .
Subdivision .................................Filed Map No. ..........Lot No. .............
Permit No. .......... Date of Permit ..........Applicant ....9dWAX4. J... Kvll.en ...........
Health Dept. Approval ........................Labor Dept. Approval ........................
Underwriters Approval ........................Planning Board Approval ......................
Request for Temporary Certificate .....................Final Certificate ...... X................
Fee Submitted $. . 5...00 ......................
Construction on above described building an p*sais d and regulations.
Applicant....... ......... ...............
d 1p, Attorney, for Edward J.
Rw. 10-10-78 Mullen
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
LocationJ'�S_- N ?,//Zwr/9�0 Uv
number & street Municipality
Subdivision Map No. Lot(s)_______
.gym- of • - i _ �, �� • 1t, _.� >►
Occupancy / =,4,v s w
type owner -tenant)
Admitted by: _i7/,o/t,,� ,o/��Sa,y Accompanied by:
Key available,
Source of request
DWELLING:
Suffolk Co. Tax No./�Q-04 4�7 o/7
UoF&, Date�� -SCJ
Type of construction Zuja, t/C!g1 f� #stories_
Foundation (20,C Cellars%- Crawl space Sty
Total rooms, 1st. F1 z errs 2nd. Fl 3rd. F1 —
Bathroom(s) 0 NF- Toilet rooms) --
Porch, type Deck, type Patio, type -_-
Breezeway Garage Utility room
Type Heat GcnsTiz,.oc.� .. Warm Air — Hotwater ®ee- FJ&E�P
Fireplace(s) No . Exits 7T() d Airconditioning —
Domestic hotwater s/ Type heater ,T.4.ciCLg�S �rG/2�
Other
E
ACCESSORY STRUCTURES: moo rer.
Garage, type const. t /L C.oz Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS: Housing Code, Chapter 52
Location
Description
Art.
Sec.
-ilii r
.f2 Z Y3
Remarks:
Inspected by
Date of Insp.
Time startend