HomeMy WebLinkAboutZ-11288FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No.41'23:3......... Date .....October 22`' ................192.
THIS CERTIFIES that the building ................................................
Location of Property .P7R0................. Road Laurel
House No. Street Hamlet
County Tax Map No. 1000 Section .1 +2........Block .Q ( ............Lot .. 0 0.6...0 02
Subdivision ....:s ..........................Filed Map No. .. x.....Lot No. ............
Requirements for a commercial building built prior to
conforms substantially to the-Applieatiea-for$nMrrgfernritiieretufore—Piied,tzrtMrzffta- tell
Certificate of Occupancy
A nri,I .23........ , 19� . pursuant to which -Bnttdirr9-Petmtt No. 41.1.233F? ..............
dated .....Oct ober. 28 ........... 1932 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 .........
....... commercial building'.• .......... .............................
.commrci .......... ..........
The certificate is issued toFrank Murphy
...........................
................................
(owner, iesseerortenarrrl
of the aforesaid building.
Suffolk County Department of Health Approval .... ??fit'
.................................
UNDERWRITERS CERTIFICATE NO............ n� L ..................................
<' //Building
/ .1�� ......... .
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 or land use $5.00
3. Copy of certificate of occupancy $1.00
Date
Nev., Building ............. Old or Pre
-eexisting Building(X) . X__. __ 1 `Vacant Laand� .............
Location of Property �O ....,�7ra%/��J../.CGS G�.............. I ..:.:4 !</ /...... .
Hou -se No. Stye t Hamlet
Owner or Owners of Property ...7f�c � l`' .. X K� er ............................ .
County Tax Map No. 1000 Section ... �:z Block .....�%...... Lot. .... .
Subdivision .................................Filed Map No. ... '...Lot No. .............
Permit No. .......... Date of Permit ..........Applicant ... ............................ .
Health Dept. Approval ....!Q/Ot.............Labor Dept. Approval ��� ........... .
N
Underwriters Approval ... 1v11.e ..............Planning Board Approval . xl*L ........,,
Request for Temporary Certificate .....................Final Certificate ..:.......
VW
Fee Submitted S .•..•......•..•.•..•••
Construction on above described bu
Rev. 10-10.78
and regulations.
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location & ®J
- (number & street
Subdivision _ Map No.
Name of Owner(s)
Occupancy
Admitted by:
Key available
typ e )
Source of request /•
ipality
Lot(s)
k owner -tenant)
Accompanied by:
Z12 -
Suffolk Co. Tax No. �
Date
Type of construction #stories CSC
Foundation Cellar Crawl space
Total rooms, lst. Fl 2 d 2nd. Fl 3rd. F1
Bathroom(s) Toilet room(s)
Porch, type Deck, type Patio, type
Breezeway Garage Utility room
.Type Heat 'Warm Air Hotwater
Fireplace(s). No. Exits Airconditioning
Domestic hotwatere5 Type heater
Other
ACCESSORY STRUCTURES:
Garage, type const.°
Swimming pool
Other.
Storage, type const.
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
Time start �-