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HomeMy WebLinkAboutZ-11253FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. .......... Date ......October 13 ..............1 1982. THIS CERTIFIES that the building e... i? ) .......................................... Location of Property..?95.............. Town_ Creek Lane ... Southold House No. Street Hamlet County Tax Map No. 1000 Section ..064 ....... Block . Q 1 ...........Lot . 006, ......... . Subdivision ..... X.........................Filed Map No. ..X .....Lot No. . X........... Requirements for a private one -family dwelling built prior to conforms substantially to the A.riplicatiori.fos_hefet& � .iii-tkis-offiee­dated- Certificate of Occupancy APril..23........ 19 5.7. pursuant to which Buildin-PrrnritNo. .. X 1 1253, ......... . dated .......October 13 ......... 19 82 , 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 d>relling and one accessory storage building. ....................................... The certificate is issued to ........Roger! .McCarvill ................................. (owner, leseeeer�teti►enti of the aforesaid building. Suffolk County Department of Health Approval .... r. a............................ ....... UNDERWRITERS CERTIFICATE NO............ n/a.................................. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 or land use $5.00 3. Copy of certificate of occupancy $1.00 / Date Nev., Building ............. Old or Pre-existing Building(X) . _- _ s Vacant Land p Location of Property ..... �. . . _ ... l .:L�_I, itr..' . .. �T�....... House No. e Hamlet / Owner or Owners of Property t?�2��.-�, , , , , , ,l,�Ci4�.`�1. County Tax Map No: 1000 Section .... Block ....... Lot .. . (a....... Subdivision .........x ......................Filed Map No. ..K ........ Lot No. ..A....... G Permit No. ...�-:.... Date of Permit ........Applicant ....... ......................... . CiA_ Health Dept. Approval ......X .................Labor Dept. Approval ..... y. ............. . Underwriters Approval ...... Y................Planning Board Approval ....1� . . Request for Temporary Certificate ............... .... Final Certificate ......�........ - S4S Fee Submitted $ ... S. ..... ............. .. . Construction on above described building an ermirme cable c and regu ti Applicant Rev. 10-10.78 � �. 00 jcu_ G y r ecj Av-e 5o_�04 0. 1 (Q S73 ��. a a YoD ,/ s-s�s 01(3/g,) BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location number & street Municipality Subdivision_ Map No. Lots) Name of Owner(s) 0 c cup ancy_ --- tlroc e)// towner-tenan Admitted by:_ Accompanied by: Key available �� Suffolk Co. Tax No. Source of request �' �"'�� Date- DWELLING- Type ate DWELLING°Type of construction/�� -� #stories_ Foundation W41asr6V 1- Cellar Crawl space Totalrooms, lst. F1 2nd. F1 3rd. F1 Bathroom(s) Toilet room(s) Porch, type_ Deck, type e, Patio, type _ Breezeway. Garage Utility room Type Heat Warm Air Hotwater a Fireplace(s) No. Exits_Airconditioning Domestic hot-water Type heater Other ACCESSORY STRUCTURES: Garage, type const.__ Storage, type const. Swimming pool Guest, type const. Other VIOLATIONS: Housing Code, Chapter 52 Location Description, Art. Sec. /�Ta�r��OP.tI- laz ,✓ `'D q+� ,� r� G►v1�nn r�C t�� 1/ 1716x3 (%YtR Grim �, r �f.4 ea / 01y"41 "O_U .mGriALv/ `E Remarks:rL,/► 2 A7V0Ci� i +n.! Inspected by: Date of Insp. 0 Time start end I Y Y�