HomeMy WebLinkAboutZ-10968FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. .Z I C).9.6,8.. Date ........Apr. il..22................ 19 8a
THIS CERTIFIES that the building ....................................... ...... .
Location of Property .: 0 f ............ Cr.eat. P.econi.c . Bal. .131Yd........ UtureI.. .
House No. Street Hamlet
County Tax Map No. 1000 Section ... 1.26 ...... Block ..1.0 ..........Lot .: p.1.4 .......... .
Subdivision ... Y ..........................Filed Map No. . X ...... Lot No. ..X..........
Requirements for a private one -family towelling built prior to
conforms substantially to the, Applicatiar.►..for-RWkl ag-Perinit-hereto€ore-filed-in-"s-e€fteednted-
Certificate of Occupancy
.A pr.i l .2 3 ......... , 19514'. pursuant to which BuildingXe;mit No. ,2.1.0968 • . • .. • ..... • •
dated ..... A p ni 1. 2.a ............. 19 3 2. , 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 .........
. ,e. P.r itV?-Y'A , gtie, .far:i,7,y, inF;r , &, a,ece s,ory two -car garage .
The certificate is issued to ..... h e 1 e.n . 6 a.caK e n Z.i q ....................................
(owner, lowee-oz teaanll
of the aforesaid building.
Suffolk County Department of Health Approval ........... n 0 t. • • . • ..... • .... .
UNDERWRITERS CERTIFICATE NO ................... n Q t. r.g Q V} r q 1................ .
........................................
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.
X 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 $1.00
Date
New Building ............. Old or Pre-existing Building(X) . _. _. _$'Vacant Land .............
6955 Peconic Bay Blvd., Laurel, N. Y.
Location of Property .... _....................................................
House No. Street Hamlet
Helen MacKenzie, owner - Margaret Meinke, purchaser/
Owner or Owners of Property .......... ....... ..:. . .........................daughter
County Tax Map No. 1000 Section ....126........ Block ........ Lot.... 1,4
Subdivision ..... ...........................Filed Map No. ..........Lot No. .............
Permit No. .......... Date of Permit ..........Applicant ..................................
Health Dept. Approval ........................Labor Dept. Approval ......................,. .
Underwriters Approval ........................Planning Board Approval ..................n
Request for Temporary Certificate .....................Final Certificate ..................
Fee Submitted $ .5 .. ✓ .......................
Construction on above described building andel�permirmeetss all a}pp-1 c�a�bltodes and regulations.
Applicant . _' '
11
. !`" ........ ..... .
Rev. 10-10-78 C . � /O
fir - .
,��1 fro, zt e
6 Rocky Ridge Drive
Trumbull, Ct. 06611
April 10, 1982
Town of Southold
Building Department
Town Hall
Southold, N. Y. 11971
Gentlemen:
Helen MacKenzie, my mother, until January 1981,
had lived in her home at 6955 Peconic Bay Blvd., Laurel,
N. Y. since 1947. It is currently occupied by a friend,
Edna Mayer, and is in excellent living condition.
A survey is being prepared by Van Tuyl, Surveyors,
and I am instructing them to forward a copy to your
office.
SIGNATL7 ::c GUARANI i EE)
\ J
R`.CGPUPi , C0Ji�!N. r6 2
BY Tr
WHOSs?tS GNATUPE IJAY BL VLIZIFIED AT
,FEE "'IESMICAL B6.1>iK
NE IV YVI> TRUST CO.. N.Y.
Very truly
l -yours,
-
142Z-�za r--, �e
Margaret Meinke
BUILDING DEPARTMENT'
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location Zo7,7 C',yeza7-c-�
number & street)' Municipality
Subdivision — Map No. Lot(s) ---
Name of Owner(s) f –= , /--/ar-,
Occupancy %- /
(type) (owner. -tenant)
Admitted by: Ed/1oi ltynV f4 c- ' Accompanied by:
Key available Suffolk Co. Tax No.
Source of request �� `���������% Date
DWELLING:
Type of constructio�a/WCl�- #stories
Foundation Cellar �®1��Crawl space ;-
Total rooms, lst. Fl 2nd. Flea 3rd. Fl —
Bathroom(s) Ems// Toilet room(s)
Porch, type-;j2,/,9,s �5 J61c--/ Deck, type J Patio, type —
Breezeway Garage Utility room,
Type Heata,���-2-/ Warm Air — Hotwater�/ E�
Fireplaces) No. Exits / u d Airconditioning —
Domestic hotwater � Type heater
Other
ACCESSORY STRUCTURES:
Garage, type const—./ , ,c2r &-Py. Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS: Housing Cade, Chapter 52
Remarks:
Inspected
of Insp . -Ila 711W
starter end �