HomeMy WebLinkAboutZ-9682FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No... X9682......... Date .... Se1?t%a:: Q'r. . 1.7 ............... 19 79
THIS CERTIFIES that the building ................................................
Location of PropertyN105 Love Lane att� ttwl...
House o. Sheet Hamlet
County Tax Map No. 1000 Section ... 141 ...... Block ..... 04 ........ Lot .. P./Q . 02$ ......
Subdivision ........................ .....Filed Map No. ........Lot No. .............
Requirements for a commercial building built prior to
conforms substantially to the 1 1101
A ril 2Certificate of Occupancy Z 682 ............
P...... 3 ........ , 19 57. pursuant to which No.
dated .September 17 .......... 1979. , 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 .........
......................... Retail. Store....................................... .
The certificate is issued to .....$ruse A?.. Norris .
(owner 7RCt@LOQX.1
of the aforesaid building.
Suffolk County Department of Health Approval.............N/F......................... .
UNDERWRITERS CERTIFICATE NO .................... N/a......................... .
Rev 4/79
Inspector
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 ..
New Building ............. Old or Pre-existing Building .... X ...... Vacant Land
Location of Property ,Lot #4 on attached survey of Young & Young dated July 17 ,1979
House No. Street Ham/et
Owner or Owners of Property .... Bruce A. Norris ............... . .................. .
County Tax Map No. 1000 Section ....141 .... Block .... 4.......... Lot .P�O .28....... .
.Subdivision .................................Map No............... Lot No.............. .
Permit No. .......... Date of Permit ..........Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval .......................Planning Board Approval ......................
Request for Temporary Certificate .....................Final Certificate .......................
Fee Submitted $ . , 5.00
Construction on above described building and per a is all a able co nd regulations.
Applicant .. ...... ...... ........
R' and F. La torney for applicant
Rev. 10-10-78
-OI-?',? Q�_
Location
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
/05_ Z_" L-q/_G
number & street
C
Subdivision Map No. Lot(s)
Name of Owners)_
fzrz, s /o T' -,41 V -
Occupancy
type o er-tenant
Admitted by: *--4 , Wec,&_ Accompanied by:
Key available t3 Suffolk Co. Tax No./1000-/q/-6Pq- 1 O?2
Source of request Date O
Type of construction _#stories p,y�
Foundation Cellar Cellar Crawl space ✓
Total rooms, 1st. Fl 7ha 2nd. F1 — 3rd. Fl —
Bathroom(s) - Toilet room(4 C7d(�c
Porch, type Deck, type Patio, type
Breezeway Garage Utility room —
Type Heat `Warm Air Hotwater
Fireplace(s) No. Exits Airconditioning
Domestic hotwater j�-5 Type heater.
Other
ACCESSORY STRUCTURES:
Garage, type const. Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS: Housing Code, Chapter 52
Remarks:
Inspected by: ZV4,1zSL4�' _ Date of Insp. <? ! "17z
Time start3`:70 f'• K[- end 3�j_��i