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HomeMy WebLinkAboutZ-9995FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy Date June 23 19 80 THIS CERTIFIES that the building ................................................ Location of Property 6920 Main Road~ Laurel hi~,s~ ~io: ...................... 's't/e~i ....................... h~/n/~i County Tax Map No. 1000 Section . ~. ~ .~ ........ Block ... 9.~.-9.°..2.-.o.q . ot ................. Section One of Property of Subdivision rleorge. I,..Tuthl3,1. &. ,(~therl~iled Map No... 8~.~...Lot No.S..q../~. 2 ...... to the requirements of a "Commercial Building" built prior conforms substantially-te-t~te-A-p,p~ie~/io~-fo~-l~tr}l~q-ng PcrmFt-here~tofore-fil~d-irr-thi~-officv-daicd-- Certificate of Occupancy. .... ·. ~.p.r..~.1..2.3 .......... 195.7.. pursuant t~w~,eh-~uiq~i~4%,i,m~t-No ....... q,~.~.>. ......... dated .. 0'..~q. 9. ~3., ................. 19.8.0., 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 ......... ..... Real.Esgate. Of£ice ...................................................... The certificate is issued to .~..a~..e.s. ff.,..O.~.s..e.n..q/9..E.~, e..ly.n..C.,..C..a~..e.s..f./.k/.a..E.'y.e.ly.n...C. (owner, le~ee'or-t.~_n'~_ of the aforesaid building. Olsen Suffolk County Department of Health Approval .... .1}I/.R. .................................. UNDERWRITERS CERTIFICATE NO ............ .N/.R. ............... v .................. Building Inspector Rev 4/79 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. Bo 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 unusua~ natural or topographic features. 2. Sworn statement of owner or pre~ious 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5,00 Date June 13, 1980 X New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property Main Road Laurel House No. Street Ham/et Owner or Owners of Property ....E.~..0.1.y.~. ?.a.w.o.l..~. ?./.17. (.a..E.~..o.l.y..~. ?....? .1.s.o.~. .............. County Tax Map No. 1000 Section ............. :. Block ............... Lot ................ Section One of Property Subdivision...G..e.o.r. ge...I....T..u.t.h.i..1.1..&...o.t.[%.e.r..SFiled Map No...8.6.1. ..... Lot No.s. .1..&...2 ...... Permit No ........... Date of Permit .......... Applicant ...R..i.c.h.a..r.d..J.....C.r.o.~;..a.s..a..t.t.o.r.n. ey Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ..... .X ................. Fee Submitted $ ....... .5...0..0 ................. Construction on above described building and ~~/,,~~~s. Applicant.../:~//////f/~ ............. ~ Rich~ar~ J.~"Cr~6, ag~ attorney Rev. 10-10-78 F BUILDING DEPARTMENT TO~ OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location (number & street) (Municipality) Subdivision Map No. - Lot(s) (t~ype) Admitted by:~.x~r~_~ ~,-Q~ _/~ Key available ~ 'Source of request-~/~/f~3 ~ ~/~/v ~_~' Date Type of cons%ruction .tl3ooz~ ~-~/~ Foundation ~ ~ ~ Cellar Total rooms, 1st. Fl-~o 2nd. F1 Bathroom(s) - Porch, type Breezeway. FirePlace(s) Domestic hotwater Other ACCESSORY STRUCTURES: Garage, type const~ Swimming pool "- Other Toilet room(s). Deck, type - Garage -- ~Warm Air No. Exits ,#stories,. 0~,~. Crawl space ~ 3rd. F1 ..... Patio, type.__ Utility room Hotwater Airconditioning Type heater Storage, type con-st'. ' - Guest, type const. ~ VIOLATIONS: Mo~ing C~du, CL,'~_~a~=~ 52 ~(~. ~x~sW. ~/3~- Location Description ~ Sec. /