HomeMy WebLinkAboutZ-10137FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No ......... 7.. 10.1.37 · · Date ... E ep ~;~tnl0ex'..lB ................ 19.80
THIS CERTIFIES that the building ................................................
Location of Property ~3~;s~ ~625 .Cout~r. Road. 2.7. · (_M;Lcldle. Kd. ) .... Pecolalc ,. lg.Y.
b'treet Hamlet
County Tax Map No. ]000 Section ... 0C:>~ ..... Block .... 04 ........ Lot ...... O20 .......
Subdivision ............................... Filed Map No ......... Lot No ..............
red__one .family build~.n .built rior to
conforms substantially to the
Certificate of Occupancy
..... A1or'.i.'l.- 2.~ ....... 19.57Pursuant to which ~ ......... Z,'[0 .'13.7. ....
dated .. f>eptember, t~ ............ 19 80, 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 .........
.................. Pr.£vate .One. ~.-mil.y .Dwelling..w./2...A.c.c.e.s..sp.r:y' B,.u.i.l.d..i.n. gs..
The certificate is issued to ................ t~IMA..V....OLSEN ...........................
[owner, I~J~
of the aforesaid building.
Suffolk County Department of Health Approval ........... I~.F~ ...........................
UNDERWRITERS CERTIFICATE NO ................... N/.R ...........................
. .....
Building Inspector
Rev 4/79
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 0-- d 7
(number & street)
Subdivision
Name of 0wner(s)_~-~Xd/~
Occupancy ~
(~type)
Admitted by: _~r-~c~9
Map No.
~ Lot(s)
( own er-
Accompanied by: ~/rg~ ..
(Mdnicipality)
Key available
Suffolk Co. Tax No./O00-C3d~-O~-~r3
Source of request
.............
Date/~c~C ~0
/
DWELLIN.G:
Type of construction
Foundat ion ~F~-[~- _~ ~ Cellar
Total rooms, 1st. F1 ~- ~ ~ 2nd. F1 ~ ~ 3rd. F1
Bat~oom(s) ~ ... Toilet room(s)
Porch, t~e ~ ~ Deck, t~e "'~ Patio, t~e
Breezeway. - Garage
Type Heat ~TXY~/~.-~- Warm Air
Fireplace(s) ~ No. Exits
Domestic hotwater
#stories~,TC -~
Other
~ Utility
---- Hotwater
~ Airconditioning.
~-"~ Type heater C'D~<_ ,,,
~CCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other Z~_~_~-'
Storage, type const.~~.
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
_Location Description . Ar.t.. S_ec.
(0
Remarks:
Inspected by Date of Insp.~_~-~-
Time start//'~.
TOWN OF SOUTtIOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
June 6, 1983
Rudolph H. Bruer, Esq.'
Main Road
Southold, N.Y. 11971
Re: Fre-CO # Z10137
35625 County Road 27 (Middle Road), ?econic, N.Y.
Dear Mr. Bruer:
Fursuant to our telephone conversation last Friday, this
will verify that there are four accessory buildings at the
above location.
These structures existed at the time of our inspection
on September 8, 1980 but the Certificate of Occupancy was made
out incorrectly in that it only included two structures.
See copy of survey dated April 3, 1975 that was submitted
with the application for the Certificate of Occupancy, structures
shaded in red have been removed.
We apologize for any inconvenience this may have caused.
Your~-~ruly, /
Edward F Hindermann
Building & Housing Inspector
EFH:ec
Enclosure
'.
I,
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
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.
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 featu res.
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.
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
New Bu,d ng ............. Old or Fre-e×isti Building ........ Vacan; Land .............
Owner or Owners of Prope~y ..... ~, ~~ ~ ~ ~~ .................. ~..
County Tax Map No. 1000 Section .... ~.(.~ ..... Block ..... ~ ...... Lot...~.<'.~ ~'/
Subdivision ................................. Filed 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 ................... .,~inal Certificate ..... ~. .............
Fee Submitted $...~ ....................... Yi /'//Y
Construction on above described building and perm'~n~'s ~l~ppl~(~able codes aj:~-regulations.