HomeMy WebLinkAboutZ-9585FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
NoZ9585............ Date .......... July .69 ..............11979 -
THIS
1979.THIS CERTIFIES that the building ................................................
Location of Property .25-100 .................. • Main • Road...... • • • • • • • Orient N
House � tree �•lamlelt Y.
County Tax Map No. 1000 Section ... 41.g ..... Block .... 06 ........Lot .... fl06.........
Subdivision ........7C7= .................Filed Map No. 7(= ...Lot No.
. x7QCX.......
R uir eats for on yal
conforms substantially to the Application for
built prior to Certifies, a of Occupancy
........ April• 25 .. , 1957. pursuant to which] (No. 29585 ...............
dated ......July .6 . /............ 197.9 . , 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 .........
...Qn9. Aax13 y..dwe7.lJxg .......................................................
The certificate is issued to ... TOba . Lala . Orro...................................... .
(owner, l�
of the aforesaid building.
Suffolk County Department of Health Approval ..... N/R.................................
UNDERWRITERS CERTIFICATE NO......... R/R.....................................
Rev 4/78
E
Location
Subdivision
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
iv
mber & street
0
Map No.
Name of Owner(s) %� ,4jA- 015_/zf4
icipality
Lot(s)
Occupancy X r /
(type) own er-tetaa
Admitted by: I -//e- 0'41f� Accompanied by:
Key available
Suffolk Co. Tax No. 16M
Source of request Date Z/Z 72
DWELLING: L opKn
Type of construction 65j7oo t2Al-rc #stories TZ
Foundatio ,e,Arz& ���i`-� wc• Cellar Crawl space
Total rooms, lst. F1 2nd. Fl 3 g/ 3rd. Fl
Bathroom(.&) /��j= _TS-e�� oilet room(s)2'`f7-Z.
Porch, type Deck, ype Patio, type
Breezeway Garage Utility room
J
Type Heat Of-, ?7Z.q l Warm Air Hutwatner � - Di 2 _l�Fo
Fireplace(,s� %ori&[--;-) No. Exits Airconditioning
i
Domestic hotwateType heater ct ijz — ��w��r-rS
Other
ACCESSORY STRUCTURES:
Garage, type const./cno (A/c Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS: Housing Code, Chapter 52
Location
Description I
Art.
Sec.
(aQ5 -
✓
F
�
2 -
Remarks:
Inspected by
i,
a
Date of Insp. 7—ems % n
Time startc3% _Mend '�D /'w
TEL. 765-1802
c��FFO(k�D TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN
LL
SOUTHOLD, N.Y.A1971
June 25, 1984
To Whom It May Concern:
Checking the inspection report on the Toba-Laja-Orro
residence, we find a two car wood frame accessory garage
is mentioned. This is to verify that thru over -sight it
was not put on the Certificate of Occupancy #29585 of
July 6, 1979 but in actuality it does exist.
�Yours
`I ; A.
Victor Lessard
Exec. Admin.
VL:sw
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.
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. Attached.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. Below.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate. None.
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 . ,Tune 12 , 1979
New Building ............. Old or Pre-existing Building ..."9C....... Vacant Land .............
Location of Property . , ,Main Road, Orient, Suffolk County, New York
...........................................................
House No. Street Ham/et
Owner or Owners of Property ,Toba Laja Orro
......................................................
County Tax Map No. 1000 Section .....18 ........ Block ....6 .......... Lot ..... 6......... .
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 ....XX.
...............
Toba Laja Orri, being duly sworn, deposes & say:
Fee Submitted $ ., 5.00 Premises is a one—family dwelling, seasonal
use, and is in fair to good condition. Upon information and belief ,
Construction on above described building and permit meets all applicable codes and regulations.
�
Applicantx ..7,20 .. ......
Toba Laja ro
EWISE vltARof
Rev. 10-10-78 NOTARY PUBUC, State of New Yoq(
No. 52.4634436, Suffolk CouqW
Sworn to before me this Term Expires March A Ig �p
/% day of June, 1979.
e,a.
Notary Public
TEL. 765-1802
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
April 13, 1984
To Whom It May Concern:
Please be advised that as far as the Building Department is
concerned, on present information there are no violations on the
dwelling located at 25100 Main Road, Orient, also known as
Suffolk County Tax Map No.: Dist. 1000, Section 018, Block 06,
Lot 006.
Sincerely,
Victor Lessard
Executive Administrator
VL:ec