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HomeMy WebLinkAboutZ-10677FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z10677 NO .................. Date September 10 19 81 THIS CERTIFIES that the building ................................................ 2015 Ba Avenue, East Marion, New York Location of Property Y .~: .................................. House No. Street Hamlet County Tax Map No. I000 Section . .0.3. 1. ....... Block .... 1.7. ......... Lot .. p. q2. ........... Subdivision ............................... Filed Map No ......... Lot No .............. Requirements for a One-Family Dwellin~ Built Prior to con forms substantially to the-~p~li~t~'n- for-B~il'd/a~'~ Perm~h'c-'re~fayre' -fitc~l: i'n-' tTfi~- ~f'f'ret~ 'd~lt~fl- - - April 23 57 Certi£icate of OccupancYZl0677 ..................... , 19 ... pursuant to which-B'~l~in~'l~-~li"N"o-. ..................... dated S e p t e mb ~lr 1 0 19 8 1 , 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 ......... The certificate is issued to of the aforesaid building. [o wn e,'x ~q~,~x ~'a,~X)x x x x Suffolk County Department of Health Approval ..... ~ ./~ .................................. UNDERWRITERS CERTIFICATE NO... ~/.~ ........................................... / / 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 ,,4,~.<,.,~,~, % ?~. ~ ,~. , ,' ~* ~' ,/-77~ i ~? , ~,,* / /.~ ~ ~ ~.~ ,, ' I .I',~ . ., ~ ~..__. A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Budding~spec- tot with the following; for new buildings or new use: 1. Final ,mrvey of property with accurate location of aH buildings, property tines, streets, and unusual 2. Final approval of Health Dept. of water supply and sewerage dispo~al-{S-O form or equal}. 3. Approval of electrical installation from Board of Fire Underwriters. installa- 4. Commercial buildings~ Industrial buildings~ Multiple Residences and similar buildings and 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), Nomconforming uses, or buildings and "pre-existing" land uses: 1. Accurate survev 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. Fees: J. 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 Building ............. Old or Pre-existing Building ............ Vacant Lapd ............. House No, ~ Street Ham/et Owner or Owners of Property ....~..~....~....~.~.~.'....,.~.~.~.?..~T.~. ...................... County Tax Map No. 1000 Section ...~..'~'../. ....... Block ..... ./.~. .......Lot .... ~../~'..."~. ...... Subdivision ................................. Filed Map No ........... Lot No ............. .~ ~,~ Permit No ........... Date of Permit .......... App icant .............................. ~. ~.. , Health Dept Approval Labor Dept Approval ................. ,~,~. Request for Temporary Certificate Final Certificate Fee Submitted $ ~. .......................... ~v/Ib ~/' Construction on above described building and p.~.-fnit meets all applicable codes and regulations, Rev. 10-10-78 BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location ~:~Ol~-- ~/~ /~U~. (number & s~reet) Subdivision ~ Map No. (Municipality) - Lot(s) Name of Owner(s) 0 c cup an cy /~--/ ~2~/x~--~ ~d~/~/~2 ~ (tYPe) ( o~er-ten~t } A~itted by: ~--C~ Accomp~ied by: ~_~ Key available ~T ~y~d ~ Suffolk Co. T~ No../~/-/Z--OO~ / Souroe D te / DWELLING: Type of construction /~//~-~P Foundation ~'~h'~' ~C~ /~/~z3~.3 Cellar Total rooms, let. FI ~/~¥~ 2nd. FI Bathroom(s) ~/~ Toilet room(s) Porch, type,~$-~c~- Deck, type. Breezeway. -~- Garage. Type Heat g-~ Warm Air Fireplace(s) /_y~ No. Exits Domestic hotwater Other #stories ~/w~ Crawl space C3~__~/ 3rd. F1 '- Patio, type Utility room Hotwater Airconditionin~ Type heater ~Z-/ff~/~i. ACCESSORY STRUCTURES: Garage, type const. Swimming pool Other Storage, type const. /L/~/-~g_ Guest, type const. VIOLATIONS: Housing Code, Chapter 52 Location Description Art. Sec. Inspected by:~Z/ ~~Date of Insp. ~. ~ ~'~f' - ' Time start~;'/~/~A/snd -~':--~'~/~'/'~'