HomeMy WebLinkAboutZ-9308No. . ?9308
FORK NO. S
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
Date November 20 119....
THIS CERTIFIES that the building located at ..185• •Hickory. Ave ........ Abmatx
Map No. ...1176 .... Block No........... Lot No.s... 231 /236 inclusive
REQUIRE U NT F 0 F , LY D , B ALT PRIOR TO
conforms substantially to the
CERTIFICATE OF OCCUPANCY
dated .. AprA 23 . 19. 57 pursuant to which jM6dbkg)BjrMjt No. Z93.08.
dated .november 20 19. 78, was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is ....P.rivzte. One. Femily. Dwelling ....................................
The certificate is issued to ........ J.ean. A...Parker ...............................
(owner,'ax
of the aforesaid building.
Suffolk County Department of Health Approval .......... Yre-misting...........
UNDERWRITERS CERTIFICATE No. ... ................Pre -Existing
HOUSE NUMBER ..... 85..... Street .............Hickory Ave
Southold, N.Y.
........... i
Building Inspector
1000-077-1-22
FORM NO. B
TOWN OF SOUTHOLD
Building Deportment
Town Clerks Office
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
Inspector 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
installations, a certificate of Code compliance from the Architect or Engineer responsible for
the building.
5. Submit Planning Board approval of cortipleted 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 property 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 in-
formation 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 November 16, 1978
............................
New Building ................ Addition ................ Old or Pre-existing Building ........X ..... Vacant Land ..............
Location Of Propertyl8a..jiirXAS.y...,gtX.O.t,,,,,�outhold r New„ York 11971
Owner Or Owners Of Property..........Jean A. Parker
..............................................................................................................
Subdivision .G=sp-..B.ay...Esta1ea ......................Lot NoN.L..... Block No. P1•:. ..... House No ... 185....
Permit No..................... Date Of Permit ....................Applicant..................................................................
Health Dept. Approval ............................................Labor Dept. Approval ................................................
Underwriters Approval ..............................................Planning Board Approval ........................................
Request For Temporary Certificate ........................................ Final Certificate ............ ,X...........................
Fee Submitted $............ 5.t.QO...... I.......
Construction on above described buildin ajdrmit m ets 1 oppl' able c es o gul i S.
Applicant . �....... w�✓U'i
Sworn to before me this
h„ day of .. November• 1978 AUSTIN (stomp or seol)
Na
............
BESS�E L. Public ......, Suffolk et MCINAr—
ry blpJD7ARXfbIlnty alk CcuntY
Q 6
l GQNo. 52 3203 50 " ` a
Commission ExPires March 30. 1� ! (00 . Z_
J
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 16-5-
(number
c` number & str et Municipality
Subdivision Map No., 1176- Lot(s) zee ire z
Name of Owner(s)
Occupancy
type owner - ant
Admitted by: Accompanied by: rcv,v 2
Key available
Suffolk Co. TaxZ-
Source of requestDate ////,g beep
DWELLING:
Type of construction Cele-lcjg, Jr1F #stories olcz
Foundation Cellar ca,;_ Crawl space
.. i•vcL
Total rooms, 1st. F1 5 L gr32nd. F1 3rd. Fl
Bathroom(,4 Toilet room(s)
Porch, type Deck, type — Patio, type —
Breezeway -- Garage Utility room --�--
Type Heat ol, rlr'ae Warm Air Hotwater
Fireplace(s) No. Exits vo Airconditioning --
Domestic hotwater 411 Type heaterEZrci L�/ e -
Other
ACCESSORY STRUCTURES:
Garage, type const. Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS: Housing Code, Chapter 52
Location
Description*
Art.
Sec.
;c— mac- •rCi�
� d - irif' ^�C<�b
Remarks:
Inspected
Time
of Insp. // 4/
start :'v �'. end �': �5ti`• /`l