HomeMy WebLinkAboutZ-10230FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
210230 October 31 80
No. ................. Date................................,19...
THIS. CERTIFIES that the building ................................................
Location of Property .,160 Sailors Needle ..Road Mattituck{ N.Y.,
................
House No. Street Hamlet
County Tax Map No. 1000 Section .....I 4.4 ....Block ... 05 .......... Lot .... 026 .........
Subdivision ................ .. ....Filed Map No. ........Lot No.
requirements for a one family dwelling built prior to
conforms substantially to the
Aril 2 Certificate of Occupancy Z10230
......p ...... 3....... , 19 .fir.? pursuant to which ) i;+**X4WNo. .....................
dated ... October. 31 ... 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 .........
PRIVATE ONE FAMILY DWELLING
................................................................................
William A. Penney & Deborah Penney
The certificate is issued to .......................................................... .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval............. .............................
UNDERWRITERS CERTIFICATE NO ..................... N .............................
........................................
Building Inspector
Rev 4/79
FORM NO. 6 r
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.
B. 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.
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.
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 ... .� ........ .
New Building ............. Old or Pre-existing Building .. Y ...��//.... Vacant Land .............
Location of Property(e� f �/� �� ~ /�%� T a �'/� ° ° l� `- 2s
u! .......................,�.... .........
House No. Street Hamlet
Owner or Owners of Property-//, f'(/ � . // ...1��� � ..- `.` ...... .. ....�
County Tax Map No. 1000 Section . ! ` .... Block ...OS �..... 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 .....................Final Certificate .......................
,� e -a
Fee Submitted $ . �? !a .... .
Construction on above described building and per�mititt meet7a5plicable codes and regulations.
Applicant ......... �
.................. ........................
Rev. 10-10-78 /da%.30
ROA p,l
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YACHT BASIN —= to JAMES CREI
95-04' -
SURVEY FOR
WILLIAM A.
PENNEY
LOT g , JR, 8 DEBORAH PENNEY
SALT
LAKE VILLAGE"
AT MATTITUCK
TOWN OF SOUTHOLD
SUFFOLK COUNTY,
DATE SEPT 23
NEW YORK
S UNA U THOR IZ
SURVEY
SCALE: I :3Q, ' 1980
IS A V fl1A710NROF1pN
NEW YORK STATE SECTfOry001TION TO THIS
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SURYE YOEY
NO 8Q'461
GUARANTE
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BUILDING DEPARTMENT
TO1-al OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 1.Sailors Needle Road Mat3tituck, N.Y.
number & street Municipality
Subdivision
Map No. Lot(s)
Name of Owners) William A Penney & Deborah Penney
Occupancy
R-1 Wm. Penne
�typ e)
Admitted by: Owner Accompanied
owner -
by: Owner
Key available Suffolk Co. Tax No. 1.000-144-05-026
Source of request William A Penney Date October 23, 1980
DWELLING:
Type of construction Wood #stories 1
Foundation Cement block Cellar Crawl space X
Total rooms, 1st. F1 5 2nd. Fl 3rd. F1
Bathroom(s) 2 Toilet room(s)
Porch, type roof over Deck, type Patio, type
Breezeway Garage Attached Utility room
Type Heat Gas 'Harm Air X Hotwater
Fireplace(s) 1 No. Exits 3 Airconditioning
Domestic hotwator yes Type heater gas
Other Outside shower
ACCESSORY STRUCTURES: NONE
Garage, type const. Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS: Housing Code, Chapter 52
Location
Description
Art.1
Sec.
Kitchen
Gas stove - no shut off
-
Remarks:
Inspected by: I���� Date of Insp. Oct. 30, 1980
Curtis Horto;���Time start 9:30 end 10:00
BUILDING DEPARTMENT
TOV1N OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location
number & street Municipality
Subdivision Map No.
Name of Own er(s)
Lot(s)
Occupancy
type owner -tenant
Admitted by: Accompanied by:
f-
Key available Suffolk Co. Tax No.
Source of request
DWELLING:
Pate
Type of construction y/ �/ #stories p
Foundation ����Cellar Crawl space !ice
Total rooms, 1st. F1 2nd. F1 3rd. F1
Bathroom(s) Toilet rooms)
Porch, typeacf,„-wyn Deck, type Patio, type
T
Breezeway Garage Utility room
Type Heat 'Warm Air Hotwater
Fireplace(s) No. Exits Airconditioning
Domestic hotwater Type heater �
Other
ACCESSORY STRUCTURES:
Garage, type const. Storage, type const.
Swimming pool
Other
VIOLATIONS:
Guest, type const.
Housing Code, Chapter 52
Remarks:
Inspected by: Date of Insp. `�/�3(/��'' v
�C Time start end la`