HomeMy WebLinkAboutZ-11124FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
Date ..... ~. u..g.u.~.l?...1.1 .................. 1982
THIS CERTIFIES that the building .~... I .3.) .........................................
Location of Property 1.35.5. ............... .D.e.e.p. Hole Drive Mattituck
h3,,~ No. '" 's't,~3i .......................
County Tax Map No. 1000 Section .. ! .15 ....... Block .. ! .3 ........... Lot.. 1..~. 3.. ~..2 .......
Subdivision .... .X .......................... Filed Map No..X. ...... Lot No..X ............
Requirements for a private one-family dwelling built prior to
conforms substantially to the A'~fieati~n-f~r
Certificate of Occupancy
·. Ape. g.i..2.3. ......... ,19.5. 7. pursuant to which'Bo2qdingPe, fi,i; No .... Al. ] .1.2?. ..........
dated ..... .~. u. ~..ug.~' . .1.1 ............. 19 .~2., 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 .........
.a..p.e. ;.v.a?...o.n.a.-. ~..a.m3Ay...a~. % .Lx.n.~...a.n?...~.~.o..a. ¢..c?.~.~. 9r.y' .a. ?9.r.a.g. ?' .b.u.~.x.a. 3.n.g..?:'
The certificate is issued to ...... ~.n.n...P.q~..np.n.~.ls.~ ......................................
(owner,-le,~ee.o't-te'den'r)'
of the aforesaid building.
Suffolk County Department of Health Approval ....... n./..r ................................
UNDERWRITERS CERTIFICATE NO ............... n./..v ................................
Building Inspector
Rev. 1/81
Location
Subdivision
BUILDING DEPARTmeNT
TOl'~ OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
1355 Deep Hole Drive
(number & street)
Mattituck
Map No. x
(Municipality)
Lot(s)x
Name of Owner(s)
Ann Fosnanski
Occupancy R-1
(tYpe)
A&mitted bM: Jean Croce
tenant
(owner-tenant)
Accompanied by: same
Key available
Suffolk Co. Tax No.115-13-11 & 12
Source of request
Richard J. Cron, Esq.
Date 6/15/82
D¥~LLING:
Type of construction wood framed
Foundation cement block Cellar
Total rooms, 1st. F1 6 2nd. F1
full
#stories 1
Crawl space
3rd. FI
Bathroom(s) 1
Porch, type
Breezewa~
Type Heat oil fired
Fireplace(s)
Domestic hotwater
Other
Toilet room(s)
Deck, typ~
Garag~
Warm Air
No. Exits 2
~as
Patio, typ~__
Utility room
Hotwater x
Airconditioning
Type heater tankless
ACCESSORY STRUCTURES:
Garage, type const, wood storage Storage, type const.
Swimming pool Guest, type const.
Other cement block garage
VIOLATIONS: Housing Code, Chapter 52
_Location l' Description ... Ar~.~ Sec.
cellar/ cellar steps narrow & steep II 52-27-A
outside porch columns need repair III 52-30-A
III 52-30-A~C
_storage needs major r~airs .....
block garage door & windows need replacing, ., III 52-30-C
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 install~
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), Nonconforming 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.
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
Date June 15, 1982
New Building ............. Old or Pre-existing Building ..... ~. ...... Vacant Land .............
Location of Property ..... [.3..~.5 ................. .D.e.e.]~..H.o.~.e.. ?.~.~ .v.e ......... ~ .~.t.~.~.u..c.~ ....
House No. Street Ham/et
Owner or Owners of Property Alfred J. Posnanski - ~.Q/?ow
County Tax Map No. 1000 Section ... !!5. ........ Block ...... .~.3. ...... Lot....1~..&..~,2 .....
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No ........... Date of Permit .......... Applicant..~..~.c~.a?.~.. ~....?.~.o?.~...a?..a. ~ .'c.o.~?..ay
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate ....... .Z. ..............
Fee Submitted $...5.., .0.0. .....................
AppliCant/~f. ~~~_,,¢~.....~...~¢~. ........
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