HomeMy WebLinkAboutZ-9895FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
THIS CERTIFIES that the building ................................................
Location of Property . .1.q.e.d...1~..]..]...~.17. ?.~.k' .D..~.:Ly.o. ............ ~..o.Ll.~..1~..1.d.,..I~. ?.~..Y.o..I'.k...
House No. Street Hamlet
County Tax Map No. ] 000 Section .... 1. :~ .....Block .... 0.~. ......... Lot ...... ~¢~ .........
Subdivision.. e ;-.: ~,-..-.: .................... Filed Map No ......... Lot No ..............
requirements for a ~'~one t~mt.:Ly dweZ~ng bu~ prior to
conforms substantially to the
Cer~iftcate of Occupancy
.... .~]p.~.$ .J...2.~. ....... ,19 .~.7. pursuant to which ~ No .........
z.909 . .......
dated .... .~.87.q~., .I.1 ............... 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 .........
The certificate is issued to ........ ~t'8. PIII?$~J, ......................................
(owner, ~
of the aforesaid building.
Suffolk County Department of Health Approval ............. .N./.R. .........................
UNDERWRITERS CERTIFICATE NO ..................... .N/.R. .........................
Building Inspector
Rev 4/'/9
~i%~v~%~:' ' ' BUILDING DEVARTMENT . ~ ~T' ·
TOWN OF SOUTHOLD,
.. ~0USING CODE INSPECTION ~PORT -
Loca'kion J005 Mill Creek Drive Southold, N.Y.'
_ ~ .. (n~ber ~ street') (~unioipali%y)
~ ~ Subdivisioq Map No.
Name'of Owner(s) -Eva Pursel
Occupanc~ , R- 1
'A~mitted by: Eva Pursel
K. ey available
Source of r~ues, t." 'Rudolph H.
owner.
{ovmer-tenant
· Aecompanie~ ~y: self'
.. 'Suffolk Co. Tax No..1000-1..35-0..SX39:-~-
Bruer~' Esq.
March. 5, 1980
T~pe 6f eons~Tuction ' Wo~d frame.~ ..... #storie[~.- 1' ~/~-
Foundation cement block' Cellar_oartialCrawl space. 'Me.st.
Total.rooms, .lst. F1 1'5 2nd. F1 5rd,' F1
Bathroom(s). I .. Toilet room(s), ' , ~
: porchi.~ype
~ee~eway. "
_- : Type Hea~ oil fired
'Fireplace(s). I
Domestic ho~wa%er ' X
Other attached st0~age shed"'
ACCESSORY STRUCTURES: -NONE
· G~r. age, type const-.
-. Sw~ing poo~
Oth&r
~eok, type Patio, typq_ .~
- 'Gsrage. Utility room'
· ~Yarm' Air Hotwater '.x,
No. Exits 2 Aircon8 ~ tioning
Type heater tankless .
Storage, type con'st.
Guest, typ~ 'const.
--.VIOLATIONS: Housing .Cod~, Chapter 52
~Loc~tion .'- Description Art. sec. .
Cellar. Seve~a~ et'ectric boxes not fastened V 52-56-2
Stair rail is not parallel-to stairs II 52-27-B
Remarks:
Curtis Horton. Tim~ s'har-~ J: 30, end.,
1980
2:00
Bo
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 disposel-(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 featu res.
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 $1.00
Date ... ~C~ .-~,. ~.9..l~O .......
New Building ............. Old or Pre-existing Building .Z.Vacant Land
Location of Property ............ ~£,1,[. C~c.(~]~. D,~fi, V~..$¢)Q.t~O[~,. ~. ~c~[c ............
House No. Street Ham/et
Owner or Owners of Property . .~.~.~...~.u.~.s..e.[ ...............................................
County Tax Map No. 1000 Section .. ,~.3.5 ......... Block . .~ ............ Lot... 39 ...........
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No ........... Date of Permit .......... Applicant .]~¥~-. ~P.q~'¢9.], .....................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .... ,X .................
Fee Submitted $...~. ~.,. ~.~ ..................
Construction on above described building and permit meets all applicable codes and regulations.
Applicant_s,. E.v.a, .p tlr.~iel ,. h~:. Rgtc~olI~b, .~ ,. B~..Attorney /
,~ ~ ~ ~ / g 7~ ~
7209 OF m~ NEW O~ STAT[