HomeMy WebLinkAboutZ-11167FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Occupancy
Date ....... A.u.g.u.a.~..5.1 ................ 19.8.~
THIS CERTIFIES that the building ................................................
Location of Property .1.555. Kenney'$ Road $outho~.d
house No.' ...................... 's'~i ....................... /-/ikiei
County Tax Map No. 1000 Section . .0.5.9 ....... Block ...0.7. .......... Lot ...0.1.1~ ...........
Subdivision.. ~C.e.r~og.w.o. qc~ .................. Filed Map No. ~.I.~Q...Lot No... 9 ..........
Requirements for a private one-family dwelling built prior to
conforms substantially to the Appli~aeiore'fi:m-Btfiktflvg-Permtt-h~'fltffd'ItrtM~'Bffl~l!'~llflfll
Certificate of Occupancy
..... b.o.r.$ ~..2.5 ....... 19~7. pursuant to which Beiha~tng'Petmtt No .... g.] .1.1.6.7. ...........
dated .... .Aug~ta ~;. 3.1 .............. 198..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 .........
The certificate is issued to ...~?.a.r.]-.e.a...&..C.b.r..:L.a.~:l:.n..e..R.e. ..............................
(owner, lea~ee-e~
of the aforesaid building.
Suffolk County Department of Health Approval ....... .n./y. ...............................
UNDERWRITERS CERTIFICATE NO ............... P./Y. ...............................
Buildins impeetor
Re. 1/11
BUILDIL~C
T0','iT,[ OF SOUTHOLD, N. Y.
HOUSIiiG CODE Ii'iSPECTION REPORT
1355 Kenney's Road
(n~moer ~ szrees)
Su~_z_~_on Kennewood
Name of Owner(s)
Occupancy R- 1
Ad.mitt ed by: Mr.
Key available
Source of request
Charles & Christine
Charles R~
Southold
(14unicipaiisyj
21~0 Lot(s) 9
owner
(0wner-venan~)
Accompanied by: same
Suffolk Co. Tax No. 59-7-18
Date 5/27/82
D?~LLI~:
Type of construction
Fou~.dation cement block
Total rooms, 1st. Fi
Bathroom(s) ~
Porch, t)~e
Breezeway carport
~Mpe Heat oil fired
Fireplace(s)
Domestic hotwater
Other
wood framed
Cellar full
2nd. F1
Toilet room(s)
Deck, type
Garage
'Warm Air
No. Exits
~ype heater
#stories 1
Crawl space
3rd. F1
Patio, type
"Utility room
Hotwater x
Airconditioning
tankless
ACCESSORY STRUCTURES:
Garage, type const.
Swi=.ming pool
Other
Storage, type const.
Guest, type const.
ViOLATIO[,[S: Housing Code, Chapter 52
--Location
kitchen
De~
~as stove--no shut off
10/19/82: THIS VIOLATION HAS BEEN
CORRECTED. NO OTHER VIOLATIONS OF
TNE HOUSING CODE, CHAP.TER 52,, WERE
FOUND.
Art. t Sec.
V t52-52-E~, 6
Remarks:
Curtis W. Horto~ 'Time start11:10 end 11:30
. ;../:?J~:.i.~... ;::L':,~ .:::-,: : ' -
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, s~reets, 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.
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..
New Building ............. Old or Pre-existing Building(Z) .~ .... ~ fVacant Land i ...........
Location of Property ST . ........... ...... ....
Hou~ No. Steer Ham/et
Owner or Owners of Proper~ .~.~ ~ . ~. ~/~.~/~ ~.... ~. ..................
County Tax Map No. 1000 Section . ~. ........ Block .... ~.~ ..... Lot.. O.t.~ ....... -:
Subdivision .F~N.~. ~D ................ 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 ,.../.. .......... *
Fee Submitted $ .... .~.~. 0.~. ~ ..............
Construction on above described building and permifmeets all appJ~cable_.codes and regulations.
7(-o-~- c~/ APplicant /~.//~j~,.~:~.,.~..~.~...' ,O /
/ q,71