HomeMy WebLinkAboutZ-11265FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No...Z.I. 1265 ......... Date ........ 0¢.t. qt~ot'..19 ............. 19.82
THIS CERTIFIES that the building ~...(.21 .. ........................................
Location of Property .2.9.5. ........... .M.a.i.d.e..n..L.a.n..e .................. lq.a.~.i.t.u.c, lf ......
House No. Street Ham/et
County Tax Map No. ] 000 Section ...1.t~ 0 ...... Block .. 0.1 ........... Lot .... 0. Q ? ..........
Subdivision... Z ........................... Filed Map No.. X ...... Lot No..X ...........
Requirements for a private one-family dwelling built prior to
conforms substantially to the Al~l~lioat-ie~e -f~r-B~qht/ng- taermit- heret~ffore filed- in- toais- effiee.~ate4
Certificate of Occupancy
.... gpr. ll. 23 ......... 1957. pursuant to which B~i.k~4~-laei, m~t No. Z.1.1265 ..............
dated ..... 0 c.t.o b e lC.. l 9 ........... 19.82, 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. pr. irate..one.-.family, d~e.e, lling .~;i.th .acc.e. as o~'3., one.-.cat', g.,ere~-,., .....
The certificate is issued to ....... .Ha.r.q ], .d..R.... R..e.e.v..e...~..l{.n.g.t.h. 91? ......................
(owner, ~ .ta~erJ~)..
of the aforesaid building.
Suffolk County Department of Health Approval .... .n./..~ ..................................
UNDERWRITERS CERTIFICATE NO ............ .n / a ..................................
Building Inspector
Rev. 1/81
Location
BUILDING DEPART~NT
TO%'~I OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
295 Maiden Lane
[numoer & szree~)
Mattituck
(Municipaii~y ~
Subdivision X Map No. Lot(s)
Nmme of Owner(s) Harold R. Reeve, Jr. & another
Occupancy R-1
(tyPe)
A&mitted by: Silkworth Agency
unoccupied
(owner-tenant)
Accompanied by: same
Key available
Suffolk Co. Tax No. 140-01-007
Source of request Robert L. Tooker
Date 10/15/82
D?~LLi~:
Type of construction
Foun. dation poured cement
Total rooms, 1st. F1 ~
Bathroom(s) 1
Porch, t~e screened in
Breezewa~
Type Heat gas
Fireplace(s) 1
Domestic hotwater
Other
wood framed #stories 2
Cellar partialCrawl space rest
2nd. Fi 3 3rd. Fi
Toilet room(s)
Deck, type.
Garage. one-car
'Warm Air
No. ~its 5
Patio, type__
'~ZZZ~ room pantry
Hotwater gravity feed
Airconditioning
yes Type hea~er gas
ACCESSORY STRUCTURES:
wood,
Garage, type const.one-car & stor~rage, type const.
Swi~ing poo! Guest, type const.
Other
VIOLATIONS: Housing Code, Chapter 52
Location Description Art. I Sec.
kitchen
gas s~ove--no shut off
V I 52-52-B (2)
'
Remarks:
Curtis W. Hort6'n 'Time start 3:10 end 3:30
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 installa-
tions, a certificate of Code compliance from the Architect o'r 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 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 prem, ises, or other pertinent informa-
tion required to prepare a certificate. ,
Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwe{ling or land use
3. Copy of certificate of occupancy $1.00
$5.00
New Bui!ding ............. Old or Pre-existing Building(~). _.~/_,. _-=/Vacant Land .............
Location of Properw...~..~'-~, ............. /~.~../~ ....
Owner or Owners of Property . .l~. .' . .-.~..~. ~'~./.~.1~. ..... ~ .......
County Tax Map No. 1000Section ..}.~..q ...... Block ....~..J ......... Lot .... 0~...~. ....
Subdivision ...... .)~r. ......................... Filed Map No... ~ ...... Lot No..,~'. ..........
Permit No. -- Date of Permit ~ .Applicant
Health Dept. Approval....~.{.d{.. ............... Labor Dept. Approval .... ./~.l.~. ..............
Underwriters Approval . ,A~/(~ .Planning Board Approval ../~/..~. ...... ..
Request for Temporary Certificate ..................... Final Certificate .....~...- ......... *
· ¢z~
Fee Submitted $....~. ...... ~ ..............
Construction on above described building and permit'meets all app~cable_,codes and regulations.
Rev, 10-10-78