HomeMy WebLinkAboutZ-9940FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
m~,,~.~, Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No..Z. 9..9./*.0. .......... Date....l~.a..~..'1 ........................ 19.80.
THIS CERTIFIES that the building ................................................
Location of Property . 1.7.0...~,I...e.~.c.h..e.r..B.~..~.e.e.~. .................... .0.~.i..el1. ~ ............
House No. Jtreet PSl~ Of ~1,~ Hamlet
County Tax Map No. 1000 Section .. 2. .~ ........ Block . .-~. ............ Lot ....' .~ ............
Subdivision ............................... FLied Map No ......... Lot No ..............
..... ,regui.re~ents $o~. ~,qcee,.por~j' ,$1;.['~:~_tm.lCleq l:n4l, lt ~rlor ~o
conforms suos[an[im~y.~-~te-.A~eetie~-te~-l~m~Peg~-c~,r,~v.crc, ~.ll~a-i~.TtTa~.ol*,ae, e-~ala41.
..... A.*r.t.1.. ~.~ ........ 1 ~.~... pursuant to which'~n~gf:]~.-f .?.C.C..l~.~. ~.C.~. .........
dated ...~l.a.y.. 1. .................... 19 .8.0. ,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 .........
.....~.o. ~,.c.q e,s.o, r3r. g.truc.'mres ................................................
Regens Interua'ctonal Corp. . ..............
The certificate is issued to ..................... [~n'e;', ~,J'~t~iffr[~' .... ' '
of the aforesaid building.
Suffolk County Department of Health Approval ..... .N./.R. .................................
UNDERWRITERS CERTIFICATE NO ..................................................
Buildi~[g Inspector
Rev 4/79
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location... 170 Fletcher Street
(number & street)
Subdivision Map No.
Orient
(Municipality)
Lot(s)
N~me of Owner(s)~ Regens International Corp.
Occupancy P-3
Admitted by:
Key available
Source of request Richard F. Lark
(type)
Mr. Cohen
(owner-tenant)
Accompanied by: Mr. Cohen
Suffolk Co. Tax No. 25-03-12
Date
DWq~,LING:
Type of construction
Foundation
Total rooms, 1st. F1
Bathroom(s)
Porch, type
Breezeway.
Type Heat
Fireplace(s)
Domestic hotwater
Other
TWO
#stories
Cellar Crawl space
2nd. F1 3rd. F1
Toilet room(s)
Deck, type
Garage.
Warm Air
No. Exits
Patio, type
Utility room
Hotwater
Airconditioning
Type heater
Inspection of accessory structures Only
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other
Storage, type const. Small, Wood
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
L..ocation D. escripti0n Art. Sec.
4 Car Needs Roof, Floor, Doors Fixed .. III 52r31-A,i
Storage, Needs various repairs III 52-31-.A~i
,B,C
Remarks:
Date of Insp. 4/28/80
Time start 9:45 end 10:15
FORM NO. 6
TOWN OF SOUTHOLD
Building Departm, ent
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-
Lions, 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 unusua~ 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-
Lion 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
April 21, 1980
Date ..........................
X
New Building ............. Old or Pre-existing Building ............ Vacant Land .............
Location of Property . .F..l.e.t.c.h..e.r..S.t..r.e.e.t.,...O.r.i.e.n..t.,..N.e..w..Y.o..r~ ..........................
House No. Street Ham/et
Owner or Owners of Property .R.e..g.e.n.s...I.n.t.e..r.n.a.t.i.o..n.a.1..C..o.r.p.,. ............................
County Tax Map No. 1000 Section .. ~. ~.. ....... Block ...~. ........... Lot .... [t .~,, ........
Subdivision .......... ~./.A .................... Filed Map No....N./.A. .... Lot No...N../.A ........
Permit No ........... Date of Permit .......... Applicant ..................................
N/A i{/A
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
X
Request for Temporary Certificate ..................... Final Certificate .......................
Fee SUbmitted $ 5.00
Construction on above described building and pe.r, rf~ m~ets all.,aj;~plicable c.~;~de~and regulations.
Applicant ..... · ............................
R , ney for Bernard and
R~.10.10.Ta Phoebe Cohen, Contract Vendees with Regens
International Corp.