The URL can be used to link to this page

Home My WebLink AboutZ-10796FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.~- %0 7 9~. .......... Date ...... .D.e.c.e. rH).e~. 1 ............... 1~1.. THIS CERTIFIES that the building ................................................ Location of Property ~ ?.6.0.5 ........... C. 9~la.t;.y.. [ap.a.d...4.8.(.N or.1;jl .//d...)....G.r.e.e. 0 p97.~... House No. Street ' Hamlet County Tax Map No. ] 000 Section . 0 .~ ~ ........ Block .Q 8 ............ Lot ·. 0 0Jb.. ~r ......... Subdivision ..)~( ........................... Filed Map [No.. ;~ ...... Lot No...~ .......... REQUIREMENTS FOR A PRIVATE ONE-FAMILY DWELLINa BUILT PRIOR TO conforms substantially to CERTIFICATE OF OCCUPANCY · ~.~ ~ ~-..a3 .......... ,195.?. pursuant to whic~ l~i}i~l l~¢r~nit No ........ .g.l.q ~[ 9 .6 ....... dated .. p.o.q O ~aka.~...1 .............. 198.1.., 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.r gy.a.~.~.. 9.n.~.-..e.a.~.~.% ~t..a?.~..~ .~.~.n.~ ....................................... The certificate is issued to .... ?.r,.gn. 9.l.a' .a..rig..~ .iy.~.a.n...R.a.m.y. ........................... of the aforesaid building· Suffolk County Department of Health Approval ... ~I/p, ................................... UND ERWRITERS.CERTIFICATE NO ........... .Ii/.~. ................................... Rev. 1/81 Building Inspector BUILDING DF-OARTr.~NT TOV,~! OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location 5760s North Rd. (~,,nty R~~ nS) (number & street) Subdivision XX Map No. Greenp~rt (Municipality) Lot(s) X Nnme of O~er(s) Francis Remv & wife Occupancy ~-1 (type) Admitted by: Mrs. Egau Mrs. E~an {owner-ten~-,t) Accompanied by: s~e Key available Suffolk Co. Tax No. ·.44-2-6 Source of request J.M. Brandt Date DYf~7.LING: Type of construction wood framed Foundation sement block Cellar full Total rooms, let. F1 4 Bathroom(s) 1 Porch, type Breezeway yes Type Heat oil fired Fireplace(s) 1 Domestic hotwater Other #stories Crawl space 2nd. F1 3rd. F1 Toilet room(s). one Deck, type Garage. · Warm Air X No. Exits yes Type heater Patio, type__ Utility room- Hotwater Airconditioning electric ACCESSORY STRUCTURES: Garage, type const. Swimming pool Other none Storage, type const. Cuest, type Const. VIOLATIONS: Housing Code, Chapter 52 Location Description Art. Sec. -, no violations--Housin~ Code, ch. 52 Remarks: ·' Inspected by: ~,~- ~/ Date of Insp. 12/1/~1 ....... ' .... ~-~'>--.' ..... ' /:~-~'~'tis- W ~:Hort'on - Time start ~1 o :'co 'end 10Lli_i~-- FORM NO. 6 TOWN OF SOUTHOLD Building Depa,~ent Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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 featu res. 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 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 properW 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 $5.00 .,~- 2. Certificate of occupancy on pre-existing dwelling or land use ~.~$ .5~00 3. Copy of certificate of occupancy $1.00 New Building ............. Old or Pre-existing Building .... .Z. ...... Vacant Land ............. Location of Property . .~.?~ ~).~. .................. ~p.~?:.h. ?.o.a.d. ...................... House No. Street Ham/et Owner or Owners of Property ..... .~.~y.i.a.n..~.e.m~..(.E.r.a.~.c.~.s..1~.e.m~,..d.e.c.t.d..&..~.~..v.~.a.~..l~.e.m~.) ........ County Tax Map No. 1000 Section .... .4.4. ........ Block .... 2 ........... Lot .... 6. ........... Subdivision ................................. 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 $ .s,pp ..... ,,(. .................. Construction on above described building and permit meets all appl~table codes and regulations. Applicant .... .~~~ .................... Rev. 10-10-78 ~)/~ .C.o. ~ Io~lqU ~ ,~l,l~i. ti; EEM"f