HomeMy WebLinkAboutZ-10307FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No....Z. A9.597. ...... Date ..... .D.e.c..e.m.~.e.z?.
THIS CERTIFIES that the building ................................................
Location of Property ...... .5.2.]~..0..C.o..m'). ~y..~,.O~.d..~ .7.~ ........... ~.qu..t.~.O.l.d. ...........
House No. Street Hamlet
County Tax Map No. 1000 Section .... '1.~? ..... Block ..... 0..~ ........ Lot ..... 0.7.~ .........
Subdivision ............................... Filed Map No ......... Lot No ..............
Reo~utr. ement~ for ~ One Family /)w~llin~ Built Rrior to
conforms substantially to the
Certtfica~te of. Occuoency Z 10307
...~ .p.r.i.1..'.'?.~.' ........ , 19~..7. pursuant to which Brd'tdin, g'rermit-Ntr:....". ............ :..'..
dated Dec ember' '17, 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 .........
....... ~r.~y.~..t.e.. 9.n.e...~.m.~ .y..re. ?. ~.~3~r~..,,.~3.~. ?:~.c..e.~.o. rr. 2~r..~g.e. .............
The certificate is issued to . .S.i.l.v.O...~....R..e~.e.~.rl..i.t.~..J.T:..&..
9r.~... .......................
(owner,~~K.~{
of the aforesaid building.
Suffolk County Department of Health Approval .... .I~./.R. ..................................
UNDERWRITERS CERTIFICATE NO...N./.R ............................................
Building Inspector
Rev 4/79
BUILDING DEPARTMENT
TO¥~ OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location
Subdivision
Nnme of 0~er(s)
Occupancy. R-1
(type)
Admitted by: William Smith
Key available
Source of request William Smith
52330 County Road 27A,
(n,,mber a street)
Southold
(MuniciPality)
Map No. Lot(s)
Silvo E Resciniti Jr & Ors.
(owner~tenant)
Accompanied by: William Smith
Suffolk Co. Tax No..135-03-018
Date 1~/16/~0
DWELLING:
Type of construction Wood
Foundation Poored Concrete
Total rooms, let. FI 3
Bathroom(s) 1
Porch, type Open
Breezeway.
Type Heat gas 2
Fireplace(s)
Domestic hotwater Yes
Other
#stories2
Cellar Partial Crawl space
2nd. F1 3 3rd. F1
Toilet room(s)
Deck, type
Garage
Warm Air X
No. Exits 2
Type heater
Rest
Patio, type.__
Utility room
Hotwater
Airconditioning.
Gas
ACCESSORY STRUCTURES:
~arage, type const. Large-Wood
Swimming pool
Other
Storage, type const.
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
.~LQcatipn., Description .... Art. Sec.
~ellar . Cellar steps spaced ~o. far apart.
rail II 52-27-A
Kitchen Gas stov~ no shut
Outside Back porch sills .ba~, shingles broke~
III 52-30-A
fr~ p~ah ~e~d~ repairing ........
Garag[ .. Cornice bad, roof b@d_an~ windows broken III 52-31-B &
Remarks:
12/16/80
Curtis Horton Time start~:00 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 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-
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.//.~././. ~.X .~- · .~. ........
New Building ............. Old or Pre-existing Building .. ~ .... Vacant Land .............
Location of PropertyHou~e' ~' ' ~' ' '~ ~' ~'No. ..... ~' ' ~ 'St~re/ ~' ' ~' ~ .... ' ' '~' ~~Hamlet
OwnerorOwnersofProperty ...~...~..~.~ ./~~..~..*. ........
County Tax Map No. 1000 Section .... /..~. ~4.--'. .... Block .... .~..~ ....... Lot ..... ~ ('..~. ....
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 $..~.: ........................
Construction on above described building and~o~e, rmit meets all applicable codes and regulations. ~,,,
~p~91ieant ................................................. .'~
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