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HomeMy WebLinkAboutZ-9535FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ................................................ Location of Property . HJJ~e 'No. ' .... St/e$i ............. Sollthold h$/nie~ County Tax Map No. ] 000 Sebtion . 0~5..0~,. ...... Block .. 00~. ........ Lot .... ~10 ......... Subdivision ............................... Filed Map No ......... Lot No .............. RE~UIREHENTS FOR ONE FAI~ILY DWELLING BUILT I~IOR TO conforms substantially to the - CERTIFICATE OF~ OC~JPANCY .Ap?.~.l. .... 2.~. ......... , 19~.7. pursuant to whichj)j¢~d/aV ~ No ....... Z9555 ......... dated ..... IvY. Y...~ ............... 19 .~.9, 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 ......... ............. P=ivate. One .F-~ y. D~elling .wi.th .Acaessor~.. S~r~ctur. e .... The certificate is issued to ........ Robert. ~ock~f~ller. &. wf.... ...................... of the aforesaid building. Suffolk County Department of Health Approval ............ . .Pi? .e.-..~.i. ~..~.:[.~.g ............... UNDERWRITERS CERTIFICATE NO .................... P.17o.-Exl,$~JJag ............... Building Inspector Rev 4/79 Location Subdivision Name of Owner(s) Occupancy Admitted by: BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. CODE INSPECTION REPORT 2955 LightHouse Rd. (number & street) Map No. Robert Rockefeller & wf. R-1 (type) Helen Brown Key available__ Source Of request Southold, New York (Municipality) Lot(s) own er (owner-tenant) Accompanied by: Helen Brown Suffolk Co. Tax NoJO00-050-003-010 Helen Brown Date May 23, 1979 DWELLING{ Type of construction Wood Foundation wood posts Total rooms, 1st. F1 4 Bathroom(s) 1 Porch, type cement with Deck, roof over de~age Breezeway Type Heat space heater Warm Air Fireplace(s) 1 No. Exits Domestic hotwater yes Other ACCESSORY STRUCTURES: Wood Garage, type const. 1 1/2-car Swimming pool Other #stories Cellar Crawl space 2nd. Fi 4 3rd. Fi Toilet room(s) type wood Patio, type Utility room Hotwater 2 Airconditioning gas Type heater two Storage, type const. Guest, type const. VIOLATIONS: Location Outside Living room Stairway - up Back porch Front Porch Housing Code, Chapter 52 Description Chimney needs repairs Gas heater unvented Very narrow, r~l not right Sills & deck rotten Cement breaking up IArt.I Sec. III 52-30 B V 52-53 H-3 II 52-27 A & B III 52-31B III 52-31A Remarks: Inspected by: Date of Insp. May 23, 1979 Time start 10:00 end 10:30 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, 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 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 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 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 .,../'F~.. ...... Vacant Land ............. Location of Property ..,~.~..~'~. ........ '~' '~~'~'~'/~'~' ' '"'JJ"~~' ' '~- treet -- House No. Ham/et Owner or Owners of Property ..~"~.~...~'~~...~../,~..~. ............... County Tax Map No. 1000 Section . t.~.~..~2. ...... Block ... ~.~. ........ Lot .... ~. (.4~. ...... Subdivision ................................. Map No ............... Lot No ............... Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Request for Temporary Certificate ..................... Final Certificate . Fee Submitted $..~., ~.~2. .................... Construction on above described building and permit meets all applicable codes and regulations. Applicant...~~.. ~. ........................