HomeMy WebLinkAboutZ-9699FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No .... '.Z.9.6.q. ? ........ Date .... S..ep.t.e.m..b.e?..2..8 ............... 19..7.9
THIS CERTIFIES that the building ................................................
Location of Property .... .2./4.~.5.....G.e.d..a?. ~a..n.e .................... i~a..~. ~a..r.ip.n..
House No. Street Ham/et
County Tax Map No. lO00 Section ... 9.~.7. ..... Block .... 96 ........ Lot....0.9 ............
Subdivision .~..a.q'..d.t.n..e.rg. ?.gY. )~.~. 9~.e.~. ..... Filed Map No. 2.7.5 ..... Lot No..'13.~..&..'Iff. 3..
Requirements for a one family dwelling built prior to
conforms substantially to the ~~ ....
Certificate of Occupancy
...... .Ap?.i. 3:..2.~ ...... 195.7.. pursuant to which ~ No ............... ~.9.6. 9. .9.
dated ..... S..ep.t.e.m..b.e.r..2..8 ......... 19.7.~, was issued, and conforms to an of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
................... . .~.?, .~.a~.~.y. ~:?.z.~?.n. ~ ......................................
The certificate is issued toHelena J. 5chmidt
..................... ?oYn'~;, '~~~ ......................
of the aforesaid building.
Suffolk County Department of Health Approval .................... ' ......................
UNDERWRITERS CERTIFICATE NO ............................ I~/f.R ...................
Building Inspector
Rev 4/79
Locatio~
'-:BUILDING DEPART~'~%~T
TO%'~OF SOUTHOLD, N.
HOUSING CODE INSPECTION REPORT
2435'Cedar Lane
(number & street)
SubdivisioN Gardiners Bay East, Sec. II
Name of Owner(s)-
Map No. 275
Helene J. schmidt
East Marion
(~unicipality)
Lot(s)
Occupanc~ R - 1 "
'Adm~tedhy:_ Ellen Rorgan
Key available '
Source of ~e~uest- Ellen Jane Ro~gan-
'(ovmer-tenant)
· ~ccompanied~y: Ellen Morgan
Suffolk Co. Tax No. 037-04-09
Date Sept. 26, 1979
D%,rk~r%iNG: -
· .:Type Of construction Wood fr~d
'FoundatiOn C~ment block Cellar
Total.rooms,.lst. F~
Batbroom(s)_O~e
· , porch, . type
~reeZeway "
Type Heat 0il fired-
Fireplace(s) One.
Domestic hotwmter
5 2nd. F1
Toilet room(s)_
~)eck, type_
Garage
· ~yarm Air X
No. Exits
Sstorie~
Full Crawl spao~
2 3rd.'F1
One
Other
.'1 1'-]2' ' '
ACCESSORY STRUCTURES:
Ga?age, type const-.
Swimming pool
Other
Patio, typ~ Slate
utilityroom
Ho~.~ater
3 ~rconditioning
Yes Type heater Oil fired
Storage, type co'st.
'Guest, typ~'const.
_VIOLATIONS:
Location
Roof
,NONE
Art. Sec.
III 52-31-C -
Cellar
Housing Code, Chapter 52
. DescriptiOn
Shi-n~!es bad front of house
No water pump
(being repaired)
Outside Windows broken in front of house
III 52'~1-B
Remarks:
Inspected by: ~.~,~
- Curtis
Date of Insp. Sept. 28, 1979
Time start 9:30 end 10:00
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 featu res.
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 ...... ~./~, .~. · L',' ,-~. · .......
New Building ............. Old or Pre-existing Building .... ~ ..... Vacant Land .............
Location of Prol~e~rr~ .~.?...~.~..~.-..~)..(~...r .Z~...~.~'.~..Q.F.J!..t~.~ .~:~.~3 .~_~.,~ ~h .~. (0~), ~J',L~
J Ham/et
House No. Street
Owner or Owners of Property ~.~:¥cC-, .'~.. ~.~ v~ Ct~.. (~..~ ..............
County Tax Map No. 1000 Section ...O. ~..--] ...... Block . ~ Lot
Subdivision...'.~..~...~...~..~..~led Map ~oi ' i~.' .~ i_~.' i iLot N~i ~.' .'ii-. (
Permit No. .......... Date of Permit .......... Applicant .~1.[~.../~%.. l .(~..~.~. :~. ·c2~, · ....
t
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ ....... ?.: .0. ~ ...............
Construction on above described building and permit meets al~ applicable codes and regulations.
Applicant ....... ~-..~-,~-~. ~.x,~._ . [.0zJ~'. ~-~ ..................