HomeMy WebLinkAboutZ-10182FORM NO. -
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy 1.
No ...... Z1 01 82 ..... Date ........October. 6 ............... 19 .��
THIS CERTIFIES that the building ................................................
15
Location of Property 5 `°-,est Sl1 o pe Drive ° cuth�iv..�. , ld ,
House No. Street Hamlet
80 2 =5
County Tax Map No. 1000 Section ............Block ... ...........Lot ................ .
Subdivision . , Reyaon Shores Filed Ma No. 631 .:Lot No. (.`) . l.'.2' ,4 & 5
reclui�°ement s fox, a. one Map
dwell ia- built. prior to
conforms substantially to the Appliea��fdr�=$riidiel�`ftdrld�int%s'�€€cted-'c
April 2� 57 Certificate of Occupancy X10182
..................... . 19 ... pursuant to which RRIR i'�e911 No. .................... .
dated October 6 80
........................... 19... , 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 .........
PrZ1'J'ATER ONEIrl i'i'i .�Y
................................................................................
Nl
The certificate is issued to .... ...................... (owner, �ss�e�i}��enj
of the aforesaid building.
Suffolk County Department of Health Approval ............... /R
UNDERWRITERS CERTIFICATE NO .................
....... .....!! .. ............. 1�i.......
Building Inspector
Rev 4/79
0
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
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 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.
B. 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.
C. 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
Date . S.eptemher. 12, .19RQ ...
New Building ............ 10 . Old or Pre-existing Building ..... X ..... Vacant Land .............
Location of Property .. ..... W.QSt. Shore. Dr.ive..... S.Qutho.l.d.....................
House No. Street Ham/et
Owner or Owners of Property ..... Sherry. .Kroepel . S.r hreiber..........................
County Tax Map No. 1000 Section .. RQ .......... Block ...2........... Lot ......25....... .
Subdivision .Reydon. Shore.s,.. Sec..B....... Filed Map No. .Q3l...... Lot No. ..1, . 2.,..3, ..4 & 5
Permit No. .......... Date of Permit ..........Applicant .. ShQrry. K3:Qepe7.. Soklxei er ...
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................Planning Board Approval ......................
Request for Temporary Certificate .....................Final Certificate ...... X................
Fee Submitted $ . . 5 f 00 . . . ..................._
Construction on above described building and
Applicant .. .
Ru
Rev. 10.10.78
and regulations.
•lig ' M ave r . . V..Y•' . . . . . . .
uer, for Sherry Kroepel Schreiber
/,�" TOWN OF SOUTHOLD PROPERTY RECORD
CARD
OWNER
STREET
VILLAGE
DISTRICT
SUB.
LOT
FORM V OWNER
N
E
ACREAGE
ILI
W
TYPE OF BUILDING
RES.
SEAS.
VL.
FARM COMM.
I IND. I CB.
misc.
Est. Mkt. Value
LAND
IMP.
TOTAL
DATE
REMARKS
31 &,o
CD
lz Z71s AAf? e 7/,r/ c
_el
4,� 'e 7,-
AG6
BUILDING CONDITION
NJ
NORMAL
BELOW
ABOVE
FRONTAGE ON WATER
Form
Acre
Value Per Acre
Value
FRONTAGE ON ROAD
Tillable I
Tillable 2
BULKHEAD
DOCK
Tillable 3
Woodland
Swampland
Brushland
House Plot
Total
kill
M. Bldg.
2� 5,',v 4 J Z
z4so
Foundation
Both
Extension
lo, L0 32 a
('-0
Basement
Floors
Extension
Walls
�-
C"`Ext. Interior Finish
Extension
Fire Place
Heat
4Zcjq�
Porch Roof Type
C X I Iq 2 Y
Porchl! Rooms 1st Floor
Breezeway!
Patio
Rooms 2nd Floor
Garage
Z 5,
Driveway
Dormer
Lew
O. B.
N
GV
a
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
�tll�l� y
HOUSING CODE INSPECTION R��/E��PORT
Location
number & street Municipality
rr�k�
Subdivision IFEWN' SF►ohEss Map No. G-3/ Lot(s) /,.Qr3, `/mob
Name of Owner(s) S"%JEPkY AIYN 5'C 14R'L= /13 EE/� .
Occupancy
type (owner -tenant)
Admitted by:� Accompanied by: �–
(vtoo
Key available Suffolk Co. Tax No.
011q -
Source of request O ("-)G- ) Date
DWELLING: /
Type of construction f/�Dy-d' �/f #stories /Z—
Foundation Cellar Crawl space
Total rooms, lst. F1 2nd. F1 - 3rd.. Fl
Bathroom(s) l Toilet room(s)
Porch, type type
Breezeway
Garage -- Utility
Patio, type
room'
Type Heat 9-9c-t�Z 'alarm Air Hotwater
Fireplace(s) No. Exits 3 Airconditioning
Domestic hotwater Type heater ac= Rzet %(
Other
ACCESSORY STRUCTURES:
Garage, type const. "'( LL)Storage, type const.
Swimming pool
Other
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
Location
Description
Art.1
Sec.
;�
,a �, , Z e .vier .cvh�P •,�
5=L - 30 A
1
Remarks:
Inspected by:rA/a,74 Date of Insp.
Time start�_end
.SAA
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