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Home My WebLink AboutZ-9728FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy /Z9728 October 24 No.................. Date ................................,1979. THIS CERTIFIES that the building ................................................ Location of Property Avenue B Fisher's. ,Z$�.�cl, House No. street Hamlet County Tax Map No. 1000 Section ....0........ Block ....... 02 .....Lot . 012 & 013 Subdivision .............. Filed Ma No. .Lot No. ............. Re4iuirements ror a one family dwelling built prior to conforms substantially to the April 23 g7 ........ Certificate of Occupancy Z28 ...................... l T ... pursuant to which �1��. 9? ............. ob24 dated ... Oct Ober ee ................ 199.. , 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 ......... One Family Dwelling with Accessory Garage ................................................. I.............................. David M. Seerman and Susan G. Seerman The certificate is issued to ..................... (owner,��iJ of the aforesaid building. Suffolk County Department of Health Approval.......................................... UNDERWRITERS CERTIFICATE NO ................... N/R f Bui ding Inspector Rev 4/79 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted a 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 pmperty 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 New Dwelling, $25.00, Accessory ,$ 10.00 Business $50.00 2._Certificateof-occupancy on pre-existing dwelling $ 50.00 —_ 3. Copy of certificate of occu5.06, over 5 years $10.00 Vacant Lan 2 , 0 -- ----- - — — 5.Uodated C.O. $ 50.00 Date .......................... NewConstruction„ , „q, Old or Pre-existing Building ............ Vacant Land ............. Location of Property ..... A.- tt n ().�, ...f? 1. Cl -.s F 1� ,Z, � .. 1TT,S I a n U House No. Street Hamlet Owneror Owners of Property ....................................... . County Tax Map No. 1�0,r00 Section ......(0....... Block ...... .�.......... Lot ...1, l� oL 13... . Subdivision ........ ! VAfr1 . .................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$.�.Q ...CoPpre- Construction on above described building and�gmit meets all #pplicable codes a regulations. �f�Z Lam' 1�I� Applicant,-. , � ..... ............................. Rev. 10-10.78 �� r a! � I 37704 GUARANTEED TO TITLE GUARANTEE COMPANY, HARTFORD NATIONAL BANK AND TRUST GOMPANY, AND DAVID M aSUSAN G.SEERMAN IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR TITLE SURVEYS 0FTHE NEW YORK STATE L AND TITLE ASSOCIATION. TITLE N0. 1207969 NOTE C oordinote distances are measured from U.S.Coast and geodetic survey Triangulation Station "PROS Hyl AREA=0.23 f Acres PLAN OF PROPERTYTO BE CONVEYEDTO DAVID M. & SUSAN G. SEERMAN A\/Ir KI 111= R FISHERS ISLAND, NEW YORK SCALE: 1 11 = 20ft. Chandler, Palmera King_ N orwich, Co nn. OCTOBER 1979 I I r 1 Q I 3 I� LL 0 l] I— f cD o✓ f I Hyl AREA=0.23 f Acres PLAN OF PROPERTYTO BE CONVEYEDTO DAVID M. & SUSAN G. SEERMAN A\/Ir KI 111= R FISHERS ISLAND, NEW YORK SCALE: 1 11 = 20ft. Chandler, Palmera King_ N orwich, Co nn. OCTOBER 1979 BUILDING DEPARTMENT TOWN O.F • SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location yr 6A%veS ANO-- N- -(number & street) (Municipality Subdivision Map No.- Lot(s) Name of Owners)�-,2 %i2� Occupancy (type) owner-#aRaeA Admitted by: Accompanied by: Key available Suffolk Co. Tax No./000- 40-Z-.0 12 0_15 Source of request! Date 4 0 DWELLING• Type of construction 7&00.0 #stories Foundation Cellar Crawl space Total rooms, lst. Fl 2nd. Fl 3rd. Fl Bathroom(s) Toilet room(s) Porch,.type Deck, type Patio, type Breezeway Garage Utility room Type Heat Warm Air Hotwater Fireplaces) No. Exits Airconditioning Domestic hotwater Type heater Other ACCESSORY STRUCTURES: Garage, 'type const.�lioew �&0.�1 Storage, type const. Swimming pool Guest,.type const. Other VIOLATIONS: Housing Code, Chapter 52 Remarks • .(/a Inspected by: Date of Insp. Time start _end