HomeMy WebLinkAboutZ-10816FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
tCertificate 'Of Occupancy
THIS CERTIFIES that the. building .~ ......................... · ......................
,:Location of Property 36230. Hain Road Cutchogue
. h 3 & 'e 'N'o : ...................... 'S't /e 3 i .......................
:'County'Tax~Map No. 1000 Section .0 9 7 ........ Block . .0. ¢ ........... Lot ... Q .0 J ...........
SubdMsion ..... )f. ................. [ ....... Filed Map No...X... :..Lot No...X ...........
Requirements for a private one-family dwellin~ built prior
conforms substantially to the
Certificate of Occupancy
.t..o..A. p .r.i.P.. 2. ~ ......... 19.5. ? pursuant to which-B.~i~Oi~ t%rm-it-No ....... g. 1. 9.8.1.6. ........
dated .. D.o. Cera.b.e.~...15 ............. 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 .........
The certificate is issued to
of the aforesaid building.
Walter R. Silleck
(o wner,'t~t~' or'tL~stmtrt)
Suffolk County Department of Health Approval ..... .N./.~ .................................
UNDER%VRITERS CERTIFICATE NO. N/R
Building Inspector
Rev. 1/81
Location
Subdivision X
N~me of O~,~er(s)
Occupancy
Admitted by:
Key available
BUILDING DEPAF. Tr-~NT
TO%'~ OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
36230 Main Road.
(number & street)
Walter Silleck
R-1
(type)
Nr. Silleck
Map No.
Cutchogue
(Municipaii~y)
X Lot(s)
Source of request
unoccupied
{owner-tenm,t)
Accompanied by: same
Suffolk Co. T~x No. 097-03-001
Walter $il~eck
Date 7/15/81
DYFEI,LING:
Type of construction wood frased,, brick veneer
Foundation poure~ cement Cellar full
Total rooms, 1st. Fi 5 2nd. F1 4
#s~ories
Crawl space
3rd. Fi.
Bathroom(s) 1
Porch, type
Breezeway
~/pe }{eat
Fireplace(s)
Domestic hotwater
Other
o~] fire~
Toilet room(s)
Deck, type
Garage
Warm Air
No. Exits 2
ves
1
Patio, type__
Utility room
Hotwater x
Airconditioning
Type heater tankless
ACCESSORY STRUCTURES:
Darage, type const, wood: 3 car
Swimming pool
Other
Storage, type const.
Guest, type const.
VIOLATIO;~S: Housing Code, Chapter 52
Location
Dutside
out~%~e
garaMe
Descriotion
needs painting badly
no cellar door
door ang front sills bad, ,
Art. I Sec.
III
III 52-31-B
III 52-30-A,B
Remarks:
Curtis W. Horton T~me 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 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 ..... 7//?.T/.?. L .......
New Building ............. Old or Pre-existing Building ..... . .~"~. · ·. Vacant Land .............
Location of Property..~...~*t~....~ / "~¢~') ....... .~..~.~..~. ............... ~.~..~. .~' ~.~c(~. ....
House No. Street Ham/et
Owner or Owners of Property ..... · .~..~..~.f~--~.~. ...... .~.....~.'./7//.~ .~.A .............
County Tax Map No. 1000 Section ..... ~-'7 ..... 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 $ ~_3 . --
Construction on above described building and permit meets all applicable codes and regulations.
Applicant . . .~..~ ...........
C.c. , /21/We/,
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