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Home My WebLink AboutZ-11178FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. .Z11.1.7.8......... Date ...... S,e.pte¢$er. 1.0 ............. 1982. THIS CERTIFIES that the building .............. ............................... . Location of Property . 40.0 • ... • ... • • .. • • .. • .Smi.t.h . Drive. v.ar.th.......... Sou told. House No. Street Hamlet County Tax Map No. 1000 Section ... 4.7.6 .....Block ..02 ........... Lot .. 0.1.7........... . } of 89, 90, Subdivision .. C oas e . b'e.c k .................Filed Map No. 166.a ...Lot No. & . i. Of.. 91. . Requirements for a private one—family dwelling built prior to conforms substantially to the Applicztiow.toa$wilding.Pet�nither�tofcr�.tsIotlin.khic.vt"u�-ciateQ Certificate of Occupancy Ap s i l..2 3 ........... 1957. pursuant to which $aMr rPermit No. . Z.1.1 1 73 ............ . dated ...... Ss.ptembar.. 10 ........ 19 .3?, 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 ......... ..... a..pr.iva.te.on.a-farxiIy. AjeIIi.rig#....................................... The certificate is issued to ..... John. .G.. &.. Inez. .X.. Sillen.heck..................... (owner, /etsaaocleaansL- of the aforesaid building. Suffolk County Department of Health Approval.......n/r ................................ UNDERWRITERS CERTIFICATE NO...............n/r............................... . ��._ // r � uildi Insp t --G 7i ..: . Rev. 1/81 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 August 20, 1.9.8.2 New Building ............. Old or Pre-existing Building .... XX ..... Vacant Land ............. Location of Property . 4 ........... 00. Smith Drive North Southold ..................... .. House No. Street Hamlet Owner or Owners of Property ......Inez Y. Sillenbeck .............lent ................................... 02 County Tax Map No. 1000 Section ........ 6...... Block ............... Lot ............. 1/2 of 89 Subdivision.. MaR of Goose ..Neck 1663 90, & 1/2 of 91 .................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 ....... XX Fee Submitted $ ... 5.00 ..................... Construction on above described building and permit meets all applicable codes and regulations. Applicant.................................................... Inez Y. Sillenbeck by Irving L. Price, Jr. Rev. 10-10-78 Attorney/Agent obi 1 14r- k_�// r r 1 L�:T �1 .. _w'.�r l., �. �.. ••NT '\! ,� � v�I �,:� �. C,��ii'� _✓ �l �C j1'}'r _..1..� ^_-C��.i_ �F"I`I_ 1 0 11131911 z 7�° in �m �.51'00 E. +n �- Zv�" rG� *--� . GUAt2ANTEFG TO THE SK,1J217Y T IT J # GQA2ANT'Y CO AC SURVEYED AUC.9 �Y32 G'C�i�1t VAN r' ►YL,PC, IZ ' r ,4`` L -,4Q a ( Z'. MCN, UMIFN`r' _150.0 - Ne Tli LE NO -5-0 8738 _-- - 5UFF CG. 'AX MAP AT IOM -76•Z--17. „ 11 L IC.LAlWG 5lJrZVEY0127 — GREEfvPGr '`NY. MAP OF_P20PE12-TY 1 A j\ l u C2 SU r2YtYE 0 FG-2- D ` ,., OR ADDIfIOw AS A VIOLATION ro rnls suRvcr Is A vlourwN of ;TO THIS SURVEY �+It f SECTION 7709 OF THE NEW YOWL STATE _ - EDUCATION LAW. n�- COMES Of THIS SURVEY MAP NOT KARR.IG "BaYV I EW ` THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT K CONSIDERED - 10 BlE)�A,(VALID TRUE COPY. 0F_ SOUTH0L0 GDA- ES INDICATED HEREON SHALL RLN .7cwN j---�- . b^•+• *^ THE PERSON FOR WHOM THE SWV �T iS PREPARED, AND ON HIS BEHALF TO THE • TITLE COMPANY, GOVERNMENTAL AGENCY . LENDING INSTITUTION LISTED HESRON, ANf TO THE ASSIGNEES OF THE LENDy1G MY' ... nN f�_ •a ••CfOS ✓f NT`f •Y•NY• Location Subdivision Name of 0 Occupancy BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT 0 number & stre pality Map No. I X e� 7 Lot ( s 17 -.!2-. Admitted by: r/�� Accompanied by: -icezz Key available�Suffolk Co. Tax No.'7y,",0 � ' 7 Source of request Date , j-�O i DWELLING: Type of construction #stories Foundation4 ellar�ZZ Crawl space Total rooms, lst. F1 2nd. Fl 3rd. Fl Bathroom(s) Toilet room(s) Porch, typeDeck, type Patio, type Breezeway Garage p -7,P -Utility room Type Heat =-'Warm Air Hotwater Fireplace(s) G No. Exits Airconditioning Domestic hotwater Type heater Other ACCESSORY STRUCTURES: Garage, type const._ Storage, type const. Swimming pool Guest, type const. Other VIOLATIONS: Housing Code, Chapter 52 Remarks: Inspected by:20 A A!;'.7, Date of Insp. f ��Time start11115-- end