HomeMy WebLinkAboutZ-9415FOBM NO. 4
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
$outhold, N. Y.
Certificate Of Occupancy
No.. Z .~/~.~.9 ..... Date ....~.~...~.0. ........... , 19..7.9.
THIS CERTIFIES that the building located at ....8(~.......0A'9....hake.... 8.tF..e..e.~.. Jt~lcst
Map No ............. Block No ........... Lot No ..................................
REQU~R~TS..Ffl~ATE ONE F,~4II,Y D~FELLING BUILT PR.TOR ~
conforms substantially to the'~ k-*l-~,~a, ~-~ a ~,~.A...~._~_~ ~
CI~TIFICATE OF OCCUPANCY
dated ...Ap~,I .... 2~. ....... , 19..~? pursuant to which ~'ldhm -- 't No.. Z9/41~.
dated ....J.~....u~ry...~.0 ........ , 19.7..9., was issued, and conforms to nll of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
The certificate is issued to .......... .V.~.c..~..r..S..~o..1..~.s.k~. ...........................
(owner,:~]~,,,~. = 4~,,~
of the aforesaid building.
Suffolk County Department of Health Approval ........ Pre,~.s.2;:Lr~ ..............
UNDERWRITERS CERTIFICATE No ................. .P?..e~...E~..~.~..t.n~ .............
HOUSE NUMBER ..... 00~. ..... Street ............... . .O~.c.~..S.~..e..e.'c ..........
..................................................... ~.~...s..uf.f..o.~.k.~, .~..~..~..or~.
Building Inspector
County Tax
1(X)(~117o0~-0~0
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 805 Orchard Street
(number & street)
Subdivision
Name of Owner(s)
Occupancy R-1
(type)
Admitted by: Self
Key available Carol Duhnowski
Source of request Peggy White
Map No.
Victor Smolensky
New Suffolk
(Municipality)
Lot(s)
Unoccuoied
(owner-tenant)
Accompanied by: Self
Suffolk Co. Tax No. 1000-117-05-040
Date January 25, 1979
DWELLING:
Type of construction
Fomadation stone & brick
Total rooms, 1st. F1 4
Bathroom(s) 1
Porch, type two-open
Breezeway
Type Heat G~s
Fireplace(s)
Domestic hotwater yes
Other
ACCESSORY STRUCTURES:
Garage, type const.
Swi~Lming pool
Other
wood
Deck, type
Garage
Warm Air X
No. Exits
Type heater
#stories two
Cellar partialCrawl space rest
2nd. FI 3 3rd. Fi
Toilet room(s)
Patio, type
Utility room
~ pipeless
Airconditionin~
gas
Storage, type const.
Guest, type const.
one and half, 24 X 14 Large Utility Shed
VIOLATIONS:
Location
Stairway up
2nd Floor
front porch
back porch
util ity shed
Housing Code, Chapter 52
Description
no electric switches
no heat
roof 1 eaks
sills, ~ oor joists & deck
sills, roof~ bad shape
Art. Sec.
52 56-B-2
52 53-1
52 51-C
52 50- A & B
52 BO-A & B
51-C
Remarks:
Curtis Horton
Dat~ 'of Insp.
Time start 2:00
PM
January 26, 1979
end 3:00
PM
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 featu res.
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 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 .~0.O.~-~..~..~-~J.~.Ot..~..~....
New Building ............. Old or Pre-existing Building ...~-~.. ...... Vacant Land .............
Location of PropertY.House~.SNo. .... .~.c~.L/] ~. . .~. . .~. ~. C. .~.~'. .T. street ...... ~.(.~.~-~4p.~ ~---~ . ~ ' '~Ha~nie't
Owner or Owners of Property...~. ).~-'~O..~-....~ .~:'~O. (:::~ ~. ~ [~J~-~.',~y ...........................
County Tax Map No. 1000 Section [O(~.o.-~.l.t3..-~-..-q~Block ............... Lot ................
Subdivision ................................. 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 $..~'...(~.O. .....................
Construction on above described building and ~,~mit meets all applicable codes and regulations.
Applicant .... ~'~--1C~-~· '~' L~'~- .~.~. ............. 7..~ - ..... ~- .-