HomeMy WebLinkAboutZ-9406FORK Na s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. ..X9406 .... Date .... January...�3...........119.79
THIS CERTIFIES that the building located at . 20 West . Lane
Map No ............. Block No........... Lot No................................. .
REQUIREMENTS FOR ONE FAMILY DWELLING BUILT PRIOR TO
conforms substantially to the
CERTIFICATE OF OCCUPANCY
dated ... April. • .23• • • • • . • •, 19.57. pursuant to which Herm No. ..zg4o6
dated ... January ... 2.3 ....., 19.79., was issued, and conforms to all of the require.
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is . . ... _ Private One Family Dwelling -Seasonal .. , . .
.1
The certificate is issued to ................ Arthur .H.. Stewart.... .............. .
( owner, 1its 1)
of the aforesaid building.
Suffolk County Department of Health Approval .............J rF - I xisting
UNDERWRITERS CERTIFICATE No . ..................... Pre -Existing
HOUSE NUMBER ....?0........ Street ........... West Lane .. . ...... . ........ .
..................................................Southold,..New York
............
Building Inspector
County Tax Number
1000-088-12-6
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location
er
Subdivision
c
Map No. Lot(s)
Name of Owner(s) Azr(,/� o� rELI�A�
PfAffirA
Occupancy )e— / .5 -A_5-0A),a/'
(type) (own er-te�)
Admitted by: SLLF Accompanied by: SQL F
Key available. Suffolk Co. Tax No.fOar
Source of request jb/. 4��Date /zozz
DWELLING:
Type of construction [//d,jp 42rA /E #stories /
Foundation ec,G/;EAiT �'/c- k Cellar Crawl space_
Total rooms, lst. Fl - 64&2nd. F1 3rd. Fl
Bathroom(`,;j // Toilet room(s)
Porch, type -- Deck, type Patio, type
Breezeway Garage cijx64lz Utility room
Type Heat AJo.yZ alarm Air Hotwater
Fireplace(W) No. Exits '!`wd Airconditioning
Y
Domestic hotwater Type heater L-4ac jet L
Other
ACCESSORY STRUCTURES:
Garage, type const._
Swimming pool
Other
Storage, type const.
Guest, type const._
VIOLATIONS: Housing Code, Chapter 52
Remarks:
Inspected by:
Date of Insp.
Time start /'S/oif/V end ;_'OG
_4
Description
iMOMS
Remarks:
Inspected by:
Date of Insp.
Time start /'S/oif/V end ;_'OG
_4
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Clerks Office
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
Inspector 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
installations, 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 property 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 in-
formation 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 ..January 22, 1979
..............................
New Building ................ Addition ................ Old or Pre-existing Building .... X......... Vacant Land ..............
Location Of Property�ht-of-Way off Main Bayview Road, Southold, New York
............................................................................................................
Owner Or Owners Of Property .,Arthur H. Stewart and Gertrude E. Stewart
n District 1000, Section 088 Lot No....1?.... Block No. .A....... it vN6............
..... .................
PermitNo ..................... Date Of Permit ....................Applicant..................................................................
Health Dept. Approval ............................................Labor Dept. Approval ................................................
Underwriters Approval ..............................................Planning Board Approval ........................................
Request For Temporary Certificate ...... Final Certificate X
............................................................................
Fee Submitted $ ..5.: 0.0 ................
Construction on above described building and r bets lic a odes and regulations.
Applicant........ .................... ...."...............................................................
chard F. Lar attorney for applicant
Sworn to before me this
22nd day of .....Januar.Y.,...19.79........
(stamp or seal)
Notary Public ....... Suffolk............ County
'BARBARA N
Notary Public, State of New
York
No. 52-4635190 Suffolk County
Cornmission Expires March 30. 19 d 6
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