HomeMy WebLinkAboutZ-9792FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's o~f~ce
Southold, N.Y.
Certificate Of Occupancy
No... Z9792 .........
Date..~OO~.~er..!4 .................. 19~
THIS CERTIFIES that the building ................................................
Location of Property .. 295./til~mlx'o~m .l~i.v.e ................... 8Ou~:hold~ .l/o~.,
House No. Street Hamlet
County Tax Map No. ]000 Section ...... 6~...Block ..... 2 ......... Lot .... ~ ...........
Subdivision. BeJ,xedola .Et~.~8~;ei~ ........... Filed Map No .... ~7~.Lot No .... 7 .........
requir~ents for a one f~ly d~elling ~ilt prior to
confo~s substanti~ly to the ~-~-~= ~~~-~.
Ce~ificate of Ocoup~cy
.... &Pril. 2~ ....... , ]95T pmuant to w~ch ~,-'~=~-,-~ ...... ~$ ..........
dated ...l~O0.1~tl~p..1./~ ............ 1979., 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.
............ James. Sullivan ..............................
(owner, j_ ..... ?
Suffolk County Department of Health Approval ........ I~I~R ..............................
UNDERWRITERS CERTIFICATE NO ................ I,I/R ..............................
Building Inspector
Rev 4/79
BUILDING DEPARTMENT
TO%'~N OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 295 HiDDodrome Dr$ve
(number & street)
Subdivision Beixedon Estates
N~me of Owner(s)
Map No.
James Sullivan ~ wf.
Southold, N.Y.
(Municipality)
Lot(s)
Occupancy R - 1
(type)
Admitted by:. Mr. Sullivan
Key available
Owner
(owner-tenant)
Accompanied by: Mr. Sullivan
Suffolk Co. Tax No. 1000-66-2=53
Source of request Nancy Gil]is
Date Dec. l&, 1979
D~ING:
Type of construction
Foundation ·hollow
· Total rooms, 1st. F1
Bathroom(s) 1
Porch, type
Breezeway
Type Heat oil fired
Fireplace(s) 1
Domestic hotwater ves
Other
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other
Brick & stucco #stories
Cellarpartial Crawl space
2nd. F1 1 3rd. F1
Toilet room(s)
Deck, type Patio, typ~
Garage Utility room
~Warm Air Hotwater X
No. Exits 2 Airconditioning
Type heater tankless
1 1/2
X
NONE
Storage, type const.
Guest, typeconst.
VIOLATIONS: Housing Code, Chapter 52
Location Description
Sec.
No vi olaf4 n~.~ n~ Housing Chapt. 52
Remarks:
Inspected by: ~~,~
Curtis Horton
Date of Insp. Dec. 14. 1979
Time start 1:30 end 1:45
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.
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 unusum 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 .... ./~ ~./.~.~. ..........
New Building ............. Old or Pre-existing Building ...v'.. ....... Vacant Land .............
Location of Pro~ty'~. · .~.../~. · · ~ .x~,.. ~ .... '. ~..'~ .~'~:..
House N~. Y Ham/et
Street
Owner or Owners of Property .... , - . .... .~.-.-.-.=...,~-¢.= ........... /.. ~/~.-:===~-.; ..........
/,_
//
County Tax Map No. 1000 Section .... ~'.~. ....... Block ..... ,,~ ........ Lot ..... '~ ..........
Subdivision ',~,~,/,~_~. ~'d~~i..Filed Map No. J.~.7, ;~.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 $...'~.~ (~..~. ...................
Construction on above described building and permit meets a, II applicable codes and regulations.
Applicant . . .' .................................