HomeMy WebLinkAboutZ-9392FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
29392 January 17 79
No. ............ Date ............................9 19....
THIS CERTIFIES that the building located at ...329.0..W1ckh0m. Ave...... Skg&x
Map No. ...1.184..... Block No........... Lot No...... 1.1 ..........................
1Q�J DS FOR ONE FAMILY DWELLING BUILT PRIOR TO
conforms substantially to the
pursuant to which z 't ATE N OCCUPANCY
dated ,r�u�zy....1.7...... 19.79. 9392..
dated .. January... 1.7......., 19. 7.9, 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 .........
Pr...ivate.One.Family Dwelling with Accessory Structure
........................................................
The certificate is issued to ......... Carmen Sweeney
399CX@Bc�cX7lI
(owner,IIRlDCx
of the aforesaid building.
Suffolk County Department of Health Approval ........ .............
UNDERWRITERS CERTIFICATE No . ................ Pre -Existing.............
HOUSE NUMBER ..329.0........ Street Ave .... ..............
1K�tt Lllc14.. N. YOrk .........
i
.�. .. �
Building Inspector
County Tax Number
1000-107-9-14
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location z 2 0 Ili 4
number & s
i
Subdivision .114'7Z//ic!'l_
Name of Owner(s)
0
Map No. Lot(s)j/___
Occupancy /L-
typ e
Admitted by:",c5. % 7c_r7�z/i,1 Accompanied
Key available
Source of request
DWELLING:
074it/'L®c_
owner-tenan
by:
Suffolk Co. Tax No." --A17 _Y -
to j!W /c/ /
Type of construction Joao t`2d�1 #stories
Foundation eE,,4e iut A5ZI:� Cellar Crawl spaced
Total rooms, 1st. Fl 1�7 2nd. F1 02s 3rd. Fl /iG
Bathroom( Fc-,// ZA:!f FZaaee__ Toilet room(s) --
Porch, type Deck, type Patio, type
Breezeway Garage Utility room
Type HeatZ,� F1k&',O Warm Air Hotwater ,p/e,' 1(�'ColY3
Fireplace( //C No. Exits � O Airconditioning
Domestic hotwat er,.64e[[_rl,<. Type heater
Other
ACCESSORY STRUCTURES:
Garage, type const. torage, type const.
Swimming pool Guest, type const._
Other
VIOLATIONS: Housing Code, Chapter 52
. .
-Description
MOVIE,
■M-
_
Mai
Remarks:
Inspected by:
Date of Insp.V.dti /6 / %�
Time start /L5 W end rQ - f l` -
4 f
/ 23
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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 ....��. � ....... .
New Building ............. Old or Pre-existing Building ... ! .. Vacant Land .............
Location of Property ............. ... l4f2// a.. ...... 1".
House No. Street Ham el't
Owner or Owners of Property ......... I
County Tax Map No. 1000 Section ............... Block ............... Lot ............. .
Subdivision .................................Map No... .......... Lot N ..........
Permit No. .......... Date of Permit ..........Applicant ........ ? ........ .
Health Dept. Approval ........................Labor Dept. Approval ........................
Underwriters Approval ........................Planning Board Approval ......................
Request for Temporary CCe�rtificate .....................Final Certificate .... -- - - - - - - - - - - .
Fee Submitted $ ..lJ. !.................. .
Construction on above described building and permit ets all applicable codes and re ulations.
Applicant ...... "n...�...... ....
Rev. 10-10.78
15;991z)
7
Subdivision
Name of Owner(s)
Map No. Lot (s) .._.l_.-
dG�icc�ts��l
i .
Occupancy'- - 0 2li41Z..
type owner -tenant
Admitted by: Accompanied by: ,.
Key available Suffolk Co. Tax No. JW.- /6 7.77-/y
Source of request p. ,� Date cT.(/ /,((%:
DWELLING:
Type of constructionstories Z
�,�.o%L
Foundation t-Z�'il���ud �;( Cellar�_�Craial ' space &I(le
Total rooms, lst. Fl %_ 3rd. Fl
Bathroom(} E / 2x -e2 rZyq e- Toilet rooms)
Porch, type Deck, type --- Patio, type..
BreezewayGarage Utility room
Type Heat G145 F/imy Warm Air Hotwater
' Fireplace(//No. ExitsO Airconditioning
Domestic hotwater ' C. Type heater,(J�
Other
ACCESSORY STRUCTURES:
Garage, type const. _Moaot,-C� Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS Housing Code, Chapter 52
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