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Home My WebLink AboutZ-11246FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z 112.4.6.......... Date ....0.q t vbe.r.. 7 ................... 19$ 2. THIS CERTIFIES that the buildings....? !........................................... Location of Property :378.0 ............. MA rl . ,Road .............Cutchogue House No. Street Hamlet County Tax Map No. 1000 Section ..09.7 ....... Block ... 02 .......... Lot ...012 Subdivision ..... X .......................Filed Map No. .X . ...Lot No. . % ... ... . Requirements for a private one -family dwelling built prior to conforms substantially to the -Applieatien-for i)ndcfin-'erntit1mretio'tbftrf etT jffIrarofftct-dttted Certificate of Occupancy ....Apr 11.2 3 ........ , 19 .5 7 pursuant to which ftflding Permit No. . ;1.1.246 dated .....Q c t o.he r ..7 ............. 19 .$ � , 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 . �....... pr,�ypte one-familX dwelling h two-story accessory storage building. The certificate is issued to .... ?'®ar l Tay 1 or of the aforesaid building. .. (orvnei,'7�Ssee'a►'te►�rlt1' ..................... Suffolk County Department of Health Approval ......n /a UNDERWRITERS CERTIFICATE NO ............. n/a................................ . Ae Zoo ............ A� ... / e .... .. Building Inspector 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 surrey 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. ,September 14, 1982 ................ New Building ............. Old or Pre-existing Building .... ....... Vacant Land ............. 3 311, Location of Property . , Main Road Cutchogue ........................................... House No. Street Ham/et Owner or Owners of Property ....Pearl Ta.y.lor ................................................ County Tax Map No. 1000 Section ... 097........ Block ....?.......... Lot ... l............ Subdivision .................................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 .....X .................. Fee Submitted $ .5. OA ........................ Construction on above described building and permit eets all app1ic1bblle codes and regulations. Applicant ........ Fe'Kq4a�lTo— Rev. 10.10-78 e ek4_,,. ao778 J 3') 9 3 STATE OF NEW YORK: . ss. COUNTY OF SUFFOLK: PEARL TAYLOR, being duly sworn, deposes and says: That I am the owner of a parcel of land on Main Road, Cutchogue, New York (Suffolk County Tax Map No. District 1000, Section 097, Block 2, Lot 12). I acquired this parcel on August 24, 1944 along with my husband, Samuel Taylor, from Home Owners' Loan Corporation (Liber 3888 Page 153). Located on the property is a two-story frame house which has >een used continuously as a residence approximately 1920. Also Located on the premises is a separate garage and shed. All of :he buildings are in good condition and have been constructed prior =o 1957. This application is made for the purpose of obtaining a )re -existing Certificate of Occupancy from the Building Department )f the Town of Southold. V Pearl Taylor Sworn to before me this L4th day of September, 1982. (2dA l t . L Notary Public BARBARA DIACHUN Notary PubNc, State of New.York No. 52.4635190 Suffolk County Commission Expires March 30,19P