HomeMy WebLinkAboutZ-10649FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. „Z 10649 Date .......August 3,1 81
19 .
THIS CERTIFIES that the building .' 9 ............................................. .
Location of Property... ?.1.445_ Main Road Orient, New York
House No. Street Hamlet
County Tax Map No. 1000 Section .... 1.T ..... Block ..... 4.........Lot ..... 15 ..........
Subdivision ............. ...................Filed rMaap No. ........Lot No. .............
conforms substantially to tie cmaeW94"�t44 ixg-t�ePM,4Iie�e��1F�-irgi-01is- ffiee.dated--to
April 23 57 Certificate of OccupancyZ10649
.......... 119 ... pursuant to wWch43tii44iR#Rer-t* -Ne- .....................
dated August 31 198.1.. , 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 .........
Private One -Family Dwelling with Two Accessory Buildings.
................................................................................
The certificate is issued to .... Jane...D..Townsend..............................................
(ownerXa ai1V7CXXj tX
of the aforesaid building.
Suffolk County Department of Health Approval .... VIA
UNDERWRITERS CERTIFICATE NO...... NZR........................................
i.
........ ...............................
Building Inspector
Rev. 1/81
0
BUILDING DEPARTnENT
TO1'.Td OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 21445 Main Road Orient, New York
number & street riunicipality
Subdivision Map No. Lots)
Name of Owner(s) Jane D. Townsend
Occupancy R-1 Tenant
type (owner -tenant
Admitted by: Arnold Gardner Accompanied by: Arnold Gardner
17-4-15
Key available Suffolk Co. Tax No.
Source of request Arnold Gardner Date8/19/81
- .
D'rE LING:
Type of construction
Foundation Stone
Total rooms, 1st. Fl_
Bathrocm(s) 2
Porch, type Screened in
Breezeway
Type Heat Gas
Fireplace(s)_ 1
Domestic hotaater Yes
Other
Wood
7
#stories 2
_CellarPartial Crawl space Rest
2nd. Fl 3 3rd. F1
Toilet rooms) 2
Deck, type Patio, type
Garage Utility room 1
Warm Air X Hotwater
No. Exits Airconditioning
Type heater Gas
ACCESSORY STRUCTURES:
Garage, type const. wood -2 Car
Swimming pool
Other
VIOLATIO;IS:
Storage, type const.
Guest, type const._
Housing Code, Chapter 52
Wood
Location
Description.
Art.
Sec.
Porch
Sills and deck rotten
III
52-30-A
Upstairs
Rear bedroom roof leaking
III
52-31-C
Cellar
No rail and cellar step broken
Cellar
Some floor joints dry rotted
Bathroom
Floor bad
ITT
92-32-1
Gas -Stove
No shut off
52-52B-1
Thru out
Some light boxes uncovered
IV
52-56-A-1
Storage
ildings Both buildings bad condition
III
52 -30 -A -C
Remarks:
Inspected by: Date of Insp.8/20/81
Curtis W. Horton Time start ll:oo end 11;x._
W
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 ��yy c
Date ... O... / ! �/ ...... .
New Building ............. Old or Pre-existing Buildi�ng�......... Vacant Land .............
Location of Property ................ A-Yi011v...................
House No. / Street Hamlet
Owner or Owners of Property ........... ��%�i/L4.....�!3`. �R'uA
County Tax Map No. 1000 Section .. 017....... Block .. Q .� ....... Lot ....
Subdivision .................................Filed Map No. .. ......Lot No. ...
Permit No. .......... Date of Permit ..........Applicant ..................................
Health Dept. Approval ........................Labor Dept. Approval .....................I�.
Underwriters Approval ........................Planning Board Approval ................
Request for Temporary C��
Certificate .....................Final Certificate ........... ��,.^ y
Fee Submitted $ ... S110
(\� rt 1�
Construction on above described building and permit meets all licable codes and regulations. 6 l%
Applicanty. Al...VLe. ..................
Rev. 10-10-78
Location
BUILDIVIG DEFT+F:-1:-:!,+'T
TOi'M OF SOUTHOLD, N. Y.
HOUSING COD- IiJSPECIIOId RL�'ORT
number & street
Subdivision Map No.
Name of Ormer(s)
Occupancy
stype I
Admitted by: NwE�4n% accompanied
Key available
Municipality)
Lot(s)
owner-tenan
Suffolk Co. Tax No..
Source of requestr��/ '�ip'�f Date
D'�TEL,LIi•IG
Type of construction rstories
Foundation ��, Cellar Crawl space
Total rooms, 1st. F1 2nd. F1 3rd. Fl
Bathrooms) Toilet room(s)-
Porch, type Deck, type Patio, type
Breezeway Garage Utility room
Type Heat Warm Air Hotwater
Fireplaces f No. Exits Airconditioning
Domestic hotaater Type, heater
Other
ACCESSORY STRUCTURES:
Garage type const. � Stor'age' t; e const.
Garage, J P b 9 yp
Sti-,imming pool Guest, type const.
Other
VIOLATIOr:S: Housing Code, Chapter 52
Inspected by:
Date
of Insp.�--��a
pU`v:?C�_-
Time
s�;���'t� �...