HomeMy WebLinkAboutZ-10547FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. ..41.05.4.7......... Date ............ Jurne. �.h ............. 1�'-J .
THIS CERTIFIES that the building ................................................
Location of Property .,500. grove,Drive Southold.,. York
House No. Street .Ham/et
County Tax Map No. 1000 Section .... (90 ...... Block ...... 4 ........Lot . ... ? 2........ .
Subdivision. Ae y d ori .3 h or.e s ...............Filed Map No. . 6.31 ...Lot No. -H,9-1.1 .
conforms substantially to the=A 4Ua'a(i e '- "W7uigr-F&R1?4- gto e iled'xoli- sn- ate e 1tedp r i o r i
......... ir.RY. i 1..23 .. , 19 . 5. -pursuant to whi(94t i)�i�rrtft c c u p a n c y . Z 1.0.547 ....
dated .... J.un e. 2.6 ................ 19 . 8.1, 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 ..........
.......Fr..v,ate, One. Family..!)wet.rif .Wit�j .ACG�:s.sOry..$u71.d�r� .............
... .. . ... .... ..
The certificate is issued to .........A r: t h u.r.. G ...a n d . P.0 t b. VI... .'T r u c.k e n b r.a d t ..........
(owner- rrnanJ_ _
of the aforesaid building.
Suffolk County Department of Health Approval ...... ! R .................................
UNDERWRITERS CERTIFICATE NO.... P. /13 ...........................................
Building Inspector
Rev. 1/81
P,
n
BUILDING DEPAF.TijEIIIT
TOLL OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 500 Grove Drive Southold New York
number & street P icipaiity
Subdivision Reydon Shores Map No. 631 Lot(s) H -q -1l
Name of Owner(s) Arthur G. and Ruth M. Truckenbrodt
Occupancy R-1
type owner -tenant
Admitted by: Mrs. Truckenbrodt Accompanied by: Same
Key available
Source of request
DPTELLING :
Suffolk Co. Tax No. .80-4-22
George Milanos
Date June 12, 1981
Type of construction Wood Framed #stories 1'-z
Foundation cement Block Cell arpart a1 Crawl space RPsr.
Total rooms, 1st. Fl 5 2nd. F1 1 3rd. Fl
Bathrocm(s) 1 Toilet room(s)
Porch, type Deck, type Patio, type
Breezeway Garage Utility room 1
Type Heat Gas 'alarm Air x Hotwater
Fireplaces) 1 No. Exits 3 Airconditioning
Domestic hotwater Yes Type heater Gas
Other
ACCESSORY STRUCTURES:
bathroom and dressing room.
Carage, type const. one Car with ,Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATTONS: Housing Code, Chapter 52
Remarks:
Inspected by:�� Xelz�`Date of Insp. 6/26/61
Curtis W. Horton Time starttj:3o end 9:55
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 ...Jung .12,..1981........
New Building ............. Old or Pre-existing Building ... X........ Vacant Land .............
Location of Property ...1485 Grove Piace� Rexdon Shores ,
House No. Street Ham/et
Owner or Owners of Property .... ARTHUR G; , and, RUTH, M,., TRUCKENBRODT, , , , , , , , , , , , , ,
County Tax Map No. 1000 Section ..080; 00 , , , , , , Block Pi. -A0, , _ , , , , , Lot .. 02 2; 00 , , , , ,
Subdivision ...................:.............Filed Map No. ..........Lot No. .............
Permit No. .......... Date of Permit ..........Applicant ..................................
Health Dept. Approval ........................Labor Dept. Approval .......................
Underwriters Approval ........................Planning Board Approval ............. .....4�(j�
Request for Temporary Certificate .....................Final Certificate ....................
Fee Submitted $ ....:00 .....................
Construction on above described building and pe _ it meets al applicable codes and regulations.
Applicant...... . .........................
OIE MILANOS
Rev. 10-10-78 Attorney for Applicants,
James and Athena Staphos