HomeMy WebLinkAboutZ-10346FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
THIS CERTIFIES that the building ................................................
Location of Property 61'155 North Road~ Oreenport~ N,Y,
h;,&', 'N'o: .......................
County Tax Map No. 1000 Section .... .0.6..5. .... Block 01 .Lot 005
Subdivision ............................... Filed Map No ......... Lot No ..............
Requirements for a One Family Dwelling Built Prior tc
conforms substantially to the
Certificate of Occupancy __
.... A. p.r.i.1...2 .~., ....... , 19..57pursuant to which ']~i4dd~g.'{~l~m.fe-l~er. ......... .Z. !05~6. ....
dated ...... .ff.a.n.u.a..ry..! ~.t .........19.8.1, was issued, and conforms to alt of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
............. ~r.~.v~t.e..o.n.e..v.,my.;y..~..ey.;.~.n.g..y3.'q.~...a?~e.s..s?..rX.' .s.t..m.?..~..e. ....
The certificate is issued to ...... I~y~. ~a..M:..~.i..1.1y.
[0 v~n'e'r, '1 .............................
of the aforesaid building.
Suffolk County Department of Health Approval ....N./.R. ...................................
UNDERWRITERS CERTIFICATE NO .... N~.R. ..........................................
Building Inspector
Rev 4/'79
BUILDING DEPARTMENT
T0I'~ OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 61155 North Road~
(n-mber & street)
Subdivision
N~me of 0vaner(s) Lynda M. Tilly
Occupancy R-1
(type)
Admitted by: Mrs. Tilly
Key available
Source of request Mr. D.Aurichio
Greenport, N.Y.
Map No.
(Municipality)
Lot(s)
owner
(owner-tena~t)
Accompanied by: Self
Suffolk Co. Tax No. 045-01-005
Date 1/12/81
DWELLING:
Type of construction
Foundation stone
Total rooms, 1st. F1
Bathroom(s) 1
Porch, type
Breezewa~
Type Heat Oil Fired
Fireplace(s)
Domestic hotwater Yes
Other
Wood Framed #stories 1½
Cellar Partial Crawl space X
3 2nd. FI 2 3rd. F1
Toilet room(s).
Deck, type
Garag%
Warm Air
No. Exits 2
Type heater
Patio, type__
Utility room
Hotwater X
Airconditioning
Tankless
ACCESSORY STRUCTURES:
~type const.
Swimming pool
Other
Wood
Storage, type const.Small Metal
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
Locatign Description Art. Sec.
Kitchen Gas Stove No shut off V 52-52-B2
Stairs Uo steps Narrow and steep II 52-2__~
Utility Buildin~ Need repairi~K III 52-~0-A
Remarks:
Inspected by:~~ ~~ Date of Insp. 1/15/81
Curtis Horton Time start11:50 end 11;48
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 unusual natural or
topograph ic featu res.
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
~te..~/~'~"~.~..~.. ?.i...//.~. ?.../ .....
New Building ............. Old or Pre-existing Building Vacant Land .............
Location of Propert~ .............. .~......1 ?-'
House No. ' .................
Owner or Owners of Property ..... .~..~../~.../)../~ .... ./¥,. .... ~/.' .~.. ~--..~/.. ...................
County Tax Map No. 1000Section ../~.Z'.'~.~,.¢.'.~'.... Block £~ / ~ ~ ?. Lot..('.~.~.~.'::.4".~.~.~'~
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 ....... ~ ..........
Fee Submitted $. ~.~'~ .L?? .....................
Construction on above described building and ~ermit meets all applicable codes and regulations.