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Home My WebLink AboutZ-9622FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No ....g96~2 ........ Date .................... August. IR.., 19.7.9 THIS CERTIFIES that the building ................................................ Location of Property .~59.'1.5. .......... Main. Rcl, ................... Clxtchogue ...... House No. Street Ham/et County Tax Map No. ]000 Section . .097. ....... Block ...Q1 .......... Lot ...Q20 ........... Subdivision ................. ~ ........... Filed Map No.. X ..... Lot No .... ~ ........ REQUIREMENTS FOR ONE FAMILY DWELLING BUILT PRIOR TO conforms substantially to the ~ CERT IF_I_CA_T_F~ _QF _OCCUPANCY ·.. ADril. 23 ........ ,19 5.7. pursuant to which ~ No ......... Z9622 ....... dated ......... A1lg~. sJk .8 ......... 19 79. , 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 ......... .... .priv~.t e. ov.e. £am~l¥. d.w. elling, wi.th, a¢.e.e~, 0r3(.. ~ .'ck'~le. $-~e..e. ............. The certificate is issued to .......... Rob.e~.'c. F....~'h.l~ll:l. ll ............................. (owner, ~ of the aforesaid building. Suffolk County Department of Health Approval ..... N./.R .................................. UNDERWRITERS CERTIFICATE NO ........... .lkl/.R ................................... Building Inspector Rev 4/79 Location Subdivisioq BUILDING DEP~qT[.~NT TOWN OF SOUTHOLD, N. Y. 'HOUSING CODE INSPECTION REPORT BSqJ~number & street) XX Map No. X C~4tchgg~e. ~N .Y., unzczpa~i'~y Lot(s) Name of Owner(s). OccuPancy_ (type) Admitted by: Key available Source 6f request Suffolk Co. Tax No. 0q7-01-070 · Willism Wic~b~m, R~q. Date July ~0, ~Tq DWELLING -~ ' · Type of constr~ction Foundation c emer~t block · Total rooms, 1st. Fi Bathroom(s) Porch, type Breezeway Type H~at oil fired Domestic hotwate~t°ve Other ACCESSORY STRUCTURES: Garage, type const. Swimming pooh Other woodworking wend fr~m~.d #s~ories ewe Cellar partial Crawl space re~t. ~ 2nd. 'Fl B 3rd. F1 Toilet room(s) 1 Deck, type wood Patio, type Garage Utility room ~ steam Hotwater No. Exits a Airconditioning yes Type heater oil fired Storage, type con'st. Guest, type const. (shed on building, 16' ~ ~P') VIOLATIONS: Location Housing Code, Chapter 52 Description no band rail w~th cellar steps brick steps and landing needs repairing Art. ~ Sec. ~III ~2-~-~ Remarks: Date of Insp- ~g. 7, 1979 .. ...._,. 10:00 o?n 10:30_ 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 featu res. 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 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date ....J.u.l.y..3.0. (..]..9.7.9. ....... New Building ............. Old or Pre-existing Building ....X.X. ...... Vacant Land ............. 3~,,~' Location of Property .... (.~.o...~)...H..a.i.~...~.o.a~ :. C__u.t.c.h..o~.u.e. ,..~.e?...Y.o.r.~. .................. House No, Street Hamlet Robert F. Tuthill Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section ....0.9.7...0..0 ..... Block ...0.1....0.0 ....... Lot...q2..0...qq0. ..... Subdivision ................................. 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..X ................ Fee Submitted $..5...0.0. ....................... Construction on above described building and permit Applicant ......... /./;Z//<./.. ~../<./...~.. ~ ..... ~ .......... WirlF.~m~lckham'~ gsa/., Attorney for Rev. 10-10-78 Robert F. Tuthill