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Home My WebLink AboutZ-9590FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Omce Southold, N.Y. Certificate Of Occupancy No .... g. 9..5.9.0. ........ Date ............... J.u, ly. 13., ........ 197.9. THIS CERTIFIES that the building ................................................ Location of Property $/3t~.~ ~o5.55. K.i.z~k~p- .Lane.,..Matt. i~ck. street ..................... County Tax Map No. 1000 Section .... 12.1. .... Block .... 03 ......... Lot . 008 ............ Subdivision ......... XXX ................... Filed Map No...XXX. · .Lot No... K.~X ....... e ui m n s o . .Pr'v On F ' D el ' . b il ' to ~ c_ Certificate of Occuoancv ......... April. ~3, . , 19~pursuant to whic~~[9'o...Z 959.0 ............. dated ........... J. uly. ~,3, ....... 19 79., was issued, and conforms to aU of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... The certificate is issued to ...Belier .B.. lJakelhach ................................... of the aforesaid building. Suffolk County Department of Health Approval ..... I~RE--ISXI$~.I;NG ....................... UNDERWRITERS CERTIFICATE NO ........... gR~,-~.X~/'~.T.NG...-..)/'. ............... C~ /i Building Inspector Rev 4/79 Location Subdivision BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT (number (Municipality) -- -- Map No. Lot(s) Name of Owner(s)~~.~/~ '~- ~/X/;f~L~/$C/~/ Occupancy ~-- / "~// ~'~q"~---- (type) (owne~-tcnant) A~itted by: ~. f~Z~Accomp~ied by: Key available - Suffolk Co. T~ No./~-/~/-~-~ Source of request ~/~ /~L~CJ/ Date ~--//-~/ DWELLING: Type of construction ~_z~/~--~C~U~~/~,~#stories Foundation O~'~-~k Cellar~// Crawl space Total rooms, 1st. Fl~'-- ~'2nd. Fl~/~-~ 3rd. FI Bathroom(s) /-~// Porch, type -- ' Breezeway Type Heat ~Y~Z~ Fireplace(s) / Domestic hotwate ~r~--~H~/~Type heater Other Toilet room(s) Deck, type " Patio, type ~ Garage ~ Utility room Warm Air ~t~ ~ Hotwater No. ~ts--;--~o Airconditionin~ ACCESSORY STRUCTURES: Garage, type const.~ ~;~,~ Storage, type const. Swimming pool Guest, type const. Other VIOLATIONS: Housing Code, Chapter 52 Location Description Art. Sec. Remarks: ~ Inspected by: ~ate of Insp. Time start/~.'~--O~end {"(~ ~--' FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office 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 Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, anti 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 installations, 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 1057), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property 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 in- formation 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 New Building ................ Addition ................ Old or Pre-existing Building ...~.. ........... Vacant Land .............. Location Of Property ...s...e..e.....a.~.~.~..c...h..e...d.....s.?...r..v...e..~. ..................................................................................... Owner Or Owners Of Property ....... ~.~[i~...~.,....~Q.[.b.~.C.h...~....~,Q.QI~..~...~.~..~..~. ........................ Subdivision ................................................................ Lot No ............. Block No ............. House 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 $ .5..:..0..0. .......................... Construction on above described building an~Lpermit meets all ool~licable codes and regulations. Applicant ....,~,~')~.., .~,. :..,.. ,~..~ ................................................... (Robert L. Tooker, Attorney for Owners~ Sworn to before me this ..~.~.h.. .... day of ..... ..J..u.~.y..~...~.~ ............... (stamp or seal) NOTE: m -- MONUMENT / I I I II i/ / / SURVEY FOR AtDO JAHIER ~ RUTH M. JAHIER AT MA TTI TUCK TOWN OF SOUTHOtD SUFFOLK COUNTY, NEW YORK ~ UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW ~ COPIES OF THIS SURVEY NOT SEARING THE LAND SURVEYOR'S INKED SEAL OR EMSOSSEO SEAL SHALL NOT SE CONSIDERED TO 8E A VALID TRUE COPY ~GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS ~REPAREO, ANO ON HIS SEHALF TO THE TITLE COMPANY, GOVERN- MENTAL AGENCYANO LENDING INSTITUTION LISTED HEREON,AND TO THE ASSIGNEES OF THE LENDtNG J INSTI'TUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUSSEGUENT OWNERS ~ DISTANCES SHOWN HEREON FROM PROPERTY LINES TO EXISTING STRUCTURES ARE FOR A SPECIFIC PURPOSE AND ARE NOT TO BE USED TO ESTABLISH PROPERTY LINES OR FOR THE ERECTION OF FENCES. .~.~ YOUNG e, YOUNG . ALDEN W. YOUNG,PROFESSIONAL ENGINEER AND LAND SURVEYOR N.Y.S.LICENSE N0.12845 HOWARD W. YOUNG, LAND SURVEYOR N.Y.S LICENSE N0.45895 DATE : JULY 5, /.97.9 SCALE: I"-- NO. : 79 ~g TITLE GUARANTEE CO. ~LDO a RUTH M. JAHIER RIV~W YORK