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HomeMy WebLinkAboutZ-9629 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. . .Z96z9. . ... . . . . . Date . . . .August .10. . . . . . . . . . . . . . . . 1 .1 19 -79 THIS CERTIFIES that the building . . . . . . . .. . ... ... . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . Location of Property 180=220 Lake ;View Terrace �0. . tax ion House lUo. Street Ham/et County Tax Map No. 1000 Section . .031. . . . . . .Block . . .09. . . . . . . . . .Lot . .017. . . . . . . . . . . . Subdivision . . .XXXXX=1=. . . . . . . . . . . . . . .Filed Map No. . . .3= .Lot No. .lavocgg=- . . conforms substantially'{oer�n 's f r e t e0 ARR1L,• •2 . . . . . . . . . . 19 .57pursuant to whiciia • Z9C29.ig . . dated . .ALUf-rUST. .1.0. . . . . . . . . . . . . . . 19 .7.�3 ,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 FOr, -a . • . • .one. •family. •dwe•1.1-ing• w/• garage. •accessory. . . . . . . . .. . . . . . . .. . . . . . . . . . . . . . The certificate is issued to . M/M. ANTAL;TER .RpBL-Ny0(Z" ,lessee or rei►antl of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . N/.fit.. . . . . . . . . . . . . . . . . . .. . ... . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . . N/.R. . . . . . . . . . . . . . . . . . . . . . . . . . . . . l Building Inspector Rev 4/7s BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. HOUSING /CODE INSPECTION REPORT Location number & street Municipality Subdivision 'Map No. Lot(s) Name of Owner(s) vC)/J ] 79 Occupancy «-!'/ 1 0 Ci i� 00 rejC type owner Admitted by:/jtje Accompanied by: 54"c Key available Suffolk Co. Tax No. 9`/-0>'7 Source of request -�/��.r�,c/ 6�d0 C)COCk Date 2 77.117 7 DWELLING: Type of construction -&20gj- 2 zt?ZA Xwr #stories Cad./, Foundation Cellar Crawl space Pw,,il/- Total rooms, lst. Fl, -7j,�3 2nd. Fl - 3rd. Fl Bathroom(4 04/0, tom// Toilet room(s) Porch, type Deck, type Patio, type �,Wd Breezeway Garage Utility room Type Heater c7-d ss ' Warm Air pry r-:/-/;?�,--,-erHotwater Fireplace(s) No. Exits::=d Airconditioning Domestic hotwater ��S Type heater5ogzg- Other ACCESSORY STRUCTURES: Garage, type const. .&/cop �i ,<4cStorage, type const. Swimming pool Guest, type const. Other VIOLATIONS: Housing Code, Chapter 52 Location Description Art. Sec. 7/-Z1 M 71 Remarks: Inspected by, as Date of Insp. ? -,/(g -� _ Time star 4.4nd "FORM NO.6 tiV TOWN OF SOUTHOLD '�'�� Building Department Town Hall 5 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 9 . . . . . . . . . . . . New Building . . . . . . . . . . . . . Old or Pre-existing Building,(. . . . . . . . . Vacant Land . . . . . . . . . . . . . . G(EVlC7� dwy Agee) Location of Property V.r�4. . .�i:�. � f�'/Pf��!`l . . . . . . . . . . . . . . . .1. . .-. �/.d . . . . House No. Street Hamlet Owner or Owners of Property . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No. 1000 Section . . . . . . . . Block . .(. . . . . . . . . . . . Lot . 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 $ . . . . . . . . . . . . . . . . . . . . . Construction on above described building and permit m�eeet a I applicable codes and regulations. Applicant "I.- . N. : �f'. . . . . . . . . . . . . � lib Rev.10-10-78 . .", '�'�'-�'�,� . - '-- - ...:v -�' '-�. 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