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Z-9970
FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. Z9977. . . . . . . . . . . . . . . . . Date . . . . . . . .June. . . . 13. . . . . . . . . . . . . . . . . . . ., 19 8 . THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property 275 Sound, V.-J ew Avenue Exl;ention, Southold House No. Street Hamlet County Tax Map No. 1000 Section . . . ... . . . . . .Block . . 2 . . . . . . . . . . .Lot . . . . .5. . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . .Lot No. . . . . . . . . . requirements for a one-:fai.ily dwelling built prior to conforms substantially to the tip}�li�atioir€vr- ikl2ng-Pexit-12eYetnfre-filmed—in—this'office tla�ed p 3 Certificate of Occupancy . . . ri.. 2 . . . . . . . . . , 19 57 pursuant to which Btsifdinng-PermittYo:—. . . ... . . . . . . . . . . . . . . . . dated . `.j.�z. . 3 . . . . . . . . . . . . . . . 19 . $U 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 Private One-Fam3:ly.Dwelling with the following Accessory Buildings-2 Car Garage, Stg. Building & Cabana near beach. The certificate is issued to . . . . . . . . . . . . . . . . . . . . Jane .Ha Lander (owner,lessee or�tenantl of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . N/R. . . . . . . . . . ..... . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . �R. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector Rev 4/79 BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location 275 Sound View Avenue Extention, Southold number & street Municipality Subdivision Map No. Lot(s) Name of Owner(s) Jane H. Lander Occupancy R1 (type) owner-tenant Admitted by: Jane Lander Accompanied by: Jane Lander Key available Suffolk Co. Tax No. 50-2-5 Source of request Jane H. Lander Date 6/12/80 DWELLING: Type of construction Wood Framed #stories 1 Foundation Cement Cellar Crawl space x Total rooms, 1st. F1 3 2nd. F1 1 3rd. F1 Bathroom(s) 1 Toilet room(s) 1 Porch, type Deck, type Wood Patio, type Slate Breezeway Garage Utility room Type Heat Gas ' Warm Air Hotwater X Fireplace(s) X No. Exits 2 Airconditioning Domestic hotwater Yes Type heater Tankless Other ACCESSORY STRUCTURES: Garage, type const. Wood-2 Car Storage, type const. Small,wood Swimming pool Guest, type const. Other Cabana near beach VIOLATIONS: Housing Code, Chapter 52 Location Description Art. 1 Sec. Kitchen No Shut Off Gas Stove V 52-52-B96 Upstairs Stairs Narrow ect. II 52-27-A B Outside Needs Painting ect. III 52-3-L-B Toilet Rm. Gas Fired Heater V 2- 3 G 1 ,2 Remarks: Inspected by: Date of Insp. 6-13-80 r o Time start9' 15 end 9:40 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 5�11 e . . . . . . . . . . . . . . . . . . . . . . . . . . New Building . . . . . . . . . . . . . Old or Pre-existing Building . . . . . . . . . . . . Vacant Land . . . . . . . . . . . . . Location of Property . . . . . . . . . . . . . . . . . .S 0.10.b_V. 1 CG�7 AV C.'.Lam, ,1:. . .� House No. Street Hamlet Owneror Owners of Property . . . . .l%j :. . . . �:Awxs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No. 1000 Section C. .�.... .. . . 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 $ 15.a-0. . . . . . . . . . . . . . . . . . . . . . Construction on above described building a rmit meets all jpfilicable cod s and regulations. . Rev.10-10-78 J q� �0