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FORM NO 4 -; 7 ;t: rf�� t
TOWN'OF SOUTH,OLD" zY ,
1, BUILDING DEPARTMENT , Syr "' z `
x j{._ ..Town Clerk's Office )-,,,f n1 F i'` ,,1'7
Southold, M,Y b a yy. ;tr 1
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ertificate Of Occupancy `q ,;, ,'{ ,
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F No:,: �9Q ?. . . . . ... . Date ' ,a May 23 ` 19',w n` iVl''
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This CERTIFIES that the building . . . . . . . . ' '' , , 1
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Location of,Property 295 BeCkyvlth. JkVenw rS6#*014�� TeX: +' ` ; r ,�', r
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` 'County TaielMap No. 1 OOO Section . . .61. . . . Blocky" 't';'Q�x .Lot Qt�3` *„ r,��ir'Y7I ' ` t J
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t Subdivision ', Filed Map No , ' ': ' ' x , .— 1 '�''�.3`, i'
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` l!�; r�gctirements for y`dne fe�dlyt draelling built prior +to
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,�I'''f' Certificft`e oP tOcCu arlcy, ., ' , "}4 �
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dated 'MaY 2'� 19.. ,wasj�sued, `and conforms''to all of the requirements �'1 k
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+ of they applicable provisions of the law. Tlie occupancy foriwluch this certificatevs issued is n'", , la`
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UNDERWRITERS CERTIFICATE_ NO. . . . . . . . . 4'11 Nl ' . i,1� �`'"'`; r � �Y
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.,-
HOUSING CODE INSPECTION REPORT
Location 295 Beckwith Avenue Southold, N.Y. .
number & street Municipality`
Subdivision_ .Map No. Lot(s.)
Name of Owner(s) Heleri Linton
Occupancy R-1 unoccupied
.. .
type owner-tenant
Admitted by: Paul Montpr mery Accompanied by: Paul Montgomery
Key available___R Rruer Suffolk Co. Tax No. 1000-61:-01-023.
Source of request Rensselaer G: Terry,Jr. Date May, 21'; 1980
DWELLING:
type of .construction wood fr am_ #stories 3
Foundation hr; ck Cellar fth, Crawl space
Total rooms-, 1st. F.1 2nd. F1 4 3r.d. F1 2
Bathroom(s) Toilet room(s) 1
Porch, type gl ASS .d ;ri Deck, type Patio, type
Breezeway Garage Utility room
Type Heat. oil •rJarm Air steam
Fireplace(s) No. Exits 2 -Airconditioning
Domestic hotwater yes Type heater gas
Other
ACCESSORY STRUCTURES:
Garage, type const. Two care Storage,' type const.
Swimming pool Guest, type const.
Other *with s,tnra P over
VIOLATIONS: Housing Code, Chapter 52
Location Description Art. Sec.
Cellar Inside. cellar stair - no hand rail
treads narrow - B
l
Remarks
Inspected by: Date of Insp ' May `.22;, 1980
Curtis Rorton Time start 3:00 end 3:20
1LG Qe _9�eetll W�
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-confoj-ming 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 Z v
V.
New Building . . . . . . . . . . . . . Old or Pre-existin Building . . . . . . . . . . . . Vacant La
Location of Proper �`.
. � . .
House No. / Hamlet
Owner or Owners of Property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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County Tax Mao. 1000,Section . . . . . . . `. . . . . Block . . . . I. . . . . . . . . Lot . .p�N . . . . . . . .
Subdivision . . . . . . . . . . ..%V, - . . . . . . . . .Filed Map No. . . . . . . . . . .Lot No. . . . . . . . . . . . . .
Permit No. . . . . . . . . . . Date;,of Permit . . . . . . . . . .Applicant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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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 per ' meets a applicable codes and regulations.
�. Applicant . . . . . . . . . ..... .!.
Rev.10-ioas
TOWN OF SOUTHOLD PROPERTY RECORD CAR®
OWNER STREET VILLAGE DIST. SUB. -LOT
FORMER OWNER N —rr— , E f ACR./
S n i W TYPE OF BUILDING
RES. SEAS. VL. t" FARM COMM. CB. MIC Mkt. Value
LAND IMP., TOTAL DATE REMARKS
O D O 3 6 .0 0
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value, Per Value —
Ac re
Tillable FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD
Meadowland DEPTH 0
House Plot BULKHEAD
'Totor- DOCK
{( >"1 r"�- � � `--------•---+�. lam+-- - .
COLOR A •
`..``•;• `c:.�;'" • .L,, _ ;;. .. . ", . _ . . __ /U "1` TRIM C- i:._3
UU
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M. Bldg. . ' —
5
Extension _
Extension
y —
Extension
i .. -. Foundation G Both L Dinette
Porch S-X ,S ' _ G S ,, ` S Basement f .� .� Floors'. K.
Pi�v
Porch 3 (, Ext. Walls Interior Finish ` � o° LR.
woo SN �.Breezeway Fire Place IVHeat S r�AM DR.
Garage: . o'o o. 6, Type Roof Rooms 1st Floor BR:', _
Patio Recreation Room Rooms 2nd Floor FIN. B
O. B. Dormer Driveway
Total ,� s"0 6 ;