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Home My WebLink AboutZ-14321 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. . Z.1.4321. . . . . . . . . Date . . . . . . . . . . . . . . . . . . . . .. 1986, THIS CERTIFIES that the buildings. . . Q ae, .f apU l y• w Q 11 n g• . • • . . _ • _ . • • • • • • • . • • • • Location of Property 35.9.95. M.aiza. R.O.4d. .(.Rt . 25.). . . . .CIJtchggvp. , . . , . • House No. Street ldamlet County Tax Map No. 1000 Section . . . . .9 7. . . . .Block . . . . . . . 1. . . . . . .Lot . . . . . . . 21. . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . Requirements for a private one-family dwelling built prior to conforms substantially to the 3�1B1K�RiI�X �(1g�ptcDf P �1i�rc3'r #nX tisK bi 'c�f $'eBX Certificate of Occupancy Z14321 A p r i 2 3. . • • . . . . 19 5? pursuant to which Bff1dWPUe iit No. . . dated . . . . .M�a r,c 4 . 2 6. . , • • • • • . . • • . • 19Q 0. ,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 . . . . . . . . . • • • •One• •famd•l•y• dweIIi-ng • antd •2• a•oces-s•ory• �>uild•ing5•.. . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . . .RICHA.RD . &. .ELIZA.BETH. MAC. RISE. . . . . . . . . . . . . . . . . . . . . . (owner,kgW poXxphytWX of the aforesaid building. Suffolk County Department of Health Approval . . . . . .N/A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . .NIA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector Rev.1/81 BUILDING DEPARTMENT TO�JN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location 35995 Main Rd . ( Rt . 25 ) Cutchogue number & street Municipality Subdivision Map No . Lot(s) Name of Owner(s) RI CHARD E . MAC NISH Occupancy R-1 SAME type owner-tenant Admitted by: Accompanied by: 97-1 -21 Key available Suffolk Co. Tax No. Source of request Mr. Mac Nish Date 3/. 24/86 DUELLING Type of construction WOOD FRAMED #stories 2 Foundation Tight Cellar full Crawl space Total rooms, 1st. F1 3 2nd. F1 4 3rd. F1 Bathroom(s) 1 Toilet room(s) " Porch, type wood Deck, type Patio, type_ Breezeway Garage Utility room Type Heat oil fired ' Warm Air Hotwater xx Fireplace(s) No. Exits 2 Airconditioning Domestic hotwater Yes Type heat'er oil firers Other Coal" burner ACCESSORY STRUCTURES: 2 Garage, type const. Storage, type const- wood & metal Swimming pool Guest, type const. Other VIOLATIONS: Housing Code, Chapter 45' N.Y. Stateldina Uniform ire Prevention Location Description Art. Sec. No violations where Remarks: Inspected by: ti a-J Date of Insp. 3/24/86 _ CURTIS W. HORTON ' e` Time start9 :30 end 10 _ nn FORM NO.6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted na�iiii 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 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 informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15 . 00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5. 00 �� 5,.Updated C.O. $15 .00 Date . / . . . . ... . . . . . . . . New Building . . . . . . . . . . . . . Old or Pre-existing Building . . : . . . . . . . . Vacant Land . . . . . . . . . . . . . Location of Property . . . . . . . . . . 1 ✓�:` .��P`tom. �'a4lpZs) . . . . � o�4.�e -. . . House No. n / Street/ Ham/et Owner or Owners of Property .l�—��,�.�'S �� :6� .Lj �, . , , /)f.�, , eel" h , , , , , , , , , , , , County Tax Map No. 1000 Section . . . . . . .?.tl . . . . Block . . . . Z . . . . . . . . . Lot . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . . . .Lot No. . . . . . . . . . . . . . Permit No. . . . . . . . . . . Date of Permit . . . . . . . . . .Applicant . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . Health Dept. Approval . . . . . . . . . . . . . . .Labor Dept. Approval . . . . . . . . . . . . . . . . . . . ... . . . Underwriters Approval . i9a , , ,Planning Board Approval . . . .,. . . . . . . . . . . . . . . . Request for Temporary Certificate . . . . . . . . . . . . . . . . . . . . .Final Certificate . . . . . . . . . . . . . . . . . . . . . . . Fee Submitted s/. . . . . . . . . . . . . . . . Construction on above described building an ermit meets all applicable codes and regulations. Applicant . . . . ... . . . . . . . . . . . . . . . . . . Re,,.10-10a8 :z V-3 f' CONSENT TO INSPECTION Q• C_Cn al(_ 7-A MA the undersigned, Owner(s) Name(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at 682- Ed, cuz�, o ctt � T A,)✓ V, 1157,36 which is shown and designated on"the Suffolk County .tax map as District 1000, Section Block Lot l That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold Town Building Inspectors Office for the following: 1+T-E ems' C ; That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: M1 (signature) Mae CS (print name) . (signature) (print name)