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Home My WebLink AboutZ-9567 A FORM NO.4 TOWN OF.SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No.Z95-67:I.A. . . . . . . Date . . . . . . . . .June .26:,. . . . . . . . . . . ., 197.9 . THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property .1.93 Oak•AV-0. • • • • • • • • • • • • • . . . . . Southoldt. X. Y. House No. Street Hamlet County Tax Map No. 1000 Section . . 0?.7. . . . . .Block . . . . . .02. . . . . .-.Lot . . , .010. . . . . . . . . ri Subdivision . . Googe• Bay• Estates • • • • • • . •Filed Map No. . . . . . .'. .Lot No. 1.32-155 y . ihol. Requirements for a private one fapjl dwelling built conforms substantially to the prior t Certificate of Occupancy AApR1. 23 t . • • • • . , 19 . 5-Wursuant to which No. . . .Z9567 . • • • • • • • • • dated . . . . . . . . . . . . . 19 . ..,was issued, and conforms to all of the requirements. June •26$. . . . ?� • of the applicable provisions of the law:"The occupancy for which this certificate is issified19-`1... . . . . . . . . . .Private. .one. tnily. .dwelling. . . . . . . . . . . . . . . . . .. ... . . . . . . . . . . . . . . . . . . .. . ... . . .. . The certificate is issued to . . . . .VIJ11jam F &:,7Vf. . • • • • • • • • . (owner, of the aforesaid building. Suffolk County Department of Health Approval .NIR.. . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . ..N,/R. . . . . . . . . . . . • • • • .. . . . . . . . . • • • . Building Inspector Rev 4/79 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 $5.0.0 3. Copy of certificate of occupancy $1.00 Date . .Juries .25,. .1.979. . . . . . . . . New Building .. . . . . . . . . . . . . Old or Pre-existing Building . . . . . . . . . . . Vacant Land . . . . . . . . . . . . . Location of Property . . . 195 .oaK. AVPnue, . S�authold, . new.York. . . . . . . . . . . . . . . . . . . . . . . House No. Street Hamlet Owner or Owners of Property Frr Lnces. .Willets. & .Rose. .Jonpas . (Estate. of.Mae .Maria) County Tax Map No. 1000 Section .77. . . . Block . . .?. . . . . . . . Lot . . 10 , . , , , , , , , , , Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Map No. . . . . . . . . . . . . . . Lot No. . . . . . . . . . . . . . . Permit No. . . . . . . . . . . Date of Permit . . . . . . . . . .Applicant . Albert ,J. , Arias , , , , , , Health Dept. Approval . . . . . . . . . . . . . . . . . . .. . . . . .Labor Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . . Underwriters Approval.. . . . . . . . . . . . . . . . . . . . . . . .Planning Board Approval . . . . . . . . . . . . . . . . . . . . Request for Temporary Certificate . . . . . . . . . . . . . . . . . . .Final Certificate . . . . . . . . . . . . . � t Fee Submitted $ . . 5.•.Ro. . . . . . . . . . . . . . . . . . . . . . - � Construction on above described building4andi ee I I' I des and regulations. ' 61�1� Applicant . . . . . . . . . . . . . . . . . . ph Bruer, as ,atto ney for Albert J. Arias MARY DIANA 9STER 7,�a NOTARY PUBLIC, State of New York C/ 1—e No. 52-4655242, Suffolk Countyr �L commission Expires MaroM 3b, 19 N 6B� _`5G�" �d•,Q 17b:9�: to�pr`Te -s7/ cl tiY`� ,T \ ..bario ` (T) JN ORIZED ALTERATION OR ADDITION' TO IS SURVEY IS A VIOLATION OF _ $ T ON 7209 OF THE NEW YORK STATE, ATION LAW.'-` �J "lt • - PIES OF THIS SURVEY MAP NOT BEARING T E LAND SURVEYOR'S INKED SEAL OR . _BOSSED SEAL SHALL NOT BE CONSIDERED,= _ O BE'A'VALID TRUE COPY. - GUARANTEES INDICATED HEREON SHALL RUN ONLY TO ME PERSON FOR VY,y'OM THE�SURV_EY IS►REPIARED,AND ON HIS BfHALF�TO THE 1 ` _ :TITLE L'S+IMPAh'Y,-GOVERNMENTAL AGENCY`AND•_9` o•c� 2G.per. G 2 ,,�-� ,'LENDING INSTITUTION LISTED H.zRC•ON,.AND - _ TO`F.,HE ASSIGNEES OF,TUE LENDING,INSTI- .�•`� 4 o 4�0 - -TUTION.GUARANTEES A!;E'kOT-TRANSFERABLE.: TO,*00ITIONAL INSTILUi(IQNS-.08 SWBSEQUENT. -, 4 cxcxf�cir�i¢ec� e Cf`Itc.cY 'o r%� � �L�c/ � �•�. �. .. Tr;-��'��i-ls ,rtx�rr�e. Corr� �t� �o- hQO -?czi rrlc�� 10:5 ' rleu,�d' ,.Jt rye S, 1=.1:1V: ., 4at)b�—=dr...s•�I'4.LAG...--VAN Co..7c�x lYlcx�b L�" e�it��'rQf�l: >! -{�t;l�;�4 G'. f 1� f s'1`✓ ' l�Y� `Y ✓ f �ltd �a I t`. BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. .Y. HOUSING CODE INSPECTION REPORT Location �- (number & street Municipality Subdivision�7Vo-s TF.S Map No. Lot(s) /�2-/SS x"CL Name of Owners) i9 �/yAc//q c� o!/ Occupancy, — type owner-tenant Admitted by: L,= Accompanied by: Key available Suffolk Co. Tax No./Qp0 —07-7'0Z-C9/0 Source of requestZZ vE/2 Z. Date DWELLING: Type of construction #stories Foundation Cellar,`;Crawl `spaceAZ — Total rooms, 1st. Fly' Z B,C 2nd. Fl4cati 3rd.; Fl Bathrooms -( ) O�C,c Toilet room(l) ) Porch,' type Deck, type — Patio, type — Breezeway Garage Utility room' Type Heat CZ.Vr/z�<- `Warm Air Hotwater F11z46o Fireplace(s) — No. Exits Twd Airconditioning Domestic hotwater /o &e Z15e Type heater--7_,j"rtZ2�V;�5— . Other ACCESSORY STRUCTURES: Garage, type const. Storage, type const. Swimming pool Guest, type const. Other VIOLATIONS: Housing Code, Chapter 52 Location Description Art. Sec. a A /7CF, bi L 4 Is' "5 Z- Z - r Remarks: / Inspected by: Date of Insp. S --7 Time start5-•c,0 Pkend 3: /: 6��.