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HomeMy WebLinkAboutZ-10629 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. v Certificate Of Occupancy No. . Z10629. . . . . . . . . Date . . . . . August. .1.1 . . . . . . . . . . . . . . . 1981. THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property 40 Fox Hollow Road, Mattituek r New York House No. Street 'Hamlet County Tax Map No. 1000 Section . . 113. . . . . .Block . . . . . .6 . . . . . .Lot . . . . . .18. . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . . conforms substantially to thRe ui r= r-Sc!>^,.a $ne-F milt' D 1�}1 8 _s�il�te Prior to y �g ree � errn+t-fteretotare iir► p Certificate of OccupancyZ10629 . . . . A ril 23 . . . . . _ . f 19 57. pursuant to which Rtiiidn>b Permit-3tr.-. . . . . . . . . . . . . . . . . . . . . dated August 11 . . . 19 . . �,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-Family Dwelling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . . . . . . . . Albert Rohrer (o wnex��g�p7c��48t7X1x of the aforesaid building. Suffolk County Department of Health Approval . . . . .NiR. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . .N/R o Building Inspector Rev.1/81 BUILDING DEPARTi ENT TO1',TT OF SOUTHOLD? N. Y. HOUSING CODE INSPECTION REPORT Location 40 Fox Hollow Road , Mattituck , New York number & street Municipality Subdivision Map No . Lot(s) Name of Owners) Albert Rohrer Occupancy R-1 Unoccupied type (owner-tenant Admitted by: Self Accompanied by: Self Key available First Towne Suffolk Co. Tax No. ..113-6.-18 Source of request Richard F . Lark , Esq . Date July 10 , 181 Dy'I�.LIP1G: " Type of construction Wood Framed nstories 1 Foundation Cement Block Cellar* Full Crawl space Total rooms, 1st. F1 5 2nd. F1 3rd. F1 f Bathroom(s) 2 Toilet room(s) Porch, type Deck; type Patio, type Sla ,e Breezeway Garage 2 Car Utility room Type Heat oil Fired Warm Air x Hotwater Fireplace(s) 1 No. Faits 2 Air' conditioning Domestic hot'viater Yes Type heater Electric Other ACCESSORY STRUCTURES: NONE . Garage, type const. Storage, type const. S�."imming pool Guest, type const. Other .- VIOLATIONS: Housing Code, Chapter 52 Location Descri-otlon Art. Sec. Cellar No rail cellar steps II 52-27-B _ Remarks: Inspected. by: Date of Insp. 8/11/81 .Curtis W. Horton Time start end 12 : 00 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 surrey 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 $1.00 Date 1981. . . . . . . . New Building . . . . . . . . . . . . . Old or Pre-existing Building . . .X . . . . . . . . Vacant Land . . . . . . . . . . . . . Location of Property . .4[Q . , Fox Hollow Road Mattituck House No. Street Hamlet Owner or Owners of Property . . . •Josephine Rohrer County Tax Map No. 1000 Section . . •113 . . . • • • • • Block . . . . . . .6 . . . . . . . Lot . . . . 18. . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . . . .Lot No. . . . . . . . . . . . . . Permit No. . . . . . . . . . . Date of Permit . . . . . . . . . .Applicant . . . . . . . . . . . . . . . . . . . . . . . . . . . . ��. . . . . Health Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . .Labor Dept. Approval . . . . . . . . . . . . . . . . .$ Underwriters Approval . . . . . . . . . . . . . . . . . . . . . . . .Planning Board Approval . . . . . . . . . . x Request for Temporary Certificate . . . . . . . . . . . . . . . . . . . . .Final Certificate . . . . . . . . . . . �1�. 5.00 % V I, Fee Submitted $ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Construction on above described building and perm' ee s all=appli codes and regulations. Applicant . • cTia'rd 'F: ark',' 'Esq'.'; 'attorney 'for' 'applicant Rev.10-10-78