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Home My WebLink AboutZ-9297FORK NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ....29297.. Date ...... Uovember' ..8........ 19.78. THIS CERTIFIES that the building located at .1.620. Stregt� Map No ............. Block No........... Lot No................................. . REQUIRE�IEIV I S FOR ONE FAMILY DZVEL 'LING BUILT PRIOR TO conforms substantially to thep1jc.z1hrd�teit��ledtrigie CERTIFICATE OF OCCUPANCY dated ..April ..... 23........ 19..57 pursuant to which Ojed i gj�t No. .. ,Z9297 dated ..IN v—eraber • . • & .. • • • ., 19..7e, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy.for which this certificate is issued is .............Priv ate. One. F.amily. Dwelling ........................... The certificate is issued to ...... RuPS ell , C & .Donna S , Vanderbeck ............ ( owner,Alessee�or terian ) of the aforesaid building. Suffolk County Department of Health Approval ......... Pre`Existing UNDERWRITERS CERTIFICATE No . .....................PreExisting HOUSE NUMBER ....'1.620...... Street .......Bailie Beach Road Mattituck, New York ................................................................................ Building Inspector HOUSING CODE INSPECTION October 22, 1978 1620 Bailie Beach Rd. R-1 Mattituck, N.Y. Tax Roll: Russell C. & Donna S. Vanderbeck occupied: owner Upon receipt of an application for a Pre -Existing Certificate of Occupancy I made an inspection of the dwelling on this premises. I began this inspection at approximately 9:00 A.M. with Mrs. Vanderbeck. Located on this property is a one story, wood framed dwelling, no other buildings are on this property. This dwelling consists of a combination living room, kitchen, dinette all in one room. There is also a full bathroom and a small den. To the rear of this dwelling is a bedroom, laundry room and a attached storage shed. This section is brand new and a Certificate of Occupancy is now being issued for this section. This dwelling has a cement block foundation, crawl space only. All rooms are heated electrically. No violations of the Housing Code, Chapter 52, Code of the Town of Southold, N.Y. were found. Inspection completed at approximately 9:45 A.M. Respectfully submitted, CURTIS HORTON Building Inspector FORM N0.6 TOWN OF-SOUTHOLD Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector 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 installations, 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 in- formation 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 ......�.... f. �.. ,,..�. ............ �......... Old or Pre-existing Building ............................ Vacant Land ............................ New Building ...... Location Of Pro ertt2e,�.. .. '..�� C u.�.L:..h:Ctf h..! x......... Owner Or Owners Of Property ....:.................................... Subdivision................................................................Lot No............. Block No............. House No............. Permit No. ... Date Of Perrf*C/,.. Applica �� ,..� 1.. 49 HealthDept. Approval ............................................Labor Dept. Approval ................................................ Underwriters Approval ..............................................Planning Board Approval ........................................ y. Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ ...... .......................... Construction on above described building/and permit meets all applicable codes and regulations. Applicant d�'1 ''' // Sworn to before me this ................ day of ............................................ (stamp or seal) Notary Public .................................... County Rk-UAIEU ,iyd/d— vv 2yj I TINt wFSt 11' No 0hc.nalUNS1 )SINUI ULI Idh.,,,1)LIN S UNES w - !•. nESND f011 A S. Iqu "Y fOSF AND USEANL 1:¢Ilt .,, p jlnE N01 1,11 td L U ?,E ENEU]IUN W fEiiLtS,Yh.- TAINING WAL S Y'WU PA) US. PLANTING AREASAOUNIUN f0 QUItUINCS MY UENEA QONSTNDGEIDryU,R 7 '' SHA HdN �r CHICAGO TITLE INSURANCE COMPANY 0 (516) 7274455 d -nor- s ro JJ RIC►IARD WILHELM NU Ait�q �r - -- - FON,ECE,.Qyo,.E' Cr4 aoet- I` ns-oc)c33I RS WA Enr d, N. TITLE # U. 878-0I •I. / :r P6R I P Ao. 3001e �3D d -a Si 3/ Rk-UAIEU ,iyd/d— vv 2yj I TINt wFSt 11' No 0hc.nalUNS1 )SINUI ULI Idh.,,,1)LIN S UNES w - !•. nESND f011 A S. Iqu "Y fOSF AND USEANL 1:¢Ilt .,, p jlnE N01 1,11 td L U ?,E ENEU]IUN W fEiiLtS,Yh.- TAINING WAL S Y'WU PA) US. PLANTING AREASAOUNIUN f0 QUItUINCS MY UENEA QONSTNDGEIDryU,R 7 Uualduu+x ow•ea:eu �, Nrdd end unN su0eh l�, ` 11)0 `�+rveyus en" pa Mu'ntdl all lu lne lib DN. 'ton IiFIW dNenry ddu'1 I�.nC,1�.? nn�valu NC/f011, hV MlWd1W inalti idJRlliun GUNdmeca an.. Noll Nd L° aI m �AWM oNnerd. Sht. NN M ui.ulnul,d.� �, 1". N ie a �c:uru w• ei1 I ud New Yeie '09 aw.e EJu.d�•.1 Vrv. Cepb: of Ids aurver 1-130 nul Neu IF shoo Surveyald mood ...I or am WF d shoo 11N W oondiddrdd to W d v 4 1 ror. MAP OF PROPERTY / PONALD J. TASE, L 0 OF NE'f — SUCCESSOR TO SE S.N.11 Gwnp, N. Y. SURv6T60 F.pvugrc�r,9, i ro JJ RIC►IARD WILHELM NU Ait�q �r - -- - FON,ECE,.Qyo,.E' Cr4 aoet- LICENS0 LAND SU GAt•r Moricti•d, N. Y. 11934Br• RS WA Enr d, N. 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