HomeMy WebLinkAboutZ-6242FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. 26242 ..... Date ............ Doc ... 1.3 .... ..., 19..71+
THIS CERTIFIES that the building located at . ''iestr Lake .&-. Little. PeeoAi&t$ar La
• No. Cedar..C • No ........... Lot No.• o.
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• • • • the ��
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dated ........ Doc .. 1.3 19. 71+, 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 .Private. -orae. family -dwelling .......................................
The certificate is issued to .vii11.iam. J.... Van�iatox .... Owner ......................
( owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval pros—existing . • • • • . • • • • • • • • • • . .
UNDERWRITERS CERTIFICATE No. pm -existing ..............................
HOUSE NUMBER ....24-5 ..... Street .. Little • Peconic..Bay. Lan* • • • • • • • • • •
30 West Lake Dr
................................................................................
. ..... r,_ _.J . ; ....... .
Blinding Inspector I
HOUSING CODE INSPECTION
December 12, 1974
2475 Little Peconic Bay Lane
and 30 West Lake Drive R-1
Southold, N. Y.
Subdivision: Cedar Beach Park #90 Lot #125
Tax Roll: William J. Van Mater, Jr.
Upon request of an application for a Pre-existing Certificate
of Occupancy, I made an inspection of this one and one half
story framed dwelling. I was admitted to building by Mr.
Van Mater and began inspection at approximately 1:35 P.M.
The first floor consists of a kitchen, living room,
full bathroom and three bedrooms. Second floor has two
bedrooms. Heat is supplied to each room from an oil fired
hot water heater located in partial full cellar.
Violations of Housing Code, Chapter 52, Town of
Southold, New York, follow:
Cellar: stairway, open sides, requires handrail.
Article II, Section 52-27. Window on
east wall, broken pane of glass. Article
III, Section 52-31 A. Water pump,
electrical connection requires a connector
at terminal box for conductor, connection
of ground wire of conductor and terminal
box cover. Article V. Section 52-56 A.
Inspection completed at approximately 2:10 P.M.
subm#ted,
Edward Hind'erron
Building Inspector
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
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 DUPLICATE 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...........December 12, 1974
.....................................
New Building ................ Addition ................ Old or Pre-existing Building .... N......... Vacant Land ..............
Location Of Property .corner of Little Peconic Bay Lane and West Lake Road, South–
.......................................................................
ld
Owner Or Owners Of Pro William J. Van Mater
..................................................................................................................... �
Property Y..
Subdivision Ce...dar ...Beach.......Park....Lot No..1?.5.... Block No ............. House No.............
........................
Permit No ..................... Date Of Permit ....................Applicant..................................................................
Health Dept. Approval ............................................Labor Dept. Approval ................................................
Underwriters Approval ..............................................Planning Board Approval ........................
Request For Temporary Certificate ........................................ Final Certificate ..........................................
Fee Submitted $ ..5.00
Construction on above described buildin 'an rmit a all pp' c es and regulations.
App l icon
�' uer, a a orney or tn)'ilI'iam .��. Van
Sworn to before me this Mater
12th da of December, 1974
........ y .............. ...........
Notary County hW&k1k_
jessm C. AUSTIN
NOTNY PUBLIC, State of New York
No. 52-3203050 - Suffolk Counfy
Commission Expires March 30, 1975
(stamp or seal) k_lz c 1
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