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Home My WebLink AboutZ-9078FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, BI. Y. Certificnte Of Occupnncy No..Z. 9.07.8. ..... Date ..... J~.. 22. .............. ,19..7.8 THIS CERTIFIES that the building located at ~.~. ~,. M.~..~.. R.o, .~.d .......... Street Map No ............. Block No ........... Lot No .................................. RE~U~ql~F~S FOR ONE FA~LY DI~.~.ING BUILT BEFORE conforms substantially to the ' ' ' ~ C~RTIFICATE OF OCCUPANCY dated .Ap~l.1-- 2.3 .......... , 19.57. pursuant to whic~t dated .June-.. 2.2 ........... , 19~.., was issued, and Conforms to a/1 of the require- ments of the applicable provisions of the law. The occupancy for ~vb/ch this certificate is issued i, .... . .~...~X..T.~..0.~..~HI~.L.¥....m~...~.,!.~.. The =ert~ficate is issued to ........ ~..i.%a..C..o.o.k.~., .W.o.~i..o.m ............................ of the aforesa/d building. Suffolk County Department of Health Approval ....... .P~. e.-..E~.~.$~.~'%~ ............... UNDERWRITERS CERTIFICATE No ................ .P~..e.-...E~l..s.t..L~. g. .............. HOUSE ~U~BER. !~.~ ....... Street ......... Building Inspector l~nor Sub. ~ 151, LO~ ~ 2 Housing Code Inspection June 22, 1978 l~n__j]Main Road J~5~st Marion, N.Y. Tax Roll: Rita Cooke Woglom unoccupied Upon receipt of an application for a Pre-Existing Certificate of Occupancy I made an inspection of the buildings on this premises. I began this inspection at approximately 3:30 P.M. with Mr. Woglom. Located on this property is a large two story wood framed structure. This structure is a single family dwelling. Also located on this property is a three car garage, no other buildings. Cellar is a half cellar, rest crawl space with 3' clearance. Inside and outside entrance. In the cellar is the electric pauel, three zone hotwater heater, and pump and tanks; all are in excellent shape. First floor consists of living room with fireplace, dining room, a very large sun room, full bathroom and a kitchen with a good size porch outside. In the kitchen was a electric stove, refrigerator, washer and dryer. Second story consists of five bedrooms, two full bathrooms and a large deck with steps leading to ground. Outside of dwelling consists of wood shingled roof and sidewalk and all necessary screens and storm sash. All are in very good shape. No violations of the Housing Code, Chapter 52, Code of the Town of Southold, N.Y. were found. Inspection completed at 4:15 P.M. Respectfully submitted, CURTIS HORTON Building Inspector Minor Sub. $151, Lot ~ 2 FORM lgO. 6 TOWN OF SOUTHOLD , Building Deportment Town Clerks Office Soul, hold, N. Y. 11971 APPLIGATION FOR GERTIFICAT£ OF OCGUPANCY 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 disposel--(S-9 form or equal). 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, N~ultiple 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 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 ...... ~g~e..~J...~.~.7.~ .......... New Building ................ Addition ................ Old or Pre-existing Building ......~.. ........ Vacant Land .............. Location Of Property .... ~.~...~.t~.~4...~kt~.~.ql~ ................................................................................... Owner Or Owners Of Property ....~[.~&..~..~l~[~l~J~ ........................................................... .............. Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No ..................... Date Of Permit .................... Applicant ~g~.~.~,~..~..~'.g~3~ ............................. Health Dept. Approval ............................................ Labor Dept. Appl;oval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ FinaJ Certificate ........ .X.. ............................... Fee Submitted $ ..... .5...,..0..0.. ..................... ~ Construction on above described building and permit meets all appllcable codes and regulations. P. udolph Sworn to before me this ..... .Z..9.~'~.. day of ..... .~'...g..~...e,y.....Z.~ .7..~. ............... Notary Public ~1,1~1~ ................... County Applicant ......................................................................................................... d COo~<~- VP'o~z_oM