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Home My WebLink AboutZ-5469FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~-~ ..... Date ............ Sept; ..... ~0 , 19.73. THIS CERTIFIES that the building located at . }~,d8. ~a.~. BO~ ........... Street Map No..~ ........ Block No. ~ ....... Lot No.. ~ . .. ~gOh0~O .... ~,Y, ....... conforms substantially to the ~t~ll~ b~lt before ~of ~eup~e~ dated ........... April ~2~ , 19.~. pursuant to which ' No. Z' dated ....... Sept ...... ~..., 1~.., 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..~. ~IF .dwel. t~ .&. ~eesao~. bulldog .............. The certificate is issued to . .Jean .~o~ ...... ~er ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .Pre,a~g .................... UNDHRWRITERS CERTIFICAT[ No.. p~.~.~g .................................. ttOUSli NUM I31. R. ~2~ ...... Street ....~.~. RO~6 .................................. ............................... Building Inspector HOUSING CODE INSPECTI0~ September 19~ 1973 2~02~ Main Road Cutchogue~ N.Y. Tax Roll: Occupied: Richard L. Woodhull & wf. Owner Upon request of the Southold Town Building Department I made inspection of this two story framed dwelling and found the following violations of Local Law # 1~ Housing Code~ Town of Southoldo I was admitted to west side en- trance by son of Mrs. Woodhull~ who accompanied me on my inspection which began at approximately 11:1~ a.m. First Floor: dining room~ violations. Consists of Laundry room~ bathroom~ kitchen living room and entrance to hall. No Second Floor: Consists of four bedrooms~ one full bath and one half bath-no violations. Heat is supplied to all rooms on each floor. Uni~nished ~ttic: used as storage area. Cellar: Stairway-plaster loose and missing on wall left side stairway to platform. Section 303C Cellar window storm sash broken-pane of glass Section 60~b. Accessory Building: Former corn crib now being used as a utility building-deteriorating-roof needs repair-no door and opening in west side-floor boards rotting. Section 301Co~ Section 302 b.c. Trailer indicated on plot survey submitted with applica- tion has been removed. Inspection completed at approximately 11:40 p.m. ~pectfu~y/,ubmitted~ ,,, Building Inspector FORM NO. 6 TOWN OF $OUTHOLD Building Deportment Town Glerk~ 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 3. Copy of certificate of occupancy $1.00 $5.00 Date ~ .~,1~ .'~.~.~ ~'...1 ~., .. ,], 9.~.~ ..... New Building .................... Old or Pre-existing Building ...... ~ ................. Vacant Land ............................ Location Of Property ..]~].~T~.]....Q;~..~SJ.~I..]~Q~.d...m..Q.1/.%.C/3.0~Ile~...T/.Q..~OL~;~I~ ........................ Owner Or Owners Of Property ...~.~.~..~.,...~/..O.g.~.l~ ............................................................................. Subdivision ................................................................ Lot No ............. 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 $ '"~'""0'0' ........................ Construction on above described building and nd regulations. Appli co nt ......... t,;,¢6/~///.i~ .~,¢~ ~¢',,. ~'.. ~ ........................................ Sworn to before me this ~t.,~r ~O .... ~-.~.~.. day of ~.~.~.~.~.fh~.,..~.9~7~ ........ (stamp or seal) ~'~Z, ~'~ . uf£olk Notary_Pubhc ....... ~ ........................County Term Expires March