HomeMy WebLinkAboutZ-7006FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No.Z.7.006....... Date ............ Kay .... 5........ 197.6..
THIS CERTIFIES that the building located at . r/. S •.last • Greek. •Ave . . • • . Street
Map No. .XX ........ Block No. .XX ...... .Lot No. Xx ... CRtGhogue... ...........
r•eq�irements f. o e far ly dweJ.lin hou ing code
conforms substantially to the 3 € OPJQhx� 1 ,e,� Qj( ttx
udiit certificate of Occupancy
da e b.e�gxe, .Qnr,., ,23.., 19.57. pursuant to which 00"6W2t3110.Z7006"
dated .......... �,aY...5...... 19.76., 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 1'X iVate. Azle. rA411y, AV9r 1 a
.111 g,wi,tkl. , two. ccgssory, puil.d.i;2ige...
The certificate is issued to .&dvPXd.G. Gertxude. � Ylie.....'vg1erg................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval .pre-..ex3 sting ................... .
UNDERWRITERS CERTIFICATE No. .pre -..existing ............................
HOUSE NUMBER ....152.5 ..... Street ..... est..Cre ek .::•.ve ....... Cutahogim . .
l C7 >s: 'i'his, C/O.covers, the, mein• puilr ini .l efor�, the, arc ition-permit#6507?
C/C Z5210
Building Inspector
HOUSING CODE INSPECTION
May 4, 1976
1525 West Creek Ave.R-1
Cutchogue, N.Y.
Tax Roll: Edward C. Wylie
Occupied - owner
Upon receipt 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 Mrs. Wylie who accompanied me during this
inspection which began at approximately 4:00 P.M.
The building consists of a kitchen, living room, full
bathroom, bedroom on first floor with a sleeping balcony
on second floor half story. An addition to first floor
constructed under Building Permit #6507 contains a dining
room and den. An enclosed front porch runs entire width
of building. Heat is furnished to all rooms with the ex-
clusion of front porch. These rooms contain electric
baseboard heating elements. Foundation of building is
cement block with a partial cellar; balance of building's
foundation is crawl space.
An accessory building constructed under Building Permit
#64372 and one car garage which was added under Building Permit
#78552 are in the rear yard.
The following violation of the Housing Code, Chapter 52,
Town of Southold, was found in the Pre -Existing portion of
dwelling which this inspection covered:
Front entry - no means of controlling light
in room on entry, Article V,
Section 52-56 B.2.
Inspection completed at approximately 4:15 P.M.
kar
Zne EH:mm rma�
Building Inspector
766 -1 e3s
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
New Building ................ Addition ................ Old
o�r�Pre-eexisti Building ../�.......... Vacant Land ...........
Location Of Property ..... ....?......�f✓. !'...`✓.. `' i! ...
Owner Or Owners Of Property Aew�k.l... ......... ..
rl
Subdivision...................�
.............................................Lot No.....1..1.. Block No../.�...... House No //
r/..S.......S.
Permit No...—........... Date
Of Permit ..—..........Applicant .Tri' S !17.....4. e ....
Health Dept. Approval ...Y... t^ y.....Labor Dept. Approval .........1.....� -
1 Al,
Underwriters Approval ..t��? .'.. ......,.Planning Board Approval .......
y+ ......................
Request For Temporary Certificate ........................................ Final Certificate............(/.1.,.......................,
Fee Submitted $ ...
Construction on above described building d permit meets all applicable codes and regulations.
Applicant............................................................ T 6
Sworn to before me this
.........y. day of ...........1.1..17....
Notary Public ....... .. County
(stamp or seolvx,
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