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Home My WebLink AboutZ-4764FORM NO. s TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~1k76~. .... Date ...AI~ 29 , 19 ~ THIS CERTIFIES that the building located at . atilla~ater. A?e Street Map No. ~X Block No...~ ..... Lot No. x~ .... Ci~t~hogue ..... requirements for one famil dwellin & housin co~e conforms substantially to the tprior to Certificate of Occupancy "April" 2~ ..... , 19 ~7. pursuant to which ~. ~+~61~ dated ... A~9 ..... 29 .. , 19. ~2.., 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 .Itr. ivata oho. ,fa,w~i.ly .dwallt~g ................................ The certificate is issued to . .AI2A~ .Kol~r~lt~. ....... Owner ............. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE No .... 1~r..e:.e.x~stJ-~g. HOUSE NUMBER. ~'P-~.O .... Street ... .pre.~isglng .................. Exception to Housing codo~ !oLt$~t sw~teh & fixture living room, a 2 bedrooms '~ 3° " " = Collar " ~ some rubbi~ in yard to be cleaned up Building Inspector FORM NO. $ TOWN OF SOUTHOLD Building Department Town Clerks Office Southold, N. ¥. 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 dispcsal--(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 .. A .~. ~....s...~.....2.~..,....Z. ~..~ ?.. ......... New Building .................... Old or Pre-existing Building ...... ~ ................... Vacant Land ............................ Location Of Property ~./'s'...~...~.'~..'~.'~..~..e~.'~'~.~.~'.'e..~.~...e.~....~'~.~...~.~.~..~§~q~.~ ............................... Owner Or Owners Of Property ...~..~....~...~..~.~..]~.....~...(.~.e..~....~..~...~.?...e...mJ~...~..e~.~.~ .................................. 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 ........ ~Z' ............................ Fee Submitted $ .~..:..O..Q .......................... ~Z~'~ ~, ~,~/ Construction on obove described building a~~ all~b~~,ond regulations. Applicant .. ~. &~:'_...~¢?...~. ........................................ Wzllzam Wick_ham, Esq., at%y. for Owner Sworn to before me this Notary Public ... _.S....~....~..o...]:..~. ..... ~.... County (stamp or seal) JOAN HINDERMANN NOTAI~y PU~tLIC, State of New York No. $2_6~05~0 HOUSING CODE INSPECTION AuguSt 28, 1972 5220 Stillwater Avenue Cutchogue, New York Tax Roil: Anna Konarski Unoccupied Upon request of the Southold Town Building Department I made inspection of this one story framed dwelling and found the following violations of Local Law ~1, Housing Code of the Town of Southold; I picked up the keys at the office of William Wickham, attorney, Mattituck, N.Y., and let myself in through the front door, beginning inspection at approximately 10:35 A.M. Living Room - No light switch on entry for controlling a light - Section 529b; no lighting fixtures - Section 529a. Bedroom - southeast - no light fixture - Section 529a. Bedroom - northeast - no light fixture - Section 529a. Cellar - No light switch available at bottom of outside stairway (only means of access to cellar) - Section 529b. Open junction box not secured, laying on girder - east side of cellar Section 528a. Rear yard accumulations of refuse against rear of building. I completed this inspection at approximately 10:55 A.M. ~ectfully s~itted, ~ Inspector EH:tle