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Home My WebLink AboutZ-4627FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~'~7 ...... Date .............. l~&7. at. !~)'~.2 , 19 THIS CERTIFIES that the building located at .I/8 8~;1~ .~-~.. Street Map No. ~ ......... Block N~ ....... Lot N~ .... ~[~..~,~., ........ conforms substantially to th~ ~~t ~0~ tO 19. ~ pursuant to whieh~eO~}~ ........... · dated .......... ~ .... ~..., 10..~, 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 ...~e. ~. ~ 'dvel'~8 ~itb..aece~.aory..gq~g¢.e.[¢. g~.[~gg,- The certificate is issued to ~O' & .~O~. ~ ....... ~O~a .................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~.~ ..................... UNDERWRITERS CERTIFICATE No...~ .............................................. ItOUS[ NUMBFR..~. ....... Street... ~h .~ .~ ......................... HOUSING CODE INSPECTION For C.O. On Pre-Existing Dwelling March 6, 1972 V. Amari 565 South Harbor Road Southold, New York The office received an application for a certificate of occupancy, dated March 3, 1972, and asked me to make the in- spection. The owner admitted me to this one family dwelling about 1:30 P.M. Several electric outlet face plates have been removed and not replaced yet. At the top of the inside cellar stairs the cellar light switch outlet box is not anchored and has no face plate. Mrs. Amari said that they would correct them. There is a half bath inside with no fan or window, located in a bedroom. There is no rail in the attic around the stair well. I found the building and area in good shape, completing my inspection about 2:15 P.M. Respectfully submitted, George H. Fisher Building Inspector A sketch of the floor plan is in the Housing Code file. FO~ NO. 6 TOWN OF $OUTHOLD Building Deportment 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 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, an6 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: I. 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. Date i~U: Ch .. 3.,... 19.7.2 ................ New Building .................... Old or Pre-existing Building ....... .~.. .................. Vacant Land ............................ Location Of Property ~5~G~5~.~n~r~¥~r~d~q~9~];~;~e~"~.~ ................ Owner Or Owners Of Property ~V~W~J:~];~]:~J;~m~.A~?.~9~c1~e~e~A~f~~ ...... Subdivision .............................................. ../~/../Z~ ......... Lot No ............. Block No ............. House No..5.~,~ .... Permit No ..................... Date Of Permit ......../.Y~.~....Applicant ..~..L..¥~O.......J,.'~..././..~..(.(~L,~'~.....~...~.t~P,..)''1 Health Dept. Approval ................................ /~///]...Labor Dept. Approval ...~../.~. .................................... Underwriters Approval ................................ ~/..//~J... Planning Board Approval /~//.~. ........................... Request For Temporary Certificate ........................................ Final Certificate ...X~.. ..................................... Fee Submitted $ ..~..,g.Q ......................... Construction on above described building and pej, m3. t m~ts~all/ppplic~bl~, codes and regulations. Rudolph H.~Bruer, As Attorney Sworn t~fore me this .... .J.. ...... doyof ........... /£Zx sta po sea,) ~/illiam H. De Zavala ROTE: · ~MONUMENT YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVFRH£AD, NEW YORK ALDEN W YOUNG HOWARD W. YOUN~ S IRVEY FOR: EDWARD LUKOSVICUS 8~ BARBARAH.LUKOSVICU$ AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK CO., N.Y. SCALE: ii' = ~t 0' DATE: GUARANTEED TO: $OUTHOLD HOME TITLE DIVISION OF CHICAGO TITLE MAR. I, 1972 72--106