HomeMy WebLinkAboutZ-7116NO. &
TOWN OF SOUTHOLD
BUH.DING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificnte Of Occupnncy
No..Z.7.].].6. ..... Date ............. .J.~.ly...8 ...... , 19. ~.(~
THIS CERTIFIES that the building located at . E ·. Le~gon Ave ........... Street
Map No.. XZ~ ....... Block No..~ ....... Lot No.. ~... ~t~Xt~¢k...N ,Y. .........
conforms substantially to th~
~,,hi,h~~De curacy
dated ... ~fore .Apr...23., 19.%% pursuant to ........... Z~6" '
dated ............ ~... 8.., 19.. ~ was issued, ~d conforms to ~ of the r~
ments of the applicable pro~sions of the law. The occup~cy for which
issued is .. Pr. ivata .one..f~ily. dwalling .....................................
The certificate is issued to ...Dale. ~gen...~. of. reoord ....................
(owner, lessee or ten~t)
of the aforesaid building.
Suffolk County Department of Health Approval . .Dr~r..eX~.~$~g. ..................
UNDERWRITERS CERTIFICATE No..D~Ov. 9.XiS~ng ............................
HOUSE NUMBER ..... ~ ..... Street .. E,..~iX~n. ~ .... ~attitucK ........
Building Inspecto/r~
HOUSING CODE INSPECTION
July 7, 1976
555 East Legion Avenue R-1
Mattituck, N. Y.
Tax Roil: Dale Bergen
Occupied: Mr. and Mrs. Horace Ragan
Upon request of Gary F. Olsen, Atty., Mattituck, for a Pre-
existing Certificate of Occupancy I made an inspection of this
one story framed dwelling. I was admitted to building by Mrs.
Ragan and began inspection at approximately 10:15 A.M.
The building consists of two bedrooms, living room, kitchen
and a full bathroom. Heat is furnished to all rooms from an oil
fired forced warm air furnace located in cellar of building,
cement block foundation. A raised deck is attached to the rear
of building.
The following violations of the Housing Code, Chapter 52,
Town of Southold, N. Y., were found:
Stairs:
interior to cellar, and rear deck access, no
handrails on open sides, Article II, Section
52-27 B.
Inspection was completed at approximately 10:30 A.M.
Re~ctfully submitted,
Edward Hindermann
Building Inspector
EH:med
FORM NO. 6
TOWN OF SOUTHOLD
~ Building Department
Town Clerks Office
Southeld, 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 naturoi
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: ]. Certificote of occupancy $5.00
2. Certifieote of occuponcy on pre-existing dwelling or Iond use $5.00
3. Copy of certificate of occupancy $1.00
New Building ................ Addition ............... .0Id or Pre-existing Building ..... .~..... Vacant Land
Location Of Property ............ ..L..~.~-~...~/.. ........ ..~..~./..~'-~"'......~..~.....~...~...~..(~.~....~.-~z...~.......~... .........
Property .....,~. ,~_ ....~.... ~... ~ .~., ...~.....~..~o / -- .............................................. '/ /. ............
Owner
Or
Owners
Of
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 Ce~ificate ........................................ FinaJ Certificate ........ ~)~.. ............................
Fee Submitted $ ............ ,~."~ ............. ~
Construction on above described building and p~d~pph'cable ~ulations.
App,,cant ................... ......
· S..~.:~.~..t.~:faCf~f~ ~ ~ ~Z.~' ~ (stamp or sea,~