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Home My WebLink AboutZ-8902FO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z8.9.02 ...... Date . .J~nuar¥.... 9 ............. , 19.78. 75 Bailey Ave THIS CERTIFIES that the building located at .. $50' North. Road ......... Street Map No ............. Block No ........... Lot No .................................. ~' S.~0R 'NE ~ ~IILY D~~ N.G .gILT. conforms substantially to the ,., ~E~[Fi~ATE..OZ OCCUPANCY dated . 'APR'I~', ....... 23 ....., 19..~? pursuant to wmcn ]Eaj0r~,,F,]~,~ l~o. Z8902.. dated ' 'JANUiH'(¥ ...... 9 ..... , 19..7{~ was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ... P.RtVA-T/~. 0NF, .FAM.I-LY- D~ELLING .................................... The certificate is issued to ... Robert..R, -Brown.. & 'Kathr2n-G',' 'Brown ........... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..... P.~E-SXIS~I.ING ................. UNDERWRITERS CERTIFICATE No .............. t~?J1-.EXIf~'i ING. ................ 75 BAILEY AVE HOUSE NUMBER .. '850 ........ Street .. NOi{TId..,ROAD ............................ ........................................ CeREENP. ORT ~..N .Y ........ % ~ 91~+ .......... Building Inspector Housing Code Inspection January 6~ 1978 ~5 Bailey Ave & 8~0 North Road R-1 Greenport, New York 119~4 Tax Roll: Robert Brown unoccupied Upon receipt of an application of a Pre-Existing Certificate of Occupancy, I made an inspection of the building at this location. I was admitted by Mr. Brown who accompanied me during this inspection that began at approximately 11:30 A.M. This dwelling is a one and one half story wood framed dwelling constructed on a poured concrete foundation. First floor contains a kitchen, dining room, living room with fireplace, bedroom, family room and a full bathroom. Second floor contains a bedroom and an attic storage area. A one car attached garage is located on west side of building with access driveway from Bailey Ave. I found no violations of the Housing Code, Chapter 52, Code of the Town of Southold, N.Y. Inspection completed at approximately 11:$~ A.M. Respectfully submitted, Edward Hindermann Building Inspector FORM NO. ~ TOWN OF $OUTHOLD , Building Depertment 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 fallowing; 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 disposol--(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 os 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 o 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 or Pre-existing Building .....x. .......... Vacant Land .............. Location Of Property ....~/~.~.....C..~..~...~..e...~.:.....~..~..~.~...~..~..~..~...~..c]...~.&.....B..~.~..Z..e..~.~.~.~.!.~`.~.~.~!~.~.~ Owner Or Owners Of Property ...R..~'..b..e...r..t.~.~.R..:~...B...r..~...w..n.....&~..~.K..a...t..h..r...y..n.....G'.:.~.~.~.~ ................................... 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 $ ...5..:..0...0. ........................ Construction on above described building ]~b~]~Lg~i~.m~et~Hat~[~u:a~l.e ~/~ nd~ulations. Applicant .B...Y..:. .............. ~ ~......./..~ / .......... ............................ Sworn to before me this 6th day of January ///~/~ ........................................................... (stomp or seal) Not~ry Public , Suf£olk County t,~J,':,ltl t,~,~ i/ 't