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Home My WebLink AboutZ-9272NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No... $9.2.7.2. .... Date ..... 0.c. t0ke~. .... 2.7. ......., lg..7.8 THIS CERTIFIES that the building located at . .2650. Pine..Tx'e~. ~oad ... ~ Map No .... 1.179 ..... Block No ........... Lot No ......... 39 ....................... REQUIR~4ENTS FOR ONE FAMILY DWELLING BUILT PRIOR TO conforms substantially to the ~ · · A .... dated ...Ap.r.~.l .... .2.~ ........ , 19..5.7. pursuant to which-~q~°~%~t No..Z.9.27.2.. dated ...0.c.t..o.b.e.~7...2.7. ....... , 19.7.8., 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 ........... Private. One. Family. D~ellin~ ............................. The certificate is issued to ....... J..i~'..al}...D:..C. 9.1.e' .J..r: ............................. (owner, 9mm~g:~x:~eg~ of the aforesaid building. Suffolk County Department of Health Approval ........ Pra~Exia~cin~ ............. UNDERWRITERS CERTIFICATE No ................. P~.e-.Exis~;lng ............. HOUSE NUMBER .... 265.0 ..... Street ........ P/ne. Trace. I{Qad ................. .............................................. C.utchogue,. l~e,~. ~.ark ........... ...... ~..'.'.~//~.~.. ~. ~. ~.~U..-~'.~.~ ....... Building Inspector i~OBM NO, S TOWN OF SOUTHOLD Bnilding Dep~mnnt 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, 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, AAultiple 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 3. Copy of certificate of occupancy $1.00 $5.00 Dote October 21, 1978 New Building ................... O~1. or Pre-e.x. istil~g Building..,....,.,....~.......~..,~ .Vacqrtt Land. ........................... [z~.D ~: north [rom so_ucn zzne o= mcerllng , ....... W/s Plnetree ~oad, Gutchomue, New York Loca[ion ~Jr rroperry ................................................................ ,~. ................................................................... Owner Or Owners Of Property .......... .[~.....~..~...o..~..~...e.....C..o...]:.e. ............................................................................. Subdivision ........]~.....~....o..~....~..a...s.~..a.,~.....~..a..~?.s. ........... Lot No....].?..... I~a~, No...[...];..7...?.. House No ............. Permit No ..................... Date Of Permit .................... Applicant ...... ..b~a.....~.,~..o...~.~e.....A..:....C...o..[...e. ..................... Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate X Fee Submitted $ ........ ..~.:..0.~Q .................. Construction on above described building and permit meets all applicable codes an~ regulations. - ....... Sworn to before me this Applicant ............. .~...x.~....~....?~/.~.~,L.~.~~ · Suffolk Notary Pubhc ,¢ .................................. County · (stamp or seal) HOUSING CODE INSPECTION October 25, 1978 2650 Pine Tree Road Cutchogue, N.Y. R-1 Sub~ Div.: Tax Roll: unoccupied Nassau Farms, Lot 39 Jirah D. Cole Jr. Upon receipt of an application for a Pre-Existing Certificate of Occupancy I made an inspection of the dwelling at the above captioned premises. I picked up key for rear entry from the law office of Richard J. Cron and began this inspection at approximately 1:10 P.M. This building is a one story wood framed structure constructed on a cement block foundation. The ground floor contains, three bedrooms, a living room with fireplace, kitchen and a full bathroom off rear entry hallway. Heat is furnished to all rooms from an oil fired forced warm air furnace located in partial cellar. Hot water is furnished to'all plumbing fixtures within building by an electric hotwater heater. The following violation of the Housing Code, Chapter 52, Code of the Town of Southold, N.Y. was found: Shut off valve - gas cooking range, no shut off valve at unit. Article V, Section 52-52 B 2. Inspection completed at approximately 1:25 P.M., key was returned to Mr. Crons office. Respectf~l:~y submitted, Building Inspector