HomeMy WebLinkAboutZ-4592FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupnncy
THIS CERTIFIES that the building located at 'l~/~. -Hobart. Rc~l ......... Street
Map No.. ~ ........ Block No... ~ ..... Lot No...XX~... B.~th~.. lJ,¥, .......
conforms substantially to the ~ . r - · ~ .
' Certlfteato ef oeeupaney
B~f~ro.. &pri~. .2~ .... , 19..~ pursuant to which ~~ No.
dated ........ Mar~... 23.., 19..~, 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 .... Pr.l.wate. ~e..f~tmt.l..y .~lwO~l.~.~g ....................................
The certificate is issued to ... '~-ol~,~rt' & Sv,,'~a~ '¢or~o~ ....... (~en~al.s .............
(owner, lessee or tenant)
of the aforesaid building. I~0~E~ HOusing inspection llar 23~ 1972
Suffolk County Department of Health Approval . prior..cons.truc.tion. & .l~ukJ~ic. water
....... ...... ......
Building Inspector
/
FORM NO. 6
TOWN OF SOUTHOLO
Bui~dlng Department
Town Hall
Southo d, ~.~. i ~ ~
APPLICATION FOR CERTIFICATE OF OCCUPANCY
.ertificate of occupancy on pre-existing dwetl[ng or land use
opy of certificate of occupancy $1.00
Instructions
A. This application must be filled in typewritar OR ink, and suSr~itted in duplicate to the Building Inspec-
tor with [he following; for new buildings or new use:
1. Final sur*zey of property with accurate location of all buildings, property lines, streets, and unusual
natural or topographic fe3~dres.
2. Finalapprova of Health Deo~. of water supply and sewerage disposa _(S.9 form or equal).
3. Approval of electrical instaliation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings Multiple Residences and simi ar buildino~ and ' -
tlons, acertmcate of Code compl,,nce tram the Architect or Engineer responsible'for the
5. Submit Planning Board approval of compieted site plan requirements where applicable.
B. For existing buildings (prior to ,~pril 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1o Accurate survey of peoperty showing all prooerty lines, streets, buildings and ~Jnusual 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 informa-
tion required to prepare a certificate. ;
Fees:
1. Certificate of occupancy $5.00
S5.00
Date ..
g ......... O,a or ~re-ex~sdng Budding(X) . _.._'~_ __~ ZVacant Land ......
... Owner or Owners of Property .. ~...' ........
Coun,v Tax Map No..1000 Section .... ~.~ ..... Block ..... 3 ....... Lot ..... :.~ ........
Subdivision
............................... Filed MapNo...: ....... LotNo.
Permit No ........... Date of Permit ~-~ ~.~ .
Health Dept. Approval ............. ; .......... Labor Dept. Approval ...................... ,..
Unde~vriters Approval ........................ Planning Board Approval ..................
Request for Temporary Certificate ..................... Final Certificate .. .......
Constructi~ ~nabove. described building a~d p~r~i(mee~s alt app~pabl~od~s a .
HOUSING CODE INSPECTION
May 5, 1975
250 Hobart Road R-1
Southold, N.Y.
Tax Roil: William P. Metzger & Wf
New Owners:John Targonski & Wf
Upon receipt of an application for a Pre-Existing Certificate
of Occupancy, I made an inspection of this two story framed
dwelling. A previous inspection had been made on March 23,
1972 for a Pre-Existing Certificate of Occupancy which was
issued to Robert and Susan Conlan. At that time the report
indicated that the building was in good condition except for
the exterior porch and chimney. Based on the previous
report, this inspection was made on the exterior of the
building only.
The porch has been repaire~. However, the chimney is
still in need of repair - (bricks require p~inting). Violation
of the Housing Code, Chapter 52, Town of Southold, N. Y.,
Article V, Section 52-54 A.1.
Inspection bega~nat approximately 3:00 P.M. and was com-
pleted at approximately 3:10 P.M.
~-H: mm ~dward 'Hi~d~rm~fi~' ' -
Building Inspector