HomeMy WebLinkAboutZ-6393 AFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. Ze39.3. ...... Date .............. ~'Z~%...~3. ..... , 19.7~.
THIS CERTIFIES that the building located at ...WZ~ .B~y.b.e~'.ry...Rd.. ~x.t... Street
Map No.N~.~Z :..P.~;,.. Block No..S.~.(~ .I~ .... Lot No..~..~.8. .... .C.u.t.c.h.o..gu~....1~ ~¥.o ......
conforms substantially to the. r m~ to ® f dYel & Hou n cod®
~rt~f:~eat® of oeeupaney
dabteU~J'g...~. $.o.r,. ARr.,..23.., 19..~.? pursuant to which ~ No. Z. 639.3.
dated ............ .J.a!l...1.].., 19 .~., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is . .prSy.a.~e.. ~.n.e.f.am.$..ly..d.w..e.l.l.~ng ......................................
The certificate is issued to ...E~,l~.e.n. ¢o.o.k ....... . .okra..or ...........................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval pr..~?..~.X~s~;lng ....................
UNDERWRITERS CERTIFICATE No. p.r.e.-...eX.i.$.t~..n.[ ............................
HOUSE NUMBER ..... 1.380 ..... Street....B.ay.b.~'.ry...R.o~..4. .......................
Building Inspector [
Sub. Div:
Tax Roil:
HOUSING CODE INSPECTION
January 13, 1975
1380 Bayberry Road R-1
Cutchogue, N. Y.
Nassau Point Club Properties
Map 789 B. Amend. Sec. B - Lot
Eileen Cook
118
Upon receipt of an application for a Pre-Existing Certificate
of Occupancy, I made an inspection of this one story framed
dwelling. I was admitted to building by Mr. Cook who accompanied
me during this inspection which began at approximately 10:00 A.M.
The building consists of three bedrooms, two full bathrooms,
dining room, living room, kitchen and a breakfast room. Heat is
supplied to all rooms with the exception of the breakfast room
from an oil fired forced warm air furnace located in the attached
one car garage. An enclosed heated porch provide~ a front entry
to dwelling. Building's foundation is cement block with crawl
space and partial full cellar with entrance from exterior.
The violations of the Housing Code, Chapter 52, Town of
Southold, N. Y., are as follows:
Garage:
Smoke stack from forced warm air furnace
requires sealing at chimney connection.
Article V, Section 52-54 A. (1) -
Electrical connection of hot water heater,
junction box requires plate to cover
conductor connection.
Accessory structure, beach house, is located in rear yard
area.
Buildings and grounds are well maintained.
completed at approximately 10:30 A.M.
EH:mm
Inspection
/
Building Inspector
FORM NO. S
TOWN OF SOUTNOLD
, Building Deporfment
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 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 dispasal--(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 end 'pre-ex'sting"
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 $.5.00
3. Copy of certificate of occupancy $1.00
Date January 8 197~+
New Building ................ Addition ................ Old or Pre-existing Building ....~.... Vacant Land ..............
Location Of Property ~/`~Q~'~]~i~f~(~[~$~~$~Q~e~
Owner Or Owners Of Property ..~.~.,]:.,e.~.~....q.o...o..~. ............................................................................................
Subdivision ~e~-~.~S~s~1~.~.~`~C~-~t~ ..~..~.~.... Block No ............. House No....~.-~.~.~
Permit No.....:~q~ ........... Date Of Permit ...... ~ ......... Applicant ...... ~ .....................................................
Health Dept. Approval ...]g.~.e...--..e...~..J:.s..~.J:.~ ............ Labor Dept. Approval ....... .~...'..~...'. ...............................
Underwriters Approval ...~.-..e.X.~S.~'lt'~ .............. Planning Board Approval .... .~...'.~..'. ..........................
Request For Temporary Certificate ........................................ Final Certificate ....~,~. ...............................
Fee Submitted $ .~.....0..0. ..........................
Construction on above described building and permit meets all applicable codes and regulations.
^pp,icant ............ .................
Sworn to before me this
(stamp or s.ol~ ~ ~'~
...... /.~. day of ...~..J~.Z~ ............
Nota~ Publ,c ~~~ Coun~