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Home My WebLink AboutZ-4957FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No...~9..~ ...... Date .............. D0.o...5. ..... , 19.72 _ Maiden La THIS CERTIFIES that the building located at .I/D.d,dlo. Road. (.C~)..~..~ Street Map No. XIX ........ Block No... ~ ..... Lot No...XZ ...l(~tt$1;~Lk.. ][,Y, ....... conforms substantially to the before ~3 19~ p~snant to which~~. dated ......... ~ .... ~ ..... , 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 . .~0. ~. $~. d.~.~ ...................................... The certificate is issued to . E.at&l;e..of. JM~lco..F. Cox ...(hrm~ ................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. p?.~..-y..0~..s.~.~.~.g .................. UNDERWRITERS CERTIFICATE No....J~[~?..O. IK:IkS.~.:l~g ................................ ItOUSE NUMBER...~0~ ..... Street... J/iddle .Road .(CR2~.) ........................ 1, lo H~t ~h at po~t of ent~ llv~g ~ ....... a, no ~ut oft valve at ~a~ tense appX~oe ./ Building Inspector ~ 3. ~go~y ~h fo~ otl b~er d~s ~t ~rk/ gP~erA7 & ~dentified ~2~ &leg,O ~o ~ on eoll~ s~ire by bono be ~1-2 a 70~ HOUSING CODE INSPECTION December 22, 1972 5500 County Road ~27 Mattituck, New York Tax Roil: Janice F. Cox Occupied: A. Grassenbacker Upon request of the Southold Town Building Department I made inspection of this two story framed dwelling and found the following violations of Local Law #1, Housing Code of the Town of Southold. This is a one family residence, heated, consisting of seven rooms, one full bath, a toilet room and full cellar. I was admitted to rear entrance by Mrs. Grassenbacker and began inspection at approximately 1:40 p.m. Living Room: No switch to control light in room at front entrance - Section 529b. Kitchen: Gas range, no shutoff valve at unit - Section 508b. Heating System: disconnect, electrical emergency switch at foot of cellar stairs does not hold in off position - Section 528a. Switch not identifiable, U.S.A. standard Electrical Code - Section 424-22 (Switch and circuit breaker to be indicating) Accumulation of clothing and boxes at east entrance on landing, obstructing egress from kitchen. Accumulation of clothing and boxes at foot of cellar stairs - Section 401-2 and Section 703-4. EH:tle Inspection completed at approximately 2:05 p.m. ~. ctful~itted, Building Inspector CONS E NT T 0 NSI ILC 1 I(ON " Ow~mr(s) Name(s)-' ' do(es) her'eby state: the undersigned, 'l'hat the undersigned (is) (are) the owner(s) of the premises in the Toval which is shown and designated on the Snffolk Coul,l.y tax map as District 1000, Section __/_~_~_o Block ~ , l,ot //4/ . That the undersigned (has) (have) filed, or' caused to be filed, an applica- tion in the Southold Town Buil(lhL~ inspector's Office for' the f~)llowing: Th:t( the undersigned do(es) hereby give consent to the Building lnspecto~'.~ of the Town of Soutbnld to enter upon the above described prnperty, including any alld all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections [o determine that said premises comply with all of the laws, ordinances, rules and re~lulations of the Town (~f Southotd. The undersigned, in consenting to such h~spections, do{es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may 1)e used as evidence in subsequent prosecutions for la(ions of the laws, ordinances, rules or regulations of the Town o~ Southold. (signature) (print name) (signature} / (print name) FO~M NO. ~ TOWN OF SOUTHOLD Building Delmrfment 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 dispcsal--(S-9 form or equal). 3. Approval of electrical installation from Board o~ Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code coenpliance 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 pertirmnt 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 $1.00 New Building .................... Old or Pre-existing Building ....~ ................ Vacant Land ............................ Location Of Property Middle Road & Maiden La Mattituck N.Y. Owner Or Owners Of Property Estate of Janice Cox Subdivision ................... ~ ........................................ Lot N .o~,, .......... Block No...,,X~.. ..... House No.,~,,,00... S,.~th T~k~.r & .F. ink~.l tein Permit No ........ .z.. .......... Date Of Permit .........~, ........ Applicant ......... ~ ............................... .$. ........... Health Dept. Approval ...~...r..e.~....e...x..i..s...t..i...n.~$ ......... Labor Dept. Approval ........ .N......R.... ............................... Underwriters Approval ...P.3~P~.~...Etxis.t.i~3,~ ........... Planning Board Approval .N..t..R..? ............................... Request For Temporary Certificate ........................................ Final Certificate ....... ~ ............................ Fee Submitted $ ..~..~.QQ ......................... ~ / Construction on above described buildin~,permi~t eetr~s..~,ab~l codes a~ regulations. Applicant/1(~.~....~.....~... ~.~ ....... Sworn to before me this °checked Dec 22 Notary Public .................................... County C/O # Z$957 (stamp or seal)receipt 6887 1972 NO ?E ~ . ~ ~' MONUMENt' R£WS~ONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD. NEW YORK SURVEY FOR: ALFRED J. GROSSENBACHER,JR. ~ /';~ ~ CAROLYN A. GROSSENBACHER/ -' .i, "-..~. GUARANTEED TO: MATTITUCK $OUTHOLD SAVII~GS BANK TOWN OF' GUARANTEED TITLE DIVISIONOFAkL---RIC;AN SOUTHOLD TITLE INSURANCE CO, 72-921 STATE OF NEW YORK SURROGATE'S COURT : COUNTY OF SUFFOLK Probate Proceeding, Will of : JANICE F. COX, : Deceased. : STATE OF NEW YORK ) ) COUNTY OF SUFFOLK ) File No. 1569 P 1971 AFFIDAVIT HARRY S. COX, being duly sworn, deposes and says: 1. I reside at 1101 Flanders Road, Riverhead, New York. 2. I am the son of JANICE F. COX, deceased, and I am the sole beneficiary under the Last Will of the said JANICE F. COX, deceased, which was probated in the Surrogate's Court of Suffolk County on December 6, 1971. 3. I am familiar with the real property and the struc- ture situate thereon as shown on the annexed survey dated December 5, 1972, and prepared by Young & Young, land surveyors. The structure situate on this parcel of land existed prior to April, 1971, and has always and continuously been used as a dwelling. The said dwelling is in good condition and suitable for dwelling purposes, and there are no housing code violations to my knowledge Since April, 1957, there have been no structural alterations or additions made to the building. Sworn to before me this 18th day~ Decentber, ~1972.. PAUL J, BAISLEY Nof. ry Public, 5f~fe of ~ew Yor~ Harry S~Cox