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Home My WebLink AboutZ-9265FO~.~ NO. 4 TOWN OF SOUTHOLD BUr[ .DING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupnncy 10896 R.0.W. off THIS CERTIFIES that the building located at Grea.~ .Peconie..Bay. B~vcl.. ~ Map No ............. Block No ........... Lot No .................................. RECIUI~S FOR ONE FAMILY DW~.T.ING BUILT PRIOR TO conforms substantially to the A__, ..... ~ ................ ,..C~;[~TC~E 0F.gCCUPANCY dated ....Ap?.~.i. .... 2.~. ...... , 19. ~.7. pursuant to wmcn3~:~ ~o. 'Z9265' dated .... 0o.~ober. 24 ....... , 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 ......... P..r.~.v.e.t..e...m.a...F..e~...~¥..D~..e.Z..Z.~..~ ............................... The certificate is issued to ..... .Al. b.e?.~...J....C..u.s.a. .................................. (owner, ~ of the aforesaid building. Suffolk County Department of Health Approval ................. N/R ............... UNDERWRITERS CERTIFICATE No .......................... N/R ............... HOUSE NUMBER .. 10896 ...... Street.. R. 0,.~.. off.. Gr. eat. Reconic. Bay .Blwd. ......................................... Laum. el/..~r ''~,/~, ......... ~~'~'"/' .......... Building Inspector HOUSING CODE INSPECTION October 24, 1978 10896 R.O.W. off Great Peconic Bay Blvd. Laurel, N.Y. Tax Roll: Albert J. Cusa unoccupied Upon receipt of an application for a Pre-Existing Certificate of Occupancy I made an inspection of the building at the above captioned premises. Accompanied by John Moore of the Silkworth Real Estate office I began this inspection at approximately 11:35 A.M. This dwelling is a one story wood framed structure constructed on a cement block foundation. Ground floor contains two bedrooms, a full bathroom, living room, kitchen and an enclosed porch. Heat is furnished to building from an oil fired warm air furnace located in full cellar with heat outlets in all rooms, also a gas fired warm air furnace with heat outlet located in living room floor approximately centrally located in the building. An open raised, concrete patio is located on the south side of building. The following violations of the Housing Code, Chapter 52, Code of the Town of Southold were found: SewaEe system - no house trap. Article V, Section 52-51C 1. Fuel ~as - shut off valves gas cooking range, gas filed hotwater heater, gas fired warm air furnace, no shut off valves at units. Article V, Section 52-52 B 2. Entries - no means of controlling lights in room at points ~y. Article V, Section 52-56 B.2. Inspection completed at approximately 11:50 A.~ c bmitted, Building Inspector FORM NO. ~ TOWN OF SOUTHOLD Buildl.g Depmtme.t Town Cle~,* 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, 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 aT 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 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 New Building .................... Old or Pre-existing Building .....~ ...................... Vacant Land ......~ ................ : .... Locat on Of Property ..~....~../'~ ~'./.~.......~....~...~../...~........~....~'.~.......~....d~ ~ ...... ...~...~....~..~..~..~....~' n r Af ~"~'p Y .............. ./.../...~....d.~..~/,...~. ~,,C'~',/,,~..d ,~'/,~/,/~,~ Owner Or Ow e s u ' ................................................................... -r-.......... ................ Subdivision ................................. ; .............................. Lot No....-~. ....... Block No ............. House No../.....~....../~~ Permit No ....... ~ ......... Date Of Permit ..... .~. ............ Applicant .................................................................. Health Dept. Approval ......... ~.~.Z.....~..~..~.~.d.~...'a~.Labo, Dept. Approval .......................................... Underwriters Approval ..~d...~.'.![d..~..~.Planning Bo~rd Approval ~.~......~..?.~...~../...d-..~...~ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ ..~.......Z..~....°... ................. Construction on above described building and p~al~fi~and regulations. Apphcant ~:':~ ~....~.~..: ..... / Sworn to before me this ................ day of ............................................ Notary Public .................................... County (sta~np or ~eal)