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Home My WebLink AboutZ-5881FOI~M NO. S TOWN OF SOUTHOLD BUILDING DEPAI1TMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. z.~881 ...... Date ........... .May. . ..2 .........., 19. THIS CERTIFIES that the building located at . .14/,S. ?~cl~l~ .A.Ve ......... Street Map No...x~ ....... Block No .... .x~ .....Lot No. ~, .C~.~.~h.o .g~..., ~I.~Y.: .......... conforms substantially to there r me t f r o f 1 d ell & housin code h~~ occu ancy ted . .before. April 23. 19.~7. pursuant to whic o. dated ........ .l/laY... 2 ........ , 19. ?.be., 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..famll2. dw. elll~g ...................................... The certificate is issued to .J .. 14yroll ~ixOll .&. vile....ow~ners ..................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. p.r.e.~, e.x.~s..t.i.n.g .................. UNDERWRITERS CERTIFICATE No..pre.-..exiating ........................... HOUSE NUMBER ...~-.67.0. ...... Street .... P.e.q.u~..s..h..A.v.~. ......................... Building Inspector FOI~M NO. 6 TOWN OF SOUTHOLD Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, end submitted in DUPLICATE to the Building Inspector with the following; for new buiIdings or new use: i. 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 ]957), Non-conforming uses, or buildings and "pre-existing" land uses: ]. 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: ]. 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 ........ A. P..~..i...]:....~. ~.......! .~ .~. ~ ...... New Building ................ Addition ................ Old or Pre-existing Building .~ ..... Vacant Land .............. Location Of Property W./.S Pe~.u. ash Ave Cutchogue N.Y. Owner Or Owners Of Property ..(.?..a...~....r...o..~...]=~.......~..~..s.......~.~r.~g~...D.~.~...o..~...~. :~.~..e. ....................... Subdivision xx ....... Lot No. :Y~ Block No. ~ House No LF6~.0 Permit No ..... ~ ........... Date Of Permit~ ............. Applicant Health Dept. Approval .... p.~e...-..e...~.~..s.~.J,...~.~ ....... Labor Dept. Approval .......... ~.:..fi..: ............................ ~re-existln§ ~. · N.R. Underwriters Approval .¢. ........................................... I~annmg Board Approval ........................................ Request For Temporary Certificate .............................. ~ertificate ......~... Appl leant ._ ..~....~....~/ ............... .~..~ ~ ,~.~ ..................................... ......................................................... (stamp or Notary Public .................................... County HOUSING CODE INSPECTION April 30, 1974 4670 Pequash Avenue R-1 Cutchogue, N. Y. Tax Roil: James Myron Dixon & Wf Occupied: Mrs. Dixon Upon request of the Southold Town Building Department I made inspection of this one story framed dwelling and found the following violation~ of Chapter 52, Housing Code, Town of Southold. I was admitted to building by Mrs. Dixon who accompanied me during inspection which began at approximately 10:00 A.M. The building consists of two bedrooms, living room, kitchen, and full bathroom. Heat is furnished from a gas fired floor furnace centrally located. Cellar is approxi- mately 50 per cent full with balance being crawl space. A car port is attached to rear of building. Kitchen: Gas range, no shutoff valve at unit, Art. V, Sec. 52-52, B-2. Grounds and exterior of building well maintained. Inspection completed at approximately 10:30 A.M. EH:mm R~ectfu~,su~.itted, Building Inspector