HomeMy WebLinkAboutZ-7000 trosat xo. s
TOWN OF SOUTHOLD
BUII.DING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No.~7.049....... Date May.. 3 1976..
THIS CERTIFIES that the building located at . gungayoq. Lane........... Street
Map No.. xx Block No..xX.......Lot No. ncxx • • I~ttituck...11.Y......... .
conforms substantially to the ~re~~i°~~~~~~~u~ igcode
certificate of occupancy
bfl~~ ~be~Eore~ ~Npr11. ~23..., 19.57. pursuant to which 1$i~~No.Z7000.. .
dated ...........~ay...3....., 1976.., 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 Fsiva.ta.one..fauLi,].y. S3.w.e1]~I~g
The certificate is issued to ..Y,'ilbur. Eberhard.....-owner .oP..reCPF.d............
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval F're- , existing .
UNDERWRITERS CERTIFICATE No. . xz.e~ .exm.sting......... • .
HOUSE NUMBER ...57.5....... Street ...&ungalow. bane .
Building Inspector
HOUSING CODE INSPECTION
April 30, 1976
575 Bungalow Lane R-1
Mattituck, N. Y.
Tax Roll: Wilbur Eberhard
Occupied: Estelle Olsen
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 the building
by Mrs. Olsen who accompanied me during this inspection
which began at approximately 1:50 P.M.
The building consists of a living room, dining room,
kitchen, laundry room, den, full bathroom and two bedrooms.
Heat is furnished to all rooms from an oil fired hot water
furnace located in full cellar. Inside access to cellar is
provided in the attached two car garage portion of the building.
The following violation of the Housing Code, Chapter
52, Town of Southold, was found:
Front entrance - no means of controlling light
in room on entry. Article V,
Section 52-56 B.2.
inspection completed at approx' ately 2:00 P.M.
Res tfully s mitted,
SG'~~-
EH:mm E ward Hindermann
Building Inspector
FORM NO. 6
TOWN OF SOUTHOLD
Building Department J"
Town Clerks Offiee
Southold, N. Y. 11971 C~ `b
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 I«ation of all buildings, property lines, streets, and
unusual natural or topographic features.
2. Final approval of Health Dept. of water supply and sewerage disposal-(5-9 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 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, «cupancy and condition of buildings.
3. Dote 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 «cupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use $5.00
3. Copy of certifica}e of «cupancy $1.00
Date
New Building dition ...............~~O,"l\~d``or Pre,-,existing Building .~.;1..1.,... Valllcant Land
L«ation Of Property ~Uxv...~NY~........... ...~~.'~1~
Owner Or Owners Of Property ........!a
Subdivision of No BI«k No............. House No..?~5.,. ~z-!
Permit No.....:_.-:......... Date Of Permit ......Applicant
Health De t. A royal
P PP ............................................Labor Dept. Approval
Underwriters Approval ........................................Planning Board Approval
Request For Temporary~ertificate Final C rtificote
Fee Submitted $
Construction on above described building and pe m applicable nd regulations.
Applicant
Sworn to before met ~ ~
day of « (stamp o eop
Notary Public County