HomeMy WebLinkAboutZ-6873 FOB~M NO. 4
TOWN OF SOUTHOLD
BUII.DING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. 7i687a Date Jaa„ .~0, , 1976
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THI5 CERTIFIES that the building located at t~t11[o1De2'1'~ .$1].1, .Ad..... Street
Map No. Block No...]c7[......Lot No....sR.. 1Ti~lit. Mus~~4... Rey... .
conforms substantially to the ~tQ1~1~'i1111~at/.,~'Ar o~M_ tari~.y.dYOlll3t.d<.,ltouainc ood~
~~it ~t oocnp.xto~
~betoTe• •~~r3.1.23• 19.5'J'. pursuant to which o• Z68'J3 .
dated ,T.aBwt~y.. 3Q, 19.7!6., 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 . Pa~,tnb• •oae• ,Lasilg . d~ralllaA. ~r1th. A.C.. ~ri~at®. wrap. ,tc . bs.~b laouso
The certificate is issued to ..1~O.t;to, o~.~,s~q~, Ei., .E¢xpard~. , , , ,Ormsl, , , , .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval .Pi'!'!!=1st121` . . .
UNDERWRITERS CERTIFICATE No..P~'~ .4A~At1nA . . . . . . . . . . . .
HOUSE NUMBER ...415....... Street ~Inltsk,R2DOT~. $9,~~.. Road .
1~
.
Building Inspector
HOUSING CODE INSPECTION
January 29, 1976
415 Huckleberry Hill Rd.
R-1 East Marion, N. Y.
Tax Roll: Leroy G. EdwardpEState
Unoccupied -seasonal
Upon receiving an application for a Pre-Existing Certificate
of Occupancy, I made an inspection of this two story framed
dwelling. Accompanied by Ernest G. Radford, realtor,
inspection began at approximately 3:05 P.M.
First floor consists of a kitchen, dining room, living room,
pantry, and bedroom with a full bathroom. Second floor
has three bedrooms and a full bathroom. Building has no
central heating system. Foundation is masonry, brick and
cement block, with crawl space and partial cellar.
Accessory structure in front yard area contains a one car
garage with a leanto, two section bath house.
The following,. Violations of The Housing Code, Chapter 52,
Town of Southold, were found:
Kitchen- Gas cooking range and gas hot water heater.
No shut-off valve at unit. Article V, Sec.
52-52 B.2.
Bathroom - second floor, no moisture resistant floor
covering. Article II, Section 52-26 A.4.
Bedroom - east, off hallway - loose and cracked plaster
on west wall. Article III, Section 52-32 C. '
Inspection completed at approximately 3:30 P.M.
Res ctfully submitted,
EH : mm
ward H n e
Building Inspector
FORM NO. 8
TOWN OF SOUTHOLD
Building Department
Town Clerks Offiee
Souehold, N. Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instruetions
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 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 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:
l . Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use $5.00
3. Copy of certificate of occupancy $1.00
Date January 29 196
New Building Addition Old or Pre-existing Building Vacant Land
Location Of Property ..P.z'.i.Nate...$QaIJ....~...I~uOILelhssrY•..~I1i.1...Rd...QF,3,..TlIA...Q1t1...Ox>rliax:d...La
East Marion
Owner Or Owners Of Property ..F'i.State...0.~..~eS.AY...FrdW,axd.S
Subdivision .................................................Lot No..... Block NO...~GXX... House No..`?'~~.`~~.
Permit No........ Date Of Permit .......x1;71;.......Applicant .......xHK;X~7iXaC7S~CXZC
Health Dept. Approval ..pTe-.,eXistin~•.,,,._•.•Labor Dept. Approval ........N,.R.
Underwriters Approval .......PX:e-...lrxC~S.t~.Ug........Planning Board Approval .....N.r.~~
Request For Temporary Certificate Final Certificate
Fee Submitted $ .....Jr..e.~Q
Construction on above described building permit me s a i abl codes and regulations.
Applicant ~.,.~.,~/J.~.~./~
Agent of o er ~//~apl'6
Sworn to before me this Po
...2.9.. day of .....Jatil7axy.....J.9.7.6........ (stamp or seoMY - v Ze~~7~
Notary Public .......S.LI~.~R~,kG............ County / ' i