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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No.z'I36'1....... Date .............llo~!?.. 1Q......, 197.6..
THIS CERTIFIES that the building located at $/.8.Old .ltosth .Bald Street
Map No... ZZ Beck No...~...... Lot No.. a[ 6o1tt11ald l[.Y.... • • • • • .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ~.6..., 19 60. pursuant to which Building Permit No. ~!'jZ.. .
dated ~r...16..., 19.60., 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?'l~ats, fly..gtp3~,~1td.1t3td1.atAasso~.bulldind.l. tascln`
The certificate is issued to . 8!tty ,L.. l~lt~pat~lflk v1rAS1' .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval ~=M. ex.1~t~,At .
UNDERWRITERS CERTIFICATE No. P.~M.•X1ttlTls
HOUSE NUMBER Street 0~ .~Ol~.t~ . t1~ .....$0'aX,1Wld....... .
....f~ ~ .
Building Inspect
HOUSING CODE INSPECTION
November 8, 1976
4600 Old North Country Road R-1
Southold, N.Y.
Tax Roll: Betty L. Fitzpatrick
Occupied: Owner
Upon receipt of an application for an updated Certificate
of Occupancy, I made an inspection of this one-story, framed
dwelling which was constructed under Building Permit #9972,
dated March 16, 1960, to which subsequent Certificate of Oc-
cupancy #2705 was issued to Robert and Judith Williams on
July 14, 1960. I picked up the key from Edward J. Boyd V,
Attorney, in Southold, admitted myself to the dwelling, and
began this inspection at approximately 12:50 P.M.
The building consists of a kitchen with a dining area, a
living room with a heatilator fireplace, a full bathroom, and
three bedrooms. Heat is furnished to all rooms from an oil-
fired, hot water heater located in cellar of building's cement
block foundation.
The following violations of the Housing Code, Chapter 52,
Town of Southold, New York, were found:
Kitchen - entry at rear of building to dining area, no
means of controlling light on entering, Article V,
Section 52-56 B (2).
Cellar - open electrical box on the first floor joist
orated over the furnace, Article V, Section 52-56 A (1).
Open yard area contains the following structures: a
paddock-type fence along the front yard property line, and a
greenhouse located in the rear yard area.
Buildings and grounds in good condition. Inspection com-
pleted at approximately 1:10 P.M. Key was returned to Mr. Boyd's
office.
Re ctfull supmitted,
ward i dermann
Building Inspector
EH:med
FOB.M N0. 8
TOWN OF SOUTNOLD
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, 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 equoq.
3. Approval of electrical installation from Board of Fire Underwriters.
b. 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-
forrnotion required to prepare a certificate.
C. Fees:
1. 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 1 h'
Dateyy......~.Igl.!~1
New Building Addition Old or Pre-existing Building ....L1........ Vacant Lord
Location Of Property ~,1~ ~Ot~t,
V' ......J~~.'s.'.r.~1.....~-
Owner Or Owners Of Property ~Q ~ ~ ~~Pr~~~`
Subdivision x'
..................................................Lot No.....}~..... Block No... K....... House No.............
Permit No...........~.... Datet~Of Permit ...x .............Applicant
Health Dept. Approval ......!..~.'."....Fr..~,.n,/..~.:.:~.......Lobor Dept. Approval
Underwriters Approval ............~.L ...........:..............Planning Board Approval ..........~.:..R"...............
Request For Temporary Certificate Final Certificate
fJ'J
Fee Submitted $ ~
Construction on above described building an mit is all oppl' able codes and regulations.
Applicant ..........:^:J
Sworn to before me this ~e`•'*Rfs`~""'~jroira-~i £`~t,
Q.. day of l..L.~.~...... (stamp or sea!) ? l~~~r~i
Notary Public County ~,p 1 r~ 76