HomeMy WebLinkAboutZ-7706 FOEM NO. 4
TOWN OF SOUTHOLD
BUII,DING DEPARTMENT
Town Clerk'e Office
Southold, N. Y.
Certificate Of Occupancy
No. ?r?70.ri Date ..............duae..? , 19'l.'I. .
THIS CERTIFIES that the building located at ~ .pr~,p Street
Map No popes. Ba7.E8ock No...........Lot No..1~8$~1•Ql ~ ~8o1~Lhold• • • •g.7G.
cnnonfottrms substantially to the Q .Teaente for ,one faa a rel f ~ Hou 1n Code
bdated ...before .Apr .23.... , 19.57. pursuant to which~~'~ ' No oO~~oy
Z7')OG . .
dated Jy~...7 , 19 7.7 . , 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 . P7C19~4e . Gt4e.. ri~~1Y. dWe3.lin& .
The certificate is issued to ..Frank .Foad~ Ovner. oS reoOrd .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval pre-azietin~
UNDERWRITERS CERTIFICATE No. pre...ezietind • • ~ ~ ~ ~ • • • • • • • •
HOUSE NUMBER ...360 Street ....Oak .Drltte .....8outhold .
~
Building Inspecto
~r*.,'.A
HOUSING CODE INSPECTION
June 6, 1977
360 Oak Drive R-1
Southold, N.Y.
Sub. Div.: Goose Bay Estates #1176, Lots 188-191 inclusive
Tax Roll: Frank H. Fonda
Occupied: Owner
Upon receipt of an application for a Pre-Existing Certificate
of Occupancy, I made an inspection of this one-story wood framed
structure. I was admitted to dwelling by Mr. Fonda and began this
inspection at approximately 3:15 P.M.
The building consists of a living and-*dining room combined,
kitchen, two bedrooms, one full bathroom, a half bathroom with
laundry washer and dryer, and an attached one-car garage. Heat
is furnished to all rooms from an oil-fired hot water furnace
located in cellar of building's cement block and poured concrete
foundation. Cellar is partially full with crawl space.
The following violations of the Housing Code, Chapter 52,
Town of Southold, New York, were found:
Gas cooking ran e & oven - built-in units, no shut off
valves at uni s, Artic a V, Section 52-52 B 2.
Laundr washin machine - no water seal on waste line,
Artic a V, Section - 1 C 5.
Inspection completed_at appro 'mately 3:35 P.M.
Res c fully ubmitted,
Edward Hindermann
Building Inspector
EH:med
FOEM N0. 8
TOWN OF SOUTNOLD
Building Deportment
Town Clerks OfHee
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 equoU.
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 camplionce 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 promises, 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 $5.00
3. Copy of certificate of occupancy $1.00
Date ..........'~.:.~r~..~~I.7.7......
New Building A~dd~itQion ...~...`.......COId or~Pre-(ex(is~ting Building Vacant Lond
Location Of Property ..1../.C9.XZ....•Rd~>•........7.1~~1n~?r:~,k~C(,K:..~~:.~
Owner Or Owne Of Property .~.~.~1Y..t!~'.
Subdivision .3..~L4:•.~,.1.7i~!/.Lot No. /~'.`.l.!. Block No...-...... House No..3Qa
Permit No Da~trre--~~Of Permit ....................Applicant
Health Dept. Approval ....1..)...~ . labor Dept. Approval ,
Underwriters Approval ...........................Planning Board Approval
Request For Temporary Certificate Final Certificate
O~O
Fee Submitted $ ~
Construction on above described building~d
peromit meetps all appli able, _codes and regulations.
Applicant :~-~.~1..2~:?.:lt~Yt~.~...(.tX,dNY.`
~6 77
Sworn to before me thi ''77 ~ 7,7 0 ~
.............T day of ..A..f... 1.l...... (stomp or seal)
Notary Public County