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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. Z.SQ43...... Date ............Feb 19.93.
THIS CERTIFIES that the building located at . PO,r . TerTaoe. ~reet
Map No...7(x........ Block No.. Lot No... ]t~oC Orieat" 'II:Y: " " " " ' .
conforms substantially to the i1t 1Br1~ code
wilt before . 19.. T~~p y
Apr ~ 23 , ~ pursuant to .which Cu .anc
3
dated .....F. eb... • 14....... , 19 . , 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 • •privste • one • Yaaily ~w11~ .
The certificate is issued to Thi14 C•• • • • •
~ . p~ y.....Owaer
~ (owner, lessee or tenant)
of the aforesaid building. ~
i
Suffolk County Department of btealth Aliproval . p~ . esisting • • • • • • • • • • • -
UNDERWRITERS CERTIFICATE No...pX.«,. ,~at~
HOUSE NUMBER...t~.......Street.W111-at?•Terraoe•f,a•-••••••••••••~-~•-•••••-•••
DfOTEt t1Y~le was and addition 12/~~~2Z~ C/0 Z485
Tttsr4 le as ad itioat in pr~oess ~ b321Z ~ ~ c~., - • • • • .
dated 1.2/29/q~e
Building Inspector
r
~a
HOUSING CODE INSPECTION
February 13, 1973
#190 Willow Terrace Lane
Orient, N.Y.
Tax Roll: Philip C. Frey
Unoccupied - summer residence
Upon request of the Southold Town Building
Department I made inspection of this one family
framed dwelling and found the following violation
of Local Law #1, Housing Code, Town of Southold.
Kitchen: Outlet for refrigerator wired with
lamp cord and plugged into living room outlet
Section 528a.
The building is sheathed with novelty siding
and is not insulated. There are two bedrooms,
living room, kitchen and bathroom. A floor type
gas heater is in living room and is accessible
in crawl space of building foundation. Electric
hot water heater is located in crawl space.
I was admitted to dwelling by Mr. Philip A.
Frey, father of the owner beginning inspection at
approximately 2:20 p.m. and completing at approximately
2:40 p.m.
The building is presently being added to under
building permit #63212, dated December 29, 1972,
issued to Tony Norklun.
Resp tfully sub tted, ,
vim----
ward Hind rmann
Building Inspector
EH:tle
F08,M NO. 6
TOWN OF SOUTHOLD
Building Department
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 triplicate 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 noturol or topographic features.
2. Final approval of Health Dept. of water supply and sewerage dispcsal-(S-9 form or equop.
3. Approval of electrical installation from Boo rd 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 pion 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 noturol
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:
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 ...Jaxius~,xY...~.6.....?.~7.3.......
New Building Old or Pre-existing Building ....X..................... Vacant Lond
Location Of Property W/S„Pearl,_Street~„Orient,,,.Town of Southold
.
Owner Or Owners Of Property ......P.hi.lip...C.,...E>"ey...3x1d...Jpdn.,...ux
Subdivision ................................................................Lot No............. Black No............. House No.............
Permit No Date Of Permit ....................Applicant
Health Dept. Approval ............................................Labor Dept. Approval
Underwriters Approval ..............................................Planning Board Approval
Request For Temporary Certificate Final Certificate .X......................................
Fee Submitted $ 5 -
Construction on above described building and permit meets all applicable codes and regulations.
Applicant ......Philik?..C:...FreX.c...b~r
Sworn to before me this Rudolph H ue Att rney
11 ~ ~~~,.~,Ry
...A.J. day of ...y.:...1973......... p or sea
Notary Public ........Suffolk....,. , „ County ?~,c6 13 ~ f )3
TERRI LEE ELAK OCR-'~"" ~L /
NOTARY PUurIC, State cl :!r.~ nrM
N... ~i682S~
pualn~a Lccnty i
~OlOmission &pires March 30, 19