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HomeMy WebLinkAboutZ-5606FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPA.I;TMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. z.56o6...... Date ....... 0�.t . • .25 .......... 19-7.3 THIS CERTIFIES that the building located at • WVS . i"equa s iTe• Street Map No. .xx......... Block No. zx .......Lot No. Cutehorue .. .J::.'Y ,,.: .. . conforms substantially to tie f . l v ci a i �J n • ic�u� n c o4 ► t afore ril '23 57 C r 'tic i;e a ©ce"upane7 ....... .. , 19 . . pursuant to which Zb C6 dated ........0ct .... ...., 19.57., 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 ... Private..due..Jamily .dwa ling ............................... ... . The certificate is issued `to . -Harriet. T. Gageia.. • • • • ?wner ......................... . (owner, lessee or tenant) of the aforesaid buildipg.. Suffolk County Deparrtment of Health Approval .... pre- , exiWng .. . UNDERWRITERS CEATIFICATE No..pr — axisting• . • • .......... . HOUSE NUMBER . p...... Street .. Pequash .Ave ............................. F . • . . . . • . . . • • • • • . • . • • . • • • • . • • • . • . . . • • • . . . • • . . • • . . • • . . . • • • • . . • . • . . . . . t Building Inspector J FORM NO. 6 TOWN: OF SOUTHOLD 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 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: 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 .......October.. New Building ................ Addition ................ Old or Pre-existing Building ..... x........ Vacant Land Location Of Property.....south...westerly . . ... side . . .. of ...Pequash . . ... Avenue, ..... Cutchogue, . . ... N . . Y. ................................................................................................. Owner Or Owners Of Property RgXX P.t. ff, ..GA &en ................................................ Subdivision................................................................ Lot No............. Block No............. House No.j_a.0 PermitNo ..................... Date Of Permit ....................Applicant.................................................................. Health Dept. Approval ............................................Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ..... Fee Submitted $ -.0.0 Construction on above described buil Sworn to before me this 21$k 25th day of ......October ..................... Notary Public ...... 5Mf, fOlk............. County Final Certificate.............. (stamp or seal) / v �S�l XRED W. WON, 1R. fib Ilbto Public, State of New Y04P Residing in Suffolk County No. 52-7135315 I;omm+�sion F-ir•, "A,rh HOUSING CODE INSPECTION October 25, 1973 520 Pequash Ave. -R-1 Cutchogue, N.Y. Tax Roll: Harriet T. Gagen Occupied: Tenant 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: gas range, no shut off valve at unit -- Section 508b. I was admitted to south entry by Mr. and Mrs. Gagen and began my inspection at approximately 12:50 p.m. The building consists of living room, dining room, kitchen, and one bedroom and one full bathroom. There is a full cellar with one access from exterior. The building is heated with a forced warm air system which supplies heat to each room. A screened in porch runs full length of south end of building. A one car garage is located on south west corner of property. Buildings and grounds are in good order. Inspection was completed at approximately 1:15 p.m. ;ar;iVn4�1&n ectfully submittedt Building Inspector AV II / II r r illillilillillil� 110 - I'� I II L a_ WL-- i �- rAMM.P7074M- i