HomeMy WebLinkAboutZ-7885TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No..'&~/8~,~' ..... Date, ............ ~ept..1.~ ....... , 197.2..
THIS CERTIFIES that the building located at . .Sigahy. flaad ............. Strut
Map NoMa~.t,. P~,. P~pck No ........... Lot No. ~ .66~7 ...... ~a~~.. ~...Y,
,, rec~re~e~s~n, one ~ami~ dwe~ ]i~g ~. h.q~si~ code
confor~ substantially to me ' ~ ~~
b~ be. fO~'~..Ap:..23 19. ~. p~suant to whic~~~:cu~an~y
...... , . z7~8.~ · ·
dated ............. ~Pt-..~, 1977.., was ~sued, ~d co~o~ ~ ~11 of ~e ~
men~ of ~e applicable pro~io~ of ~e law. ~e occup~cy for wM~ ~s ce~iflcate ~
issued ~ . ~.r~va~. ~n~ -f~y- d~9l~n~. · .~Zth .acc~ssor.~ · st~aSe..bids · · ·
~e certificate is issued to . ~ .~,. Hall ..... o~er..o.f..~ec~md ...................
(o~er, le~ or ~n~t )
of ~e afores~d b~lding.
S~o~ Co~ty Dep~tment of He~ Approval P~ .~.~ ....................
UNDERWRITERS CERT~ICATE No.. p~e~ext~tin& ............................
HOUSE NUMBER .... .~90~ ..... Strut...S~gsh~. 2g.~d ..... ~is~L~.t~Ck
........... .........
HOUSING CODE INSPECTION
September 13, 1977
#1905 Sigsbee Road R-1
Mattituck, N.Y.
Sub Div.:
Tax Roil:
Mattituck Park Properties
Map #801, Lots .5 of 66 - 67.
Ann R. Hall
Upon request of Gary F. Olsen, Attorney, Mattituck, New
York, I made an inspection of buildings at this location. I
was admitted to dwelling by Mrs. Hall and began this inspection
at approximately 1:35 P.M.
The dwelling is a wood framed structure constructed on a
cement block foundation and contains a kitchen, bathroom, two
bedrooms and a living room. All rooms are heated with electric
baseboard heating units. Domestic hot water is furnished by an
electric hot water heater located in full cellar. A wood framed
accessory storage building is located in rear yard area.
I found no violations of the Housing Code, Chapter 52,
Code of the Town of Southold, New York.
Inspection completed at approximately 1:45 P.M.
Re~ c ~t~f~, 1~ ub~it t ed,
.-~w~ard~.~l/~er~a~n~ Building Inspector
EH:med
FORM NO. 6
TOWN OF $OUTHOLD
, Building Deportment
Town Clerks Office
Southold, N. Y. 11971
APPLIGATION FOR CERTIFICATE OF OCGUPANCY
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 "pm-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
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 //
n~Date/~ ......... .~...~..~. · .~.....~...~ .................
New Building ................ Addition ................ Old or,l~re-existing~Buildi g ..... ~...~ ....Vacant La d ..............
Owner Or Owners Of Property .......... ...... ~ .........................................................................
Subdivision ................................................................ Lot No ............. Block No ............. House No .............
Permit No ..................... Date Of Permit .................... Applicant ..................................................................
Health Dept. Approval ............................................ Labor Dept. Approval ................................................
Underwriters Approval .............................................. Planning Board Approval ........................................
Request For Temporary Ce~rtificate .............................. ~ Fincd Certificate ..... ~. .............................
Fee Submitted $ ...... .~. :../..~. .............. / /,// //~
Construction on above described building and~er~ n~;~ opplicabl c~~ regulations.
Sworn ,o before me t~s~ ~ ~ ............ ~ .................. '~ ~~'~'~ ........
~ot~a~,~..~:bdl:cy of ...~....~....~.,i..~:~ (stamp~l~/~