HomeMy WebLinkAboutZ-6373 FORM NO. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. Z6373 . . . . . . Date . . . . . . . . . . . . .Xarch. . 21. . . . .. 19.75•
THIS CERTIFIES that the building located at R.()..W 9•NIS •Laland• Mex• Wat
amg�y�e�nded Peconic b Rstates
Map No. . . . . . . . . . . . . BIock 1Po. . . . . . . . . . .Lot No. .X7:X. . , .0raenport . . N.Y.. . . . . . .
conforms substantially to the e
A91t before .ApT. .23. . ., 1957. . pursuant to which I li . 2cMi cY
dated . . . . . . . . . .March. . . . .21, 19. 25, 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 FfitYate. .Ome. .fa1]X.dr!QllilaB. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to .Hubbard .1land.rickson. . . . QVner . . . . . . . . . . . . . . . . . . . . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . . P.rer. existing. . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE No. pre- .existing . . . . . . . . . . . . . . . . . . . . . . . . . . . .
HOUSE NUMBER . . . .4BO. . . . . . Street l.aland .Viax .Lana . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . .
Buildin`�r
TEL, '765-~- 66n
TOWN OF -C:JOUTHOLD
OFFIOE OF BUILDING INSPECTOR
TOWN OLERK'S OFFII3E
SOUTHOLD, N. Y. 11971
Tax Roll:
unoccupied
HOUSING CODE INSPECTION
March 21, 1975
#480 R.O.W. N/S Island View Lane R-1
Greenport, N.Y.
Hubbard Hendrickson
Upon receipt of an application for a pre-existing Certificate
of Occupancy, I made an inspection of this one story framed
dwelling. I was admitted to the building by Mr. Hendrickson
who accompanied me during this inspection which began at
approximately 10:45 A.M.
The building consists of a living room, kitchen, full bathroom,
and two bedrooms. A gas fired floor frunace is centrally located
in building, so that heat generated by furnace is supplied to all
rooms. The building foundation is cement block with crawl space.
An enclosed porch is on the south side of building. City water
is furnished to building and hot water is supplied from an
electric hotwater heater located in lean-to on the east side of
building. A one car garage is located in the rear yard.
Buildings and grounds are in good order.
I found no violations of the Housing Code, Chapter 52, Town of
Southold, N.Y.
Inspection was completed at approximately 11:10 A.M.
~~pectfully~ s~m, itted,
Building Inspector
ED/bn
cc: f
FORM NO. $
TOWN OF $OUTHOLD
, 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 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:
]. 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: ]. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or lend use $5.00
3, Copy of certificate of occupancy $].00
Date ..~....~..~......~ t./...~....~...5...~...
New Building ................ Addition ................ Old or ~re-existing Bui~ing .... ~... Vacant Land .............
Location Of Prooertv ..~..: O C,J , ~'l/'/(~- ,~ ~ ~,, {) b/~ , F ' - ', ....................... ~...~.~...¢ ...........
Owner Or Owners Of Propert /~ o~...~. '
.......................... [ ............................ ,~u .............~ocK Ho ............. House No ~..~...W
Permit No ..... ...~. ........... Date Of Perm t ~x, ~ I cant ~/' V
_ · ................... ~PP ' ....../-~.. ............ ~. . .
P/'L.~...~.~.~.~ Lobar De t A ' /~ '1~ "i .................
Health Dept. Approval ............................ ...~... p. pprova~ ....................................
Underwriters Approval .............................................. Planning Board Approval
Request For Temporary Certificate ........................................ Fin(zl Certificate .......... ~. ..........................
Fee Submitted $ ~' ~
Construction on above described building an~rmit_meets all,,~l~icable ,codes and regulations.
.......................... ,
Sworn to before me this
........ ~../ day of ...... ~;.~..~r~...%~....~..~...~. ,~'-~' (stamp or seal)~;;~ ~ 7J
Notary Public ........... ~'~/~--County