HomeMy WebLinkAboutZ-4725FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. !Z! 721� ..... Date ............ Jtaiy .... 26 .... , 19.7.
THIS CERTIFIES that the building located at PIAOVOO...4. 0.04tk Cr*PS. 44treet
Map No.. me ........ Block No. ..XX ..... of No.. @ to. A 04. +Cil�tl3.Nggpi p •Y
requirements f+�r e��amm IWO11
conforms substantially to the
t beforeCate moan -Panay
April.23...., 19.57. pursuant to which Cer ' _ � Z472- �. .
dated ......... July..... M . , 19.7+x. , 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 . SUMN''A pCCU?ANCY one family. dwell3nR ............................
The certificate is issued to .R4ymond. & .Beatrice. Himting.ton..... QMerf ......
( owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval ZrP. XIP: 49 ....................
UNDERWRITERS CERTIFICATE No.. pry? .OXJ.A IZ8..................................
HOUSE NUMBER. o ..inn*fit fond ..... ...................................... a
......................................... .................... ..........
Exceptions to housing code= r a
No keating facilities .............
bedrooms not Imulated or Miffed Buildin Inspector
FORM NO. e
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 natural or topographic features.
2. Final approval of Health Dept. of water supply and sewerage dispcsal—(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
Dote ..... .?:4? ... J.v ��...!�i.?.2.....
New Building .................... Old or Pre-existing Building .......... .............. Vacant Land ............................
� 40 P1 K WOAD20At>(.`�. Location Of Property .. ..... ....:..........................
i
Owner Or Owners Of Property A�/�I bN b ..gl i 121C C L
.,;, AYNJ�.kTZ.,TO�J
....
.............
Subdivision .......................... .........................Lot No. ....... L Block No..... ... House No. .9.`—,_,A
Permit No.........i......... Date Of Permit .........!.`.........Applicant .............
Health Dept. Approval ...... `......``................... Labor Dept. Approval .......V.:� =
Underwriters Approval ........`J`... :::h..............Planning Board Approval ...../. :2-.......................
Request For Temporary Certificate ........................................ Final Certificate .......
Fee Submitted $-�f
....................................
Construction on above described building and a it meets al o (ic le codes an regulations.
Applicant.... ........ ........................ ......... ........... ,lJ............I.........................
Sworn to before me this (/
................ day of ............................................ (stamp or seal)
Notary Public .................................... County
HOUSING CODE INSPECTION
7/27/72
840 Pinewood Road
Cutchogue, New York
Tax Roll: Raymond Huntington and wife
Upon request of the Southold Town Building Department,
I made this inspection of this one story two bedroom dwelling
starting at 11:45 A.M.
The bedrooms have not been completed, walls are uncovered
and there is no trim on windows and doorways. There is a
partial basement with crawl space, floors have not been
completed.
The house is unheated, and can only be used for summer
occupancy in accordance with Section 513a Local Law #1 - 1967
Housing Code of the Town of Southold.
Inspection completed at 12:15 P.M.
Re ectfu=sumitted,
Edward Hindermann
Inspector
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