HomeMy WebLinkAboutZ-9199FO~ NO. ·
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No..Z9199 ...... Date ........... Sep.tembe=. 8,..., 1978..
THIS CERTIFIES that the build~g located at 14.45. Ruth. Road ........... Street
Map No ...... 099 .... Block No .... XX ..... Lot No ..... 199 ..........................
· _ Reqg. irement for One-Family dwelling built prior
conforms substantially To the
to ,. , C~r~ific&te o~.Occupancy
~ .... April..23., ....... , 19.57. pursuant to wnlcn ~~~Ro. z9199. ·
dated .... Sept~iD~' '8 ..... , 19.78., was issued, and conforms tO all of the requJ~
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is . .PRI~ATK .O~E.-FI~. !LY .DWET.~.ZNG ......................................
The certificate is issued to ...Chr~stoa .Ka~tos ...................................
of the aforesaid building.
Suffolk County Department of Health Approval
(owner,~xq~x~R~W~x
.... PRE-.EXISTINC- .................
UNDERWRITERS CERTIFICATE No ............. .P..P~.r.E.X.!$TI~G .................
HOUSE NUMBER .. ~445 ....... Street ... R~th. P4~ad ,. Matt£tuck.,..New. Xork...
Building Inspector
Housing Code Inspection
September 8, 1978
1445 Ruth Road R - 1
Mattituck, New York
Tax Roll: Christos Ksntos
Upon receipt of an application for a Pre-Existing Certificate
of Occupancy I made an inspection of the dwelling on this premises.
I began this inspection at approximately 9:00 A,M. with Mr. Kantos.
Located on this property is a one story, wood frsmed dwelling.
There is slso a one car garage with a screened in porch.
Dwelling has a four coarse cement block crawl space, no floor.
Located in this crawl space is a gas fired central hot air heater
which provides heat for dwelling.
Dwelling consists of a dining room, kit6hen, living room, two
bedrooms and a full bathroom. On the outside of this dwelling the
roof, sidwalk, coiu~ice and gutters are all in good condition.
No violations of the Housing Code, Chapter 52, Code of the
Town of Southold, New York were found.
Inspection was completed by 9:45 A.M.
Respectfully submitted,
Curtis Horton
Building Inspector
FOB,~ 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 triplicate to the Building
Inspector with the following; for new buildings or new use:
1. Final survey of property with accurate location of oil 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 os 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 $I.00 ~ .~'/~
New Building .................... Old or Pre-existing Building ............................ Vacant Land ............................
Location Of Property ......... !....~....~.~.. ....... ...~...~...~-....~..~ ...... ....~...~..~.: ........ :~..~.~..~--.:.~.:.~..-~.~...~.~.~....
Owner Or Owners Of Property .... ..~..~.......~. ~..~-~.....~-~ ............. .~..~......~;.~-..~-~ ..................................
Subdivision ........... .,~...~.~..,?. ....................... '. ............... Lot No../....~..../~.... Block No ............. House No .............
..................... .........
Health Dept. Approval .... ~ ........... ...~ ....... .X. ...... Lobar Dept. Approval ........ ~ .........................
Underwriters Approval ......... ~ ......................... Planning Board Approval ..~ ........................
~ertificate ...... ~-. ..................
Request For Te ,r~.porary Certificate ........................................ Final
Fee Submitted $~[:.~....~....:...(~..~ ..........
Construction on above described building and p,e?~it meets all ap~lic~able codes and regulations.
Applicant ............. {..~...'~. ........ x ........... f"'~"! ........ ~' ........................................
Sworn to before me this ~~ ~X~,
................ day of ............................................ ~(stamp or seal)
Notary Public .................................... County ~,.//j_~"~ ~ ~ ~ c~ / ~ ?