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Home My WebLink AboutZ-6912FORK NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.. Z6912..... Date .................Rar .... 3 ., 19.76 THIS CERTIFIES that the building located at .. Bust. Road ............... Street Map No. ..ZXXZ .... Block No. ...zx=..Lot No... t ate!} ague...p.'y,............. conffo�orms substantially to therAMAir code Jed.... bafore..Apr. 23.., 19..57 pursuant to which ® � if tie occupancy J z6912�a dated ........... Mar ..... 1 ., 19..76 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. one. family Awelling. with . ff!c�C .ao,¢eeaoxy. garage ....... The certificate is issued to ...John .Lake .......Owner ............................ . (owner, lessee or tenant) of the aforesaid 'building. Suffolk County Department of Health Approval pX0-r. az1stJzg.................... UNDERWRITERS CERTIFICATE No. pre,.. existing ............................ HOUSE NUMBER ......950 .... Street ..:.. East. Road .... Cuteho$ue.......... A ............................................................................... ........... . Building Inspect r I'\ HOUSING CODE INSPECTION March 1, 1976 950 East Road R-1 Cutchogue N.Y. Tax Roll: John T. Lake Occupied, tenant Upon receiving a request from Gary F. Olsen, Main Road, Mattituck, New York for a Pre-existing Certificate of Occupancy, I made an inspection of this one and one half story framed dwelling. I was admitted to building by Mr. Lake who accompanied me during this inspection which began at 3:45 P.M. The first floor consists of a kitchen, living room, bed- room and an inside full bathroom. A screened in porch is located on the southeast section of building. Second floor has two bedrooms. Heat is furnished to all rooms from c -v( gas fired warm air furnace located in crawl space of building's cement block foundation. Accessory structure, one car garage, is located in front yard area on northwest corner of property. Electric water pump supplying domestic water to this dwelling is located in a cement block crawl space on southeast corner of garage. Access door was padlocked, key was not available, and inspection was not possible. The following violations of The Housing Code, Chapter 52, Town of Southold, were found: Bathroom - inside - no mechanical means of venting. Article II, Sec. 52-26 4.B. Accessory Building - Roof covering on west side missing. Bottom of siding on west side deteriorating. Article III, Section 52-31 B. -C. Inspection completed at approximately 4:05 P.M. C • Res��>��tfu� bmitted, EH.mm Edward Hin ermw ann Building Inspector FORM NO. 6 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 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. S. 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.... . �.� ......................... New Building ................. Additionn(............... Old or Pre-existing Building ..�/1�.v......... Vacant Land .............. Location Of Property .J'la1Y�.Y�..(SAL....� s71. f� ... .. !lt.t ..sit............................ Owner Or Owners Of Property y ......` ......................................... 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 Certificate ..................................... nal Certificate .................................... �. O Fee Submitted $ ..�.'��................... Construction on above described building and perm' eets licable es a regulations. Applicant....... .... ......... ...... ......`.. ....1�.s� Sworn //to before me t J•,.... day offi�� (stamp �' Z L .......................... ... ( mp or seal Notary Public .................................... County d?a-yXIO7 -ts4gi r4 "- J I e i - -ts4gi . M M"Am W 2 4�-, 0, - I I� it -t e.-F-�. �,c.� ;,,'ry-a,.� Ilig," loo, ------- Jz� _0 I