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Home My WebLink AboutZ-7469FOB~M NO. · TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..~ .~..~. ..... Date ............. .~.a~...~ ...... , 19. THIS CERTIFIES that the building located at ...~, ~k'al~ · La~ ............. Street Map No.. ~ ........ Block No .... ~ .... Lot No. ~.. ~ho~. · .N, ~ ......... ~ t . · e~e conforms substantially to d~ed ........... ~...~ .... , ~g. '/~., ~s issued, ~d co~o~ms ~o ~11 o~ the ments of the applicable pro~sio~ of the law. The occup~cy for which this ce~ificate issued is .. P~vate .one..~y. ~well~g ...................................... The certificate is issued to .~tK .G,. ~ge ........ ~ner ........................... (owner, lessee or ten~t) of the Moresaid building. S~olk County Dep~tment of Health Approv~ ...px'~ .e~ztl~ ................. UNDERWRITERS CERTIFICATE No..pro-. ~xX~g ............................ HOUSE NUMBER ..... ~ 9~ .... Street .... ~kunk..La~e. .... ~tcho~e .......... . ............. Bffil~ing I~e~or HOUSING CODE INSPECTION January 14, 1977 1975 Skunk Lane R-1 Cutchogue, N.Y. Tax Roil: Ruth G. Lange Unoccupied Upon receipt of an application for a Pre-existing Certificate of Occupancy, I made an inspection of this one-story, wood framed dwelling. I admitted myself through the rear door entry with key I had picked up from Four Sails Realty in Cutchogue and began this inspection at approximately 1:00 P.M. The building consists of a kitchen, an L-shaped room (com- bination living and dining room), a laundry room which provides stairway access to the attic, three bedrooms, and a bathroom. Heat is supplied to all rooms from an. oil-fired, warm air furnace located in the full cellar of building's cement block foundation. I found no violations of the Housing Code, Chapter 52, Town of Southold, New York. Inspection was completed at approximately 1:25 P.M. and the key was returned to the Four Sails Realty office. R~pect fully ,~bmitted, Building Inspector EH:med TOWN OF $OUTNOLD o Bnilding Department Town Clerks Office 5outhold, 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: i. 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, ~Aultiple 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 $1.00 New B~ilding ................ Addition ................ Old or Pre-existing Building ...~ .......... Vacant Land .............. N.Y. Location Of Property -~-a~erly...~i~e .~f..R~y...~%U~.., .~ut~_h~g~e~...S~u~hold...To~,...$.uff. Co Owner Or Owne~ Of Prope~y ...... Rutk..C~....T,a~g~ ................................................................................. 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 ........................................ Fined Certificate .......................................... Fee ~ubmitted $ ......~.~.^.Q.Q .................. m/./~/~~~/~i~t Construction on above described building and per ulations. Applicant ................ .............. : ................ Sworn to before me this ~//~/7~ // ,.'~. _.¥' / - l~th da-of Janua.~, ~ ~, 7 7, .. ~.,~ .............. y ..................................... tsromp or seol;-..-{ / Noto Pub,,c ........... ........ County BA~BAF~A DIACNUN lxlc~ 524~35190 Suffolk County Ce~,,rnis~ion [xl.~ire$ March 30, N MAP OF LAND CAP-.L T ~ 17. UTH. G. LAN PECO~410 TOV/N 0F ~0UT~OLD Title Ne S-51%9~ ~urve~ VAN TUYL~ ~N Gr~e~po,- ? .' N~ Yor~ ". : '.- '~ ·