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Home My WebLink AboutZ-7094FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 27094...... Date ..J1VA4.72.................... 1976.. THIS CERTIFIES that the building located at $/. :P. Gt, . JBeG4A;L.c .$ay..$V4.• Street Edgemere Laurel Map No.... Park Block No........... Lot No, .19 .............................. .............. requirements for one family dwelling conforms substantially to th RAM — I K built before Certificate of Occupancy dated ......... April. 2 3.... , 1951. pursuant to which M410WINAWA No. Z7059.4.. dated ......... J�" .. 4r...., 197§., 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 . priyatq. one. family. dwellinng ..................................... .............................. The certificate is issued to . Penolope . L404eP ....... ............................ ( owner, lf�E3f�1Cii�CE6tiHi�7C) of the aforesaid building. Suffolk County Department of Health Approval ..... N/R .......................... UNDERWRITERS CERTIFICATE No . ............N/R 2260 Great Peconic Bay Blvd. ... HOUSE NUMBER .60........... Street pdt: ' ltoad' #'Z ' ' ' ' Laurel, N. Y. 4 Building Inspector HOUSING CODE INSPECTION June 21, 1976 2260 Great Peconic Bay Blvd. and 60 Pvt. Rd. #2 R-1 Laurel, N. Y. Subdivision - Edgemere Park, Lot 19 Tax Roll - Penelope Leather Occupied - owner Upon receipt of an application for a Pre -Existing Certificate of Occupancy, I made an inspection of this one story framed dwelling,. I picked up John L. Moore of the Silkworth Agency who accompanied me during this inspection which began at approximately 1:50 P.M. The building consists of a kitchen, living room, four bedrooms and one and a half bathrooms. Heat is furnished to building from gas fired heaters located on exterior walls of kitchen, living room, and southeast bedroom. Building is con- structed on cement block foundation with crawl space. The following violations of the Housing Code, Chapter 52, Town of Southold, were found: Utility Room on northeast corner of the building, electric open junction box on south wall - water pump electric motor, pigtail two wire to wall outlet, no ground wire. Article V, Sec. 52-56, A.l. Other structures on premises consist of an accessory storage shed, picket and chain link fence. Building and open yard area are in good condition. Re ecWHMdoermann submitted, and EH:mm 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. 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 Date ......d 1. IY7Z New Building ................ Add—itioonn ................ Old or Pre-existing Building ... 1.�......... Vacant Land .............. Location Of Property 7"Y1 ,.. �........ s� .�V�' .......... -4..... ...../.. ..... .r.. ,..o.1r��.�.�..,,��........... Owner Or Owners Of Property ........ .Gi. . f�.e4�r........ /",E.i4� ��[ / .,r ......................... Subdivision .Q��I' %� ... ;,T.........Lot No. ./.�,�..... Block No ............. House No.1.Q?A0 �0 7i Permit No..................... Date Of Permit --.-:.... Applicant ............. Health Dept. Approval ��..... ........!v (..�..r...................Labor Dept. Approval ........1. 1..................................... ,... Underwriters Approval ..........�✓.................Planning Board Approval ��jj.................... ... Al..�-,................... Request For Temporary Certificate ........................................ Final Certificate �............................... Fee Submitted $................... Construction on above described building and ermit meets all a plicable codes and regulations. App... .................. ................. Sworn to before me this At (I ................ day of ............................................ UUU (stamp or seal) Notary Public .................................... County // __-:- -_-.-- _-._.__ I 11