HomeMy WebLinkAboutZ-6366FORK NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Qerk's Office
$outhold, N. Y.
Certificate Of Occupancy
No. Date ............15, .;rqh ..1.7....... 19.75.
THIS CERTIFIES that the building located at HuokeI beim.- -Hill. -Rd . q tr #6)
Map No. max......... Block No. ......Lot No. xac mast •. asyo�i..:;........ .
conforms substantially to th eode
c'a e tbe 'ore ey
I AI:4- 2 19..57 pursuant to which �� GccupP.4Z 6366 - - -
dated ......... VI. xQh .....17. , 19.75., 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 . J.'r1vate. oAq . ................... ............... .
The certificate is issued to . F..H.4a j • Lobar ..... 0;mer .. �. r4P e $ .
( owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of. Health Approval pre+•. asisting....................
UNDERWRITERS CERTIFICATE No....lare.,..existing............... ........ .
HOUSE NUMBER .. W5........ Street ..liue"IbarFy mill• Ropd• • •( • P*t •1A• -# 6)
Building r
TEL. 765-2660
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TOWN ❑F SOUTHOLD
OFFICE ❑F BUILDING INSPECTOR
Ol �TOWN CLERK'S OFFICE
SOUTHOLD, N. Y. 11971
Housing Code Inspection
March 17, 1975
405 Huckleberry Hill Rd. (Pvt. Rd.#9) R-1
East Marion, N.Y.
Tax Roll - Frances H. Lebar
unoccupied, seasonal
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 keys from the Ernest Radford Real Estate
Office, Main Road, East Marion, and began inspection at approx-
imately 10:30 A.M.
The building consists of four bedrooms, a full bathroom, kitchen,
utility room, dining room, living room, and has a one car garage
attached to north end of building by a breezeway - The habitable
section of the building foundation is cement block piers.
The following violations of the Housing Code, Chapter 52,
Town of Southold were found: -
Lamp Cord outlets on baseboard in the N/E bedroom, east
and west bedrooms off hallway, and living room - Art.V,
Section 52-56 A-1
Fire Lace - flooring in living room at each side,base of
Tref place, and floor joist supported at base of fireplace
are deteriorating from a moisture condition. Art. III ,
Section 52-30 C
Foundation , open, no screening - Art. VI -Sec. 52-63 B
Roof south side, shingles deteriorating. Art. III, Sec.
52-31 C.
Inspection completed at :approximately 11:00 A.M.and were
-returned to E. Radford at his officer
Respectfully su tte
Ed Hindermann �t�a�`
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 ....... 3auma..... 1 ........ 3.9!z �....
New Building ................ Addition ................ Old or Pre-existing Building ...X=... Vacant Land ..............
Location Of Property ... Sl.S... .V.t...ad... #6 ..... (Jiuokelburry...Hill...Road.) ... M..W S..Bay...Ave..
Owner Or Owners Of Property t r .......................................... Last ............. Yarion
Subdivision ....... 7 Y inx ...............................................Lot No.....xxT Block Nam= House No. AFM j....
ermit No. ..= ............. Date Of Permit .........}:XX...Applicant.... Pytir.G.....!5.+±x=1-3t....
Health Dept. Approval ..... G+®....§r N' .........Labor Dept. Approval ..... AiARia.................................
Underwriters Approval r .............Planning Board Approval ..iy,al . ............................
Request For Temporary Certificate ........................................ Final Certificate ...... XXXX.........................
r
Fee Submitted $ ..7.s W .........................
Construction on above described building and pe it meets all ap I cod and regulations.
xApplicant...................... +r 1 .........................................
Sworn to before me this
................ day of ...... Larch ....... 9975........ (stamp or seaWIX/34%
Notary Public ........... i7.liff.Alk........ County � j�`j'�
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