HomeMy WebLinkAboutZ-6953FORM NO.!
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. ;6953 ...... Date ............. Mar 31 1976
& AckerYj'Pond La
THIS CERTIFIES that the building located at . wfg. �*1u. 4944. 0T. ;W. Street
Map No.. % ....... Block No..... ? ... Lot No. ??[x... 9otxthold N.x.
...................
r r ants fordwellin or businessbuildin
SWULIRM
conforms substantially to the
built before A r 2 certificate of oc ency
dated .............. � ... A ., 19 7.. pursuant to whichl i114 1:1 iNo. 6951..
dated ... 44r�k .. 7...., 197b ., 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 . �- .Easiness ,buildia (form®r dvellinx).........................
The certificate is issued to Youn4em .nomas .Ina .i'?1Br.............. .
of the aforesaid building. ( owner, lessee or tenant)
Suffolk County Department of Health Approval P:F9-..44R. 419.. .
UNDERWRITERS CERTIFICATE No..Ffie...�tst�8 ...........................
HOUSE NUMBER .... 49295.... Street ........ Y44..E44LA ..................... .
............ .
Building Inspector
HOUSING CODE INSPECTION
March 31, 1976
49295 Main Road B-1
Southold, N.Y.
Tax Roll: Lawrence J. Liso Jr. & Ors.
Occupied: Jospeh Saland Real Estate
Founder's Homes Inc.
Upon receipt of an application for a Pre -Existing
Certificate of Occupancy, I made an inspection of this one
story framed dwelling. I was admitted to building by
Larry Liso who accompanied me during this inspection which
began at approximately 10:35 A.M.
The building contains three rooms on North side of
building with a half bathroom which is occupied by Founders
Homes, Inc. This section of rooms has an East and Westerly
entrance from exterior.
A room with a half bathroom is at the South side of
building with a single entrance from the exterior. Heat is
furnished to all roomsfrom a forced warm air heat pump located
in partial cellar.
I found no violations of the Housing Code, Chapter 52,
Town of Southold, New York.
Inspection completed at approximately 10:45 A.M.
R ctfully submitted,
/
Edward Hindermann
Building Inspector
FORM NO. 6
TOWN OF SOUTHOLD
Building Deportment
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 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 ...... -., 71K ...............
New Building .................... Old or Pre-existing Building ............................ Vacant Land ............................
Location Of Property ....1!� .`�.... <`0%�`//.�Q.A./,.�.....................
.. .......................................................
Owner Or Owners Of Property /MEQ /tv
Subdivision................................................................ Lot No............. Block No..-..... House No.....Z F
Permit No ..................... Date Of Permit ....................Applicant.................................................................
Health Dept. Approval........../:zlzif:................Labor Dept. Approval...............&z2z_1.:................
Underwriters Approval ............ .. .................Planning Board Approval .... /Y„!..%�...................
Request For Temporary Certificate ........................................ Final Certificate ............ 1'
-- aO
Fee Submitted $ . ...............................
Construction on above described building and ermit meets all applicable codes d regulations.
Applicant 4; t� . ........
Sworn to before me this
�/�/j
... �.. day of ......... .Y..::..k./� (stomp or sea{��[c
Notary Public cV o 3
.......... .. �. County � NIT,
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