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Home My WebLink AboutZ-7400No. P....... FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy Date ............. Dee.. 3 . . . . . . ., 1976. THIS CERTIFIES that the building located at ...6/8 Road...... Street Map No. . 7C7C ........ Block No... 70 ..... Lot No.)!I.Y • . . . . . . . - a_. _�_ ee_11� .f_��7t •.��. conforms substantially to the built Certificate of occu� gancy dated . b!fore Apr.. 23.. , , , 19. �7 pursuant to which �� No. Z,?400� . . dated ............De! ..3...., 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..Priva.te.one family.dwellng accessory buildin�� sole fencing ...................... i ...... The certificate is issued to ................................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Pre• existing. ............................ UNDERWRITERS CERTIFICATE No. ..Pre• existing .......................... HOUSE NUMBER .... P40 ..... Street ..... Bayview.Road ............................. ................................................................................ r� Building Inspector �% 3 �� 3 FORK NO. 6 r 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 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 ....�. `.:... �.r'... I ..1.... �. �' New Building ................ Addition ................ Old or Pre-existing Building ..... X..... Vacant Land ............... Location Of Property ...�...�.�j�lr..o�R� -! .TMJ/ ... Owner Or Owners Of Property ....../ %/;�'%...........�,[. •✓••/ /!..1.., ....................................... 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 ........................................ Final Certificate .......................................... Fee Submitted $ .5� ..............•...... Construction on above described building and er,(mit eets all applicable,cod{7es� and r uI tions. Applicant .../.r1ti...eI Sworn to before me this . A d� �.....'., day of ..,.�,F�. (stomp or seal, yol 2, �y Notary Public ... . . .. ............. County ld� HOUSING CODE INSPECTION December 2, 1976 5340 Main Bayview Road R-1 Southold, N.Y. Tax Roll: Benedict A. Manasek Unoccupied Upon receipt of an application for a Pre-existing Certificate of Occupancy, I made an inspection of this one-story, framed dwelling and the unattached two -car garage on premises. The door of the dwelling was left unlocked and I admitted myself, beginning this inspection at approximately 2:30 P.M. The building consists of an entrance vestibule on the east side of building, utility room, bathroom, kitchen, dining room, living room, and two bedrooms. Heat is supplied to all rooms from an oil -fired, forced warm air furnace located in the cellar of building's cement block foundation. The cellar is partially full; the balance is crawl space. The following violations of the Housing Code, Chapter 52, Town of Southold, New York, were found: Utility room - gas hot water heater, no shut off valve at unit, Article V, Section 52-52 B (2). Smoke stack of this unit is rusted away and does not carry the products of com- bustion to the exterior. The section of stack which runs through the wall does not run through a metal sleeve ANpis in contact with combustible materials, Article V, Section 52-53 H (3). Kitchen - gas cooking range, no shut off valve at unit, Article V, Section 52-52 B (2). Cellar - electric water pump, pressure switch, no cover on unit, Article V, Section 52-56 A (1). Inspection completed at EH:med appro imately 2:55 P.M. Res ctfull submitted, r and H ndermann Building Inspector (Sege 385?.. 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