HomeMy WebLinkAboutZ-7259No.L7.259...... .
FORM NO. S
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
Date ............. pt. 29....... 19. jf,
THIS CERTIFIES that the building located at . D-eep- 11ole. 0;rive......... Street
Map No.. xxx ....... Block No. xxx ....... Lot No. xxx .. Yat t i tuck ................
conforms substantially to the m t 1 del n . iou�- ngcoda
Built before f o r e APr 23 .
'Occupancy
dated .. . .... , 19.57pursuant to which Z7259.
dated .............. Sc pt . 29 , 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 ...Private one family dwelling with accessgzty ,building.... .
The certificate is issued to ..Phillip ... Marriner..... Ownex . of ;r00Pr.4 ...........
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval PT*@-..existiP& _ ........ .
UNDERWRITERS CERTIFICATE No. .pre- -existing........... ...............
HOUSE NUMBER ..... 26.7.0.... Street .. Deep- Hole- D -rive...... t ...............
Building Inspector
HOUSING CODE INSPECTION
September 27, 1976
#2670 Deep Hole Drive
Mattituck, N.Y.
Tax Roll: Phillip Marriner
Unoccupied
Upon request of Gary F. Olsen, Attorney, Mattituck, New York
for a Pre-existing Certificate of Occupancy, I made an in-
spection of this one-story, framed dwelling. I picked up key
from Mr. Olsen's office and began this inspection at approxi-
mately 11:30 A.M.
The building has two bedrooms, full bathroom, living room
and kitchen. Each room is heated by electric baseboard heat
elements. An enclosed porch is located on north side of house
and an open deck is connected to the rear of building. Building
is constructed on cement block foundation. Outside cellar door-
way was locked with a combination lock; therefore, inspection of
cellar was not possible.
The following violation of the Housing Code, Chapter 52,
Town of Southold, New York, was found:
Bathroom: floor tiles at the base of toilet bowl,
joints are not tight, Article II, Section 52-32 D.
Accessory building in rear yard was constructed under
Building Permit #35612, dated August 4, 1967, to which Certifi-
cate of Occupancy #Z2976 was issued on January 2, 1968.
Inspection completed at approximately 11:50 A.M. Key was
returned to Mr. Olsen's office.
Res ctfull submitted,
dward Hindermann
Building Inspector
EH:med
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.
S. 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........1�..................
New Building ................ Addition ................ Old or Pre-existing Building ...... Vacant Lq& ..............
Location Of Property ..........�........... ......1J\w=�.. .�.0�..........�v..tl"►"�11pf/
OwnerOr Owners Of Property ..........v ................ ...........�(\�v�..'....................................................
Subdivision................................................................Lot No............. Block No............. House No.............
PermitNo ..................... Date Of Permit ....................Applicant..................................................................
Health Dept. Approval ............................................Labor Dept. Approval ................................................
Underwriters Approval .............................................. Planning Board Approval ........................................
Request For TemporaryC Certificate ....................................
Fee Submitted $ ............................ f�
Construction on above described building and
Applicant
Sworn to before me thi / /
....... G .... day of ..... / ...<Q t.l..7YA....
Notary Public .................................... County
inn) Ce ificate.................................
s applicable code, r, tions.
(stamp or sea[)
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