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Home My WebLink AboutZ-5483 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z5!+.8.3 . . . . . . Date .Sept. . . .25 , 19. 7.3 THIS CERTIFIES that the building located at . .NI. Bailey .Bea.. Road . Street Map No. RXXX Block No.XXX Lot No. X X Mattituck N.Y. re uirements for one family summer cottage conforms substantially to the built r. fi to 0 occupancy dated . . .befor.e . Apr.i1. 23 ., 19. 5•'7 pursuant to which re.�r�• t.+.;,: �,, o.z 83. y dated Sept . . 25 . . ., 1973 ., 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 . priyfxte , Me. .#'am,11y, slInmor cottage The certificate is issued to .Mattituck. Investors . . . . . .Qwners (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . . . P.ro-. e.X1St1 rag UNDERWRITERS CERTIFICATE No pre— existing HOUSE NUMBER. . .1170 Street. off. Bailey .Beach .Road . .Notes. .Cottage. .is .on .lot. 9 .14ap. or.Hlatr4lton} .approved by Board Of Appeals 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 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 September 19, 1973 New Building Old or Pre-existing Building X Vacant Land Location Of Property Bailey Beach Lot No. 9 Owner Or Owners Of Property Mattituck Investors 69/eV— lrk r?I(/1 Lk/v 494777 Subdivision Lot No. 9 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 X Qn p}'e exisiring,dwelling Fee Submitted $ ..a..QQ Construction on above described building and permit meets all applicable codes and regulations. Applicant 1dATTITUCK INVESTORS Sworn to before me this BY TM day of ftptit boixall—County� (stomp or seal) Notary Public ' "County M CI:0PC NOTARY PUB IC, Stato of Now Yolk Nt). 5" 712500 :oP;olk C:,: . Te-m t:.y�as Moron 10. .9 44 STATE OF N=:4', YORK ) ) ss: COUNTY OF SUFFOLK ) Jack Driscoll, being duly sworn deposes and says: That ? reside at North Oakwood Road, Laurel, New York and I am one of the owners of the premises known as Lot No. 9, Bailie Beach, since April 17, 1973. That the said premises had been owned by Lloyd Hamilton since January 8, 1943 and had been used and occupied as a one-family dwelling. That the building erected on Lot No. 9 is and has been in good condition and suitable for occupancy as a one-family dwelling. ,tai/iLe1 if Jack Driscoll v Sworn to before me this 19th day of Septembers 1973. eiZet:4„:" "MAW MIK NOTARY PUBLIC, Stat. of Now Yeti No. 52-S712500 caat:" HOUSING CODE INSPECTION September 24, 1973 #1170-R.O.W. Bailie Beach Road Mattituck, New York Tax Roll: Mattituck Investors Lot # 9 Unoccupied: Seasonal Upon request of the Southold Town Building Department I made inspection of this one story partial cement block and framed building and found the following violations of Local Law # 1, Housing Code, Town of Southold. I picked up the key from Jack Driscoll, North Fork Housing Guild, CR 27, Mattituck and began inspection at approximately 11:40 a.m. b•; letting myself into south entrance. The building consists of three rooms and one half bath- room and sets on a slab. West room: combination kitchen-dining and living room. gas range-no shut off valve at unit-Section 508b. Entry-no light switch to control light in room on entry- Section 529b. Half bathroom: no shower-Section 505b. (outside shower on south side of building) Building unheated-for seasonal use only. Section 513a. Exterior: roof shingles missing on west side of building- Section 302c. 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