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Home My WebLink AboutZ-6000FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 4.6.400...... Date THIS CERTIFIES that the building located at . *-;; . i%aln • zioad • • • • • . • • ... Street Map No. .X=........ Block No. xxx ...... Lot No. xxx .. Matt i tuck .. N .X .......... conforms substantially to the0. � Code Bd'Ttcr- tOrOr-e.Apr .23......, 19.57.. pursuant to which occupancy Z' 6000. dated ........ July. ..... 1-2..., 19.71+., 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 ..F.rivate. ane. family -dwelling.wi.th. accessory. building(garage.) The certificate is issued to . Iiarrison. & .Paulette. .Edwards • • • . Juvneraa .......... of the aforesaid building. (owner, lessee or tenant) Suffolk County Department of Health Approval pre-. existing....... . UNDERWRITERS CERTIFICATE No. pxe,existing ............................. HOUSE NUMBER ....1.7.950..... Street .... Dain. linad.......................... . ........................................................ Building Ins a of HOUSING CODE INSPECTION September 23, 1971 Helen Miska 17950 Main Road Mattituck, N. Y. On request of Mr. Hilly, American Title Insurance Co., our office asked me to make this inspection. About 11:00 A.M. I inquired at Mrs. Jones, wh• had a key and .showed me the house. It is a two (2) story, one family dwelling with a cellar. In the rear yard is a detached garage. The buildings appear in sound and good condition. There are three (3) bedrooms, one small room and a bath on the second floor. The only violation I noticed is that there is no rail on the open cellar stairs. I met Mr. Jones later, who said he would have his man put up a rail today. Respectfully submitted, "114d George H. Fisher 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 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: I. Certificate of occupancy $5.00 `l 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 + Housing Inspection Sept 23, 1971 everything O.K. ly Date ............... 8.....1.974.......... New Building ................ Addition ................ Old or Pre-existing Building .....XXX.... Vacant Land .............. Location Of Property ..... ........................................................ Owner Or Owners Of Property Hamrlson..J..&..Paulette..Edwards................................................ Subdivision ............................................................... Lot No.... Xx... Block No. �...... House No ...... 1.7.950 Permit No. .= .............. Date Of Permit.XX.............. Applicant ...1=........................... ............................ Health Dept. Approval .....Pne-r: ex:LS.tjzg......... Labor Dept. Approval .......N..R• . ............................... Underwriters Approval ..12ze-... XlSting Planning Board A N.R. Request For Temporary Certificate ........................................ Final Certificate.......................................... Fee Submitted $ 5.1100 ................ Construction on above described buildin nd �t meets all icable codes and regulations. Applicant ................................. . ................ ^ ... Sworn to before me this ��.23/7� AA ... t.... day of ..... ZU-1y......... 1.97.Zt............ (stamp or sea[) A i% Notary Public....County ... �? MAUREEN A. STRAUB ................ NOTARY PUBLIC, ^r,te of New York No. 30-9x, 6a j C Qualified in fJas_.G:wSy Commission Expires March 3C, 193� 40.00, uj FY uj m U Nfl^K4 ft