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Home My WebLink AboutZ-6568No. Z. � 5-.6 .rte. FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy Date THIS CERTIFIES that the building located at Map No ............. Block ►A ........... ?..., 19.5 I......... &.............. Street x W A T Y 17-u /V,-% . ...�..... �....n.... WA* .. . conforms substantially to the '-office' date.. �t'"" ...... , 19? T pursuant to which it -N0. .. �.7 ........ 19 7y� dated ......... ,was issued, and conforms to all of the require- ments of the applicable provisions of the law. The ccupancy for which this certificate is issued is .!`u..� �� ..... ...... ...... ..................... . The certificate is issued to .......� �. p. .... (owner, lessee or tenant) of the aforesaid building. l� Suffolk County Department of Health Approval .0 ..... / . .. ... . UNDERWRITERS CERTIFICATE No. PF!}<.. �. , (r .. . . HOUSE NUMBER J. Q .... Street .G� ......................... .................................................... ........................... Gc... Ci f ... . Building Inspector HOUSING CODE INSPECTION July 14, 1975 1220 Grand Avenue R-1 Mattituck, N. Y. Tax Roll: Newell Muttit Occupied- new owner (Sylvia Pafenyk) Upon receipt of a request for a Pre -Existing Certificate of Occupancy, I made an inspection of this two story framed dwelling. I was admitted to building by Norman Reilly and Sylvia Pafenyk who accompanied me during this inspection which began at approximately 11:00 A.M. The first floor consists of an enclosed porch entrance, eat -in kitchen, living room and half bathroom. The second floor has three bedrooms and a full bathroom. Heat is supplied to all rooms from an oil fired hot water furnace located in full cellar. Accessory structures include a three car garage and a utility building. .I found no violations of The Housing Code, Chapter 52, Town of Southold. Inspection completed at approximately 11:20 A.M. Respectfully submitted, EH:mm Edward Hindermann 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 -s 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 ......./..7, :s:J.......... .. New Building ................ Addition ................ Old or Pre-existing Building .... Vacant Land .............. Location Of Property ..... E/_5....... �.��.d:Mv...... LI.��.... .........% .7.. ... �.T� C /� �- / . Owner Or Owners Of Property ....... ..�':..v...:�:.........��.t.!..�Y.y.&........................j......... .y Subdivision .................. ....... ......... ............ Lot No...... /\. Block No... .... Ho e (e... Permit No ..................... Do Of Permit ...................:A licant ..... A PP .... .�u .. Health Dept. Approval ' '........... Labor Dept. Approval ............:. .�........... ......... .. .... UnderwritersApproval ....::...... .I ................... Planning Board Approval ; .......................... Request For Temporary Certificate ........................................ Final Certificate .......... Fee Submitted $ ..... j-. .2 ................... Construction on above described building and permit meets aa[,I applicable codes and regulations. Applicant ...4 .? `.^ :'.::.. at ..... ................... ....................... Sworn to before mbs ........ . day of ........... (stamp or seo4f Notary Public ........... :: County MR HOUSING CODE.INSPECTION July 14, 1975 1220 Grand Avenue R-1 Mattituck, N. Y. Tax Roll: Newell Muttit Occupied- new owner (Sylvia Pafenyk) Upon receipt of a request for a Pre -Existing Certificate of Occupancy, I made an inspection of this two story framed dwelling. I was admitted to building by Norman Reilly and Sylvia Pafenyk who accompanied me during this inspection which began at approximately 11:00 A.M. The first floor consists of an enclosed porch entrance, eat -in kitchen, living room and half bathroom. The second floor has three bedrooms and a full bathroom. Heat is supplied to all rooms from an oil fired hot water furnace located in full cellar. Accessory structures include a three car garage and a utility building. I found no violations of The Housing Code, Chapter 52, Town of Southold. Inspection completed at approximately 11:20 A.M. Wctfully sub fitted, EH:mmrd Hindermann Building Inspector i J o /