HomeMy WebLinkAboutZ-5589FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. . 55 .g .... Date .......... Gc t......1. `.......1 19..73
I
THIS CERTIFIES that the building located at . -Stroh-son. Road• •(.iPV .)• • • • Street
Map No. .. ...... Block No. ....;
HOUSING CODE.INSPECTION
October 19, 1973
#835 Strohson Road, R-1
Cutchogue, N.Y.
Tax Roll: Frank A. McGee & wf.
Unoccupied
Upon request of the Southold'Town Building Department
I made inspection of this one family framed dwelling and
found no violations of Local Law #1, Housing Code, Town of
Southold. -
I picked up key from Mrs. Steve N. Stepnoski and began
inspection at approximately 2:00 P.M. This is a one story
ranch with attached one car garage.
The building consists of living room, kitchen with
dining area-, three,bedrooms-and one full bathroom.
The building and grounds are in good order.
.Inspection completed at approximately 2;30 P.M. with
return of key t'o Mrs:-Stepnoski, '
spectfi , s mitted,
ward Hi derma
Building Inspector
P /V
FORM NO. 6
r
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:
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.%..73...
New Building ................ Addition ........ Old or Pre-existing Building .......�. Vacant Land ...............
Location Of Property .. �L...
&,LA......� ./ `
Owner Or Owners Of Property ........ l�......�....k !!.... '.....U:.. .........................
Subdivision ............. ..V. ............................................ Lot No. Block No. House No.............
Permit No......... k........ Date Of Permit ..............Applicant .. ........................................................
....
Health Dept. Approval .P)7� �X t c 1 ..... Labor Dept. Approval �"
.......... ...............................................
Underwriters Approval ........ h� �..- !��5..�.....Planning .Board Approval ..... l.Y.../� ....
Request For Temporary Certificate ........................................ Final Certificate ..........................................
Fee Submitted $ .. `. ...................
Construction on above described buildingand p m�itj meets all applicable. codes and regulations.
Applicant...... ... .. ......................9..... .. ..... .........................
Sworn to before me this V ) (I 1 f 1f73
X02
/.?. ddy of ..:.. ....................�.l..l. (stamp or seal)
Notary Public .. .. .......... County
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