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Home My WebLink AboutZ-4983FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 2498.3 ...... Date ........... January .. 24.... , 19.73 THIS CERTIFIES that the building located at ..N/. . n. in. kioad........... Street Map No... xx ....... Block No... xx ..... Lot No. xxx .. eta t t ItUQIC . N . Y ......... . e ireme t f. o €am ly d el n Yiou�, code conforms substantially to the N..rQ181 i-- ewl.�":�"4 Vuti7dt before Ce ificate o� occupancy e Ap r.... 23 .... , 19. 57. pursuant to which tom$ o. z..493 8.. . dated .......... January ... 21+, 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 . Rr..ivt tc . on )..fa.=.J ly . dtrell ing....................................... The certificate is issued to . Jam s . �.. ons.tane p...:I>7.. ... oTs 0 ................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Pre,..exist:in.g..................... UNDERWRITERS CERTIFICATE No.. Fz'e e.XiSti_,rtg... . ...... . .................... . HOUSE NUMBER. .1-590.5 .....Street.. Alain. Road .................................... ....................................................... Exceptions to housing code: S. Kitchen: 1'o shutoff valve at gas range 508b 2. Gas dryerio shut off valve at appliance 508b 3• Toilet room: no window or mechanical vent 215d 4. Sectional stairs - no hand rail 216b ......................... Building Inspector FORM NO. s 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. Date .......January 18 1973 New Building .................... Old or Pre-existing Building ..... A .................... Vacant Land ............................ Location Of Property _.........Main Road ,...Mattituck... N. ................................................._....., James H. Pim and Constance S. Pim �'�"'4� rf OwnerOr Owners Of Property ................................... .............................................................................. Subdivision................................................................Lot No............. Block No............. House Nq&/.4,,.'.j Permit No ..................... Date Of Permit ....................Applicant.................................................................. Health Dept. Approval ............................................Labor Dept. Approval ................................................ Underwriters Approval ..............................................Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final C ificate..X...................................... Fee Submitted $ 5:00 . applicabl�c es regulations. Construction on above describedbuildingper t.. e s ��—y�W Gar Flanner Olsen, Esq, attorney for Applicatits Sworn to before me this pl' ................ day of(stamp or seal) a a- ( 5 1 3 ............................................ NotaryPublic .................................... County /r 1 s1 /7j. HOUSING CODE INSPECTION January 22, 1973 #15905 Main Road Mattituck, N.Y. Tax Roll: James H. Pim, Jr. Occupied, owner Upon request of the Southold Town Building Department, I made inspection of this two story framed dwelling and found the following violations of Local Law #1, Housing Code, Town of Southold. I was admitted to the front door entrance and began inspection at approximately 1:45 p.m. The building is heated and consists of three bedrooms and full bath on second floor, living room, dining room, sun porch, kitchen and toilet room on first floor. Kitchen: Gas range, no shutoff valve at unit - Section 508b. Pantry: Gas dryer, no shutoff valve at unit - Section 508b. Toilet room: No window and no mechanical vent - Section 215d. Stairs to second story: Platform, two sets of three risers, one to kitchen - one to hall front entry, no hand rail open ends - Section 216b. Inspection completed at approximately 2:05 p.m. 2Reetfully sub itted, Edward Hindermann Building Inspector EH:tle D eu 91 A't,tx -A� d. -off �Jl�