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Home My WebLink AboutZ-7968FORK X0. TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Sontlield, N. Y. Certificate Of Occupancy No. Z7968 ..... Date ............ P0....21......9 197.7.. THIS CERTIFIES that the building located at VS - Main. Road ............ Street Map No.. XX ........ Block No. .=....... Lot No.. =..... Southold ..N.Y....... . requirements fo one family dwell n conforms substantially to the builtr fi t og occupancy dated .before April .23..., 1957.. pursuant to which7lNo.Z79� dated ......pct 21 .............. 1977.., 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 N.C,..One, ,family, dwelling .......................................... . The certificate is issued to .W117 i ew. F . QlArk. &..Wjfe• & .Qthrr:s . quArdip 4 . Wm% .F • Quirk (owner, lessee or tenant) Jr of the aforesaid building. Suffolk County Department of Health Approval Pre- existing .............................. UNDERWRITERS CERTIFICATE No.. pre., .existing ............................ HOUSE NUMBER .......5175Q . Street ....Main .Road ... Southold .............. Building r HOUSING CODE INSPECTION October 19, 1977 #51750 Main Road R-1 Southold, N.Y. Tax Roll: William F. Quirk & wf. Unoccupied Upon receipt of an application for a Pre -Existing Certificate of Occupancy, I made an inspection of the buildings at this location. I admitted myself to dwelling through rear door entry to kitchen that is left unlocked and began this inspection at approximately 11:20 A.M. The dwelling is a two-story wood framed structure con- structed on a rubble stone and masonry foundation. First floor contains a kitchen, living room, dining room, utility room, and front entry hallway. Second floor has three bed- rooms and a full bathroom. A two -car wood framed garage is attached to rear of dwelling with a 3'-0" wide breezeway. Heat is furnished to all rooms on first and second floor from an oil fired forced warm air furnace located in partial cellar. The following violations of the Housing Code, Chapter 52, Code of the Town of Southold, New York, were found: Furnace - smoke stack connection to chimney requires sealing. Smoke stack is a 5" diameter pipe and chim- ney thimble is 8" in diameter, Article V, Section 52-53 B. Furnace relay switch and junction box for electric power hook up require covers, Article V. Section 52-56 A 1. Fuel gas - leak in one inch pipe at tee joint next to furnace plenum, Article V, Section 52-52 A 1. (Leak found and tagged by Long Island Lighting Co.) Electrical service panel - two boxes are connected, both require panel covers, Article V, Section 52-56 A 1. Inspection completed EH:med at a Ooximately 11:50 A.M. R c 11-17/submitted, ar Hinger�m= a.,fxc- 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: 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 ,October 13! 1977 , New Building ................ Addition ................ Old or Pre-existing Building ...... X....... Vacant Land .............. Location Of Property ..E/S..Main„Street,,,,.Southold,, N.Y,. (Sec; 06,3;00,,,,Blk. 06.00 .•. 1;6!U"0174.6 0 0 ) Owner Or Owners Of Property William F. Quirk, Elizabeth A. Charters, Joan Marie Quirk, Patricia Mary, Quirk, William F. Quirk, Guardian of Property of Subdivision William F. -irk, ............. Block No. House No............. ................................................................ ............ Permit No ..................... Date Of Permit ....................Applicant.................................................................. HealthDept. Approval ............................................Labor Dept. Approval ................................................ Underwriters Approval ..............................................Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate..........X............................. Fee Submitted $ ... .................. Construction on above described building and it eet; lices and regulations. Applicant •1A. hard"'P. 1;a" ,” " �o"rriey o"r"owne'r�s Sworn to before me this 18th day of .....October, 1977 (stamp or seal / Suffolk Notary Public ............ County BARBARA ateDIACHUN New /� / Notary Public, State of New York Jam' i Q n /% 1 No. Commission 5190 Suffolk County r a°ji,�'L,� �(SL(dl�i-LL!`-'' COmmission Expires March 30, 19700