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Home My WebLink AboutZ-5522FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z.5.522..... Date .............Oct -.12........ 19.73. THIS CERTIFIES that the building located at ..R,.Q,V. ^.':" .?'1 t :. tr..ee. RoStreet Map No. I-T&SS ..fey Block No ........... Lot No. Vi. lot. 3.5, .. Cutcho�-v... !I *Y-8 conforms substantially to theR Dien s ' O' .ou ! el?& pus COd* �' rt V,i to . n occupancy dated Built• bei c, n--, ,., In 19. i=:�. pursuant to which S,i�ld n� � KoZ55n dated ........ Oct .... 42....... 19..r3, 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 . • .,-rivtcto • one • family- .(9umtRer) -dwv__-ling .......................... The certificate is issued to . Alias. Quicken..... U Ener• • • • • • .................... . ( owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. P+re-. eX1s.ti4g.................. UNDERWRITERS CERTIFICATE No. t'_r............................. . HOUSE NUMBER ... 2.5 ...... Street .... Pine. Tree. Road ..................... % r-� .(. .- 7�'P'7"'... ..... Building Inspector lit")USING CODE INS'ECTION October 11, 1973 #2334 R.O.W. Pine Tree Road Cutchogue, N.Y. Sub -Division: Nassau "arms Na -p # 1179 Lot W/half ,x`35 Occupied: Alice wicker Upon request of the Southold Town Building Department I made inspection of this one story framed dwelling and found the following violation of Local Law # 1, Housing Code, Town of Southold. Building consists of two bedrooms, living roo:, kitchen and one full bathroom, has a partial full cellar and crawl space. There is no central heating system, occupancy is season- al. (Play through October) Section 513 a. A screened enclosed north runs full length of South side of building. I was admitted to kitchen entrance bar AMr. Gzuicker and I began inspection at approximately 1:45 p.m. Kitchen: Gas range -no shut off valve at unit - Section 508 b. Inspection was completed at approximately 2:05 p.m. 4TRerectfull s omitted, d Hin ermann 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 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. Dote 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................................................ New Building .................... Old or Pre-existing Building ........... x.............. Vacant Land ............................ Location Of Property near Nassau Point, Town of Southold, Suffolk County, N. Y. ..................................................................................................................................... Owner Or Owners Of Property ......Alice Quicker ...................... Map ........................................ Subdivision, of Nassau Farms ,.Lot No. ..... 35..MNo. „1179 House No�:.`..� .......... .... ..... ........ PermitNo ..................... Date Of Permit ....................Applicant.................................................................. Health Dept. Approval p I_ ......1...Q:. - .............................Labor Dept. Approval ........................ ................. Underwriters Approval PtZ .Planning Board Approval ............................................. ................... �• " ................... Request For Temporary Certificate ........................................ Final Certificate .............. ............................ Fee Submitted $ ....15.00 .................... /7 Construction on above described buildirv`and,,�mp�In.Ws 3i4Y90jWble e6des and regulations. Appl ............... Esq., as. ...... .............. s attorney for Sworn to before me this Quicker t,,etz,�- it 15-13 11th day of ...,Octobers 1973 (stamp or sealv", v,575-Z7s Notary Public .........$uffolk ... County a FRED W. M,Aft1N, 1R. Notery Public, State of New YoTR Residing in Suffolk County No. 52-713S315 �� Commission Expires Aeerch 30. 19 '7 ^ - --r-�-� ------- ' ' ~ IMF EMBF M ^ - - m_ - -- - p--- ----- -- - -- - - - ------ -- i' 1 l t