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No...70 5 .. Date ............. kgs 19 ...76
THIS CERTIFIES that the building located at .. Maw - Road Magxe .Lame Street
Map No.. c ....... Block No.. xx.. ...Lot No.... xx - -Southold• • .N Yy• • • • • • • • .
conforms substantially to thec ode
dat lt. _►er.«)re-tipr-.- .23., 19..57 punt to which .0
Z?p156 cY
dated .........ay ... 2.7......, 19..76, 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 ..�r;Lvate..ane . fmily. d-wellJz& ..with .offl-oas- &..soEe,&iory- bldg -
The certificate is issued to Dorothy. .Robohm -MD. Owne-r......... ................. .
" ( owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval -pre • e xiet in g• • • • • • • • • • • • • • • • • • •
UNDERWRITERS CERTIFICATE No.. pre-existing .............................
HOUSE NUMBER ...... 55®oa .. Street ....14ain- -Read ..... 6 mbhold• .............
................................................................................
Building Inspector
HOUSING CODE INSPECTION
May 27, 1976
55000 Main Rd. R-3
Southold, N. Y.
Tax Roll: Dorothy N. Robohm
Occupied- residence, Dr. & Mrs. Robohm
office, Rudolph Bruer
Upon receipt of an application for a Pre -Existing Certificate
of Occupancy I made an inspection of this two story, partial
one story, building.
I was admitted to the one story office section of building
by Mr. Bruer and began inspection at approximately 2:45 P.M.
Office consists of five rooms and a toilet room with wash
basin . Entry to waiting room from exterior is enclosed with
screened porch.
Inspection of this section of building completed at approxi-
mately 3:00 P.M.
On May 28, 1976, at approximately -9:10 A.M. inspection was
made of the two story residence. I was admitted by Mildred Davis
who accompanied me during this inspection.
First floor consists of living room, front entry hall,
dining room, rear entry foyer, kitchen and toilet room with wash
basin. Second floor has three bedrooms and two full bathrooms.
Attic, finished, contains sleeping quarters and clothes storage
facilities. Heat is furnished to all rooms from an oil fired
hot water furnace located in cellar of cement block foundation.
One story office section, 4111 rooms are furnished with heat
supplied from same furnace. Foundation under office section,
cement block with crawl space. A two car garage is attached to
east side of building, accessible from Maple Avenue.
The following vidlations of the Housing Code, Chapter 52,
Town of Southold, were found:
Entry to office - no means of controlling light in
room on entry. Article V, Section
52-56 B.2.
Stairway to second floor, no means of controlling
light for safe ascent. Article II,
Section 52-26 B.3.
housing Code Inspection -2- May 27, 1976
Dorothy N. Robohm
The following violations of the Housing Code, Chapter
100, were found:
Attic, third floor, used as sleeping quarters.
Article I. Sec. 100-15. Floor area livable.
Accessory structure in side yd. Article III, Section
100-32.
Inspection completed at approximately 9:35 A.M.
Re pectfully sub fitted,
EH:mm Edward Hindermann
Building Inspector
>hoxx NO. s
TOWN 03; SVU3HOLD
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 naturat
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 .......,,May 27, 1976
................................
New Building .................... Old or Pre-existing Building ... ........................ Vacant Land ...............
Location Of Property ...Main Rd ; (corner Maple Ave.), .Southold,„ N. Y.
..... ..... .... ....... ...................
Owner Or Owners Of Property ...Dorothx.. M ... Robohm...........................................................................
Subdivision........................................................ ..Lot No............. Block No............. House No.............
Permit No. Date Of Permit ....................Applicant..................................................................
HealthDept. Approval ............................................Labor Dept. Approval ........................................
Underwriters Approval ..............................................Planning Board Approval .................
Request For Temporary Certificate .... :................................... _jrliY,le CXZSTZDIGTZISEF..........
Fee Submitted $A-.9.0 .........................
Construction on above described building a e a a I' able codes and regulations.
Applicant .. i m ....................................
..........................
ickham
Sworn to before me this
27th
................ day of ....... 5aY..... 1.97.4............... (stomp oeal)
NoWAY Public ....,Suffolk County
//314
JOAN MINDE of N
D /� L /INOTARY No.52 tq PUBLIC, 90t, of Now York
QRSIMed in Sofro!.'; County
Te,- 1 ' ,, res March 3J, 1979
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