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Home My WebLink AboutZ-9155NO. 4 TOWN OF $OUTHOLD BUU.DING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occup; ncy No..Z..9.~.5.5. ..... Date ........... .A.U.G.U..ST..8., ...... , 19 7.8.. THIS CERTIFIES that the building located at .7.4.0. P.e.q~l~h .Av~r~e ...... 291~m~x Map No...X~ ...... Block No..XXXX .... Lot No. XXXX... (~l~.c.l'~Og~l.e.r .~]~.W..YOr~. Requirements for one family dwelling and Housing Code confo~-,,s substantially to ~~~asl~ilKi~ll]~,-~vw~t~rl0~~e built Certificate of Occupancy ~l~..e.fo.r..e..Ap.r..i.1..2.3 ,..., 19. $7. pursuant to which ~'~,~t~ ,.Z.9155... dated ..... dar.ed .A~ust. ~., 19.7.8., was issued, and conforins to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ...P.R.~.V.A.T.E...O.NK .F..A~..~.L~. P.W~LLI~ ...................................... The certificate is issued to . .P..a.u.l..Rg.s.e...a..w.f. ,...0..w~.e..r.s ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .................................... UNDERWRITERS CERTIFICATE No ............................................. HOUSE NUMBER ...7.4. 0 ........ Street ...P.eouamli .A..v.e.n.u.e. ,..S.o.u. tho 4,..N.e.w...Y.o.r.k FORM NO. 6 TOWN OF SOUTHOLD , Building Department Town Clerks Office Southold, N. ¥. ]197! 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 New Bc~ilding ................ Addition ................ Old or Pre-existing Building ..;~. ........... Vacant Land .............. Location Of Property ..... .Ps~b,.b,~..-.n..~e~,...~'C,C.~Qc~,..~r~..~Q~)~ ......................................................... Owner Or Owners Of Property ....... ~a....u_~.......Z~....e. ............................................................................................. Subdivision ................................................................ Lot No. ............ Block No ............. House No ............. Permit No ..................... Date Of Permit .................... Applicant .................................................................. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ............. ~ .......................... Fee Submitted $ ~,.C~(~ ............................ Construction on above described building and permit ~e~t~l,l~ic~c~~~~~ Applicant ................... Sworn to before me this ...... .4...~., .... day of ..... . .~...c~.~.,...:L9.7.~. ............. Nota~Public ...JL,.~Q~ ............. C~n~ Housing Code Inspection August 7, 1978 740 Pequash Avenue R-1 Cutchogue, N.Y. Tax Roil: Paul Rose & wf. Occupied: Owner Upon receipt of an application for a Pre-Existing Certificate of Occupancy, I made an inspection of the dwelling on the above captioned premises. I was admitted to the building by Mr. Rose who accompanied me on this inspection that began at approximately 2:30 P.M. The dwelling is a one story, wood frame structure, con- structed on a cement block foundation. The ground floor contains two bedrooms, a full bathroom, living room, and kitchen. The heat is furnished to all rooms from an oil fired hot water furnace located in the full cellar. The following violations of the Housing Code, Chapter 52, Town of Southold, New York, were found: Front Entry - no means of controlling light in room at point of entry. Article V, Section 52-56 B. 2. C, 1. Sewage System - no house trap. Article V, Section~2-51 / This inspection was completed ~ approximately y45 P.M. EFH:bcc 0.~