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Home My WebLink AboutZ-9219NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Ot[ice Southold, N. Y. Certificate Of Occupency No...Z..??.'l.g. .... Date .... S..ep.t.e.m..be,..' .~.9. ....... , 19.7.8. THIS CERTIFIES that the building located at . .~.~.6..0..V..m$.s.t.o.n...R.o.a.d. ...... ~ Map No...A...~.3.9.~... Block No ........... Lot No ....... ~.0~. ....................... REGUIREM~SD'TS FOR ONE FAMILY DWRLLING BUILT PRIOR TO conforms substantially to the CERTIFICATE OF OCCUPANCY dated .Ap~'$1 ..... 23 ........ , 19.57. pursuant to which ~~ffii~No.. Z92.~ dated . .S.eP.~..e~..b.e.17.. 3.9. ...... , 19..7.~., was issued, and confo~ihS tO all of the req!!_ire. ments of the applicable provisions of the law. The occupancy for which this certificate is The certificate is issued to ........ A~'~hu~. ~.c. hw~.z. ............................... (owner,~ of the aforesaid building. Suffolk County Department of Health Approval ........... ~r..e.-~i.s..t.i.n.g .......... UNDERWRITERS CERTIFICATE No ..................... P..r'.e.-..E~..t.s.t.i.n.g .......... HOUSE NUMBER .... ~. ~.6.Q ..... Street ..... ~.~-f. AV..ar~..s.tp.n...R.o.a.d....,(. ............. d , ............................................ ...;..C.u$cb.ogme,..~¥, ............... Build/rog Inspector Housing Code Inspection September 19, 1978 1560 Vanston Road R-1 Cutchogue, N.Y. Sub. Div.: Nassau Point, Map A # 156, Lot # 305 Tax Roll: Arthur Schwarz Upon receipt of an application for a Pre-Existing Certificate of Occupancy I made an inspection of the building at the above captioned premises. I was admitted to dwelling by Mr. Schwarz who accompauied me on this inspection that began at approximately 1:15 P.M. This dwelling is a one and one half story wood frame structure constructed on cement block foundation. First floor contains a front entry vestibule, living room with fireplace, kitchen with eating area and walk-in pantry, full bathroom, hallway with rear entry and two bedrooms. Second floor half story is a unfinished area that is presently being used for storage. Heat is furnished to all rooms on the first floor from an oil fired hotwater furnace located in the cellar. Cellar is partitioned and provides a shower room and a half bathroom that contains toilet and lavatory. A section has also been partitioned to provide storage for ane car. I found no violations of the Housing Code, Chapter 52, Code of the Town of Southold, N.Y. Inspection was completed at approxima~ Buildi ~ 1:40 P~J~. ~f~y~/submi/ tted, ~g Inspector FO~M'_ NO. 6 TOWN OF SOIJTHOLD , Building Doportme#t 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. 13. 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 $1.00 New B~ilding ................ Addition ................ Old or Pre-existing Building ........~ ...... Vacant Land .............. Location Of Property ..... ~C~.~.... ~.~`~z~.a~~~]:~d~~ ....................... Owner Or Owners Of Property ...~--_~]~'..SCJ3$~'~c~ ....................................................................................... 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 ............. .X.. .......................... Fee Submitted $ ........~.,..0..0. .............. / Applicant ...................... ~~~..~ ......................... Sworn to before me thb ..~ ...... day of ....~[,...[~7.~ .......... ~o~m ~ (stamp or s~l)