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Home My WebLink AboutZ-9220TOWN OF SOUTHOLD BUT[ .DIN(; DEPARTMENT Town Clerk's Office Southold, N. Y. Certific; te Of Occupancy No....Z.9.2..2.0 .... Date ... ~.et!.~..e.m.b.e.r... ~.~. ......... , 19 .... 78 THIS CERTIFIES that the building located at ....~.7.9..~...Ma.$.n..R.~; ....... Map No ............. Block No ........... Lot No .................................. ~, ~O,I;I~~ ~O~ CQMM]~..ICIAL BUILDING B,UILT P~OR TO conforms substantially to ~ne ~ .~uci~ .... CJ~IFICATE..CLE OCCUPANCY dated ... April ..... 23 ...... , 19 ~.7.. pursuant to which ~lz mo. Z922(~' · dated .Sep.temb~r...2.1 ....... , 19.7.8., was issued, and confo.-ins t~ ~11 of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ....... .~%~i~dinF..with..of fine. s~aca .................................. The certificate is issued to ...... Scott.Ben. Eorp,..Inc ........................... (owner, of the aforesaid building. Suffolk County Department of Health Approval ..... pDe_~,i~.i, st;in~ ................ UNDERWRITERS CERTIFICATE No .............. ~.r.e-L~isti~g ................ HOUSE NUMBER ...54795 ...... StreeZ ....... ~ .... -~4a£~ .Reac~ ....... · ........... ........................................... ...... s. o. r.k ........ Housing Code Inspection September 20, 1978 54795 Main Road B-2 Southold, N.Y. Tax Roll: occupied: Scott-Ben Corp. Inc. Dr. Jerome Bloom Upon receipt of 8n application for a Pre-Existing Certificate of Occupancy I made an inspection of the building at the above captioned premises. I was admitted to this building by Dr. Bloom and began this inspection at approximately 12:30 P.M. This build&rig is a one story wood frame structure constructed on cement block foundation. Ground floor contains four rooms used for office facilities, a half bathroom containing a toilet and lavatory, two small rooms used as laboratories each containing a sink, and a rear entry vestibule. Access to full cellar is within the building. Heat is furnished to all rooms from an oil fired furnace located in the cellar. I found no violations of the Housing Code, Chapter 52. Code of the Town of Southold, N.Y. Inspection was completed at approximately ~2:45 P.M. ~.nWARD HINDEPd~ANN Building Inspector FORM NO. ~ 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. Date of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate. New Building .................... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ~!?.?.~.n.'~.~..`~.~..~.~.`?..~...~..t...h..~.~.~..~.?.~..~.~..~..~...r..k. ..... .]:.?..0..?..-. ............................................ Owner Or Owners Of Property ;~.,c..o...~.~..-..~..e...~....?..o...~...l~...o..~..,a.~,.o..~. .................................................................... 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 $ ....5.......0..0. ........................ I I Construction on above described building Jd p meets oil applicable co~nd regulo~'ons. Appl,cant .il.._._..~...'.'.~.?_/.~~ Sworn to before me this ~EORGE'~c~.. STAN~W~VICH, E~Q, v~ , ~uffolk Notary Public ..~ ............................... County [ / A. MAZZAFERR0 VJ~TARY PUBLIC, State of New York Qcalh.:;c u'~ Sutf~lk County :~. 2 4~5759~ z,~r~s ~larch 30, 197g (stomp or seal)