HomeMy WebLinkAboutZ-6495FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. zC-4.95...... Date ............... J=e.... 24.., 19.7.5.
THIS CERTIFIES that the building located atB,E),ljj •Peconie• Bay. 4Aet
Map No. i ;:; ........ Block No.. XX ...... Lot No. .XZ. ..Laur.al .............
conforms substantially to the m on fa e11
t Before •Apra •23• • • 19..57 pursuant to which o,ecu7,ncy
z6�+95
dated .........June. ..21 ...... 19 75., 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 N•,G•• P•riv&•te •one -family. dwe• •ling• .................................
The certificate is issued to . Thos. Sheehan • • to • -Bruoe •&• Nancy. Johnston• • •Owners
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval pre_. vxi-$t-ing....................
UNDERWRITERS CERTIFICATE No. 14,908096.... Oc-t. • 41- • • 9971 • • • • • • • • • • • • • • • •
HOUSE NUMBER ..2+9.20 ....... Street .. (Bay- •C)ak• d1d) • • •Peeonie • Bay • B3,vd • • • •
................................................................................
Building Inspector j
HOUSING CODE INSPECTION
June 23, 1975
#4920 R.O.W.(Bay Oak Rd.)
off Peconic Bay Boulevard
Laurel, N. Y.
Tax Roll: Thomas Sheehan
Occupied - new owner (Bruce Johnston)
Upon receipt of an application for a Pre -Existing Certificate
of Occupancy, I made an inspection of this one story framed
dwelling. I was admitted to building by Mr. Johnston who
accompanied me during inspection which began at approximately
3:20 P.M.
The building consists of three bedrooms, a full bathroom,
living room, kitchen, an enclosed porch at rear of building,
and a screened -in porch at front entry to building. Building
was constructed on cement block piers. Water pump and gas
fired hot water heater is located in pit accessible through
trap door in floor of rear porch.
The following violations of the Housing Code, Chapter 52,
Town of Southold, were found:
Front porch, two electrical outlets require plates,
Article V, Section 52-56 A.
Warm Air, gas fired floor furnace - register located
in living room floor - not connected to
chimney. Article V, Section 52-53 H.l.
Hot Water Heater
Gas fired, not connected to chimney.
Article V, Section 52-53 H.l.
Laundry Washing Machine
Drain line placed directly into sewage
drainage system, open fitting, jae crawl
space, requires water seal (trap),
Article V, Section 52-51 C.S.
Bathroom - Floor around base of toilet bowl weak
and Ip"~ - floor tiles buckled and
missing. Article III, Section 52-30 A. -
Section 52-32 D.
Housing Code Inspection -2- June 23, 1975
#4920 R.O.W. (Bay Oak Rd.), off Peconic Bay Blvd.,
Laurel, New York.
Exterior - paint peeling from trim of building. Article
III, Section 52-31 B.
Foundation - skirt - at northwest corner of rear porch -
skirt of foundation is open. Article VI,
Section 52-63 B.
Inspection completed at approximately 4:10 P.M.
Isectfully ubmitted,
EH:mm Edward Hi dermann
Building Inspector
FORM NO. 6
TOWN OF SOUTHOLD
Building Deportment
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.
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
Date................................................
New Building ................ Addition ................ Old or Pre-existing Building ..Z........... Vacant Land ..............
Location Of Property 129..0 f¢et... 1}outh... f J!R9.9.nA9..fty.19.vlIEY.I rd.,...I,a11wrel,...N.Y.
Owner Or Owners Of Property ... 1lrUA0..ATI.d..T1An(I:..johnsmall.........................................................
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 $ .5 a 00 ..........................
Construction on above described building and permit—Meets all ap icab, co s and regulations.
Applicant.......�1-�.......................................................
Sworn to before me this
day of. ...V a .� ... Z (stamp or seal)
NotaPj�.T1 County
EA1 .. MTN RICE
NOTARY pUi1i';;, State of New York
No. 24-9559315
Qualified in King, County
Certificate Filed in Neva Yolk County
Commission Ey-Piles Mazch 30, 1976
STATE OF NEW YORK
ss.
COUNTY OF
I, THOMAS J. SHEEHAN, being duly sworn, depose and
say:
1. THAT I reside at 8 Hampton Hill Court, Huntington, New
York 11743;
2. THAT I am the former owner of property known as 4900
Peconic Bay Boulevard, Laurel, New York, which is on
a private road off of Peconic Bay Boulevard and which
premises were conveyed to Bruce Johnston and Nancy
Johnston on June 5, 1975;
3. THAT I have utilized the premises as a summer home each
year since 1970 and to the best of my knowledge the
building is in good condition.
SWORN to before me
this 9e—day of June,
1975.
Notary PUblic
CArIMINE ANN RICE
*MARY PUB=', State of New York
No. 24-8559315
Qualified in IGngs County
Certificate Filed in New York County
Commission Expires March 30, 1976
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T(TtX d;a. 75- odUo4 tRce.nEs. t1 LAEgGvavrSnr:
THE NEW _'0RIC Rr)Af?n n rmg: I If in 1--1711A111731'r,7-171om
ij, — a ci BUREAU OF ELECTRICITY
;i 85 JOHN STREET, NEW YORK, NEW YORK 10038
..Dare October 14, 1971 1 Appliratiun .1o. un file N q n p
THJS CERTIFIES 525465
f LJ vI U,.
that rhe elet'mica! egitiprnenF ns desrribedhe/on'and intrnr/n red by thrrp/irnnt mmoedun Ihr nLu•n rp/irglion nor Lrr in Ae rnmi.vr•s of
Thomas Sheehan Priv. Dr. S%S Fee Bay Blvd. 1116 m�ir/o ee {z fir.
Laure,L.I.
in tla•fulloo'int; /oration: X, /Javeutent �I /st /'%. 2nd 1•%. Outside
.Section Bltr'6' Lot
icas exalt? irt r•d on Oct ober 12, 1971 andfound to Lein euntplianee trif/t t/te n•gnirenrerUs of tAi.v (bard.FIXt
'i
OUTLETS
FIXTU_R_ES RANGES COOKING DECKS i OPENS DISH N/ASHERS EXHAUST_FAN3
OUTLETS "cCEPTAGIEs SWITCHES .NCANDESCENT FLUORESCENT MEFCuRY —
ivAPOR AMT. K. W AML K. W. AMI. K.W. AMT. K. W.
AM
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DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'PTJ TIME( gEll iUNITHEATERS iMULTI OUTLET DIMMERS C
L AMT K W OIL H. P. - GAS I H_P, AMT. 1 NO. A. W. G. AMT. AMP, AMT. AMPS. TRANS. I AML H. P. NO. FEET
_ AMT.. WATTS `
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SERVICE DISCONNECT '� No OF - _ 1 _ — I —
_amt. �An1PI iwE_ METER - S 'E ..- R - y - _. 1 _ C ._ E
. OF CC COND. A W G, A. Yy. �— I— --.
EQUIP 63W 1 H 3W 3,B' 3W 3,e' dW NO NO. OF HI LEG NO OF NEUTRALS A W G
PER .9 OF cc. COND. OF HI LEG OF NEU7RAL
1 150 eb
OTHER APPARATUS: - -- -
--�----
R
I:
Wm Peters �7_
745 Bay Ave,`
Mattituck, L 1., 11952
•N<;t MANAGER
Per / D
This certificate must not be altered In piny manner- return to the office of the Board if incorrect. Inspectors may be Identified by their credentials.
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