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Home My WebLink AboutZ-4864FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z4864 ..... Date ............. Oct ....1.9 ..... , 19.72. THIS CERTIFIES that the building located at . Pvt. Read.. Camp. Mineola Meet Map No. . ? ......... Block No. 94 ....... Lot No. = .... )(Att, .tsiCltt.. X q,7t........ Req resents f, e f , ly diel di: Accessory Bldg conforms substantially to the Bmilt before April 23 5? a ti ate Occupancy ....................... 19.... pursuant to which �j o. . Z4864. dated ........ Oct ..... 1.9.... , 19.72., 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 .Private. ane. family. .dwelling. . •-($usmex. occupAncy. only)...... . The certificate is issued to ..Aobart.& .Joan. BiudXinski....... Diners........... . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..Prti-.. X10ting................... UNDERWRITERS CERTIFICATE No... pr6O!e4stirg................................. HOUSE NUMER.423.5 ....... Street .... Caap .Mineola. Road..(..Pvt. Road).......... . ................................................................................. Exceptions: �- 1* no light switch at point of entry 52 b( i C 2. Dining Roos. open function box 5y'�2 .................. �. 3. Bathroos. no waterproof covering 2146 . holes in crawl space foundation 301a Building Inspector 5. No treating facilitiesq summer occy 513a HOUSING CODE INSPECTION October 19, 1972 #4235 Camp Mineola Road Mattituck, New York Tax Roll: Robert M. Siudzinski and wife Occupancy, summer Upon request of the Southold Town Building Department I made inspection of this one story, two bedroom framed dwelling and found the following violations of Local Law #1, Housing Code of the Town of Southold. I picked up key from the Val Stype Agency in Mattituck. Access to dwelling was gained at the south entrance to enclosed porch at this point inspection began at approximately 10:50 a.m. Entrance to porch: No light switch at entry to control light in room - Section 529b. Dining Area: Ceiling fixture removed leaving open junction box - Section 528a. Bathroom: Floor covering not of water resistant material - Section 214d. No heat - summer occupancy only - Section 513a. Foundation - crawl space has opening at several points - Section 301a. I completed this inspection at approximately 11:20 a.m. Re tfully submitted, ward Hinder a n�C?�c-- Inspector EH:tle t FORM NO. e TOWN OF SOUTHOLD Building Deportment Town Clerks Office Southold, N. Y. 11971 NOTE: Please RUSH. 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 dispcsal—(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 Dote ....October 18, 1 72 New Building .................... Old or Pre-existing Building ........ X................. Vacant Land ............................ Location Of Property $05..Riggt... QL.WAY..,... Qaw..MA.PaAa,&.,... .......... Owner Or Owners Of Property ,ROBERT M. SIUDZINSKI & JOAN M. S=ZINSgI . ... .............. ... k........... ...... .............. .. Y.. ey avax.�able at �'al Stype Agency, Mattituc, N..) 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 $ `100........... Construction on above described building and p e pIi c d lotions. Applicant......... .. . .... ... ............................. Wi liam Wic am, Esq., atty for Siudzinski Sworn to before me this .....lata. day of .... O.ctrabax.,...J.97.2........ (stamp or seal) Notary Public........ Suffolk........ County NpTARr PUBLNCNOFRMgN No. State N Qualified 52.6905CeS New Yor Te in S k 0 k E+Pirea More/30, ore/ 3pu�9. MAI m I