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Home My WebLink AboutZ-8030 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy Z R D 3 v Lac-., 7 7 No. . . . . . . . . . . . . Date . . . . . . . . . . . . . . ., 19. . . . THIS CERTIFIES that the building located at . . . . . . . . . . . . . . . . . . . . . . . . . . . . Street p� ; Map No. . . . . . . . . . Bloc L , o. r G rmk substan ially to the App lca ion or ui ing err a i his e dated . . . . . . . . . . . . ., 19. . pursuant to which Bui ing er t,No. . . . dated . . . . . . . . . . . . . . . .l. . . . . . ., 19 , was issued, and conforms to all of the require- ments oft pplicable rovisio s of the 1 T occu a or hich this rtifica a is \ o .p 2 I p � -u�- -`r.. dc �, J issued is . . . . . . . . . .�,�,,SL--: . . I The certificate is issued to . .. . .._. . . �!7' . ..'. . . . ... . . . . . . . . . . . . :. owner, lessee or tenant) of the aforesaid building. P ., Suffolk County Department of Health App val . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . . . . . . . . . . . .r . . . . . . . . HOUSE NUMBER . . . . . . . . . . . . . . Street . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ./I k— . . . . . Building Inspector HOUSING CODE INSPECTION November 30 , 1977 43715 County Road 27 B-1 Southold, N.Y. Tax Roll : Florence LaFreniere .Occupied: Retail Store Upon receipt of an application for a Pre-Existing Certificate of Occupancy I made an inspection of the buildings on this premises. I picked up keys from Lewis Edson, First Town Realty, Main Road, Southold, N.Y. and began this inspection at approximately 1:30 P.M. The dwelling which is presently being used as a retail store contains two bedrooms , a living room, dining room, full bathroom and kitchen. Heat is furnished to all rooms from an oil fired hot- water furnace located in full cellar of buildings cement block foundation. Accessory building is a one story, wood framed, one car garage located in rear yard area. The following violations of the Housing Code, Chapter 52 , Code of the Town of Southold, N.Y. were found: Accesory structure -siding on west and north wall deteriorating, joints have opened leaving excessive openings-Article III , Section 52-31 B. Fuel oil tank is located within garage, fill and vent pipes terminate within building. Article V, Section 52-59 C 2 . Fuel line from tank in garage runs thru side of building :-.gcross lawn and walk-way and enters cellar of dwelling thru window-this line furnishes fuel oil to hotwater furnace of dwelling-line is unprotected. Article V, Section 52-59 B 2 . Entry- front of dwelling-no means of controlling light in room at point of entry. Article V, Section 52-56 B 2 . Gas Range - no shut off valve at unit. Article V, Section 52-52 B 2 . Cellar -window on west wall, broken pane of glass. Article III, Section 52-31 A. Furnace - relay switch requires cover. Article V, Section 52-56 A 1. Inspection completed at approximately 1:50 P.M. Keys were return- ed to Lewis Edson. Wctfu, ly submitted, Edward Hindermann Building Inspector GO 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 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. 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 .................... Old or Pre-existing Building .. ................ Vacant Land ............................ LocationOf Property ... � '...... :..... .� . . ...................................................... Owner Or Owners Of Property ... ......::.. J.......::.'.............................................. Subdivision -- .-Block No. ,,.// ......Lot No. ........... ..!1.... House No�`�7.. Permit No. ...... ::. Date Of Permit ...... ......Applicant .X\.............................. .............................. Health Dept. Approval ..... ......................Labor Dept. Approval ........ ..1�.... ......................... . Underwriters Approval ...... ........................Planning Board Approval .... ............................... RequestFor Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ ........ ..`.�� ................. Construction on above described building and permi meets all a lic odes and regulations. Applicant ... �,. �.. ...,.. .,.. Lam.... . ..... ............. .. .. .... ... .. . . . .. .......... Sworn to before me this 1��a,�l .......2,�?. day of ..../.........:/......A..........I........ (stamp or seaV $, P �?7(,l, Notary Public . County '/ 07 ----------------- ICI �„< y .�QGC �✓ r�a�/1�� c�.� i 16-4 - IF ----ram�- -- ----� _�� -- ct t t-� a- i