HomeMy WebLinkAboutZ-9132 F0RM NO. S
TOWN . OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. .Z91 ? . . . . . Date J a,Y. . . 27. . . . . . . . . . ., 19. 76
9800 Soundview Ave
THIS CERTIFIES that the building located at 2.7.5 .QaxWQQd _994c4 . . . . . . . . Street
Map No. . . . . . . . . . . . . Block No. . . . . . . . . . .Lot No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
REQUIREKENTS FOR ONE FAM LY D N .B T ORE
conforms substantially to the
A ril 23 57 IF TE. 0 OCCUPANCY
dated . . . . ? . . . . . 19. pursuant to whicimE No: . Z9132.
dated . . . J�4Y. . �7. . . . . . . . . .. 19.7s., 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 .QPe F4P .!Y. .PwollA?g. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . . . . . X� AA .R,. I,aye110. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(owner, s
of: the aforesaid building.
Suffolk County Department of Health Approval . . . . . . . . .PremExiating. . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE No. . . . . . . . . . . . . . . . . .PrQ--EXtatIng . . . . . . . . . . . .
9800 Soundview Ave
HOUSE NUMBER . . . . .275. . . . . . Street . . . . . . . . Q.od.RQad. . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Qutk�ol.d,. ►. rk. . . . . . . . . .
Building pector
Housing Code Inspection
--July 27,> 1978 ;
9800 Soundview Avdi,i&5275 Oakwood Rd. R-1
-Southold, N.Y.
Tax Roll: Willaim R. Lavelle & wf.
occupied: tenant-Alvah- Goldsmith Jr.
Upon request of Gary Olsen, Attorney, Main ,Road, Mattituck for
a Pre-Existing Certificate of Occupancy I made an inspection of
the dwelling at the above captioned premises. . I was admitted to
building by Mr. Goldsmith -who accompanied me during this inspection
at approximately 2:05 P.M.
The. building is 'a wood framed structure on a cement block
foundation. {Ground floor consists •of- one bedroom, dining room with
kitchen facilities, living room with •fireplace, hall bathroom and a
rear entry enclosed porch. ! Heat is furnished to all rooms from an
oil fired hotwater furnace .located in partial full cellar. . Cellar
is accessible through trap door in the rear porch floor. In addition
to an interior access - stairway to cellar there is an exterior �-setj._of�.
stairs. J
The following violations- of the Housing Code, Chapter 52, Code
of the Town of Southold were found:
Entries- no means of controlling light in room at points of
entries. Article V, Section 52-56 B.2.
Inspection completed at `approximately. 2: jet
f y ubmitted
- Building nspector
FORM NO. 6
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.
S. 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 a
Date ......... �-� ..G1......................
New Building ................ 1 n i ............. Vaca Land ...... . ................
Location Of Property .........QS?................................ ....
...................................'"...` ... .................................................................
Owner Or Owners Of Property .......
Subdivision ................................................................Lot No. ....... o: ............ House No.............
PermitNo. .................... Date Of Permit ....................Applicant ..................................................................
Health Dept. Approval ............................................Labor Dept. Approval ................................................
UnderwritersApproval ..............................................Planning Board Approval ........................................
Request For Temporary C,5r�ificate ....................................... Fin Certificate .........<..........................
Fee Submitted $ ............. ,............
Construction on above described building and permit a ica codes r ations.
,� Applic ntQ...... ....................... ....... .........................................................
Swo n to before me l�
�.
................ day of ............................................ (stamp or seal)
7- 2
t Notary Public .................................... County