HomeMy WebLinkAboutZ-7094 FORM NO. S
TOWN OF byUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, ,N. Y.
Certificate Of Occupancy
No. Z7094. . . . . . Date . .,7FAQ .... . . . . . . . . . . . . . . . ., 191.6 . .
THIS CERTIFIES that the building located at V-5. Gt'. . 13AWT .0 .$ &y, .4vo.. Street
Edgemere Laurel
Map No. . . .Park . . . . Block No. . . . . . . . . .Lot No. .19. . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .
requirements for one family dwelling
conforms substantially to th MKOMWgrgm1 K
built before Certificate of Occupancy
dated . . . . . . . . .April. . 23. . . ., 19 51 . pursuant to which No. Z709.4 . .
dated . . . . . . . . .June . . ;Z,. . . ., 19.70 ., 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. one .family. dwellinng . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . Penolope .Leat<heP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(owner, 14K�tX$ )
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . N/R
UNDERWRITERS CERTIFICATE No. . . . . . . . . . . . .N/R . . . . . . . . . . . ... . . . . . . . . . . . . . . .
HOUSE NUMBER 2260 . . . . . . . . Street Greatkoad nic Bay Blvd.
60 41
Laurel, N. Y.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Building Inspector
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HOUSING CODE INSPECTION
June 21 ; 1976
2260 Great Peconic Bay Blvd.
and 60 Pvt. Rd. #2 R-1 '
Laurel , N. Y.
Subdivision- Edgemere Park, Lot 19
Tax Roll - Penelope- Leather
Occupied - owner
Upon receipt,Yof an'app-lication for a Pre-]Existing^ '
Certificate of Occupancy,' _I- made .an inspection of .this one
story framed dwelling,. I picked up John L. Moore of the
Silkworth Agency who accompanied me during this inspection
which began at approximately 1 : 50 P,.M'.
The building consists of a kitchen, living room, four
bedrooms and one and a half bathrooms. Heat is .furnished to
building from gas fired heaters located on exterior walls of
kitchen, living room, and southeast bedroom. Building is con-
structed on .cement block foundation with crawl space.
The following violations,-.of the Housing Code, Chapter 52 ,
Town of Southold, were found:.
Utility Room on northeast corner of the building,
electric open junction box on south
wall. - water pump electric motor,
pigtail two wire to wall outlet,' no
ground wire.. Article V, Sec. 52-56 , A. 1.
Other structures on premises consist of an accessory
storage shed, -picket and chain `link fence.
Building -and open yard area are in good condition.
Re ectfully submitted,
ard Hi deGrmann
EH:mm Building Inspector
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 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"
a land uses:
S
4 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 .... ,c� .. ?
New Building Addition Old or Pre-existing Building Vacant Land ..............
Location Of Property ....... ..............
Owner Owner Or Owners Of Property ........ ✓,1A/ [ /� .......................
Subdivision .........Lot No. .1..�,�.. ..`Block No. ............ House No.,P).d 0
Permit No. ....-'..... Date Of Permit
�:....�-....Applicant ..............—�.....................................
Health Dept. Approval ......:! (..4.,{..................Labor:Dept. Approval �/�............... ................................
Underwriters Approval .Planning Board Approval .,,
.......... ........................ ........
Request For Temporary Certificate ........................................ Final Certificate _�<...............................
Fee Submitted $� ...................
Construction on above described building and ermit meets all a plicable codes and regulations.
Applicant ..........
Sworn to before me this 11
............ day of ............................................ (stomp or seal) 'Cy
7i
Notary Public .................................... County Z l Ijj j�