HomeMy WebLinkAboutZ-6366 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town:Clerk's Office.
Southold, N. Y.
� a
Certificate Of Occupancy
No. Date . . . . . . . . . . . .I Lx`.eh. . 1.7. . . . . .. 19.75.
THIS CERTIFIES that the buildinglocated at Yr z;. .�•: (1' Re )
•IIue�Q 1.k�,.r 1�.3.1• •Rd• • • •�treet
Map No. xx. . . . . . . . . Block No. . xx. . . . . .Lot No. xxx • :ua.s•t . . . . . . .
.00 conforms substantially to their ' ° • t do i-{ �u�od®
&1ed't. before Ap.ri1 2� . ., 19. 57 .pursuant to which x�t o0ccupzricy
dated . . . . . . . . .kl Irc.$. . . . .17., 19.7.5., 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 . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . F.11.4.1) .Eebar. . . . .Oi--mer • • (• Fral?c.Q�5. No .1,Rba2'), . .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department.of.Health Approval px.9,. exi s#.izig• . . . . . . . . . . . . . . . . . . .
UNDERWRITERS .CERTIFICATE No. . . .prQr. .existing. .. . . . . . . . . . . . . . . . . . . . . . . . .
HOUSE NUMBER . .4,05. . . . . . . . Street . .I:iuc•i-elbc>i1ry Bill. Ror-A. • •4 • P.t •I?d• 0 6)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Building Inspe or
3�
ail
51 �
TEL. 765-2660
O
c TOWN ❑F SOUTHOLD
• OFFICE OF BUILDING INSPECTOR
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y. 11971
Housing Code Inspection
March 17 , 1975
405 Huckleberry Hill Rd. (Pvt. Rd.#9) R-1
East Marion, N.Y.
Tax Roll - Frances H. Lebar
unoccupied, -seasonal
Upon receipt of an application for a Pre-Existing Certificate
of Occupancy I made .an inspection of this one story framed
dwelling - I picked up keys from the Ernest Radford Real Estate
Office, Main Road, East Marion, and began inspection at approx-
imately 10 :30 A.M.
The building consists of four bedrooms, a full bathroom, kitchen,
utility room, dining room, living room, and has a one car garage
attached to north end of building by a breezeway - The habitable
section of the building foundation is cement block piers.
The following violations of the Housing Code, Chapter 52 ,
Town of Southold were found:-
Lamp Cord outlets on baseboard in the N/E bedroom, east
and west bedrooms off hallway, and living room - Art.V,
Section 52-56 A-1
Fireplace - flooring in living room at each side,base of
fireplace, and floor joist supported at base of fireplace
are deteriorating from a moisture .condition. Art. III ,
Section 52-30 C.
Foundation , open, no screening - Art. VI -Sec. 52-63 'B
Roof south side, shingles deteriorating. Art.. III , Sec.
52-31 C.
Inspection completed. atrapproximately 11: 00 -A.M. and were
.returned to E. Radford at his officew,
Respectfully su tte ,
Ed Hindermann Q.-
} i,.
..
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 preparo 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 .......Mugb.....14.....1.975....
New Building ................ Addition ................ Old or Pre-existing Building ...ARXX... Vacant Land
Location Of Property b......(Jiuokelbar'ry..Hill—Road.)........W./.S..Bay...,Air 8..
Owner. Or Owners Of Property 1.11,-..-W)...Lebas............. East Marion
......................... ........................
Subdivision .......XXXX........•....•..••,,•,,,•,•,,,,,•,,,,,,,,,,•••;Lot No. ....;F.,x3; Block No.==... House No.ZFO5.....
Permit No. ..XX............. Date Of Permit .........MIM...Applicant ....Ss PMice......9.ttwrn3f•,•,
Health Dept. Approval ........Labor Dept. Approval .....It•R..................................
Underwriters Approval .P.T8"..%K stj;n1Z Planning Board Approval N.R..
Request For Temporary Certificate ........................................ Final Certificate ......XX 9....•.....,,....,•
Fee Submitted $ .5pW.........................
Construction on above described building and peit meets all OP lic cod and regulations.
Applicant .................. ... . .....................................
Sworn to before me this �,/7
................'day of .....:Mareh:.......9.9. .. ......... (�3�6
75 (stomp or seol�� 7
Notary Public ...........S.uff01k......... County
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