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Home My WebLink AboutZ-4799 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.P t�'.99. . . . . . . Date . . . . . . . . . . . .Sept . . 7 . . . . . . ., 19.72. THIS CERTIFIES that the building located at . X/S .Pine .Neck .Road,. . Street Map No. .xg. . . . . . . . . Block No. . .xx. ... . . .,Lot No. X= . . .Southold N-*Y; . . . requirements for, one fain ly dtarel & ous code conforms substantially to the�f §jp� I "B prior to Cer �fic'ate. o occupancy April- -2-3 . . ., 19.57. pursuant to which . Z. 4799. dated . . . . . . . .Sept• • 7 . . . . . .. 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. .one- family. -dwelling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to Rs tate -of- Henry May dom . . . .Owner. . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval pre,..existing • • • • • • • • • . UNDERWRITERS CERTIFICATE No. . . .pre. e%jG•tjng• • • • . . . . . . . . . . . . . . . • • • • • • . . • • • • • HOUSE NUMBER.27215 . . . . . . .Street. . Pine. Neck- Road. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Exeeptio?l to dousing code: 1 . No referilgerator 531a 24,. SIW Bedroom no Light or outlets 208b • Front enterance— no light switch 208b Building Inspector Cellar open junction box 528a outlet no face plate 528a two holes in foundation 302a HOUSING CODE INSPECTION September 5 , 1972 2725 Pine Neck Road Southold, New York Tax Roll: Louise Maydom Unoccupied Upon request of the Southold Town Building Department I made inspection of this one story framed dwelling and found the following violations of Local Law #1, Housing Code of the Town of Southold. I admitted myself through the .rear entrance to kitchen where inspection began at approximately 1:30 p.m. Kitchen - No refrigerator - Section 531a. .Bedroom - southwest - No light fixture; no outlets - Section 208b. Front Entrance (south) - No light switch to control light on entry to .living, room. Cellar - Open junction box - Section 528a. Outlet without face plate - Section 528a. Two openings in foundation - Section 302a. Inspection completed at approximately 2 : 00 p.m. Re ctfully sub ittedk- �/y wary Hindermann Inspector EH:tle 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 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 ,pp- Date ....... .�Y. ...7v................... New Building .................... Old o re-existin Z ding .... .......... Vacant Land . .... ........................... Location Of Property ....... / / Q / ....... G�J —/� d/C/ /�/� � , ....... �.:... .�. ........ . .........�....... .y..................... Owner Or Owners Of Property f.....I..�/e.t /... . . ..... ° Subdivision ................................................................Lot No. ............ locJk�No. ...........J./Hose No............. Permit No. .................... Date Of Permit ....................Applicant ... .1. 4i. .:�!G/./.. 1�::. ....... HealthDept. Approval ............................................Labor Dept. Approval ................................................ UnderwritersApproval ..............................................Planning Board Approval ........................................ Request For Temporary Certificate ........... Final Certificate ............................. .......................................... Fee Submitted $ .................................... Construction on above described building and Vmiets plI appliccabbl codes and regulations. Applicant ......... ....... . ....... . .......................................... Sworn to before me t P is S j C � ...... ....... day of . ... ...... . . . .. ... 1.4.... (stamp or seal) y o �� Notary Public ........ ...f�. County 5- JUDITH T. BOKEN Notary Public, State of New York No.52-0344963 Suffolk County / Commission Expires March 30, 29 f _ FOFLYNN � . 0 E. 90.0 _ ~: ; U7, �, 2 UNAUTHORIZED ALTERATION OR ADDITIO Q s Lu - TO THIS SURVEY IS A VIOLATJON OF W Ce55POOI. �'_ - "' SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. . . COPIES OF THIS SURVEY MAP NOT BEARI L 15m:zy r THE LAND SURVEYOR'S INK,.D SEAL OR J EMBOSSED SEAL SHALL NOT BE CONSIDERED FR.HC Y - t e TO BE A VALID TRUE CCPY. O _ - - t • GUARANTEES 04DK'AUD HEREON SHALL RU19 ONLY TO THE JE;-SON FOR WHOM THE SUF,/EY - - - - -- - - IS PREFARED, AND OIi HIS BcHAIF i0 THE j TITLE COM ANY, GOVER1,4MENTAL AGENCY �o 6` V_ : '%4 ' � L6NDiNG C„STiTuTION LISTED H.R:Oty AND TO THe :S;GNEES OFT E v-'DI ( INSTI. 4 - - .�-. -. - t•� Tl.t.. U.a,:ANTeES AP r F".AaLE TO AD..fIGNAL INSTITUDONS owhtRs. `'s� ref' S_8334 C3-`1►� ,L+F1K LAWN i{AVE, GUA2 ( vI R �. T� fz {�+y fir-'•�`.,Ky (/�} ]}�-�r Tt,E,. �`(� 1y {('', f .J� p .1 1E 4s.f.3.�- ��V�ii - - H ice. s.k. • �t�•��.�'�•.}Ce:-`✓L'�', '1 �-�. .___..i__.�t_ ��I KlY� ! 7 mL'C' ,`.-1L' -- SCA LICENSED U�ND � - . e r. r s - U=i'2.0N � r - �r - _ - _ Y - _ 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 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 Date �y.. .�..��. .�.g"..� .......... .. ..... New Building .................... Old or Pre-existing Build[ g ...........�.+............ Vacant Land ............................ Location Of Property ...A�/:s Y.►.Q..N,P.,c;................Cam -. ��1.4 :.. lu�710.�ui.. y' ...... . . ........... ...... Owner Or Owners Of Property .... sT .. ...�P_ri?')......yhg.vro'I............................. ....................... Subdivision �� (N.t.........................................Lot No. Block No. House No............. . . ............ . ............ ! r n............ �(. Permit No. .................... Date Of Permit ....................Applicant . lard,.✓�f::..�r`{.'1.�.r"!. .�.s................ Health Dept. Approval ............................................Labor Dept. Approval ................................................ Underwriters Approval ..............................................Planning Board Approval .. .......................... Request For Temporary Certificate ........................................ Final Certificate ....................................... .. Fee Submitted $ ..................................... Construction on above described building and p milt m�,ets all applicable codes and regulations. Applicant ...................................................... Sworn to before me this .��........... day o .zla.. . . .. .. .... (stamp or seal) e1e Notary Public ......... .c�rr. County JUDITH T. SOKEN Notary Public, State of New York No.52-0344963 Suffolk County Commission Expires March 30, 19 xu� lot, ole �zfC �2�C' � . 44 ,� � «i�r � ��oy ate =