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Home My WebLink AboutZ-7736FORM NO. & TOWN OF $OUTHOLD BUHJ)ING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at . .I.a! .~..~..V.i..w..~..~. ~ ....... Street Map No. ~ Block No....~. ...... Lot No.. ~ ..... . .CL-~..~.l!.p.o.~.....I~:.Y... ..... conforms built dated ........... J~..2~ .... , 19.~., was issued, ~d confo~s to ~1 of ~e req~ ments of the applicable pro~sions of the law. The occup~cy for which ~s ce~ificate is The certificate is issued to .... Y~a. ~}0~ ....... 0~ .......................... (owner, lessee or ten,t) of the aforesaid b~lding. S~olk County Department of Health Approval D~w. ~S~.~ ..................... UNDERWRITERS CERTIFICATE No. p~e- e~s~ Bffilding Inspector [ HOUSING CODE INSPECTION June 23, 1977 #1425 Island View Lane R-1 Greenport, N.Y. Tax Roll: Vera M. Weston Occupied: Owner Upon receipt of an application for a Pre-Existing Certificate of Occupancy, I made an inspection of this one-story wood framed dwelling. I was ad/nitted to building by Reginald Hudson and began this inspection at approximately 10:05 A.M. The building is constructed on cement block piers and con- tains two bedrooms, full bathroom, and one room containing living and kitchen facilities. A roofed over partially screened porch protects entry to living room at rear of building. A utility room on front of building contains an oil fired forced warm air furnace, electric domestic hot water pump, and side entry. The following violations of the Housing Code, Chapter 52, Town of $outhold, New York, were found: Gas cooking range - no shut off valve at unit, Article V, Section 52-52 B 2. Smoke stack - for furnace requires repair of seal at chimney connecting, Article V, Section 52-54 A 1. Entries - to building, no means of controlling light in rooms at points of entry, Article V, Section 52-56 B 2. Inspection completed at app~O~imately~ 10:20 A.M. I Re~/e c. ~y ~.bmit~ed, Building Inspector EH:med FORM NO. 6 TOWN OF SOUTHOLD Building Depo~tment 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, Ntultiple 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 buiJdJngs. 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 $1o00 Date ...... .~...t~....e.....~..~..,.....~.~...~'.7. ........... New Building .................... Old or Pre-existing Building ...~..~ ....... Vacant Land ............................ Location Of Property ....Z..~..~..l~...d......V...~.e...~.....~...~....e. ............................................................... .~...[..s...~....]....0..0...0. ...... Owner Or Owners Of Property .......... ..V..~.....~..e..a..~.o...a. ...................................................................................... Sect~on Subdivision .S,.~..,~..~...o.~.~.....C...o..,~...~...,~.,.a..~. ..................... Lot No...lJ ..... Block No .....~)2,..~T~e No....~.~.~.. Permit No ..................... Date Of Permit .................... Applicant .................................................................. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ . ~. .... .0.. .0. ......................... Construction on above described building and p~ ~_s all applicable codes and regulations. Applicant .......... ~~.~. ~..~.....~. ......................................................... Sworn to before me this ...~.~... day of .....~..~,.q.~....]~c~.7. ................ Notary Public ............. ~.~.~'~g ,~1~ ...... County ~]UL~A D AANES'rA~ ~-'' NOTARY pUBLt~, State of NeW York No. 52.0000[00 Suffolk Coanty Term Expires March 30, lg.~.~