HomeMy WebLinkAboutZ-7474FORM NO. 4
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificnte Of Occupnncy
No. Z .~..~.. ...... Date ......... ~Tala.. 19 ........... , lg.~I.
THIS CERTIFIES that the building located at . .]1/1~. ]~lap]~. P~L&e~t ........ Street
Map No. ~ ......... Block No...x~. ....... Lot No....~. .... G..l'.e.e.~.p.o.l'.~....]i.,.Y. ? .......
conforms substantially to the S r N t Oe £ i ~I
built before Apr 2~ aertiflcate of occ.~p.aney
dated ...................... , 19. ~[~ pursuant to which~][~i~[No. Z~.~. ·
dated ........... J.s~.... ] 9...., 19 ??.., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is . .P~..!¥a.t.e...o~ .f..a~..!l!r. d.~.e!.l..ing ......................................
The certificate is issued to . .~d.it.h...l~...I'd.d.c. ....... . .o~a..®.~. ..........................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval pF.e.-., eX.!S!;ilag ....................
UNDERWRITERS CERTIFICATE No. pr.e-~ .exl,~t;$ng ............................
HOUSE NUMBER ..... 2~ ..... Street . .l~..pp..P.l.&.o.e. ....... G..l'.e.e.l!.p.o.r.~. ..........
Building Inspector
HOUSING CODE INSPECTION
January 19, 1977
#255 Knapp Place
Greenport, N.Y.
Tax Roil: Edith Andrade
County Tax Map - %1000-34-2-16
On Wednesday, January 19, 1977, I made this inspection
as requested by our office.
At approximately 2:00 P.M., Mrs. Andrew Ciupryk,
occupant and buyer, admitted me to this two-story, one-
family dwelling.
On the first floor there is a living room, dining
room, one bedroom, and a kitchen. In the kitchen near
the rear door, the floor is approximately 4" lower than
the main kitchen floor.
On the second floor, there are two bedrooms and a
bathroom.
In the cellar I noticed that there is no rail on
the cellar stairs as is required.
I found no other violations of the Housing Code,
Chapter 52, Town of Southold, New York.
Respectfully submitted,
George H. Fisher
Building Inspector
GHF:med
TOWN
, Building
Town Clerks Office
Southold, N. Y. 11971
APPLICATION FOR ~3ERTIFICATE 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 disposalm(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 oil 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 ....~..a..q .~...a..:. y.....5. ,.....].. ~ ?...?. ........
New Building ................ Addition ................ Old or Pre-existing Building ..~{..X. ......... Vacant Land
Location Of Property ..3;~.~..~' ~;...~%~.~...~r.~.Q~..3Ne~...~.Q~..),~.~.4 ..............................
Owner Or Owners Of Property .~..d..~.~...~..~sTLc]..:..a..~...e. ........................................................................................
Subdivision ..~./..A. ........................................................ Lot No...N./..A..... Block No.....N./..A.... House No...~.....~...~.
Permit No ..................... Date Of Permit .................... Applicant .~{~Rg~..~.,...~C%~,~L,...~,....
Health Dept. Approval ............................................ Labor Dept. Approval ................................................
Underwriters Approval .............................................. Planning Board Approval ........................................
Request For Temporary Certificate ........................................ FinGI Certificate .~ .....................................
Fee Submitted $ .5.....0..0. ...........................
Construction on above described building/~; ~ ;n~ts all applica~.~d~es~.~d..~oti~,c~;
Applicant( ..... GEORGE C.
Sw~.to before me this Attorney for Ecl~th Andrade
.~r ............. aay or ............................................ (stamp o
Notary Public ............ ~.1~.~ .o.]...~ ....... County
L,~ ~ -52:4524771