HomeMy WebLinkAboutZ-4994FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupnncy
No. 3..~'99.~. .... Date ........... J.a~n~,~ry. 2 ..... , 19.73.
THIS CERTIFIES that the building located at ..E/~..~.n~..h...~.o~. (.PJ~ .1~). Street
Map No...x~r~ ...... Block No ..... x~ ...Lot No..~XX... 8nuthold.. ~.,¥,. ~h. Di~t ¶0)
the~'~ uirement~ fgr on famil dw~_l & Housing Code
conforms
substantially
to
cle~zl .......... A~=il. 23., 19.~7. pursuant to which o
dated .......... J~n... 2 .... , 19.7~., 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 . .Pti.rate. ~ne. f~mll[f..dwelling ......................................
The certificate is issued to . 24ari& .Baue~ ..... (~ne~ ..............................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . .P.r.e..-..e.x..t.s.~.$.n.g ...................
UNDERWRITERS CERTIFICATE No...P~.~.-..~..S~-g ................................
HOUSE NUMBER... '~.~.~ ...... Street .... Ru. etl .La D_~. ..................................
¶ !~o l~ght ~J. th at ~ point of entry ~ _...
2. Vent pipe elbow on water heater needs repair
~. Open elec Junction box 528a Building Inspector
HOUSING CODE INSPECTION
February 2, 1973
735 R~usch Lane
Greenport, N.Y.
Tax Roil: Marie Bauer
Unoccupied - R 1
Upon request of the Southold Town Building
Department, I made inspection of this one family
framed dwelling and found the following violations
of Local Law #1, Housing Code, Town of Southold.
I was admitted to building at south entrance
to living room by Mr. James Baker, Real Estate
Broker, at approximately 2:10 p.m. Mr. Baker was
present during my inspection.
Entrances: Three from outside, no switch to
control light in rooms on entry - Section 529b.
Cellar: Open junction box not secured -
~n 528a.
Flue Pi~e from 9as hot water heater: Elbow,
metal deteriorating at joint forming an
opening - flue pipe connection to large flue
pipe from furnace, connection not tight
Section 523 a, b.
Inspection completed at approximately 2:35 p.m.
- ~l~w~ r d Hind~rmann
Building Inspector
EH:tle
FORM NO, 6
TOWN OF SOUTHOLD
Building Depmtment
Town Clerks Office
So.thold, 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, 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), No~-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
3. Copy of certificate of occupancy $I.00
$5.00
Rte ....... .
New Building .................... Old or Pre-existing Building ...... ~, ................... Vacant Land ............................
Location Of Property ...... ~../~. ..................... .~/....~,..~..6~...~.~ .................................... .~.., ........................
Owner Or Owners Of Property ..... ~...~....~..~..~.........~....~....~.....~.....~. .............................................................
Subdivision ~..~..~....~...~.....~/....~...~/.....~..~,~..~......~.?....L~......~.f. Lot No ............. Block No ............. House No..~..~.~j
Permit No ..................... Date Of Permit .................... Applicant ..................................................................
Health Dept. Approval ............................................ Labor Dept. Approval ................................................
Underwriters Approval .............................................. Planning Board ,~oproval ........................................
Request For Temporary Certificate ........................................ Final Certificate ~
Fee Submitted $ ....~..~.~ ....................
Construction on above described building a~c~ permit meets all applicable codes and regulations.
Apphcant ~.~ .............................................................................
Sw°rn ~-b~fa~r~fme'~ ~/f ..~.....~....~..... (stamp or seal)
Notary Public ~~ County
TERRI LEE ELAK
NOTARY pUIJLIC, State of Hew '~ork
No. 52 616S. 95