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Home My WebLink AboutZ-5138FORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~..5.138 ..... Date .......... May .... 9 ......... , 19.23. THIS CERTIFIES that the building located at .. ~t: .l~mrt~h. Ave ........... Street Lits Map No.~ashinggon Block No ........... Lot No..39&~0. ·..Greenport...I;.Y., ..... conforms substantially to the ' & ~X ~g~, ~, ~ Occupancy dat~!P, be£ore..Apr...23., 19 .[7. pursuant to which ...... Z513'g" dated ......... N~. .... $ .... , 19.~3., 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 . .I?ri.v. ate. me. family..dwelling ..................................... The certificate is issued to . ~ouglas .~. Erendo .¢la.~.k .... 0muers ................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . Die-,. existimg ................... UNDERWRITERS CERTIFICATE No.. 'pre-' .exis.tl~g ................................ HOUSE NUMBER....k.O.~. ...... Street.. i;~i[ll~tO.~t, il. t~Y.~ ................................ Excep.t.ion. :~.Q .hour. int. c.~de; ..................................................... 1, Center hall & center bedroom- missing elec.outlet pl~tes ['~a 2. bedroom I.~/E/ no door for ~'rivacy 209b , / ..... - 3. ~:eeds h~nd rail on eel]ay stairs 216b " , (j "~ Building Inspector HOUSING CODE INSPECTION May 8, 1973 ~405 Wilmarth Avenue Greenport, N.Y. Tax Roil: Douglas V. Clark & wf. Occupied 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, Town of Southold. I was admitted to premises by Mrs. Clark who accompanied me during this inspection beginning at approximately 2:15 p.m. Center Hallway: Electrical switch plates were removed due to walls being repainted - Section 528a. Center Bedroom, south side: Wall outlet, no plate - Section 528a. Bedroom, northeast: No door for privacy - Section 209b. Cellar: Stairway, open side - Section 216b. Inspection completed at. proximately 2:35 p.m. Building Inspector EH:tle TOWN OF SOUTHOLD Building Depmtment 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: l. 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--($~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 os 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 $1.00 $5.00 D~te ....... = ....... . ....... : ....................... New Building .................... Old or Pre-existing Building ....... 2~'. ............... Vacant Land ............................ Location Of Property -: ~ ~ ~ ~ t r /~ ~ ~ ~ '~ ~ ' ' ~ ~ ~ Owner Or Owners Of Property ..../~.~.~-.;~'/..~.;._. ,.~,. ....... ./..../~," / ', / ,~'''//lx ~' - ............................... ._.. ......... ..__.. .................... ._ ....... Lo, ............. House Permit No ....... ~ ........ Date Of Permit ....... ;...'.' ........ Applicant .................................................................. Health ~pt. Appr~al ~ ............................................ Labor ~pt. Approval ................................................ Unde~ritem Approval .............................................. Planning Board ~proval ........................................ ~quest For T~mporo~ C~ifioate ........................................ Final C~ifioate ~ ~ ~/ Fee Submitted $ ~' Construction on above described building and permit meets all applicable codes and regulations. Applicant .......... Sworn to before me this ............ NOTARy PUBLIC, Stere of Now York Suffolk C~:u:~} 0Y742~ ~Szon ExpJ res ~a~'elt 30,19,~,~ (stamp or seal) FORM NO. 6 TOWN OF SOtJTHOLD BuJJdlng Department Town Clerks Office Southold, N. ¥. 1197! 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 dispasal--(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 ....... t.;_;...ff.. ..... ,~ .................. New Building .................... Old or Pre-existing Building ....... ~. ............... Vacant Land ............................ :'.. ,ti, il' Location Of Property ............ ............. :.y...,4~.,. ...... ,.: ......... ........ :., ....... t,C../...(.......f~. ................. ;ff.,. .... Permit No. - Date Of Permit ..... ;:....' ......... Applicant .................................................................. Health Dept. Approval ................ ~ .............. Labor Dept. Approval -- - Underwriters Approval .............................................. Planning Board Approval ........................................ Req-est For Temporal/Certificate ....................................... Fee Submitted $ ...........:...J ................... Construction on above described building and permit meets all applicable codes and regulations. Applicant ...... ~.~ ........ ~ ............................................ Sworn to before me this ~"~ day of L~.,.,,';,~./~ /..~/.~...~ -- ~ ~DNA R. ANGELL NOTARY PUBLIC, S~ate of New York (stamp or seal)