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Home My WebLink AboutZ-5169FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certi[icate O[ Occupancy No..2;~1.69. ..... Date ............. bia~... 2.9 ..... , 19.73. THIS CERTIFIES that the building located at . ?aradLse. SkQres. Road... Street Map No... ~ ....... Block No..~ ....... Lot No... X~:~...80'a~;h0!d.. ~;.~ 7 ........ conforms substantially to the - o ' e 6 n ,..code ~:. i~$ol'e Aprik .23. 19. ~?. pursuant to which ~o~. occupancy ' 'z '~69 dated .......... l~tlr .... ~9. , 19.73, was issued, and conforms to all of the require- ments of the applicable prows~ons of the law. The occupancy for which this certificate is issued is .... Private. one. £amil¥. aw~] Xing .................................... The certificate is issued to .. itiChar~l .~lar~ .~. k,'.~£e ..... .OM~...e.r.a .................. of the aforesaid building. Suffolk County Department of Health Approval (owner, lessee or tenant) ·. Pr.a?. exist;i~g .................. UNDERWRITERS CERTIFICATE No .... ~I'~.-.~ ~.~,n.g ................................ ItOUSE NUMBER... ~ 1 ~,.O ..... Street .... P.a~O.d.~. ).h.qr9O..3~ ...................... ~xeept~ons · to..co~e.~ ............................................................... 2. No shutoff valve at kitchen range %08b 3, No shower o~' tub in bathroom 50~ ' '/'~q~ ~'"~'~;~' ~, Exterio~ ~/S no fo~datlon or skirt ~02a / Tax Roil: Seasonal HOUSING CODE INSPECTION May 29, 1973 #1160 Paradise Shores Road Southold, N.Y. Richard C. Clark and wife 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 south entrance to screened enclosed porch by Mrs. Clark and began inspection at approximately 9:30 a.m. Large room containin~ living room and kitchen: No switch at south entrance to control light in room - Section 529b. Kitchen: Range, gas, no shutoff valve at unit - Section 508b. Half Bath: No shower or tub inside dwelling - Section 505b. Exterior: Building on posts with crawl space; section on west s--i~e under kitchen and bath area not skirted - Section 302a, and Section 604b. Inspection completed at approximately 10:00 EH:tle ~ pe ct fu~l 1/y~bmit t ed , , Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Delm~tme~t 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: 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 disposol--(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 whe[e 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-ekisting dwelling or land use 3. Copy of certificate of accupancy $1.00 $5.00 Date ......... .~- ./. - · .'~...~..Z~.. · · .-~ ............ New Building .................... Old or Pre-existing Building .......... ~i ....... Vaoant Land ............................ Location Of Propert~,~'t~-CL-~.~~.:~.~. ............................................................................... Owner Or Owners Of Pro, party ..~.,,q~.,,~.....~.,...~...~~,~, ....................................... Subdivision .... ~ ............................... Lot No......~.,.... Block No......~...... House Permit No .......~ ......... Date Of Permit .......~... .......... Applicant ..... ~ ................................ Health Dept. Approval ..... .~....~.,....~ ........... Labor Dept. Approval ...... ~.....~....~..', ............................ Underwriters Approval ....... .~..../~d,....:.....,~,,,.,.,~.. ........ P ann ng Board Approva ..,.~...~...~..: ..................... Request Far Te para Cert.icate ........................................ Final Certificate .......... Fee Submitted $ .,~...; ............................ JUDITH T. BOKEN Notary Public, Stole of New York No. 52-0344963 Suffolk County..~.~ Commission Expires March 30, 19-~::~' Construction on above described building and permit meets all applicable codes and regulations. Sworn to before me this ~ ~? 73 (stamp or seal) /~. 51 (~ c/