HomeMy WebLinkAboutZ-7656NO. ·
TOWN OF $OUTHOLD
BUH~ING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificnte Of Occupnncy
No. Z?6~ Date ............... . .!~.~'.
THIS CERTIFIES that the building located at . .~..YAr!.. e.w..A.~. .............. Street
Map No. 8~F~lock No ........... Lot No. ~ ..... G~P?~ ...........
· eq~r~ent~ fo~ o~ f~ly
conforms substantially to tb~
~lt ee~tifieate of ~cup~ney
dated ~ ~ ~ 19.~ was issued, ~d conforms to ~ of ~e req~
ments of the applicable pro~sions of the law. The occup~cy for which
~d ~ .~,. ~,. ?~. ~,~ .......................................
The certificate is issued to . ~e~e. B~.~e~h .~. ~if, ..... ~ ...............
(owner, lessee or ten,t)
of the aforesaid building.
S~o~ County Dep~tmen~ of He~th Approval . ~. ~X$~g ...................
UNDERWBITEBS CEBTIFICATE No. ~. eX~t$~.~ .............................
HOUSE NUMBEB ...... ~0~ .... Street .. ~.~e~. ~ ...... G~P~ ..........
Building Inspector [
HOUSING CODE INSPECTION
Sub. Div.:
Tax Roil:
Occupied:
May 10, 1977
900 Bayview Avenue R-1
Greenport, N.Y.
Summer Haven, Lots #93 through 98 inclusive
George H. Hollerith & wife
Mrs. W. Leiblein
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 admitted to building by Mrs. Leiblein and began
this inspection at approximately 10:00 A.M.
The building consists of two bedrooms, living room, kitchen
with eating area and a full bathroom. A storage area is attached
to rear of building accessible from rear yard. Heat is furnished
to all rooms from a forced warm air furnace located in crawl space
of building's cement block foundation. An enclosed porch protects
front entry to living room.
The following violations of the Housing Code, Chapter 52,
Town of $outhold, New York, were found:
Storage Area - ceiling electric light, pigtailed socket,
ceiling electric outlet - pigtailed, Article V, Section
52-56 A 1-2.
Inspection completed at approximately 10:15 A.M.
Re~ect fu 1 ly~b, mitted,
Edward Hindermann
Building Inspector
EH:med
FORM NO. 6
TOWN OF SO~JTHOLD
, Building Department
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 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), 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 $1.00
me ...... ...............
New Building .....~../...~. ..... Addition ..... ..~../...~.... Old or Pre-existing Building .... ~ZeS ..... Vacant Land .... .~./..~....
Location Of Property .~Q.~.~....~.~...~h~...~..$...~%~iD~.V.~..At...'.'.S.~T~er...~L~.'~ ............................
Owner Or Owners Of Property ~G~e~r~.c~[~e~-~9~]:~]~e~z~j:~-~a~n~d~[9~[9~D~q~%~
(District 1000 Section 052 Block 05 Lot 045)
Subd,v,s,on ..... ~.UV~_ER../~U~ .............................. Lot No ............. Block No. 5 House No .............
Permit No ..................... Date Of Permit .................... Applicant G~or.~e...C~...S.ta~k~.v.i.~b~,...~q ......
Health Dept. Approval ...~./..~.. .................................. Labor Dept. Approval ...... 1~/...~. ...................................
Underwriters Approval ...... ..~../.~ ................................ Planning Board Approval ....~./..~. ..............................
Request For Temporary Certificate .......... '~'~"~7/ .................. FinaJ Certificate ...~e~ ...............................
Construction on above described building/nd~"pe~'t;~etLal~,~pplicab~/~code~a~r,~s.
App l ica nt .!
c. S mVZCH, 'eSQ. . -
Sworn to before me this
................ day of ............................................ (stomp or seal)
LINDA F. KOWA. L, SKI
NOTARY PUBLIC, State of ~ Y,x&
No. 52-d52a77!
Qualified in Suffolk Cour,t,,
~ 5xf:~res March 3b, 177~