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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
NoZ7c.51........ Date ............
Aug ... 25 ........ , 19.77.
THIS CERTIFIES that the building located atBa y.view..kve .............. Street
Map No.sUL-,-a;er.}aveABlock No........... Lot No. .72&,7.3 • • • • •Greenport • 314Y.... .
conforms substantially to a code
ilt e��o���f����ooc curancp
-before -Apr .23 ..... 1 1957. pursuant to whicl?� k c"0S%8rj1 .. .
dated ........... pug.. 25..., 19.77., 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 ..gpivete- one • family dwelling -&. accessory..garage ...............
The certificate is issued to Dorothy. -Lynch • • • . • • Owner • • • • • • • • .. • • ............... .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . pre.-. existing ...................
UNDERWRITERS CERTIFICATE No. pre—existing . • . • . • ... • .. • • .............. .
HOUSE NUMBER .....350...... Street ..Bayaiew. Ave.....Greenport ...........
Building Inspect
HOUSING CODE INSPECTION
August 24, 1977
#350 Bayview Avenue R-1
Greenport, N.Y.
Sub Div.: Summer Haven, Lots 72 & 73.
Tax Roll: Dorothy S. Lynch
Occupied: Owner, seasonal
Upon receipt of an application for a Pre -Existing Certificate
of Occupancy, I made an inspection of buildings on this property.
I picked up keys from Arnold Larsen at his real estate office on
CR27 in Southold, N.Y., and began this inspection at approximately
9:50 A.M.
The dwelling is a one-story wood frame building constructed
on a concrete block foundation and contains two bedrooms, full
bathroom, living room, kitchen with eating area, and an enclosed
porch. Heat is furnished to building from an oil fired free
standing space heater located at north end of living room. A
small pit accessible in south end of foundation contains electric
water pump and electric hot water heater for domestic water. A
one -car garage constructed of cement block with wood framed gable
roof is located in rear yard area.
The following violations of the Housing Code, Chapter 52,
Code of the Town of Southold, N.Y., were found:
Front entry - porch, no means of controlling light in room
at point of entry, Article V. Section 52-56 B 2.
Electric switch - for porch ceiling light fixture located on
wing room si a of partition is faulty in that it does not
hold in off position, Article V, Section 52-56 A 1.
Garage - trim on each side of garage door rotting at base,
Article III, Section 52-31 B.
Inspection completed
returned to Mr. Larsen's
EH:med
at appro imately 10:00 A.M. Key was
offi;Reje
tfu 1 sued,
dward F. Hindermann
Building Inspector
FORM NO. 6
TOWN OF SOUTHOLD
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 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—(5-9 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.
I 5. Submit Planning Board approval of completed site plan requirements where applicable.
t 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
ry 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 .. .. . .. ............
New Building .................... Old or Pre-existing Building .........41.............. Vacant Land ............................
Location Of Property .....�I'TT rr`t,�L�....iJ�i1.........................................................
Owner Or Owners OfPro erty ....,GIQ. Q........f..,7...1`....
............................................................
rn%� �3�
Subdivision ...&..0 1•S )YLI ...Y..�Y+.?4.......KLot No...........' -Block No. House No .............
Permit No ..................... Date Of Permit ....................Applicant..................................................................
HealthDept. Approval ............................................Labor Dept. Approval ................................................
Underwriters Approval ..............................................Planning Board Approval ....................................
Request For Tempora Certificate ........................................ Final Certificate ........................................
Fee Submitted $,.-,IrL.G.....................
Construction on above described buildin n p e all bl��ecoodes and regulations.
Applican ..:4( w....
Sworn to before me th' %� e yy rM• C� rBr/I h ft' 11� l h 1t t7n
�j� /f �C-C�nrd c- r1en��
�.1.. day of ...... .� �•d�...
� (stamp or seal) T�
ota y Public ._ ��' 1
r ...•...• .}b -.....f County
T �>4✓'�'✓� BESS!E L. AUSTIN
NOTARY PUBLIC, State of New York
No. 52.3203050 - Suffolk County
commission Expires March 30, 1%7
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