HomeMy WebLinkAboutZ-6811FORK NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. X5811...... Date... _ .....�'g... ��......, 19.75.
THIS CERTIFIES that the building located at ... iter!�Ag . Flacse........ Street
Map No. ?X ........ Block No. X .......Lot No. QrpegppQrt N . .......
re u3.rements for one famil dwelli.q c� housing code
conforms substantially to th "M 1111
built of Pcc Haney
dated .... b� f oro Apr 197.. pursuant to which No��:j.1... .
dated ........Pep pb a r...12. , 19-75., 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 .Private fine .fp;kl4y, dwelling accessory bld; . _ _ . _ _ _
The certificate is issued to . Aor� M49. N!arn�� #t ; Owner
( owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval p!re--. existing... . .. .
UNDERWRITERS CERTIFICATE No. Pfiq- . sXist�Ag .... ........... .
HOUSE NUMBER... 521....... Street At'?T9449
Building Inspector
I/zt�� J, j,Ey ✓�J�s �,v�
FORM NO. 6
TOWN OF SOUTHOLD R�i�6
,Building Department 1K
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
Date ....
New Building ................ Addition ................ Old or Pre-existing Building ..... )1(....... Vacant Land ..............
Location Of Property ........ 3 S T�= /2 «6 %� L /� C,t ��L/y/
....................................................
...........I .................
Owner Or Owners Of Property Ind R{ S /`7 �/
............................................................................................................
Subdivision................................................................Lot No............. Block No............. House No.............
Permit No ..................... Date Of Permit i ................... Applicant ..................................................................
Health Dept. Approval ............................................Labor Dept. Approval ................................................
Underwriters Approval ..............................................Planning Board Approval ........................................
Request For Temporary Certificate ........................................ Final Certificate ..........................................
Fee Submitted $....................................
Construction on above described building and permit meets
�allo ,
licable code and reg lotions.
Applicant ........n ✓rte -T `- ...............
f /
Sworn to before me this
c Xe
/11A. . day of ... ..... 1.191 75 (stamp or sea[)
Notary Public ....... p County L ��
__ _ • ELIZABETH ANN NEVILLE �i�� 0 7 7 3
���'��L NOTARY PUBLIC, Sate of Neer York
No. 52-8125850. S_tffci� Cco
Term Expires March 30. 19 %4
December 12,1975
515 Sterling Place R-1
Greenport N Y.
Tax Roll: Doris Mae Marczewski
Occupied: Barbara Marczewski
Upon receipt of an application for a Pre -Existing Certificate
of Occupancy, I made an inspection of this one story framed
dwelling. I was admitted to building by Barbara Marczewski
who accompanied me during inspection which began at approxi-
mately 1:50 P.M.
The building consists of three bedrooms, bathroom,
living room, kitchen and entrance hall. Heat is furnished to
building from a gas fired warm air furnace located in cellar
with single outlet in living room floor, approximately centered
in building. Foundation of original building is clay block, full
cellar. Addition to front of building, foundation cement block
with crawl space.
The following violations of the Housing Code, Chapter 52,
Town of Southold, were found:
Kitchen - gas cooking range, no shut off valve at
unit. Article V, Section 52-52 B.2.
Cellar - Stairway, from ground floor, no hand rail
on open side. Article II, Section 52-27 B.
Exterior of building- shingles on southwest corner -
broken shingles exposing subsiding. Article
III, Section 52-31 B.
Accessory structure in rear yard, grounds, and buildings
in good order.
Re pectfully submitted,
EH:mm Edward Hindermann
Building Inspector
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