HomeMy WebLinkAboutZ-5009FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. ZIP99 ...... Date Feb 20....... , 1973.
THIS CERTIFIES thatthebuilding located at Sunrise. Way .............. Street
Map No. Cedar. BeaclBlo- k No. .......... Lot No. -178. • • • . w outhold . - N Y o ..... • .
reggirome t f o e fa 1 dwell be hou in Code
conforms substantially to the AXRASVakFjU
Welt before C rt fig to .o occupancy
d e`c ........... April. 23 ., 19. 5.7 pursuant to which I� occupancy
. .
dated .........Feb.... 2U..... , 19 73 . , 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 .one famil ` dweli44........................................
The certificate is issued to . W=9Y..hrZi.l4k....... Nner......................... .
( owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval .. pXQ-. OXIOAAg..................
UNDERWRITERS CERTIFICATE No. pr0�00X 4tiAg..................................
HOUSE NUMER..3'60........ Street................................... .
Exception to housing code:
1e Exterior -tingles missing at bathroom & kitchen,, ( -
windows 3010 ... r,......... %. ..... ...
2* trim cornice & facia need paint 302b Building ►nspector
3e Utility room: needs fresh air vent for
heating unit 519a4be
4e Open elec junction box 528a
HOUSING CODE INSPECTION
February 14, 1973
#360 Sunrise Way (Pvt. Rd.)
Southold, N.Y.
TAX ROLL: Barney Mrzilek
Occupied: Ronnie Mrzilek (daughter)
Subdivision: Cedar Beach Park #90, Lot #178
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 arrived at approximately 11:30 a.m. and was
admitted to front entrance by Miss R. Mrzilek.
There were no violations on the interior of the
dwelling which consists of three bedrooms, living
room, dining room, kitchen and bathroom. The
building is heated with an oil fired hot water
furnace and there are convectors in every room.
Foundation, with crawl space, vented with inspection
door.
Exterior: Trim, facia, cornice, paint peeling
considerably leaving bare wood exposed to the
elements - Section 302b. Bathroom and kitchen
window had been replaced, shingles missing at each
window leaving sub -siding exposed - Section 301c.
Utility Room: Attached to main building -
furnace contained to heat dwelling, no louver opening
for air supply and relief of heat build up. - Section
519a, b. Open electrical junction box on servicing
end of furnace - Section 528a.
Inspection completed ar_ approximately 11:45 a.m.
Re 'ectfully shbmitted,
Edward Hindermann
Building Inspector
EH:tle
FORM NO. a
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 dispcsal—(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
DateZe.b maxT..�,�.. ].9.7.'x........
New Building Old or Pre-existing Building ........ Vacant Land
.................... .................... ............................
Location Of PropertyT�at..€1�f�,...0ed r„Bea,�h„Pal k,tiSo)�thQlci..(survey,,, attached)
Owner Or Owners Of Property W..... RZTT......... ter„ CDaughlivigg,,,a1.t.. Q.W.P. ..... jjQjRP,.,After
.......
4.00 PM)
Subdivision................................................................ Lot No............. Block No............. House No.............
Permit No ..................... Date Of Permit ....................Applicant..................................................................
Health Dept. Approval ............................................Labor Dept. Approval ................................................
Underwriters Approval ..............................................Planning Board Approval ........................................
Request For Temporary Certificate ........................................ Final Certificate ............ g...........................
Fee Submitted $? -00,,,,,,,,,,,,,,,,,,,,,,,,,,,
Construction on above described building and per me s all cable es,and regulations.
...........
.l
Applicant
....... .................... ... ..............................................
chard F, ark, ty. for Owner
Sworn to before me this
...2nd..... day of .FxUaxY.,...1.973.........
(stamp or seal)
Notary Public ......... Suffolk County
Z
l� MARY LOU DORS”'
NOTARY PUBLIC, State of New York
No. 52.100CS58 Suffolk County
Commission Expires March 30, 1973
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