HomeMy WebLinkAboutZ-7171FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. u.7.171...... Date .............. Aug ... 1.0...... 19.76
THIS CERTIFIES that the building located at ... •g/S- Paradise- Shores .Agdet
Map No... xx ....... Block No. ...Xx..... Lot No.. xxx .. Southold - • N eY. • • • • • • •
conforms substantially to the
buiAted 19..57 pursuant to which coo occupancy
baford - Apr:....23. 27171
dated ............. Aug ..10.. , 19.76. , 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- family. -dwelling .......................................
The certificate is issued to . -Victoria. -Pule-so ..... Owner • • • • • • • • • • • • • • • • • • • • • • • • • •
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . pro— •existing • • • • • • • • • • • • • • • • • • .
UNDERWRITERS CERTIFICATE No. pro... existing .............................
HOUSE NUMBER .-,620 ........ Street .. • Paradise• Shores -Road • • • • • • • • • • • • •
.................................................. I.............................
...........! . ! A.. . r
lding Inspector
HOUSING CODE INSPECTION
August 9, 1976
620 Paradise Shores Road R-1
Southold, N.Y.
Tax Roll: Victoria Pulese & Another
Occupied: Owner
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 Ms. Pulese and began
inspection at approximately 3:40 P.M..
The building has two bedrooms, a living room, kitchen,
bathroom, small room off living room, and a utility room,
which provides rear entrance to dwelling. Heat is furnished
to all rooms from an oil -fired hot water furnace located in
pit accessable through trap door in floor of utility room.
The following violations of the Housing Code, Chapter 25,
Town of Southold were found:
Living Room: entry, no means of controlling light in
room near point of entry, Article V, Section
52-56 B 2.
Kitchen: gas cooking range, no shut off valve at unit,
Article V, Section 52-52 B 2.
Bathroom: window does not open to exterior due to
addition of utility room; mechanical vent
required, Article II, Section 52-26 B 4 b.
Furnace: smoke stack connection to chimney, insuffi-
cient clearance between smoke stack and
structural members of building. -11-e7-Z_ 9,51C
Structures in open yard area area a paddock type fence at
side yard and rear yard property boundaries and a small utility
shed.
Inspection completed at approximately 4:15 P.M..
Re ectfully submitted,
Edward Hindermann
Building Inspector
EH:med
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 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 ........ ......C�.. ..l
New Building .............. dition ............... Old or , re -existing Building ..v/....... Vacant Land ..............
Location Of Proper .�:`.... ,?"" . .............. Z4a.(!...............................� ..�.
Owner Or Of Property ............................ ...�.i.',.............................../......C..�//
Cllejc�
Subdivision ....................�-ec�.�? ...Lot No............. Block No............. House NO.W.40.
Permit No ..................... Date Of Permit ....................Applicant..................................................................
Health Dept. Approval ...... v..:.!!`..:..................Labor Dept. Approval ..... e R.R.. .......................
Underwriters Approval ........!..:...:. ..: ....................Planning Board Approval !!..: :.....................
Request For Tempora Certificate ........................................ Final Certificate .... A......
90
Fee Submitted $ ....`...........................
Construction on above described buildin rmi meets all�able codes and regulations.
Applicant........................................................................................................
Sworn to befor
............7. day
Notary Public
emet'
of ... ....... ...... (.. ................ (stamp or seaq l]c CLA
.. ..... County �/
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