HomeMy WebLinkAboutZ-5125FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. 25125 ...... Date ..............ley..... 3..... , 19. 73
THIS CERTIFIES that the building located at ..(k. Ave .................. Street
tst.
Map No.Goaso. Bay.. Block No ........... Lot No. .1.92-195 .... Southold. . N*1 •... .
conforms substantially to the re n d on fami dxellin do housin code
CINA . 19 5? pursuant to which MiAkl�o.Z '2pancy
' "bbfoVs' A0r: ... 23 '' ' ' S 5
dated .........May..... 3...... 197.3 . , 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 ..Priva-te • one -family- dwelling . .....................................
The certificate is issued to .Harold• 4:•Loretta• •Sehwardt(purnhasers).......... .
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . Pre -w . existing ...................
UNDERWRITERS CERTIFICATE No ... prer.oxisting ................................
HOUSE NUMBER ... 4.l G ...... Street .... Oak . Ave .................................... .
Exceptions - to. -Housing - eod-e e
I* No light switch at enterance rear porch 529b _----
2. No shutoff valve at kitchen range 508b I
Jury rigged elec, outlet living room 528s 1'
• Loose tiles in bathroom floor 30' d Building Inspector
5. loose elec fixture N/8' bedroom 52
6. several open elec, boxes in cellar 528a
HOUSING CODE INSPECTION
April 30, 1973
440 Oak Avenue
Southold, New York
Tax Roll: Hazel E. Maranzini
Unoccupied: summer residence
Subdivision: Goose Bay Estates, Map #1176, Lots #192 to #195
Upon request of the Southold Town Building Department,
I made inspection of this one family dwelling and found the
following violations of Local Law #1, Housing Code, Town of
Southold. I was admitted to premises by Mr. Harold Schwerdt
the intended purchaser and began inspection at approximately
2:55 p.m.
Entrance to enclosed rear porch: No electrical switch
to control light in room on entry - Section 529b.
Kitchen: Gas range - no shutoff valve at unit - Section
508. —
Living Room: Lamp cord outlet on north wall - Section
528a.
Bathroom: Floor tiles at base of toilet, joints are not
tigh� t - Section 303d.
Bedroom: Northeast, ceiling fixture not securely
mounted - Section 528b.
Cellar: Seven open junction boxes in various locations -
Se�on 528a.
Inspection completed at /approximately 3:20 p.m.
fully bmitted,
i s
d"wa r ediinermann
Building Inspector
EH:tle
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 ...... :' :?17.3...........
New Building .................... Old or Pre-existing Building ..... `...................... Vacant Land ......................
Location Of Property ...... ! ........
(� - / Ali 2o- 7Zu�
Owner Or Owners Of Property ...... L f ..i....� ru. .....,.??� f:...Jvc: ..l:r........:..... ...............
...................LotSNo/ J*...:. Block No............. House
Subdivision i%., No,' 2 C4 tl.:-�1 v
m �.
Permit No ..................... Date Of Permit ....................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 all applicable codes and regulations.
Applicant ���``""�'�� /' /✓�Gcrr rc�'�
Sworn to before met
day of ........... r./..9%3 (stamp or seal)
P lic .. . County%i
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70 7X15 SURVEY IS A VIOLATION OF
SECTION 22C9 OF THE NEW YORK STATE
IFtDUCATION LAW
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'COMES OF THIS SURVEY MAR NOT &ARI
THE LAND SURVEYOR'S INKED SEAL OR
-qR �••" D SEAL SHALL NOT RE CONSIDERED
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'rRgIELO INSi1HIilON LISTED N.RLON, AND
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