HomeMy WebLinkAboutZ-6733 • FORM NO. 4
TOWN OF SOUTHOLD.
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate. Of Occupancy
No. Z6733. . . . . . Date . . . . . . . . . . Oet. . 8 , 19. .7.5.
THIS CERTIFIES that the building located at E�S . Oaklwan .Ave. . . , . . , . Street
Map No.74X. . . . . . . . . Block No. =X. . . . . .Lot No, xxx
requirements for one. family rdwe!10 & Housing _eode
conforms substantially to the � tK� � l „,n„r......r.....
ryn nrh�u n��[�7��I ,p)l X
Built Certificate of occupancy
dated . .before. April-.23. 19.57. pursuan.- to which No.Z.6733. . .
dated . . . . . . . . . �?�t. . . . . . , . . ., 19.7 5.,, 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,(�-, acces,soPy, (stor,qg1P,), ,bV.� ,dizig,& fence
The certificate is issued to i.!!;* �m C. ,&, 1'�,],4'= ,Wirth , (A�n.e rs. . . . `.. . N/PL
of the aforesaid building. (owner, lessee or tenant)
Suffolk County Department of Health Approval , . . . , , . . , , , . • . . .
UNDERWRITERS CERTIFICATE. No.. .pre-. existing. • • . . . . • . .
HOUSE NUMBER . . . .925. . . . . Street . . . . ..ave . . . . . • • . • ; • . . . . . . • • • • •
.& future. .bath . . . . . . . . . . . . .
NOTE: 2nd floor- S/ Br
room incomplete ; bleed. handra h
on cellar stairs . G�-
.Building Inspector
HOUSING CODE INSPECTION
925 Oaklawn Avenue
Southold, New York
Owners : William C. & Lillian M. Wirth
Inspection made: October 8 , 1975
About 1:15 P.M. Mr. Wirth admitted me to make the
inspection.
I noted nothing wrong on the first floor.
On the second floor there is the completed hall
and one bedroom. There is also the shell for a future
bathroom and another bedroom.
In the cellar there is no handrail on the interior
cellar stairs.
Outside, I noticed no violation. This is a one
family dwelling. There is an existing rail fence and
metal accessory building in the rear yard.
Respectfully submitted,
GHF:mm ZIZZW9te 7`
George H. Fisher
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 .......................!...........J..LU�
New Building ................ Addition ................ Old or Pre-existing Building ........V Vacant Land ..............
Location Of Property ......................�..........d�:I�....�.w.u........�U......... ............................................S� .. 7 h .�
Owner. Or Owners Of Property ..............I. . L L...R.M........CJ...... ......JT .,.:LI A.v...M:.....w�.��......
i
Subdivision ................................................................Lot No. ..—....'Block No. ....—.... House No......
- v. WI ;TN
Permit No. .................... Date Of Permit ....�...............:Applicant ..................................................................
Health 'Dept. Approval .................. A ..:\............ ..Labor Dept. Approval .......... ....�......�...................
Underwriters Approval ....................1...:�.:��. . ...........Planning Board Approval ........�:. ..:.K................
Request For Temporary Certificate ......:................................. Final Certificate ............. ................
C)
Fee Submitted $ .... .............................
Construction on above described building and permit meets all applicable codes and regulations.
Applicant .....lN.. ;,-,...C. ........................... .... ...........
Sworn to before me this
da of t� 3
........ y .... .. ...5 (stamp or sea l9 -3 .
Notary Public . .. -County ``�'+'��