HomeMy WebLinkAboutZ-6848 FORM N0:.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
.`Town Clerk's Office
Southold,:N. Y.
Certificate Of Occupancy
No.'zC 8 Date 197
`THIS.;,CERTIFIES that the building;located at Z... .. Za. zE . Street
Map No Block No Lot No x Gx° p4r
e - rime t . . ,
conforms substantialiy.to the.
f a f . . l & ITota Ong code
built r.. fi to accupar�ey
'dated 'before Apr .l .. 3 ,;,19 , =,7: pursuant'to,whicli &o.Z6 ,
date
d, 19 �: ., 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 .Pr va e. •o P.,.. a� Z .y ,d ra�l�ng ,.m.cessor-y .,Svim ng pool
The certificate is issued to .e cr t :R c . .(.,.A }Z�zx'. Richter. & -Wife) . timers. . .
,(.owner,-_lessee,or tenant)
of the,aforesaid building.
Suffolk.County Department of Health-Approval
UNDERWRITERS CERTIFICATE No. :p g , ."
HOUSE NUMBER 235 Street . Sva^tset. -Lame, . .Greenpart�
,AA�dn !peralt z• *00/4 . . . . . . . . . . . . . . . .
04
Building Inspector' .
HOUSING CODE INSPECTION
January 8 , 1976
#235 Sunset Lane R-1
Greenport, New York
Tax Roll : Arthur Richter & Wf
Occupied - Owner
Upon receipt of request for a Pre-existing Certificate of
Occupancy, I made an inspection of this one story framed
dwelling. I was admitted to building by Joan Richter who
accompanied me during this inspection which began at
approximately 4 :15 P.M.
The building consists of three bedrooms , bathroom, kitchen,
and dining room, and enclosed sun porch. Heat is furnished
to all rooms from an oil fired hot water furnace located in
full cellar.
An attached garage and family room constructed under Building
Permit #4054Z is located on the south end of building. Certificate
of Occupancy #Z3756 was issued by the Building Inspector, Southold
Town, on February 17 , 1970 for this addition. I found no viol-
ations of the Housing Code, Chapter 52 , Town of Southold.
Inspection completed at approximately 4 :30 P.M.
Re W-/Hndermann
submitted,
EH:mm Edwar
Building Inspector
i
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 '
' G
Date ... ...........
New Building ................ Addition ................ Old or Pre-existing Building ./....° :....... Vacant Land ..............
Location Of Property ........ ��.r...... :5!!�?.,�.�. .......�f �4!s~.�,.......... :T. - i7 1....... !�;i`
Owner Or Owners Of Property .......:........... .........✓.. .......!.:. . ..../).! ?!7.:: :"'...............................
Subdivision ... !r �..::1 !'.���4.l.4:.�?. '..............Lot No. .....a:.... Block No. ........... House No....:... .
PermitNo. .................... Date Of Permit ........`!::.......Applicant ...,.................:............................................
Health Dept. Approval ..... .:.......�.. .'. :v:: .....Labor Dept. Approval .:...:. .`22.::-:r. .:> .�s:
J H
i
v.
y,
Underwriters Approval ....: ....Planning Board Approval"
Request For Temporary Certificate ........................................ Final Certificate .rl ...............................
Fee Submitted $ ..�c�?.... ..................
Construction on above described building and permit meets all applicable codes and regulations.
Applicant .......1...��! :., ......... ..... ....
Sworn to before m this
��
..�j.......,.... day o r:��.�..�.%�........... (stamp or seal) 0
-
N tary Public .. �'�............. County . JO& 35
EI3NA R. AN!'F7L]L`
OTARY PUBLIC, St,lr. -i r.Iow York
Con_
i cr:i I:ucii 3�,19�Z
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