HomeMy WebLinkAboutZ-5697FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. z5697...... Date .............Dec ..1
........ , 19.73.
THIS CERTIFIES Rth®®at the building located at .. Knoll. Circle ........... Street
Map No. Gard.,. -Bay-BTock Nom."...". Lot No. 25. &.26 ... Cas.t.14arloia....IfoY.•.
conforms substantially to the remenU14 1 g code
YIQt before f occupancy
......... April ... 23., 19..57 pursuant to which o• Z-5697. .
dated ......... Dec ....... 14. , 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. family..dw.e.111ng.................................... .
The certificate is issued to . Marc. • •Iglasias • • • ...Owner• • • • • • • • ................. .
of the aforesaid building. (owner, lessee or tenant)
Suffolk County Department of Health Approval ..pre,- .existing ..................
UNDERWRITERS CERTIFICATE No. .preT..Qxis.ting........................... .
HOUSE NUMBER ....380 ...... Street ... XU01 : -Circle • . • • ...... .
............................................/.n..Q..................................
Tc
............Buildinpe
HOUSING CODE INSPECTION
December 14, 1973
#380 Knoll Circle - Private Rd.
East Marion, N.Y.
Subdivision: Gardiners Bay Estates, Sec. II
Lots #25 and #26
Tax Roll: Marc Iglesias
Unoccupied
Upon request of the Southold Town Building Department,
I made inspection of this one and one half story framed
dwelling and found the following violations of Chapter 52,
Housing Code, Town of Southold. I admitted myself to east
entrance with key given to our office by John Nickles of
Lewis Realtors, Southold, and began inspection at approximately
8:55 A.M.
The building consists of two bedrooms, living room,
dining room, kitchen, and full bath, on the first floor.
Second floor; two bedrooms, one half bath, and large hallway.
Heat is supplied to each room from a forced warm air furnace
located in the cellar. A one car garage is attached on east
side of building.
First Floor
Kitchen: gas cooking range, no shut-off valve at unit.
Sec. 52-52 B2.
Bathroom: Ceiling fixture, escutcheon plate away from
ceiling leaving wires in electric box exposed.
Sec. 52-56 A-1.
Cellar: (partial crawl space north side).
Hotwater, gas heater, no shut-off valve at unit.
Sec. 52-52 B-2.
Garage: Broken windowpane south side. Sec. 52-30 - C.
Inspection completed at 9:35 A.M. Key returned to our
Office.
Res ctfully ubmitted,
Edward Hidermann
EH:mm
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 ..Dec ...... .13 ..... 1.9.73
New Building ................ Addition ................ Old or Pre-existing Building ..XXX.X.... Vacant Land ..............
LocationOf Property ....97.�..Cr.� xC.@................................................................................... ............
Owner Or Owners Of Property .... MaTC Iglesias
........................................................................................................
Gardinerd Bay Sec II
Subdivision................................................................Lot No.21&2fi. Block No............. House No.............
Permit No....�............ Date Of Permit ............Applicant ... LewisRealtors
.........................................................
Health Dept. Approval .....pKA7:M4111+ „Labor Dept. Approval .........N.R.
...............................
Underwriters Approval Pre- existing Planning Board Approval N.R.
................. ..............................:.....................
Request For Temporary Certificate ........................................ Final Certificate........:Txzz
.................................
Fee Submitted $ 5.00
..........................
Construction on above described building and permit meets aLL applica le codes and regulations.
Applicant..................... .......................................................
Sworn to before me this
. 1.. day of .......... December 1973
.... ..........................
Notary Public .................................... County
(stomp or seal0&-eL SG 4 7
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JNAUTIIORIZED AlTE6ATION OR ADDITION
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A VIOLATION OF
SECTION 7309 Of THE NEW YORK STATE
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