HomeMy WebLinkAboutZ-7265FORK NO. S
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. 2.7.265...... Date ..... ........ `'apt......,
THIS CERTIFIES that the building located at . 01d .prchard. Laxie........ Street
Map No. -Gardners H8jDc19Ao......Lot No,4S4- ?... fast Nr,rion Y.Y.
re a re ensCo pne fam dw l ine &Housing code
conforms substantially to thebbLAWoMwx
x�ilte r iQ a of Occupancy
.... be:CQre .APr..23.., 19.57.. pursuant to which oZ7265.. .
dated .............Sep.t .30.., 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 .Priv.ate..one. family ...dtve.11i 1g ......................................
The certificate is issued to PA .1 Phi, . , , , owner . of rgcard
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval Rre- existing
UNDERWRITERS CERTIFICATE No. pre-. existing .............................
HOUSE NUMBER ....1$95...... Street .. Qld .4richard. P. N4ZIP11 .......
Building Inspect r
HOUSING CODE INSPECTION
September 29, 1976
1895 Old Orchard Lane R-1
East Marion, N.Y.
Sub. Div.: Gardiners Bay Estates, Section II, Lot #45-46
Tax Roll: Ellen Ingram Pihl
Occupied: Owner
Upon receipt of an application for a Pre-existing Certificate
of Occupancy, I made an inspection of this one-story, framed
dwelling. Accompanied by Mr. Longworth, we were admitted to
building by Mr. Pihl and began this inspection at approximately
2:00 P.M.
The building consists of two bedrooms, full bathroom, living
room and kitchen. A utility room and carport is attached to
south end of building and a screened porch is attached to rear.
Heat is furnished to building from a gas-fired, warm air floor
furnace in living room floor approximately centrally located so
as to distribute heat to all rooms. Building is constructed on
a cement block foundation with crawl space. There were no acces-
sory structures or fences on property at the time of this inspec-
tion.
The following violation of the Housing Code, Chapter 52,
Town of Southold, New York was found:
Kitchen: gas cooking range, no shut off valve at unit,
Article V. Section 52-52 B 2.
Building and grounds in good order. Inspection completed
at approximately 2:20 P.M.
Respectfully ubmitted,
dward Hin ermann
Building Inspector
EH:med
FORM NO. 6
TOWN OF SOUTHOLD
Building Deportment
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 7
Dote . ...!?�. ,� .. �F7 ...
New Building ................ Addition ................ Old or Pre-existing Building .<.......... Vacant Land ..............
Location Of Property ...... .. .. JZ .........................................................
Owner Or Owne Of Property6?Z/__/,J ...........................................
Subdivision w � .. .....Lot No.716..�l Block No ............. House No.............
Permit No ..................... Date Of Permit ....................Applicant..................................................................
Health Dept. Approval ........�l✓..Z......................Labor Dept. Approval ... tellzz.:............. I..............
Underwriters Approval ........ /",`�../................... Planning Board Approval / ..........................
Request For Temporary Certificate ........................................ Finn! Certificate ..............................
Fee Submitted $ .. .....:. ..-:..........I.......
Construction on above described building and permit meets all a fico codes and regulations.
Applicant o /
Sworn to before me this
/f 7-6 �C
. day of ............ .... ...... ................ (stamp or seol�¢� .
Notary Public ...... .... . ... County X7�1
n
7
f