HomeMy WebLinkAboutZ-9897FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No ....... .Z.9.897 ..... Date ...l~.a.l~..o.h..1.7. ..................... 19 ../K).
THIS CERTIFIES that the building ................................................
Location of Property ...q.2~.~. ~ .e~...S.~.f.f.o.3.k..&.. ~..B..ay..R.o..e.d. ........ .CAI..~.c.h.o. 8~..e.m..N:Y,
House No. Street Ham/et
County Tax Map No. i000 Section .... .'1.1.6 .... Block ...2 ........... Cot .... .'1~. ........ ~ .
Subdivision ............................... Filed Map No ......... Cot No ..............
require~en~c8 for a one feafl.ly dweZlin& tmlZ~; prior ~;o
conforms substantially to the ?P~l~i~:~/~Yd/~i~g~l~/lll~
Cer~;lfica~:e of Occupancy
..... Apr;L~ .25 ........ 19 ~?pursuant to whicl~l~l~ ............. g989.7...
dated ... ~l.e.r. ~.h..1.7. ............... 19 ..SQ., was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
......................... Prl~ra~.e..One. F?.m. ~ly..D~.~.~lSng ......................
The certificate is issued to .......... ~.o.e.e.]ph. ~.,...~.~/~1~ .e?..&..~..f., .......................
(owner, ~
of the aforesaid building.
Suffolk County Department of Health Approval .......... I~./.R. ............................
UNDERWRITERS CERTIFICATE NO .................. I~/~. ............................
Building Inspector
Rev 4/79
Location
Subdivision
BUILDING DEPAI{T~NT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
12555 New Suffolk & 65 Bay Road .
(number & street)
MaP No.
'Cutchogq. e, N.Y.
(Municipality)
Lot(s)
Name Of Owner(s)
Joseph B. Wagner & wf.
Occupancy
A&mitted by:
R- 1
(tyPe)
John Moore
Key available
unoccupied
(owner-tenant)
Accompanied by: John Moore
Suffolk Co. Tax No.1000-116-2-13'
Source of request Josep~ Bi Wagner
Date March 17, 1980
D%fELLING:
Type of construction wood framed #stories
Foundation cement block Cellar partial Crawl space
Total rooms, 1st. F1 4 2nd. F1 3 3rd. F1
Bathroom(s)_ 2 Toilet room(s)
Porch, tyPescreened-in(2)Deck, type
Breezeway. Garage
Type Heat oil fired
Fireplace(s)
DOmestic hotwater
Other
Warm Air
I 1/2
rest
No. Exits
yes
Patio, tpTe
Utility room
Hotwater X
Airconditioning
Type heater tankless
ACCESSORY STRUCTURES: (NONE)
Garage, type const.
Swimming pool
Other
Storage, type const.
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
Location Description
Water from outside Q£ dwelling
coming into crawl space
One side of stairway cellar is ooen
Art.I Sec.
II___~I 52-31A
II
52-27-B
Remarks:
Inspected by:~Date of Insp.. March 17, 1980
Curtis Horton Time startfll:00 end 11:20
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
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 Inspec-
tor 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 featu res.
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 installa-
tions, 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.
For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of peoperty 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 informa-
tion required to prepare a certificate.
Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use
3. Copy of certificate of occupancy $1.00
$5.00
Date ..........................
New Building ............. Old or Pre-existing Building ...Y.e..s ...... Vacant Land .............
Location of Property . .N/.W...c.o.r.n..e.r..o.f., .N.e,w...S.u.f.f.o..l.k..A..v.e.n.u.e...&..B.a.y..R.o.a..dr..C.u..t.c.h.o.g~..e.
Hou~ No, Street Ham/et
Owner or Owners of Property . .J.o..s.ep.h...B....a.n..d..M.a..ry..E.....W.a.g.n..e.r .........................
County Tax Map No. 1000 Section .... 1.1..6 ........ Block ....2 ........... Lot ..... 1,3. .........
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No ........... Date of Permit .......... Applicant ...J.o.s.e.~.h..B.;..W.a. qn..e.r. ............
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate ..... .X. ................
Fee Su bm itted $.. 5. ...O.O. ......................
Construction on above described building and pe,5~it meets,all applica/J~le/eo~?/~nd regulations.
· '' ~ J--' , , ~ /~z"..f
Apphcant ..... ~,~_1~~ ~.'r~.. ,.~../. ~. ~ . .: . . l ..........
Joseph B./Wag~er ×'/ /~ ~ _ ~
STATE OF NEW YORK )
COUT~TY OF NASSAU ) ss.:
JOSEPH B. WAGNER, being duly sworn, says that he
resides at 122 Hempstead Avenue, Rockville Centre, New York, and
is the owner of the improved premises at Cutchogue, Town of
Southold, Suffolk County, New York, being at the Northwest corner
of New Suffolk Avenue and Bay Road and that he has owned these
premises as tenants by the entirety with his wife, Mary E.
Wagner since October 26, 1959.
That the premises have been used exclusively as a one-
family residence and, to the best of the knowledge of your
deponent, the building is in good condition and complies with
the basic requirements of the buildi~ng code.
Sworn to before me this
/'~ day of March, 1980,
"
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