HomeMy WebLinkAboutZ-18088FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Occupancy
No. z 18088
Date . . .JP.~.~..6~.. 1.9..8.9 ................
THIS CERTIFIES that the building ....... .O. NI~. FA.III. gl/'..l!Jff.~..L.L.I.~ .~ ..................
1905 GRAND AVE. & 2900 I~ESTVIEI~ AVE. MATTITUCK
Location of Property ...............................................................
/youse No. Street /Yarn/et
County Tax Map No. 1000 Section ..... 1.0.7. .... Block 08 .Lot 62
Subdivision ............................... Filed Map No ......... Lot No ..............
REQUIREMENTS FOR A PRIVATE ONE FAMILY DI~ELLING BUILT PRIOR TO
conforms substantially to the ~ORS'~[~ttCI~g2~X~iZX~XJLI~[X~g~X~
CERTIFICATE OF OCCUPANCY
.A.P.R.!L...9.,,. ] .9.5.7. ..... pursuant to wllich Blllitl'PlJ~:~gltJqlJJ~No...Z.I.8.088
dated. JUNE. ........6, 198.9 ............. wai issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for Milch this certificate is issued is .........
...O.~g. ~4~.Ik'(.9.~.~?.I:.I..~.~.. ......................................................
The certificate is issued to THERESA & HENRY ZIMNOSKI
(owner,
of the aforesaid building.
Suffolk County Department of Health Approval ....... N./..A ................................
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED:
N/A
· / B~,ffding Inspector
R~v, 1/81
Location
BU~DI:',G DEP-~,Ti,LENT
TO'~'&[ OF SOUT,,OLD, N. Y.
HOUSING CODE INSPECTION REPORT
1905 GRAND AVE. & 2900 WESTVIEW AVE.
HATTITUCK
[n~moer ~ svreez)
Subdivision
Map No.
([,[uniclpall%y)
Lot(s)
Name of Owner(s) THERESA & HENRY ZIMNOSKI
Occupancy SINGLE FAMILY DWELLING OWNER
(Type) (owner-~enan~)
A~i~ed b): THERESA ZIMNOSKI. -u -Accomp~nied b): SAME
Key ~vailable
Suffolk Co. Tax No. 107-08-42
Source of request OWNER Date 5/16/89
D¥~LLI~:
Type of construction
Foundation CEMENT BLOCK
Total rooms, 1st. FI 5
Bathroom(s). I
Porch, type SCREENED
Breezeway --
Type Heat OIL
Fireplace(s) --
Domestic hotwater xx
Other
FRAME
Deck, type.
Garage I car
Warm Air --
No. ~cits 4
#stories I
Cellar X Crawl space --
2nd. F1 -- 5rd. F1 --
Toilet room(s)
-- Patio,
Utility room
Hotwater xx
Airconditionin~
~ype heater
RECREATION ROOM IN CELLAR (NON-HABITABLE)
type CEMENT
WASHER
~CCESSORY STRUCTURES:
Garage, type const.__--
Swi.~ming pool --
Other
Storage, type const.
Guest, type const.
STORAGE SHED PERMIT #12966Z with C.O. #Z18087
~IOLAT!ONS:
Location
CHAPTER 45--N.Y. STATE ~NIFORM FIRE PREVENTION & BUILDING CODE
Description I Art.[ Sec.
Remarks:
THOM HER"
· ":: ::.. ' ' -
Date of Insp. 5/30/89
· Time start ~n,~n end
I1:00 a.m.
TOWN OF SOUTHOLD
BUILDING DEPARTHENT
TOWN HALL
SOUTHOLD, NEW YORK
765 - 1802
11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
'NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING../.~'~..VACANT LAND ........
HAMLET / ~
HOUSE ~O, //~ STREET
o~ o~ o~,~, o~ ~ro~/~.<~.:~.~ s.*..//r~x_~...~.,:~v,~:.~.~x.,,,~, i ........
co,n~ T-- ~.~ No. ,000 Se~ion '..~..:. B~o~ .~. .... Lot .'.-'.----....
Subdivision ....................... Filed Map ........ Lot ..........
Permit No ........... Date of Permit .......... Applicant ...................
Health Dept. Approval .................. Underwriterm Approval ..............
Planning Board Approval ................
Request for Temporary Certificate ....... Final Certificate ................
Fee Submitted:
APPLICANT'S.' ....
rev.
CONSENT
TO
INSPECTION
C{wner(s) Name(s)
do(es) hereby state: !
· the undersigned,
That the undersigned (~) (are) the oWner(s) of the premises in the Town
/
County tax map as District 1000, Section .//~ ~, Block Y , Lot
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in the Southold Town Building Inspector's Office for the following: __
That the undersigned do(es) hereby give consent to the Building Inspectors
of the Town of Southold to enter upon the above described property, including
any and all buildings located thereon, to conduct such inspections as they may
deem necessary with respect to the aforesaid application, including inspections
to determine that said premises comply with all of the laws, ordinances, rules
and regulations of the Town of Southold.
The undersigned, in consenting to such inspections, do(es) so with the
knowledge and understanding that any information obtained in the conduct of
such inspections may be used as evidence in subsequent prosecutions for vio-
lations of the laws, ordinances, rules or regulations of the Town of Southold·
/ - ' (signa~
(print name)
(signature)
(print name)