HomeMy WebLinkAboutZ-18120FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-18120
Date JUNE 16~ 1989
THIS CERTIFIES that the building~
Location of Property 615 KNOLLWOOD LANE
House No.
County Tax Map No. 1000 Section 107
Subdivision
ONE FAMILY DWELLING
MATTITUCK ~ N.Y.
Street Hamlet
Block 6
Filed Map No.
Lot 8
Lot No.
conforms substantially to the requirements for a private one fmmily
dwelling built prior to: APRIL 9~ 1957 pursuant to which
CERTIFICATE OF OCC. #Z-18120 dated JUNE 16~ 1989
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 ONE FAMILY DW~JJ.ING & ACCESSORY WOOD FRAME SHED*
The certificate is issued to ESTHER G. BASSFORD
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
NO RECORD PRE-EXISTING
UNDERWRITERS CERTIFICATE NO. NO RECORD PRE-EXISTING
PLUMBERS CERTIFICATION DATED NO RECORD PRE-EXISTING
*PLEASE SEE ATTACHED INSPECTION REPORT.
fuildting Inspector
Rev. 1/81
BU~mDI:',G DEP.~Ti,~NT
TO~,'~; OF SOUTHOLD, N. Y.
HOUSING CODE IHSPECTIOM REPORT
Location
Subdivision
6]5 KNOLLWOOD LANE
MATTITUCK, N.Y.
(n~moer ~ szree~)
Man No.
(Municipality)
Lot(s),
N~me of Owner(s) RICHARD & ESTHER BASSFORD
Occupancy
Ad::~i~,t ed b~:
RESIDENTIAL
~type)
DEIRDRE FEDUN
R-40
OWNER
(owner-~enan~)
~Ac~Ompanied by: SAME
Key available
Suffolk Co. Tax No. ]07-6-8
Source of request.
SCOTT A. HORSLEY'"
Date JUNE 9, 1989
Dt'~LLI~:
Type of construction
Foundation CEMENT BLOCK
Total rooms, let. F1
Bathroom(s) ONE
4
WOOD FRAME
#stories I STORY
Cellar FULL Crawl space.
2nd. Fi -- 3rd. FI --
Toilet room(s) NONE
Porch, type ENCLOSED SIDE Deck, type --
~oK~,. .Patio, type --
Breezeway. Garage Utility room
Type Heat OIL Warm Air Hotwater --
Fireplace(s)_ NONE NO. Exits 2 Airconditioning --
Domestic hotwater OFF BOILER Type heater
Other ~
ACCESSORY STRUCTURES:
Garage, type const.
Swimming pool
Other
J
Storage, type const. WOOD FRAME
Guest, type const.
~IOLATIONS:
Location
NO SMOKE DETECTOR
C~APTER 45--N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
I rt. I Sec.
Remarks: HOUSE ~ GOOD CONDITION
Inspected by: f'N~z~ ~- ~
'GARY/J~ F~SH ;
· :,-':-:'.','. 'l · ' 'q - · : .' . .~ - .' :
- S~ED IN NEED OF WORK
Date of Insp. 6/15/89
- Time start I 1:00AM end 1 ] :20 AM
TOWN OF SOUTHOLD
BUILDING DEPARTHENT
TOWN HALL
SOUTHOLD, NEW YORK
765 1802
il97i
APPLICATION FOR CERTIFICATE OF OCCUPANCY
NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING...~...VACANT LAND ........
HOUSE NO. STREET HAMLET
County Tax Hap No. 1000 SectlonlCiy,0° BlockOfo,Oo Lot
Subdivision ....................... Filed Map ........ Lot ..........
Permit No ........... Date of Permit .......... Applicant ...................
Health Dept. Approval ..................
Planning Board Approval ................
Request for Temporary Certificate .......
Fee Submitted: $ . . .
Underwriters Approval ..............
Final Certificate ................
rev. ]0/]4/88
CONSENT
TO
INSPECTION
E'
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is) (arc~ the owner(s) of the premises in the Town
of Southold located at
Vl~ ~o,c~ , which is shown and designated on the Suffolk
County tax map as District 1000, Section]OT.(~O, Block O~.~O, Loto~.~.
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 xvith respect to the aforesaid application, including inspections
to determine that said premises comply with all of the laws, ordinances, rules
and regulations of the To~vn 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.
(signature)
(print name)
(signature)
(print name)
KNOLLw
oOO -~
0
T~O0oR~
'Z.
CERTIFIED TO:
RE..qlD~NTI, AL MORT(gA(gE .,qER¥1CE
~PORA T~
EOUITY A~ACT ~C.
MARK ~KEE
PAUL J. ~KEE
SURVEY OF
PR OPER T Y
A T MA rtl TUCK
TOWN OF SOUTHOLD
SUFFOLK COUNTY, 1~8K
1000 107- 06
S~ale 1" = 40-'
MAIN ROAD
89 - 246