HomeMy WebLinkAboutZ-10069FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N,Y.
Certificate Of Occupancy
No ~ Z10069 Date August; 11 19~..0.
THIS CERTIFIES that the building ................................................
~35 Riley )venue Mattituck, N.Y.
Location of Property ..........................................................
House No. Street
County Tax Map No. 1000 Section ... !.~.~. ..... Block .... '.~ .......... Lot ..... ,o.,.o. .........
S ..... Geo. H. Riley ........ 186 -tNo 8
uomvm]on ............................... t~nett Map go.. ....... l~oJ .
requi~-emente fo~' a one family dwezzlng
conforms substantially to the ~ '~ . '
...A.I~..~.i.1.' .~..~ .......... 19~.7.. pursuant to which~ ......... ~.1.0.0..~.c). .....
dated August 11 19 80 was issued, and conforms to aU of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
................... ?::~. ¥.?..0..~:. ?..~..~.~?...~..t~)..~.~ ............................
Clarence T. Bergen
The certificate is issued to ..................... ~ohJn'e'r,'l~) ......................
of the aforesaid building.
Suffolk County Department of Health Approval ..........................................
UNDERWRITERS CERTIFICATE NO ....
to
Building Inspector
Rev 4/79
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location
Subdivision
435 Riley Avenue
(number & street)
George H. Riley
..Map No.
Mattituck. N.Y.
(Municipality)
186 Lot(s)
8
Name of Owner(s) Clarence T. Bergen
Occupancy
Admitted by:
Key available
R-1
f ~yp.e/
se~f
Wickham, Wickham &
Bressler, P.C.
unoccupied
(owner-tenant)
Accompanied by: self
Suffolk Co. Tax No. 1000-143-4-18
Source of request William Wickham
Date July 30 ~ 198.0
DWELLING~
Type of construction
Foundation
Total rooms,
Bathroom(s)
Porch, type
Breezeway
cement brick
1st. F1 5
1
glassed in
Type Heat oil fired
Fireplace(s)~
Domestic hotwater
Other
Wood
Cellar
#stories
full Crawl space
3rd. F1
2nd. F1
Toilet room(s)
Deck, typ~ Patio, typ~__
Garage Utility room
Warm Air Hotwater X
No. Exits 3 Airconditioning
yes Type heater tankless
ACCESSORY STRUCTURES: cement
Garage, type const. 2 car/block
Swimming pool
Other
Storage, type const.
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
Location Description Art. Sec.
Cellar No rail cellar steps II 52-27-B
Kitchen Gas stove - no shut-off V 52-52-E6
Outside Back steps - bad . III 52-30~A
Garage Bad crack on block walls .. IIIi ~2-~1,B
Remarks:
Inspected by:
~ ,~~_Date of Insp. August 8, 1980
Curtis Horton Time start 2:00 end 2:20
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 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 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.
B. 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 featu res.
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 ... 7/38/88 ................
New Building ............. Old or Pre-existing Building ...;( ........ Vacant Land .............
Location of Property ... ;Lile2 · kv~, ~, .F. at, t.i~.uuk, .hew · ¥ozk ...............................
House No, Street Ham/et
Owner or Owners of Property ...... gla~enoe .~.. 'Bergen ....................................
County Tax Map No. 1000 Section . .~,43 .......... Block .... 4 .......... Lot. '18 ............
Subdivision .G,~, ,~,~,&D,/'~, .~l, ey ........... Map No. ~86 ........... Lot No...8 ...........
Permit No ........... Date of Permit .......... Applicant . .Wil~.~aza .w~,o]-,~a~, .saff, ...........
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate ...X ...................
Fee Submitted $ .5.~ ........................ /
Construction on above described building and permit meets
t//// /.////.// ~--'/
Applicant ............... ~; ~-'~.,.m~,~.~/.....
Rev, 10-10-78