HomeMy WebLinkAboutZ-16604FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
pre
Certificate Of Occupancy
No. zl6604
Date January 21, 1988
THIS CERTIFIES that tbe building ....0 p.e.. f..a.m.i.l.y, .d.w.e. 1..1 .i.n.g ......................
Lc~eaticmc~fPrr~nartx, 28850 Main Road Cutcho ue
Hous~ No. Street ' ' Ham/et
County Tax Map No. 1000 Section l 02 .Block 6 .Lot 2 I
Subdivision ............................... Filed Map No ......... Lot No ..............
Requirements for a private one-family dwelling built prior to
conforms substantially to the
Certificate of Occupancy
April 23, 1957 pursuant to which ~l~~ No. Z16604
dated . . .J.a.n..u.a.r.y...2.1.,.. ! ,9 .8.8. ...... 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 .........
.... O .n.e.. f. a..m3.1, y' .d.%~. 1. l...i.n.g,..a.e.q e..s PP. KY.. g.a.r.a.g.e..1.99 .a.t.e.d., .i.n..B...z.o.n.e.: .........
The certificate is issued to ANTHONY T. /JANE BLADOS
..................... k'x' ..................
of the aforesaid building.
Suffolk County Department of Health Approval N / A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED:
Also B.P. #13816 C.O. #Z16461
B.P. #16130 C.O. #ZI6462
Also see inspection report
N/a
deck
pool & fence
Rev. 1/81
BUILDING DEPgJ~T:'r=PlT
T0~;~l OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 28850 Main Road Cutchogue, N.Y.
[nuuneer & street)
Subdivision
Map No.
(i~[unicipaiizy)
Lot(s),
Name of Owner(s) Anthony T./Jane Blades
Occupancy B + RI
(type)
A~mitted by: Mr. Blades
(owner-~enanr)
Accompanied by: Mr. Blades
Key available
Suffolk Co. Tax No.]02-6-2~
Source of request
Anthony Blados
Date 1/20/88
D~,'~LLING:
Type of construction Wood
Foundation Cement block
Total rooms, 1st. F1
Bathroom(s)
Porch, typ~
Breezeway
Type Heat Oil fired
Fireplace(s)
Domestic hotwater Yes
Other
framed
#stories 2
4
Deck,
Garage
Warm Air
No. ~its 3
Cel!arpartial Crawl space
2nd. F1 4 3rd. F1
Toilet room(s) !
type. wood
rest
Patio, type
Utility room !
~ Steam
Airconditioning
Type heater Oil fired
ACCESSORY STRUCTURES:
Garage, type const. 2 car wood
Swinuning pool in ground with a
Other fence
SIGN
Storage, type const.
Guest, type const.
frpn~ V~r~.
VIOLATIONS:
Location
Housing Code, Chapter 45 N.Y. Stat¢.qniform~Fire Prevention
& Buz±ainq Co~e
Descriotion I Art. I Sec.
No violations were found
This includes B.P.#13816Z issued 3/28/85
Remarks:C.o. z16461 also B.P.#16~30 issued 6/24/87
for a deck addition
for an inground pool
and fence C.D.~#Z]6462 .
Inspected by:~~~ -o.,f~^/_ Date of Insp.
CURTIS W. HORTON i e start 4:45
1/2o/88
end 5:15p.m.
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted m a~.--.~ 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 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 bu ildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00
1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00
4.Vacant Land C.O. $ 20.00
5.Updated C.O. $ 50.00 Date ............
New C OhS t ruc t i oh ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property ,(~.4~,~.~.?,. ~..4~.f..~. ~ ~ ~---/'L.~ ~'-c~,~ .~.~..~?.~.._~/'-
No. , .....................
OwnerorOwnersofProper"b/~.~...~..~.~...~-./.~...d~.~.?T ./~../_z~-Z) c~ -~ ............. ...- ......... .
tyTax Map No. 1000 Section ..~, ............ Block ...~,. .......... Lot ................
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temp~ary Certificate ..................... Final Certificate . .'-~-~... ..................
FeeSubmttedSf...~..~.,...~...~'. ..............
on above de~ribed bui}ding a~ts all ~odes and regulations.
Con,ruction
A~lican .....................
z/ zhf
CONSENT
TO
INSPECTION
· the undersigned·
of Southold located at
County tax map as District 1000· Section
That the undersigned (~) (are) the owner(s) of the premises in the Town
· which is shown and designated on the Suffolk
· Block i ., 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 ~vith 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.
Dated:
(print name)