HomeMy WebLinkAboutZ-11033FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Occupancy
No.Z.I. IO~2 .......
Date ...... 4Uv~..~5 .... .,. ............. 19.~
THIS CERTIFIES that the building 8.. ~ ( ~? ).: .......................................
Location of Property . 1 6 5 ................ I~e.~ua0 h..RVOaR~ ............. kll~.t:.ti~, i:~.c.l{..
Hou~ No. Slreet Hamlet
County Tax Map No. 1000 Section .. 102 ....... Block . .Q3 ........... Lot ...Q0~ ...........
Subdivision...~ ........................... Fried Map No...)~ ..... Lot No... )C. .........
Requirements for a private one-family dwelling built prior to
conforms substantially to the
Certificate of Occupancy
../~p.v. J, ~. ~.~ ......... ,19.5.~ pursuant to which Buit4in~,Pewnit~ No ..... .gAl 0~.3. .........
dated ....J.u.n.e.. J,5. ................ 19 .8.2., 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 .........
·. ~..l~C~.y.a.t,~..o31~-. ~.nlJ, 3. y..d.~/q ~.l.i.r~g. ~3qc]. ~,c,c.q :~ ~ p,r,~..t.w.q~ q .ar..g~,.rp,&q, .......
The certificate is issued to ..... ~,.q:l~ J..d..~,..C.~v. Vp.z.R .~p.d..1~$~. .wi, f0 ....... (Sh~.rle~ .....Ann
(owner, le~ ar...,mn.m II "
of the aforesaid building.
n/v
Suffolk County Department of Health Approval ..........................................
UNDERWRITERS CERTIFICATE NO .... n / r'
Building Inspector
Rev. 1/81
BUILDING DEPART~[ENT
TOVfN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 165
Pequash Avenue
(number & street)
Subdivision X
Map No.
Mattituck
(Municipality)
X Lot(s) X
Name of Owner(s)
Ronald E. Carroza and wife
Occupancy R-1
(type)
Admitted by: Mrs, Carroza
owner
(owner-tenant)
Accompanied by:. same
Key available
Suffolk Co. Tax No.102-03-006
Source of request
Rudolph H. Bruer, 'Esq. Date 4 /28/82
D%'~LLING:
Type of construction wood framed #stories 2
Foundation poured cement Cellar full Crawl space
Total rooms, 1st. FI 4 2nd. FI 3 3rd. Fi
Bathroom(s) 1 Toilet room(s)
Porch, type Deck, type wood Patio, type
Breezeway Garage. $2~t4~ room pantry
Type Heat ~ r~ Warm Air Hotwater
Fireplace(s) No. Exits 3 Airconditionin~
Domestic hotwater yes Type heater tankless
Other finished room in cellar
ACCESSORY STRUCTURES:
Garage, type const. 2-car wood
Swimming pool
Other
Storage, type const.
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
_Location Description Art. Sec.
kitchen sas stove--no shut off V 52-52-E,
tairs up rail must be continuous II 52-27-B
6
Remarks:
Curtis W. Horton Time s~ar~ 11:00 end 11:~0
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.
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 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.
C. 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
New Building ............. Old or Pre-existing Building . ..~ ......... Vacant Land .............
Location of Property .. ~.~o .~.) Fleet' s Neck Rd., Cutchogue, N.Y.
House No. Street Ham/et
Owner or Owners of Property . .R~.~.a..1¢..~.....a.~.~..S.~.~.~.~..e¥...A~.~..C.a.z'..z'.o?.a. ...................
County Tax Map No. 1000 Section . . . .~).~ ........ Block . . .3. ........... Lot..6.. .............
Subdivision ........... , ..................... Filed Map No ........... Lot No ..............
Permit No ........... Date of Permit .Applicant Rudolph H. Bruer, Esq.
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underw'riters Approval ........................ Planning Board Approval ...................... ~
Request for Temporary Certificate ..................... Final Certificate X ~/, '~
Fee Submitted $ . .5...0..0 .......................
Construction on above described building and permit meets all applicable codes and regulations.
R~v. 10-10-78
Applicant