HomeMy WebLinkAboutZ-18535FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
F~ ~IST~C
Certi[icate O[ Occupancy
No-.-.ZT.I.8-5-.3.5 ....... Date NOVEMBER 3, 1989
THIS CERTIFIES that the building ONE FAMILY B~IELLINC
--~' ~o ..... ,. 5035 PECONIC BAY BLVD. LAUREL, N.Y.
House No. Street ' ' '/~l~mlet
County Tax Map No. ] 000 Section 128 .Block I .Lot 15
Subdivision ............................... Flied Map No ......... Lot No ..............
conforms substantially to the ~_equ£rements for a busJ_ness bui[d£ng built pre. or to
APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCI, IP. ARCY .~ Z- 18535
dated............................NOVEMBER 3, !989 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 .........
ON'E FAMILY D~ELLINC **
The certificate is issued to VERNON & IRVA COX
of the aforesaid building.
Suffolk CountyDepartmentofHealthApproval NO RECORD PRE EZISTIN~
UNDERWRITERS CERTIFICATE NO. NO RECORD PRE EXISTING
PLUMBERS CERTIFICATION DATED: NO RECORD PRE EXISTIRC
* SEE ATTACHED INSPECTION REPORT.
Rev, 1/81
BUILD I'.":G DEP.~J{T,'.~NT
T0;'~ OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 5035 PECONIC BAY BLVD. LAUREL, N.Y.
~numDer ~ s~ree~)
Subdivision Map No.
(i,lunicipa±ity)
Lot(s)
N~me of Owner(s) VERNON & IRVA COX
Occupancy R-40
(type)
A~mitted by: MARIAN KING
OWNER
Accompanied by: SAME
Key available
Suffolk Co. Tax No. 128-1-15
Source of request
PAUL A. CAMINi~I', ESq.
Date OCT. 9, 1989
D%'~LLIMG:
Type of construction WOOD FRAME
Foundation CEMENT BLOCK
Total rooms,
Bathroom(s)
Porch, type
Breezeway.
Type Heat OIL
Fireplace(s)
Domestic hotwater
Other
1st. Fi 4
1
#stories
Cellar FULL Crawl space
2nd. F1 2 5rd. F1
Toilet room(s)
Deck, type
Garage
· Warm Air xx
No. F~it s 2
OIL
Patio, type_.
Utility room
Hotwater
Airconditioning.
~ype heater STATE
ACCESSORY STRUCTURES: NONE
Garage, type const.
Swimming pool
Other
Storage, type const.
Guest, type const.
V~IOLATIONS:
_Lncation
.CHAPTER 45--N.Y. STATE UNIFOP~4 FIBE PREVENTION & BUILDING CODE
D criotio I Sec.
Remarks:
Inspected by: ~,~/~
Date of Insp. OCTOBER 6, 1989
· Time start 10:30 end 10:45
APPLICATION
FOR CERTIFICATE OF OCcUPANcY
STRUCTI DATE... 8./.2.2./.8.9.
NE~ CO:~ ON ' - .....
....... OLD OR PRE-EXISTING BUILDING'':~'''VACANTLAND ........
tocatiou of PrOperty.. 5035 Pecomic .Ba.~..B.o.~.l.e.v.ard
HOUSE NO. ''-
.............. £;_~ ........
STREET HAM ' '
County Ta~ Map No. lO00 SeCtion ...1.2.8. Block ...1... Lot' ..
Subdivi: ion ..... d-5 .....
Filed Map ........ Lot...
Per=it No. ' ......
.......... Date of Permit
.......... Applicant
Health 0ept. Approval
Underwriters Approval ..............
Planning D°ard Approval
Rcquc=t for Temporary Certificate ~"
....... Final Certificate
Fee Submitted:
APPLICAN /
.. ..............
attorney
er. 10/14/88
CONSENT
TO
INSPECTION
~(PAUL A. CAbIINITI) . the undersigned,
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at 5035 Peconic Bay Boulevard
Laurel, New York , which is shown and designated on the Suffolk
County tax map as District 1000, Section 128 , Block 1 , Lot 15
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:
pre existing certificate of occupancy
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 wi~h 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 regu~o_uthold.
Dated: 8/22/89
~/~-~ (~'~ re
(print name)
(sifnature)
(print name)
NOTE*'
~-' MONU~FENT
A'£VI$1ON$
AI.D~N ~.. YOUN$
LAND $ORV~'OR.N.~.$.LI¢.NO.I~4~
VEHNOH ~. COX
LAOREL
~OWN O~
SOUTHOLO
SUFF CO, NY.
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