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Home My WebLink AboutZ-10479FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the BuiMin~ Impector Town Hall Sou~old, N.Y. No.. Z10~79 Date ........ ;Y. ........ ,19 1 THIS CERTH;IE8 that the bu~d~g ................................................ Location of Property ........94~. ~r. oa~ate~'a .Road v~utchA&ue,. .qev. ~ork ....... tf~/vo, Ham/et County Tax Map No. 1000 Section ............ 11 .Lot 009 104 Block ............................... Subdivision ............................... Filed Map No ....... Lot No ......... ¢onfom substanti-Ily to l~g/&ldl~t~_f.~fl,&_eae_iamll~,_dv~-ll~jt~~~. .~p.r. ll. tL ,19 .~ :l~tiit~-a:® of 0ccupaneyZl0179 .......... pursuant to which'B~giagt~rmt/-N8 ...................... dated ...,.a?.. 5. .................... 19..8.1, was ~sued, and conforms to a~ of ~e requiremants of the appilca~e prov~ons of the hw. The occupancy for which this certificate is hsued is ......... Private one far, lly. d~allin The certificate is iaued to ....... ~O~Aa. ~..~e~r.&er ............................... of the aformdd bufldin8. ~uffdk County Depm~nent of He~th Approval . .#/. ~ ..................................... UNDERWRITERS CERTIFICATE NO ..... ~ / a ......................................... Buildin~ Impoctor BUILDING DEPARTr,~NT T0¥,~ OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location 945 Broadwaters Road, Cu~chogue, New York {number & street) {Municipality) Subdivision Nassau Pt. Club Prop. Map No. 156 Lot(s) 295-296 Name o£ Ov~er(s) Thomas J. DeBorger Occupancy R-1 (type) Admitted by: self Unoccupied (own er-ten~'~t Accompanied by: Self Key available 104-11-009 First Towne Realt~uffo!k Co. Tax No. Source of request Rudolph H. Bruer' Date April 28, 1981 DYfELLING: Type of construction Foundation Cement Block Total rooms, 1st. Fi 5 Bathroom(s) 1 Porch, typ~ Breezeway Type Heat 0il Fired Fireplace(s) 2 Domestic hotwater Yes Other Wood #s?ories 1½ Cellar ?artialCrawl space 2nd. F1 1 3rd. F1 Toilet room(s) 1 Deck, type Patio, Garage attached ~tility room~ Warm Air x Hotwater No. Exits 2 Airconditionin~ Electric Type heater Rest type Cement ACCESSORY STRUCTURES: .. NONE ~Garage, type const. Swimming pool Other storage, type cons.t. Guest, type const. VIOLATIONS: Housing Code, Chapter 52 Location Description Art. Sec. Stairs up Stairway very narrow II 52-27=~ Outside Wood gutters rear of dwelling starting to rot. III 52-30-C Remarks: Time start 11:00 'end Curtis Horton 11:30 FORM NO, 6 TOWN OF SOUTHOLD Building Depa[i~,,ent 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. 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. 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 ... 9,3..]~'~Ad,~f~..e~;~. ~o.a,q~,. ~a,~i~.t~ .]~)~At;,. C.At;¢~p.gq(~,. ~,¥, .... House No. Street Ham/et Owner or Owners of Property ..... ~t~O~A~. ~T,..e,~,ql. ~3,~p, .E;,. p.e.]~Q~'g, ep; .................. County Tax Map No. 1000 Section . .3,0.,~ .......... Block .. ~,], .......... Lot...9. ............ Subdivision ................................. Filed Map No. ' .......... Lot No .............. Permit No ........... Date of Permit .......... Applicant . .~h.o..1~..s., .D.e.~.o.~..g.e.~. .............. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .. X. ................... Fee Submitted $ .... 5.00. .................... Construction on above described building and,oerl~t meets all applicable con'and regulations. ,,,,ica.t.. Re,. lO-,o-7a Rudolph ' ~{: ~/~ 'e'r',' ' ~'~'~n;~ ' ~;~