HomeMy WebLinkAboutZ-12411 FORM N0.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No.. 212411......... Date ......PrPI".1.1 . ~ 19$4.
*
THIS CERTIFIES that the building 5.:... 2..dWelZ?.r3gS..& .1. ~~GeSS4XY. btll.~d~Flg . .
Location of Property ~ 015 , , , , , , , , , , Great ,Peconic Bay. Boulevard.. Laurel
House No. Street Hamlet
County Tax Map No. 1000 Section ...1?6......Block ...10, , , , , , , , , ,fit , ; ,013. , .
Subdivision X .......................Filed Map No. .X ......Lot No. X........... .
Requirements for private one-family dwellings built prior to
conforms substantially to the App}iea~irm-far-Btrildit+g-Pentti!-heretofore-fik~tin~Itis~ffiee-deted-
April 23 57 pursuant to wluchCBuddinf~c~YNoof Occupancy
19... g ZZ.2P411............
dated ..........April 5 19 $.4 ,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 .
.two. .private. one-family. dwellings and one accessory building.*
The certificate is issued to ...JAMES , F,, ,DRUCK~ .III , MARGUERITE K. DRUCK, HIS WIFE &
lownerleseee ertenenr}
of the aforesaid building. CHRISTOPHER D. WADSWORTH & CATHY W. WADSWORTH, HIS WIFE
Suffolk County Department of Health Approval ....no.,;~pord,,,,,,,,,,,,,,,,,,,,,,,,,,,
UNDERWRITERS CERTIFICATE NO...........,N 533083 (8/27/81)
SEE 2 ATTACHED HOUSING CODE INSPECTION REPORTS.
*Accessory building constructed under Building Permit 116582, 5/13/82,
C.O. 212413 issued 4/5/84.
Building Inspector
Rev. 1/81
BUiLDINC DEI?ARTI•IENT
TO'~~J GF SOUTHOLD, N. Y.
HOUSING CODE TNSiECTION REPORT
• Location 7015 Peconic Ba Blvd. Laurel
number u street IQunicipal.ty)~'
Subdivision DLs's.? No. Lot(s)
i~a;ne of G~mer(s) James Druck, III & Others
Occupancy_ R-1 tenant
type -~~c~wne: -ter_ar.~
rid::ri tted by: Mrs. Druck Ar..companied by:
• Key available ' `Suffolk Co. Tux. No. 126-10-13
Source of request James Druck D;~te 3/16/84
D,~''"'LLIiiG: FRONT DWELLING
Ty~~:~ of construction wood ~staries 1
Foundation cement block ('eli;~rpartial Crawl space
Total °•co;.~e•, l.st. Fl 5 _ 2nd. F"? 3rd. Fl
Pathr_~om(s) 1 ~Tai7.et rooM(s)^
Porch, tJ,~ Decl:, type Pane, typc_slate
BrFeze•.~~ay~~~GaragF~ Utility room~~,
' ''"~"pc IIcat oil fired 'rlarm Air ht~t~~€X~~~ steam_
Fireplace(s) _-__Ne. Exits 2 Aircen~sitionir.~_
Domestic hotwater VeS r Type hoa.ter gas
OtI:°r` fenced in area, rear of dwelling
C<ira~e-, type: const.~ Stor:~re, type cc:nst.
S;•~i~,~^~in~ pool.__ Guest, type coast. M~-
Otiler
a
V70L:1TIC`d: _ I-Iousin~ Cod^, Chapter 52 ry
I_~_`ti.on I~ Descri_ption - - { r'~rt. (_S~~c N
Ste. gar i no rail--cellar steps II 52-27-B,
~ ~ _
bedrooms ~ being worked on III 52-32~C~
~ ~ _ ~.r
_.-~L~.
{
R~^r.;arks : _ _ ~ _ _
In:>pec' ed cy:~,,u~ ~ 7~,,r7~, Date of Insp. 3/27/84
Curtis W. Ho~`ton Tirce start 11 :00 end 11:35
t
BUILL).ING pEP1+FtTI~IENT
TG1~T~I Gi~ SGUTHGLD, IJ. X.
HOUSING CGDE IPdSPECTIOid REPOttT
Loc4tion 7015 Peconic Bay Blvd. Laurel
w (r:umber & s ree ~ ~,hlunicipasitY )
Subdivision X titan r1o.~X Lot(s) X
Name of Ot•rner(s) James Druck, III, & Others
Occup'3ncy R-1 owner
type, o~v~n~~ -tenant)
Ad;aitted by: Mrs. Druck Accoripanied by: same ___o.
Key available ~ ' Suffolk Co. Tax No. 126-10-013_„_
`?ource of request James Druck path 3/16/84
D`'fE;LLI;~iG: REAR DWELLING
Type: of const:ruc-lion wood #stories 2
Fo,.u~dation cement slab _MCellar Crawl space
i'ot:l rcom:,, l.st. Fl 2 2nd. Fl 2 ord. .~~'i
Bath:•aom(s) 1 Toilet raam(s)~~__ M
Porch, trps_~ Decl., type- wood Patio, typo_
B~ eeze~:ray Garage Utility room X
Type iIc:~:,t Qas central 'rfarm Air X Hat~.iar,er
Pireplaar O No. E:ciis 2 Aircon3it.ionir _
Domestic hotwat°r YeS ~ T}lpe nee.ter gas
Other wooden trellis, wood burner
AC':L• 5~0~'' STI?UCTURF.S
Garage, type coast. Storage, type coast. wood
S;•r.„wing pool Guest, type coast.
Gti?nr
VTOI,ATIONS: Housing Cod;, Chapter 52
Location Descrintian _ ~ rt. ( S_^c
insulation not covered in utility .room-~ ~
all insulation must be covered with
15 min. fire rating.
upstairs ~no rail _ ~ II 52-27-B
needs aint _ _ III 52-30-C
In:>rec±ed t;y:~~,.H/G~ are of Insp. ~1~Z~84
Curtis W. Horton -Time start 11:00 end 11:350•
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
.';outhold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted n duplicate the Building Inspec-
torwith 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, acertificate 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"
end uses:
1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natura! or
topographic features.
i/`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 onpre-existing dwelling ~ land use --Yre-Existing C . 0. 15 ; 0]
3. Copy of certificate of occupancy $1.00 Vacant lanpd~lC . 0. ~ $ 00
Date ..:3~~. ~P.~L2 `T,' .
New Building .............Old orPre-existing Building Vacant Land .
Location of Property .~~.f S ~eCO?'~lC. ~'V(~ u-~/rf~.
Hours No. S i Namlet
Owner or Owners of Property 1', UC~.~. . ~A~ ~ 5 ~ d- "{"~y~YS , , . ,
County Tax Map No. 1000 Section C. 2-. ~ 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 Temporary Certificate .....................Final Certificate
Fee Submitted $ .
Construction on above described building and,. er is appli a es and regulations.
~ ,
Applicant,{~. I
C.~ ~
AN. ,o-,o.~a ~ ~ l
~~s ~~f ~
CONSENT
TO
INSPECTION
r'?~eVcGi- ,L~ t'y°f ~,~lN"~.~'(~~`~~ the undersigned,
Owner(s) Name(s)
do(e~ hereby state:
That the undersigned ~j,s~'(are) the owner(s) of thQe~ premises in the Town
of Southold located at ~D ~ S ~°~C-O ~'l IG (da-~ g ~
U r'(L.~ which is shown and designated nn the Suffolk
County tax map as District 1000, Section ~aZ ~Q Block Lot ~ 3
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in the Southold Town Building Inspector's Office for the follotiving:
V' IS+1 r1
That the undersigned do(~ 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~so tivith 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.
i-
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Dated:
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SURVEY OF PROPERTY
AT [,,gUREL ~FRANKL/NV/LLE~
TOWN OF' SOUTHOLp
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SCNLE 20' SUR ?EYEO NOV 2, /9B/
ry o
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GUAR. TO
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THE T/TLE GCIfiRANTEE COM P.ANY ~ lC
/aa/3o/o anotio.,.o woo...,ac.~v 7 ~.c amzG3
J.9ME9 FREOCQ/CK OQ[./CK $
MAR6UEFt/TE KEL BACIGH OR[/GK
CHR/STOPNCR ~ W.105WORTiy
UTNY W N/.105W0/3TN pON~1CK ~ISSOC/AYES
~ LANO SURVEYOLTS ~+/~O
CONSULT/NG ENG/NEER9
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