HomeMy WebLinkAboutZ-10224FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
210224 October 29, so
No.................. Date ................................ ,19...
THIS CERTIFIES that the building ................................................
Location of Property 3$0 6iCks Road, 1i.ow Suffolk, Y.
House lVo. Street Hamlet
County Tax Map No. 1000 Section ...11� .....Block . 8 ............Lot ...17........... .
Subdivision ...............................Filed Map No. ........Lot No. ........ ... .
requirement for a one—fandly dwel'in built prior to
conforms substantially to the eativn-far�Bvfftling-'ermrt-ite�teFor�"llied'in'ChtS'QFPI��'ii
Au.rii 23, 57 Certificate of Occupancy 210224
..................... . 19 ... pursuant to which Butltlii►g'Fullif t'NZY.....................
dated ... Petober .?9,............ 19 80 , 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 .........
Private One -Family Dwelling.
................................................................................
The certificate is issued to .... u;,A4am Gaffga
(owner, Af`76�it�
of the aforesaid building.
Suffolk County Department of Health Approval ...IJR
UNDERWRITERS CERTIFICATE NO .... N/. R ...........................................
':...�.........
Building Inspector
Rev 4/79
BUILDING DEPARTMENT
TOI-al OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 380 Wicks Road, New Suffolki N.Y.
number tc street Municipality
Subdivision
Name of Owner(s) William Gaffga
Occupancy,
Map No. Lot(s)
R-1 Unoccu
(type
owner-tenan
Admitted by: Theresa H. Boken Accompanied by:
Same
Key available Suffolk Co. Tax No. 110-8-17
Source of request Abigail A, Wickham' Date 10/22/80
DWELLING:
Description
Art.
Sec.
Wood
#storiesl
Type of construction
52,52 E6
Foundation Cement
Block Cellar
PartialCrawl space
Total rooms, lst.
F1 2nd. Fl
2 3rd. F1
Bathroom(s) 1
Toilet
room(s)
Porch, type Roof over Deck, type
Patio, type
Breezeway
Garage
Utility room x
Type Heat_ni iyi rPc3
Warm Air
Hotwater
Fireplace(s)
No. Exits 2
Airconditioning
Domestic hotwator
yPs Type heater Tankless
Other
ACCESSORY STRUCTURES: None
Garage, type const. Storage, type const.
Swimming pool
Other
Guest, type const.
VIOLATIONS: Housing Code, Chapter 52
Loca-'tion
Description
Art.
Sec.
Kitchen
Gas Stove No Shut Off
V
52,52 E6
Oil Burner located in this room to close
to combustible material3 no fresh air
.
2 D31
G 1 & 2
Remarks: The Oil Burneu d be moved to the cellar.
Inspected by:o
Date of Insp. Oct. 28, 1980
Curtis Orton Time start i n. 1r_end n. 3.0
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 surrey 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 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 $5.00
3. Copy of certificate of occupancy $1.00
Date ...,10/22/80,,,,,,,,,,,,,,
New Building ............. Old or Pre-existing Building ... x ....... Vacant Land ..............
Location of Property ... , s/ Wicks Road New Suffolk,, New York , , , , , , , , , , ,
House No. Street Hamlet
Jessie T. Gaffga (deceased) Theresa H. Boken, Administratrix
Owner or Owners of Property........................................................... .
110.00 08.00017.000
County Tax Map No. 1000 Section ............... Block ............... Lot ................
Subdivision .................................Map No. .............. Lot No. ............. .
Permit No. .......... Date of Permit ..........Applicant ..................................
Health Dept. Approval .. NVR..................Labor Dept. Approval ........................
Underwriters Approval .. 19./.13..................Planning Board Approval ......................
Request for Temporary Certificate .....................Final Certificate . X ....................
Fee Submitted $. 5.00,,,,,,,,,,,,,,,,,,,,,,,,
Construction on above described building and permit meets all applicable codes and regulations.
W' ham,P'W' kh & Bressler P.C.
Applicant ..... 1M .`. ��4��.L .........................
Abig#1 A. Wickham `s
Rev. 10-10-78 To obtain a key see Mrs. Theresa H. Boken, Wicks Road, New Suffolk, N..
tel. no. 734-6683 1 G �
o I'�ja