HomeMy WebLinkAboutZ-23024FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTIN~
C~lqTIFI~ATE OF O(~u~ANCY
No Z-23024 Date JUNE 1, 1994
THIS CERTIFIES that the building ONE FAMILY DWELLINC
Location of Property 1030 BROADWATERS ROAD uuTCHO~UE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 104 Block 9 Lot
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a One Family Dwelling built
Prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z-23024 dated JUNE 1, 1994
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 ONE FAMILY DWELLING WITH ATTA~D TWO CAR GA~AGE *
The certificate is issued to JESSICA ~%RRIS
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*P?.~%SE SEE ATTA~D INSPECTION REPORT.
N/A
N/A
N/A
Rev. 1/81
LOCATION: 1030 BROAD~ATEP. S RD.
(number & street)
SUBDIVISION
NAME OF OWNER (s) JESSIGAHARRIS
BDILDING DEPARTMENT
TOWN OF SOUTHOLD
DOUSING CODE INSPECTION REPOET
CUTCHOGUE, N.Y.
(municipality)
[bkP NO. LOT(s)
OCCUPANCY A-{ l~S.
(type)
ADMITTED BY: GEORGE VERITY
KEY AVAILABLE
SOURCE OF REQUEST: JESSICA HARRIS
OWNER
(owner-tenant)
SANg
ACCOMPANIED BY:
SUFF.CO. TAX MAP NO. 104-09-UI
DATE: MAY !0, 1994
DWELLING:
TYPE OF CONSTRUCTION
FOUNDATION
TOTAL ROOMS:
BATHROOM (s)
PORCH TYPE
BREEZEWAY
DOMESTIC DOTWATER
TYPE HEAT OIL
O~t~R:
WOOD FRANg
CEHENT CELLAR
IST FLR. 5 2ND FLR.
ONE TOILET ROOM (s) ONE
REAR SCREEN PORCU DECK, TYPE
FIREPLACE ONE
YES TYPE HEATER ELECTRIC
WARHAIR XX
~ STORIES ONE ~ EXITS TWO
FULL CRAWL SPACE
3RDFLR.
UTILITY ROOM
PATIO
GARAGE 2 CAR WOOD FRAME
AIRCONDITIONING
NOTWATER
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.
SWIMMING POOL
OTHER:
STORAGE, TYPE CONST.
· GUEST, TYPE CONST.
V_~ATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART . SEC .
CHAPT. F
BASEmeNT PROBI.ENS WITH FOUNDATION & FIREpLAcE FOOTING AS INDICATED NYCRR ~0. 95
ON ENGINI~I~RS REPORT (SEE ATTACHED)
DATE OF INSPECTION NAY 18, & NAY 26, 1994
TINg START 9:30 END 10:00
10:15 10:35
CONSENT
TO
INSPZ~CTiON
JESSICA HARRIS (f/k/a Jessica Jof~e) . , the undersigned,
Owner(s) Name(s)
do(es) hereby state:
That the undersigDed (is)~ the owner, s) of the pre~nises tn the
of $outhold located at 1030 Broadwaters Road, Nassau Point, Cutchogue
---, . . , which is shown and designated on the Suffolk
County tax map as District !000, Section 104 . Block 09 , Lot 001.000.
That the undersigned (has) (h~,vc) filed, or caused to be filed, an applica-
tion in the Southold Town Building3nspectol,.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 with respect to the aforesaid application, including inspections
to determine that said premises comply with albof the laws. ordinances, rules
and regulations of the Town of Southold.
The undersigned, in consenting to such ~spections, do(es) so ~th tile
knowledge and understanding that any flfformation obtained In the conduct of
such inspection~ may be used as evidence in subsequent prosecutions for vio-
lations o[ the laws. ordinances, rules or re~lations of the Town o[Southo~d.
Dated: ~y 10, 1994 - V~eC /,--~
'./ (signature)
JESSICA ~RIS
(print name)
(sllznature)
(pr iht name)