HomeMy WebLinkAboutZ-17912 FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-17912 Date MARCH 30, 1989
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 125 BROADWATERS ROAD CUTCHOGUE, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 104 Block 12 Lot 8
Subdivision Filed Map No. 156 Lot No. 193
conforms substantially to the requirements for a private one-family
dwelling built prior to: APRIL 9, 1957 pursuant to which
CERT. OF OCCUPANCY. #17912 dated MARCH 30, 1989
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*
The certificate is issued toEST.OF PAULA KISO,ROBERT A. WACKER JR.,EXEC.
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NO RECORD PRE EXISTING
UNDERWRITERS CERTIFICATE NO. NO RECORD PRE EXISTING
PLUMBERS CERTIFICATION DATED NO RECORD PRE EXISTING
*PLEASE SEE. ATTACHED INSPECTION REPORT.
Building Inspector
Rev. 1/81
~
BUiLD1:':'G DCt~i2'~iT.'L.IiT
TO'ri•I CF SOUT',--:OLD, N. Y.
HOU:,IidG CCD,_. Ii1S?r.CTIGid R:r°ORT
Location 125 BROADWATERS ROAD CUTCHOGUE, NEW YORK -
~nL:.~eer a street) (i•iun~cipality)
Subdivision iviap No. Lot(s)
Na.~ne c7~~rrner(s) ESTATE OF PAULA KISO
Occupancy RESIDENTIAL
~ Hype) owner-tenant)
Ad.::ltted b~ItOBERT A. WACKER, JR. ACCOmpariled by: SAME
Key available Suffolk Co. Tax No. 104-12-8
SOUZ'Ce O~frequeSt ROBERT WACKER ~ Date MARCH 27, 1989
D~:BLLI~IG : .
Type of construction wooD FRAME rstories 1
Foundation CEMENT BLOCx Cellar FULL Crawl space
Total rooms, ls~. F1 5 2nd. Fl 3rd. Fl
Bathroom(s) 1 Toilet room(s)
Porch, type SIDE ENCLOSED Deck, type Patio, type
Breeze:•!ay Garage 2 car below Utility room •
ouse
Type Heat oIL ~ 'alarm Air Hotwater ~
Fireplace(s) ONE No. E:cits 2 Airconditioning
Domestic hotwater OI>. Type heater BOCK
0th er REAR ENTRY WAY, KITCHEN PANTRY, OUTSIDE SHOWER IN REAR
ACCESSORY STRUCT'JRD'S : NONE
Garage, type coast. Storage, type const.
Swi;.,ming pool Guest, type const.
Other
VIOLATI0~1S: Housing Code, Chapter 45 N.Y. State Uniform Fire Prevention
& Building Code
Location Description ~Art.~ Sec.
Remar.cs • HOUSE IN GOOD REPAIR
Inspected by• ~ Date of Insp. March 29, 1989
GARY • I H
BUIL NG INSPECTOR ' Tlme Start 9:30 end 9:50
. ~ ~
TOWN OF SOUTHOLD
~ ~ ~wz~,v ~ NAR 2 T h~~
_ BUILDING DEPARTMENT ~ ~
~L _ _
ayvs ~ TOWN HALL ~ ~~d-~ f~ ''>7. ~i.
rr ' rt..-'~~~iL.D
Q',.~~_/L_ SOIITHOLD, NEW YORK 11971
F'~' --"~-°"0~""" 7 6 5 - 18 0 2
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
DATE ~~?C,~.~ ~ ~ .
NEW CONSTRIICTION .......OLD OR PRE-EBISTING BIIILDING..~pACANT LAND........
Location of Property.!o2~ .....~~~%4~WAi
E~S.. C~-CN.o~IY~_ ~~93s
HOIISE NO. ter- STREET HAM,LE)T
Owner or Owners of Property.~s.TA/ OF_ -p((~~- ~/Spy ~o~E~T_ ~._(~(/f1G~'~~~~/~_E~cECN'pa
County Taa Map/,~yNo.1000 Section .1~.~. Block ._t~:/2 Lot
Subdivision././.°t'.s~u::~~ , , , J, O- - -
Filed Map 1 ...Lot
Permit No. ..........Date of Permit ..........Applicant
Health Dept. Approval Underwriters Approval..............
Planning Board Approval
Request for Temporary Certificate Final Certificate
Fee Submitted:
APPLICANT.L~~Z~JV.`?!: _ ; ,"~,cc~..
C~pc•3 ~qi9
rev. 10/14/88
CONSENT
TO
INSPECTION
~~~?~~~~a-~ f 1~~~ G(/,~-Q/fee~c~ . the undersigned,
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town p
of Southold located at ~~FOftolt)/`~TEOe,S ~OfJp~ ~jJ~-G/`~D~rUE 7 3J
which is shown and designated on the Suffolk
County tax map as District 1000, Section Block Lot ~
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in the Southold To«rn Building Ins~pepctor's Office for the following:
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 trat said premises compl~~ with all of the laws, ordinances, rules
and regulations of the Town cf Southold.
The undersigned, in consenting to such inspections, do(es) so with 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.
Dated: ~l
P.nc~` 02 ~ ~9 6 / U Q7~,~ c 11.~e. ~ I
(signature)
(print name)
(signature)
(print name)
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