HomeMy WebLinkAboutZ-18965FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-18965
THIS CERTIFIES that the building
Location of Property 450 BAY ROAD
House No.
County Tax Map No. 1000 Section 116
Subdivision
Date APRIL 12~ 1990
ONE FAMILY DWELLING
Street
Block 2
Filed Map No.
CUTCHOGUE~ N.Y.
Hamlet
Lot 18
Lot No.
conforms substantially to the requirements for a private one family
dwelling built prior to: APRIL 9~ 1957 pursuant to which
CERTIFICATE OF OCC. #Z-18965 dated APRIL 12r 1990
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 ATTACHED 2 CAR GARAGE &
REAR ENTRY FOYER & CONCRETE PATIO*
The certificate is issued to
of the aforesaid building.
CONSTANCE MILLER
(owner)
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 ATTACHR. D INSPECTION REPORT.
/Building Inspector
Rev. 1/81
Location
BUILDI~ DEPJd{TI.~NT
T0';~! OF SOUTHOLD, N. Y.
HOUSI~ CODE IHSPECTION REPORT
450 BAY ROAD CUTC~OGUE, N.Y.
(numoer ~ s~ree~)
Subdivision
Map No.
Name of Owner(s)
CONSTANCE MILLER
(i,iunicipality)
5ot(s)_
Occupancy
(type)
A~mitted by: BRIDGET DIA
(owner-~enan~)
_____Accompanied by:
Key available
.Suffolk Co. Tax No. 116-2-18
Source of request
KIERNAN & ANGIULO
.Date 4/6/90
D~,'~ELL I MG:
Type of construction
Foundation
Total rooms, 1st. F1
Bathroom(s ) ONE
Porch, type
BreezewaL
Type Heat OIL
Fireplace(s) oNE
Domestic hotwater OFF ~OILER
Other NEAR ENTRY FOYER
~OOD F~%ME #stories ONE
Cellar Crawl space
5 2nd. F1 3rd. F1
Toilet room(s)
Deck, type Patio, typ~ONC~TE
Garage 2 CAR Utility room
'Warm Air Hotwater
No. ~cits 2 Airconditionin~
~ype heater
ACCESSORY STRUCTURES:
Garage, type const.
Swimming Pool
Other
Storage, type const.
Guest, type const.
VIOLATIONS: .CHAPTER 45--N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
Location ~ Descriotion I Art. I Sec.
Remarks:
' GAff. FIS" '
Date of Insp. APRIL |0, 1990
· Time start 9:30 end 10:00
TO~N OF SOUTHOLD
BUILDING DEPA~T~IENT
TO~N ~ALL
SOUTUOLD. NE~ YORK
765 - 1802
11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
4/2/90
DATE .................
NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........
Location of Property. 450 Bay Road, Cutchogue, New York 11935
HOUSE NO. STREET ..........
HAMLET
Owner or Owners of Property CONSTANCE MILLER
116 2 18
County Tax Map No. 1000 Section ...... Block ....... Lot~' ........
Subdivision.
...................... Filed Map ........ Lot ..........
Permit No ........... Date of Permit .......... Applicant
Health Dept. Approval
.................. Underwriters Approval ..............
Planning Board Approval ................
Request for Temporary Certificate ....... Final Certificate
rev. 10/14/88
CONSENT
TO
INSPECTION
CONSTANCE MILLER
· the undersigned,
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
450 Bay Road, Cutchogue,
of Southold located at
New York 11935
· which is shown and designated On the Suffolk
County tax map as District 1000, Section 116 , Block 2 , Lot 18
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in the Southold Town Building Inspector's Office for the following:
Certificate of Occupancy for pre-existing building.
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 ~vith 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(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
lations of the laws, ordinances· rules or regulations of the Town of Southold.
Dated: 4/2/90
(signature)
(print name)
(signature)
(print name)
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