HomeMy WebLinkAboutZ-38814 S�FFad,f� Town of Southold 2/6/2017
o�O� 4Gy 53095 Main Rd
co T Southold,New York 11971
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 38814 Date: 2/6/2017
THIS CERTIFIES that the structure(s) located at: 1305 Sigsbee Rd, Laurel
SCTM#: 473889 Sec/Block/Lot: 144.-2-6
Subdivision: Filed Map No. Lot No.
conforms substantially to the requirements for a built prior to
APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 38814
dated 2/6/2017 was issued and conforms to all the requriements of the applicable provisions of the law.
The occupancy for which this certificate is issued is:
wood frame one family dwelling with accessory garage_*
Note:BP 41147 "as built"electric service in accessory garage COZ-38661;BP 41287 "as built"alterations and outdoor
shower stall addition COZ-38813.
The certificate is issued to Murphy, Shirley
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
Au ho d Signature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 1305 Sigsbee Rd,Laurel
SUFF.CO.TAX MAP NO.: 144.-2-6 SUBDIVISION:
NAME OF OWNER(S): Murphy, Shirley
OCCUPANCY:
ADMITTED BY:
SOURCE OF REQUEST: Murphy, Shirley DATE: 2/6/2017
DWELLING:
#STORIES: 1 #EXTTS: 2
FOUNDATION: concrete block CELLAR: full CRAWL SPACE:
BATHROOM(S): 1 TOILET ROOM(S): UTILITY ROOM(S):
PORCH TYPE: DECK TYPE: PATIO TYPE:
BREEZEWAY: FIREPLACE: yes GARAGE:
DOMESTIC HOTWATER: x TYPE HEATER: gas AIR CONDITIONING:
TYPE HEAT: hot water gas WARM AIR: HOT WATER: x
#BEDROOMS: 1 #KITCHENS: 1 BASEMENT TYPE:
OTHER:
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: wood frame STORAGE,TYPE OF CONST:
SWIMMING POOL: GUEST,TYPE OF CONST:
OTHER:
VIOLATIONS:
REMARKS:
INSPECTED BY: JOHNJ DATE OF INSPECTION: 2/3/2017
TIME START: 10:25am END: 11:00am
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building 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 from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1%lead.
5. Commercial building, industrial building,multiple residences and similar buildings and installations,a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings(prior to April 9, 1957)non-conforming uses,or buildings and "pre-existing"land uses:
1. Accurate survey of property showing all property lines, streets,building and unusual natural or topographic
features.
2. A properly completed application and consent to inspect signed by the applicant.If a Certificate of Occupancy is
denied,the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00,
Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00.
2. Certificate of Occupancy on Pre-existing Building- $100.00
3. Copy of Certificate of Occupancy-$.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00
Date.�® T�
New Construction: Old or Pre-existing Building: K (check one)
Location of Property: /l
House No. Street Hamlet
Owner or Owners of Property: �h,, v;, ��p�,Ar„ ' � � U'
Q9, �1� �w'� "'�T
Suffolk County Tax Map No�00 , SecM10 Block CP Lot60
oow
s
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ / o- a
A, AKIf'd
Salcgppture
_u U J 9- - -&- 44-0
'4(4
4
CONSENT TO INSPECTION
,,_;p . er<-AM+ef;1�
the undersigned, do(es)hereby state:
O ner(s)Nam (s)
That the undersigned (is) (are)the owner(s) f the premises in the Town of
Southold, located at 1 :5i3 C.,y "�jp.0 A(c� ,
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section �, Block 01.0 , Lot do(o.000.
That the undersigned (has) (have) filed, or cause to be filed, an application in the
SQ�utth Id Town Building Inspector's Office for the following:
Vel P
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 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 in subsequent prosecutions for violations of the laws, ordinances, rules or
regulations of the Town of Southold.
Dated: ;0 1/✓gn/&
(Signature)
% Cce T' , e-
r
(Sig azure)
(Print Name)
Certificate# 125913
Surrogate's Court of the State of New York
Suffolk County File#: 2015-886
Certificate of Appointment of Administrator
IT IS HEREBY CERTIFIED that Letters for the Estate of the Decedent named below have been granted by
this Court, and such Letters are unrevoked, are valid and are in full force as of this date.
Name of Decedent: Shirley W Murphy
Date of Death: September 18, 2014
Domicile: County of Suffolk
Fiduciary Appointed: Jayne Ann Murphy-Balanta Figueroa
Letters Issued: LETTERS OF ADMINISTRATION CTA
Letters Issued On: May 11, 2015
Limitations: NONE
THESE LETTERS, granted pursuant to a decree entered by the court, authorize and empower the
above-named fiduciary or fiduciaries to perform all acts requisite to the proper administration and disposition
of the estate/trust of the Decedent in accordance with the decree and the laws of New York State, subject to
the limitations and restrictions, if any, as set forth above.
and such Letters are unrevoked and in full force as of this date.
Dated: April 20, 2016 IN TESTIMONY WHEREOF,the seal of the Suffolk
Riverhead, New York County Surrogate's Court has been affixed.
WITNESS, Honorable John M Czygier Jr,Judge of the
Suffolk County Surrogate's Court.
nor'"
Michael Cipollino, Chief Clerk
Suffolk County Surrogate's Court
This Certificate is Not Valid Without the Raised Seal of the Suffolk County Surrogate's Court
RENNEE B & ASSOCIATES
ATTORNEYS AT LAW
47-01 QUEENS BLVD.. STE. 302 P.O BOX 323
SUNNYSIDE NEW YORK 11104 MATTITUCK.NEW YORK 11952
(718) 707-3191 (718) 707-3191
FAX NO. (718) 707-2928 FAX NO (831) 298-5449
PLEASE RESPOND TO. ;?UFF%O
OFFICE
OFFICE
October 14, 2016
By Hand
Southold Town
Building Department
54375 Main Road, Rt. 25
Southold,NY 11971
Re Matter 1305 Sigsbee Road
Mattituck,NY 11952
#1000-144-2-6
Owner Est. of Shirley Murphy
Attention: Amanda
Dear Amanda:
Further to our telephone conversation, earlier today, my office represents the
Estate of Shirley Murphy, as referenced above
We are presently in contract for the sale of the referenced premises and have
inquired with regard to Certificate of Occupancy status. Although there is no certificate
of occupancy on file, we understand that the structure was erected sometime prior to
1952.
We enclose herewith an Affidavit of the deceased's neighbor, Gail Faircloth who
has resided on the same street since 1946 and is personally familiar with the history of the
subject property and its chain of ownership. She correctly states that the property had
been owned by Edward G, Arbitz(acquired in 1950, copy of deed attached) and that the
structure had been erected sometime prior to 1952,the date of her marriage.
We offer the enclosed affidavit to establish that the structure had been erected
prior to 1957 and seek a statement from the Building Department to this effect and that
no certificate of occupancy is required for this structure.
Page 2.
1305 Sigsbee Road,Mattituck
October 14,2016
Thank you for your cooperation and attention in this matter and should you
require and further information,please do not hesitate to conte office.
Very ly yours,
Paul enner
PJR:rp
Enc.
STATE OF NEW YORK:
: ss
COUNTY OF SUFFOLK:
GAIL FAIRCLOTH, being duly sworn, deposes and says:
1. I reside at 1950 Sigsbee Road, Mattituck,NY 11952 and have resided there since
1946. I submit this affidavit as one who is personally familiar with the history and ownership of
the premises known as 1305 Sigsbee Road, Mattituck, NY, formerly owned by Shirley Murphy, a
former neighbor, now deceased.
2. I was born in Mount Vernon,NY on May 20, 1934. I moved to Mattituck,NY
with my family in 1946 and live in the same residence which was built by my grandfather.
3. I was married on June 21, 1952 and have resided here at the same residence since
that time. At the time of my marriage,the structure at 1305 Sigsbee Road had already been built
by its owner, Mr. Arbitz who was a home developer in the Mattituck area, specifically Sigsbee
Road and the adjacent street, Marlene Lane. I understand that Mr. Arbitz acquired the property
in 1950. The present structure at 1305 Sigsbee Road, Mattituck is the same structure that existed
prior to my marriage in 1952.
Gail Faircloth
Sworn tois
14th ' of October, 2016
/ I
Not ublic PAUL J RENNER
Notary Public,State of NewYork
�' No.02RE6205080
Qualiflea In Suffolk County y
Commission Expires May 04,20_/
Bunch, Connie
From: Bunch, Connie
Sent: Tuesday, November 22, 2016 3:40 PM
To: 'michelle@johnhowardlynch.com'
Subject: Shirley Murphy, 1305 Sigsbee Road, Laurel
After further examination of the Pre-existing C/O application,the Chief Building Inspector, Michael Verity, has noted the
following violations:
Assessors card notes the foundation is piers and only a crawl space. Now it is a concrete block full basement partially
finished.
Assessors card notes no fireplace. Now there is a fireplace.
Assessors card notes a screened porch. Now there is no porch—converted to living space.
Survey shows an outdoor shower stall—this needs a building permit.
Windows were replaced—this needs a building permit.
Assessors card notes the garage has a workshop. Possible building permit required.
Assessors card notes oil heat—now it is gas -along with hot water heater—needs a building permit.
Resptectfully,
Connie Bunch
Southold Town Building Dept.
1
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�lfade the day of Com` L„ Xineteen Hundred au•:
4'rr e &$ JOHii T. OIC0311mR �-.� or 177-100
Tr utvit
Rokd, St. Albans, L. I., Now York,
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part e$• of the first part, arui
ED:aRD G. ARITL of 32 Ashland 23nue, New Hyde Park,
�. L. I., New York,
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i'r I party of the second part,
that the pare>fe, of the first part, in consideration of
Tenand 00/100 ------------------------------------------------Dollar a
' e (S 10.00 ) lawful money of the United States, and other good and
valuable considerations paid by the party of the second part.
do hereby grant acrd release unto the part y of the second part, his heirs
and assigns forever, all that certain plot, piece or
pareel of land, s ituata, lying and being at Mattituck in the Torre of
Southold, County of Suffolk and State of New York, known and designrt.-
i as and by the Lots t,unber 77 and 78 on a certain map entitled "Amende:
i I ;dap of Property er Mattituek Park Properties, Inc., M-ittituck, it. 5'.11
Q Imade by D.utiel R. Young, Surveyor, and »hic!i Said map is on file in Mi.,
office of the Clerk of the County of Suffolk.
TC0 i4_R with the ri&t of said jurty of the second part and th;•
I; v
Hairs, successors and aaaigna of the party cf the second part to uca
in cotslnon with the other owners of lots shown on said map, the tract.
I:
shown on said say as Sit,sbee :ark for part: }•urposes, under such con-
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ditione, limitations :+nd restrictions as said ,parties of the first p;lr1
II' ! =ay impose. Such use to be such as .n the unrestricted judgment of
Ii
said Parties of the first part will not 1.1-reasonably interfere rrit2t
use and en jc)ta:nt of said Sigsbee Fark bJ thy: other owners of lett c;.
.S I said Map.
I. TCIEThPM witi% 3 :•Ight of wily over the Sigsbee Road shown on s-I: D
4� map &no over a richt Of 'h91 tnreq rods aids rtrnnir:g from PI.COt.Jc
Boulevard over p�cr i::es _:own on said map;, to ;'.conic Bay.
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„a,P,=;0+rl FAG,-327 �I
TOTL�T!'.Ltt pith Lne 3JJurtN:l.l:iCct 311 L. „
state �r. rights of
tho part, o: the; first part :t. ,:,I to slid lot, �
11
Subject,Subject, }ivU»Yrr,
to lite fvllonitlt; cvvbnants and t•estt•ietions, vi.; ,.
That, neither the party of 1110 second pa t•t r,or t.ha i:ai�s, :uccessors
1 VI• assigns of the p3 rty of the second pi :•t, will erect or permit on any J `r
part of the land horeLy conveyed ruse thatl une dtroll'ny, nor any
i building for the carrying on of nny noxious, dangerous or offensive 1
trado Or business, nor eny chve,llinE. Which shall cost less than $1,6o0.; f�
ll and no building (including stoops, pvz•ches attd plazas) sh4il be i
Ill erected or maintsined within tett-,nty-five rept of the front street line, l'I
nor any stable or garage of cher out-house, except upon the rear half st
of such property.
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These covenants x1911 be taken nu covenants rututin,_ vrith the land Jej
Land binding upon the party of the second part and the heirs, successors: �
t
I or asslgns of the party of tila second p9rt for the per`cd of fifteen f�{
years from the date hez-t:of; sul,•j6ct, itoWeVei•, to the unrastrictA_u right 'I
of the peaty of the first
part to altor, "Wend ani znrntl any of haso
covenants by agreement with any 01-1-Mor' of portion any {
of said property l li•
shown on said trap without the consent of nny of the otmers of any of j
the remaining portivns of the l,remises sPwwn on said map.
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('113F"WL{RN,with the appurtenances and all the estate and rights of t7ie
part.Ke4' of the first part in and to said premises,
r• ��''``��"�"' '''""� ' ntt5= the premises herein granted unto the part-
cp of the second.part, ltie heirs
=` and assigns forever.
r
r•
r lab said part es df tile first pa rt
I Covenant as follolos.
That said pal-4q* of the first ix rt
seized of said prantiges i» fee sinrple.,andhava good rigerlct to convey the sante;
That the part y of'the second
premises; part shall quictlJ eltjoy tJre said
That the said premises are free from, incumbrances;
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That the parts e* of the first Inrt rvill execute or procure any ,
fwrther itecessary assrtmrtee of Ike title to said premises;
Tlwt said part 44 of the first part
I
will forever ORfl1 Tall the title to sairl,prenaises.
} o%J;J Wi That thea +ranlnr 5 tail( rereive the r•onsitlertrliort for this coretrcyanrr
is gnrl. traill lint+l. tier ri�flN ht recrlrc cit-Ch. concirleration•ati a trance fltnll to be applied
)irrt fornit
/trrryar.r nj' ltuyln_s 11rr <'ast of the ir+r/nnrcntral tort! rcdll apply tier
' �anrc o snit to lin• payutr•nt of lhc• cost of the inrproventrrtl hepar osiers artrl part
of the lotet!• ly, the Maorc fear' nny other p1117tose.
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l a��J1BEflfl,1' + ��Rr!'Sr1'4��1.
the rt
heretcltto set � �� of rite f1rSt part have
their hand s and seals the day and year first above written.
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On. this - day oj' T muj- 1 �N nctem Hund�r ed anti
before lire, the st"I Tiber, personally appeared
Juim T. G Conn.r
to me personally kreoeorr• and kirown to rite to be Mea same person$ described
in and w1w erecated the ivithirt. Datrurnent, and Vic G
acknowledged to me that 4 he / executed the sante
t[nOY z,e[rnL Iia 3619
NOTARY turve IN TM[-1&7r Or 7CJT Teti
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TOWN OF 'SOUTHOLD PROPERTY RECORD - CARD
OWNER STREET ' VILLAGE DIST. SUB. LOT �'C
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FORMER OWNER N E ACR.
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S W TYPE OF,BUILDING /
RES. J SEAS. VL. FARM COMM. CB. MISC. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
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NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value
Acre
Tillable 1
Tillable 2
1
Tillable 3
Woodland
Swampland FRONTAGE ON WATER
Brushland FRONTAGE ON ROAD
House�4pt, DEPTH
BULKHEAD
Total., DOCK
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SURVEYOFPROPERTY
o LOTS 78-79 INLC.
o N AMENDED MAP OF
MATTITUCK PARK PROPERTIES
N FILED: JAN. 12, 1926 — MAP #:80f
LOT 80 a SITUATE
N69°22'00"E1410.00 N v MATTITUCK
r� TOWN OF SOUTHOLD
00 1o SUFFOLK COUNTY, N. Y.
LQ
O N O o SURVEYED: OCT. 5, 2016
39.7' 28.0 NOTES:
1. PROPERTY KNOWN AS TAX MAP# 100-144-02-06
Af ASPHALT DRIVEWAY o 2. LOT AREA =14,000 SQ.FT. (0.321 ACRE(S))
-� Frame cli c3. THIS SURVEY WAS PREPARED USING A TRIMBLE
lq N Garage N S3 ROBOTIC TOTAL STATION. 3
4. PROPERTY CORNER MONUMENTS WERE NOT SET AS y
LIGHT POLE:' LOT 79 W PART OF THIS SURVEY. 3
` W� U
28.0 w
w STANDARD NOTES:
`o
1. COPYRIGHT 2016 MICHAEL K. WICKS LAND SURVEYING d
O 2. UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY MAP'BEARING A
t~/I LICENSED LAND SURVEYOR'S SEAL IS A VIOLATION OF SECTION 7209, O
w
SUB-DIVISION 2, OF NEW YORK STATE EDUCATION LAW C14m
3. ONLY BOUNDARY SURVEY MAPS WITH THE SURVEYOR'S EMBOSSED SEAL
w ARE GENUINE TRUE AND CORRECT COPIES OF THE SURVEYOR'S ORIGINAL Ln
WORK AND OPINION O
q
4 CERTIFICATIONS ON THIS BOUNDARY SURVEY MAP SIGNIFY THAT THE MAP �
O i WAS PREPARED IN ACCORDANCE WITH THE CURRENT EXISTING CODE OF 0
PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK STATE -o
co ASSOCIATION OF PROFESSIONAL LAND SURVEYORS, INC. THE CERTIFICATION IS ro
LIMITED TO PERSONS FOR WHOM THE BOUNDARY SURVEY MAP IS PREPARED,
0 39.2 SHOWER TO THE TITLE COMPANY, TO THE GOVERNMENTAL AGENCY,AND TO THEv
W i LENDING INSTITUTION LISTED ON THIS BOUNDARY SURVEY MAP. o
1 Story. CONGO. COVER `t 5 THE CERTIFICATIONS HEREIN ARE NOT TRANSFERABLE.
O 6. THE LOCATION OF UNDERGROUND IMPROVEMENTS OR ENCROACHMENTS ARE
Frame Residence
pEll NOT ALWAYS KNOWN AND OFTEN MUST BE ESTIMATED. IF ANY UNDERGROUND
N N C�E Q) IMPROVEMENTS OR ENCROACHMENTS DOST OR ARE SHOWN.THE
#1305 IMPROVEMENTS OR ENCROACHMENTS ARE NOT COVERED BY THIS SURVEY
Mme' WALK 7. THE OFFSET(OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO
�J 39 2 THE PROPERTY LINES ARE FOR A SPECIFIC PURPOSE AND USE AND THEREFORE
• 39.8' W ARE NOT INTENDED TO GUIDE THE ERECTION OF FENCES, RETAINING WALLS, 1-
61.0 U POOLS, PA7705 PLANTING AREAS, ADDITIONS TO BUILDINGS, AND ANY OTHER w
PL TYPE OF CONSTRUCTION. >
O
Ir-4O COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED
ED
o _ LOT 78 Q OR EMBOSSED SEAL SHALL NOT BECONSIDERED TO BE A VALID COPY.
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S69022'00"W 140.00 3.5'S I
FR. SHED m
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ADJACENT RESIDENCE W En
LOT 77 �sF LAND �A.443M
0. MICHAE K WICKS, P.L.S. #50390
MICHAEL K. WICKS
PeC0�22C Bay Blvd.
LAND SURVEYING
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{ 200 BELLE VIEW AVENUE, y
CERTIFIED TO: CENTER-MORICHES, NEW YORK 11934 r
i TRACY PECK VOICE: 631.874.0156 - FAX.- 631.909.3845
BETHPAGE FEDERAL CREDIT UNION ww'w.wickslazrds'urveying.com y
FIRST EQUITY ABSTRACT CORP. RECORDS OF RICHARD C. DRAKE °
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SCALE: SURVEYED BY: DRAWN BY: SHEET:
1" 20' M.W./S.S. S.S. 1 OF 1
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
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DATE LO,41-)--' INSPECTOR�ok VQaa )
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TOWN OF SOUTHOLD BUILDING DEPT.
L
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] I ULATION
[ ] FRAMING /STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: ?fo ke, `,D 4— �V0` Z_ AGc�1'ol�
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DATE l INSPECTOR V)f
Pre,
Of SOUTy�
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] R UGH PLEIG.
[ ] FOUNDATION 2ND [ ] SULATION
[ ] FRAMING / STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: 51640
V.
DATE 1 1 I 1 wINSPECTOR
LOCATION:
(number I& street) (municipality)
SUBDIVISION: MAP NO.: LOT(S): ,,
NAME OF OWNER(S):
OCCUPANCY: �, ow el t
(type) (owner-tenant).
ADMITTED BY: klG#�l�✓'Ci ' YJ�N.�� �,.� ACCOMPANIED BY:
KEY AVAILABLE: SUFF. CO. TAX MAP'NO. 1000-
SOURCE OF REQUEST:dovii 4mji MVrohvkt/ DATE:
DWELLING \
TYPE OF CONSTRUCTION: liU pv�j 1% � ^# STORIES: # EXITS: �C
FOUNDATION: l,O h,GV _a v a . BAS'VMENT: V CRAWL SPACE:
# OF BEDROOMS: IST FLRC'J_ 2ND FLR: 3RD FLR: /
BATHROOM(S): v' �►1� TOILET ROOM(S): UTILITY ROOM:
PORCH-TYPE: �— DECK, TYPE: _. PATIO;TYPE:
BREEZEWAY: �— IREPL C `GARAGE:
k�T
i
DOMEST C HOTWATER: TYPE HEATER: AIRCON TIONING: N r
TYPE HEAT: _ l W 6AS WARM AIR HOTWATER:
# OF KITCHENS: Eve.)i
FINISHED BASEMENT:- YES NO
OTHER:
ACCESSORY STRUCTURES �q
GARAGE; TYPE OF CONST.: _'✓w� l�il'11� STORAGE, TYPE CONST.:
SWIMMING POOL: IUd GUEST,'TYPE CONST: _ A/
OTHER:.
VIOLATIONS: CHAPTER 144 &N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION N Cs�- mo DESCRIPTIO ART. SEC.
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of lot?_ v.& . V .N r
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R'EMARKS: C aA w Nv �� 2w�� t '�✓ b
INSPECTED BY; DATE OF INSPECTION:oo
TIME START; 5 END: __j/!0d AYn �
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