HomeMy WebLinkAboutZ-38875 Town of Southold 3/28/2017
a a�iy 53095 Main Rd
Southold,New York 11971
v . P
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 38875 Date: 3/23/2017
THIS CERTIFIES that the structure(s)located at: 56755 Route 25, Southold
SCTM#: 473889 See/Block/Lot: 63.-3-16
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- 38875
dated 3/23/2017 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 covered porches accessory wood frame arbor and accessory wood frame garage.*
The certificate is issued to Scopaz, Valerie
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 63-3-16
PLUMBERS CERTIFICATION DATED 3/3/2017
*PLEASE SEE ATTACHED INSPECTION REPORT.
- 0 u orized Signature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 56755 Route 25, Southold
SUFF.CO.TAX MAP NO.: 63.-3-16 SUBDIVISION:
NAME OF OWNER(S): Scopaz,Valerie
OCCUPANCY:
ADMITTED BY:
SOURCE OF REQUEST: Scopaz,Valerie DATE: 3/23/2017
DWELLING:
#STORIES: 2 #EXITS: 3
FOUNDATION: brick CELLAR: partial CRAWL SPACE: partial
BATHROOM(S): 2 TOILET ROOM(S): UTILITY ROOM(S):
PORCH TYPE: covered wood frame DECK TYPE: PATIO TYPE:
BREEZEWAY: FIREPLACE: GARAGE:
DOMESTIC HOTWATER: x TYPE HEATER: gas AIR CONDITIONING:
TYPE HEAT: oil WARM AIR: HOT WATER: cast iron radiators
#BEDROOMS: 4 #KITCHENS: 1 BASEMENT TYPE: unfinished
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: 3/1/2017
TIME START: 11:50am END: 12:30pm
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT D
TOWN HALL DD
765-1602
FEB 1 7 2017
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Departmentvy�N090ftHOLDDE T
A. For new building or new use:
1. Final survey of property with accurate location of all buildings,property Imes, 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. 11-2 ( — 1 G
New Construction: Old or Pre-existing Building: ✓ (check one)
Location of Property: ld`j5 '}77jjZ7- /,-"o ccs
House N`o� Street Hamlet
Owner or Owners of Property.
Suffolk County Tax Map No 1000, Section 31 Block 3 Lot t
Subdivision �ce1 r ��-Pr�c-t ciT+��C,� /JA' Filed Map. Lot:
Permit No. dA' Date of Permit. Applicant:
Health Dept. Approval: A1,4--- Underwriters Approval. ILZA—
Planning Board Approval: AI —
Request�for: Temporary Certificate, Final Certificate: (check one)
Fee Submitted: $ L
2
Applicant Sign e
40
� �.�
CONSENT TO INSPECTION
Valerie Scopaz ;the undersigned,do(cs)hereby state:
Owner(s)Name(s)
That the undersigned(is) 4r-c4 the owner(-,- of the premises in the Town of
Southold,located at 56755 Main Road,Southold,NY 11971
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section 63 , Block 03 ,Lot 16
That the undersigned(has)(have) Bled,or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following: pre-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 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: February 17,2017 �� 1
ignat re)
Valerie Scopaz
(Print Name)
(Signature)
DIE O V (Print Name)
15 V D
FEB 2-7 20'17
BUILDING DEPT.
TOWN OF SOUTHOLD
Town Hall Annex Telephone(631)765-1802
54375 Main Road CO- Fax(631)765-9502
P.O.Box 1179 • ao roc er.richert(atown.southoId.nV.us
Southold,NY 11971-0959 Q
I enu T`I,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Valerie Scopaz
Address: 56755 Route 25 City: Southold St: New York Zip: 11971
Budding Permit#: Section: 63 Block: 3 Lot: 16
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: AS BUILT DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph 100A Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel 100A A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks
Disconnect 100A Switches Twist Lock Exit Fixtures TVSS
Other Equipment: "AS BUILT" - "ELECTICAL SURVEY' - "NO VISUAL DEFECTS"
Notes: 100A OVERHEAD SERVICE
Inspector Signature: Date: March 23, 2017
0-Cert Electrical Compliance Form.xls
E
J Telephone(631)765-1802
` 'Pax=117fMW9.
P.O.Box 1179
&mthold,NY 119714959 Ap
WADING DEPARTMENT D [EC[E0V[E
TOWN OF SOUTHOLD DD
MAR - 7 2017
BUn DING DEPT.
CERTIFICATION "TOWN OFSOlUTIE[OLD
Date: l
Building Permit No.
-DIX— C�
Owner: C amz-
(Please print)
Plumber:
(Please print)
I certify that the solder used in the water supply system contains less than 2/10 of 1%
lead.
L
(P ers Signature)
Sworn to before me this 3
day of Pvjrr-k , 20�_
CHELSEA L. CHALONE
Notary Public,State of New York
Registration #01 CH6287106
Qualified In Suffolk County
Commission Expires August 5,2017
Notary Public, County
- of SO�ryDlo
i
Town Hall Annex ti Telephone(631)765-1802
54375 Main Road y 5 E
P.O.Box 1179 Q roaer.dchert&Own(631).soUt765ll9oia.ny.us !
Southold,NY 11971-0959
I
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION '
REQUESTED BY. Valerie Scopaz, property owner Date: 03/03/2017
Company Name:
Name:
License No.: _
Address:
Phone No.: j
JOBSITE INFORMATION: (*Indicates required information)
*Name: Valerie Scopaz a
*Address: 56755 Route 25, Southold l
*Cross Street:
5
`Phone No.: 631-765-5552 i
Permit No.:
Tax Map District: 1000 Section: 63 Block: 03 Lot: 16
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
Installed Service Panel. j
i
(Please Circle Alf That Apply)
*Is job ready for inspection: YES/ NO Rough In Final
*Do-you need a Temp Certificate: YES/ NO
Temp Information(it needed) "
*Service Size: i Phase 313hase 100 150 200 300 350 400 Other ^ j -
*New Service: Re-connect Underground Number of Meters Change of Service Overhead �` \
Additional Information: PAYMENT DUE WITH APPLICATION
82-Request for inspection Form ( O0
Q �
SURVEY OF PROPERTY
SI T UA TE
Si zUSTOVICH SOUTH 0 LD
& 5TEPH SIE ZUSTOVICH
TOWN OF SOUTHOLD
75.00 SUFFOLK COUNTY, NEW YORK
N 83*53900" E S.C. TAX No. 1000- 63-03- 16
FOUND SCALE 1 "=20'
CONC. MON.
FEBRUARY 7, 2017
0
�! AREA = 23,241 sq. ft.
z w 0.534 ac.
0 0
�I 0
e
•P
U4 r*, CER TIFIED TO:
O LAUREN BARRY
CITIBANK, N.A., ITS SUCCESSORS AND/OR ASSIGNS,
AS THEIR INTERESTS MAY APPEAR
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY
..rJJJ�J✓✓ ��..I--� JJJJ✓JJJ-�"'�JJJ ((`?j\\(
f
4\( l
lj 2
1\ `
1 l
z
°; lj l adz
cn z \
k1
z � CIn 0
�y
l y C
r n
r
� —GARAGE
` � 18.4• 1.6 W•
Z e 1 C'" N
K Z l 1 x rn
p\ °' GARAGE
1.7 W•
CONC.
e ° APRON
�-3 ° d � � p CONC^-►�
lj m GU'vEr. -
r \� 1
e e A e e 320'
z
OA
WOOD,ARBOR o 0
OVER BRICK _n°. 9
O24-6 HO ° d,
rn
(( BRICK
d )
16.4• e
m
O _ °
CONC.
° e m G1 N e e
° N � O.L.
c ` CELV+RFENCE
ENTRANCE 0.9'E.
e z 14.1'
6.0 *1 12.1
7v►1) � }\ �
A a 32.4' D
D a
� l m
00
rn
•.° ` SII � ° .' Z
o/ v 22.4
6
26.8' I 00 i z
i. >I WOOD O W
o STEP
A 4II d O FOUND MON.
° ( o . GONG.
d T / SII 0.9'W. 7.09
.' O
o '
0 . S 82.06'10" W
° .0 FENCE 0.5'W'
0„ �:;<::.: 75.00
1,022.28' ,.�' o W G CONC.
5 8 3 5 3 0 CONC. SIDEWALK �gLVE, APRON
d°.. PREPARED IN ACCORDANCE WITH THE MINIMUM
GONG. UTILITY STANDARDS FOR TITLE SURVEYS AS ESTABLISHED
APRON /�POL� ° e° ' 4 e° e e BY THE L.I.A.L.S. AND APPROVED AND ADOPTED
. —fir ' °WATER FOR SUCH USE BY THE NEW YORK STATE LAND
OVERHEAD WIRES�:`�',; .. EDGE OF PAVEMENT TITLE ASSOCIATION.
° °.d. VALVE 25 )•: �e �4� e a�. �e e.. A
° °
'° . .° (S .UAD _
MAIN �f �
N.Y.S. Uc. No. 50467
UNAUTHORIZED ALTERATION ADDITION Nathan T of t Corwin I I i
TO THIS SURVEY IS A VIOLATION OF
SECTION 7209 OF THE NEW YORK STATE
EDUCATION LAW. Land
an d S u r v Vp`,
r o r
COPIES OF THIS SURVEY MAP NOT BEARING
THE LAND SURVEYOR'S INKED SEAL OR
EMBOSSED SEAL SHALL NOT BE CONSIDERED
TO BE A VALID TRUE COPY.
CERTIFICATIONS INDICATED HEREON SHALL RUN Successor To: Stanley J. Isoksen, Jr. L.S.
ONLY TO THE PERSON FOR WHOM THE SURVEY Joseph A. Ingegno L.S.
IS PREPARED, AND ON HIS BEHALF TO THE
TITLE COMPANY, GOVERNMENTAL AGENCY AND Title Surveys — Subdivisions — Site Plans — Construction Layout
LENDING INSTITUTION LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDING INSTI- PHONE (631)727-2090 Fax (631)727-1727
TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE.
OFFICES LOCATED AT MAILING ADDRESS
THE EXISTENCE OF RIGHT OF WAYS 1586 Main Road P.O. Box 16
AND/OR EASEMENTS OF RECORD, IF
ANY, NOT SHOWN ARE NOT GUARANTEED. Jamesport, New York 11947 Jamesport, New York 11947
Valerie Scopaz
56755 Main Road
Southold,New York 11971
631-765-5552
DR [EC[E0V[E
By Hand DD
March 3, 2017 MAR - 7 2017
Town of Southold BUILDING DEPT.
Building Department TOWN OF SOUTHOLD
54375 Main Road
P.O. Box 1179
Southold,New York 11971-0959
Re: 56755 Route 25, Southold,New York—Wood Arbor
Dear Mr. Jarski:
With reference to the above property and the wood arbor over brick,please be
advised that I am the property owner and I do not have exact information on when this
arbor was constructed, but,to the best of my knowledge,the arbor at this property was
constructed prior to or around 1957.
Please let me know if you have any further questions.
Sincerely,
Valerie Scopaz
Swto before me on the
day of ch 017
No ublic
JEKATERINA GRINKO
NOTARY PUBLIC STATE OF NEW YORK
SUFFOLK COUNTY
UC.#01 GR6287178
COMM.EXP.08I05I24.....
Twomey, Latham,
MAILING ADDRESS.
Shea, Kelley, Dubin & Quartararo LLP Post Office Box 9398
Riverhead,New York 11901-9398
Attorneys at Law MAIN OFFICE.
Thomas A.Twomey,Jr. 33 West Second Street
(1945.2014) Riverhead,New York 11901-9398
Stephen B Latham
John F Shea,III Telephone:631.727.2180
Christopher D Kelley Facsimile:631.727.1767
David M Dubin o www.suffolklaw.com
Jay P Quartararo t
Peter M Mott
Janice L Snead February 17, 2017
Anne Marie Goodale
Bryan C Van Cott
Kathryn Dalli
Laura I.Dunarhan BY HAND
Lisa Clare Kombrmk
Patrick B Fife
Melissa H Sidor
Martin D Finnegan Mr.Michael Verity, Chief Building Inspector
Reza Ebmhmu Town of Southold
Kelly E Krnrrons P.O. Box 1179
PatnciaJ Russell Southold,NY 11971-0959
Bryan J Dmgo
Bernadette E Tuthill
Craig H Handler Re: 56755 Main Road,Southold,NY
Alexandra Halsey-Storch
Melissa S.Dons SCTM 91000-63-3-16
Daniel R.Bernard
Kateuna Grrnko
Dear Mr.Verity:
OF COUNSEL
Kevin M.Fox
Karen A.Hoeg We are representing Valerie Scopaz in the sale of the above-referenced premises. I am
Jennifer Nigro• enclosing our client's Application for apre-Certificate of Occupancy for the subject premises
t LLM ILA NTA A along with a check in the amount of$100.00 and an updated survey prepared by Nathan Taft
NY&NIBARS
} [l.M IN TA%ATfON
NY,NI&P BARS Corwin III,Land Surveyor,dated February 7,2017. Please note that our client's Consent for
the inspection is handwritten under her signature to the Application.
Should you have any questions or require any additional information regarding this
matter,please do not hesitate to contact me.
Thank you for your assistance with this matter.
Very truly u s,
Ka rinarinko
JKG/lk
Enclosures
OTHER OFFICE LOCATIONS
20 East
Street D
East Hampton,NY 11937 D
631 324.1200
51 Hill Street
Southampton,NY 11968 FEB 1 7 2017
631287.0090
490 Wheeler Road
Suite 150 BUILDING DEPT.
Hauppauge,NY 11788
631.265.1414 TOWN OF SOUTHOLD
56340 Main Road
PO Box325
Southold,NY 11971
631 765.2300
Twomey, Latham,
MAILING ADDRESS:
Shea, Kelley, Dubin & Quartararo LLP Post Office Box 9398
Riverhead,New York 11901-9398
Attomeys at Law MAIN OFFICE-
Thomas A.Twomey,Jr. 33 West Second Street
(1945-2014) Riverhead,New York 11901-9398
Stephen B.Latham
John F.Shea,III Telephone:631.727.2180
Christopher D.Kelley Facsimile:631.727.1767
David M.Dubin o www.suffolklaw.com
Jay P.Quartararo t
Peter M.Mott
Janice L.Snead March 7, 2017
Anne Marie Goodale
Bryan C.Van Cott
Kathryn Dalli
Laura I.Dunathan
Lisa Patrick
B.Kombrink R [ZC[E0'V[E Meliss HFife VIA HAND SUBMISSION n
Melissa H.Sidor U
Martin D.Finnegan-
Kelly E.Kintrons Town of Southold Building Department MAR 7 2017
Patriciaussell
RezaE54375 Main Road
Reza brarahimi
Bryan J.Drago P.O. Box 1179
Bernadette E.Tuthill BUILDING DEPT.
Craig H.Handler Southold,NY 11971 TOWN OF SOUTTHOLD
Alexandra Halsey-Scorch
Melissa S.Doris
Daniel R Bernard• Attn: John Jarski
Katerina Grinko
OF Kevin M Fox Re: Scopaz Property-- 56755 Route 25, Southold,NY
Kevin M
Karen A.Hoeg SCTM#: 1000-63-3-16
Jennifer P.Nigro
0NY&LA BARS
t LLM iNTAMn- Dear Mr. Jarski:
NY&NJ BARS
NY,NJ&PA BARS
This Firm represents the owner of the property referenced in the above who seeks
the approval from your department for a pre-Certificate of Occupancy. As per your
correspondence dated March 2, 2017, (see attached)please find:
➢ Application for Electrical Inspection along with the fee;
➢ Consent to Inspection, executed by the owner of the property, dated March 3,
2017;
➢ Correspondence from the property owner, dated March 3, 2017, regarding the
arbor; and
➢ Solder Certification signed by Mattituck Plumbing dated,March 3, 2017.
Please let us know if you require anything further in order to complete the
technical review of the application. Should you have any questions or concerns please
contact this office.
OTHER OFFICE LOCATIONS
20 Main Street
East Hampton,NY 11937 Very tru o s,
631.324.1200
51 Hill Street
Southampton,NY 11968
631.287.0090
490 Wheeler Road Katerina Grinko
Suite 150
Hauppauge,NY 11788 KG/dkw
631.265 1414
56340 Main Road Encl
RO Box 325
Southold,NY 11971
631.765.2300
TOWN OF SOUTHOLD OPOOPERTY RECORD CARD
m OWNER STREI=f'
--N (j -16 19 VILLAGE DISTRICT SUB. LOT
XciS60 -a Z. .
FORMER OWNER N � r
ACREAG
L) E i 7 E
'�' �• - TYPE OF BUILDING
RES.
— SEAS. VL. FARM COMM. 04D. CB. miss. � Est. Mkt. Value
Ln LAND IMP. TOTAL DATE REMARKS
Cn
En 10!9
of 00
co
6� adO z
r y
ocn — 9171
AGE
BUILDING CONDITION
NEW NORMAL BELOW ABOVE FRONTAGE ON WATER
Form Acre Value Per Acre Value FRONTAGE ON ROAD f es[
Tillable ] BULKHEAD ,
m Tillable 2 DOCK
Ln
`r—° Tillable 3
1O Woodland
m Swampfand
m Brushland
m ;-louse Plot
m
N
I-
U0
Cn
N 4
Q c- i
IL
i , V Nf / 6
I j• I � r• _� I I i �/1<<
� I
9 .{ i I i
OLO
W
uWi
LO z l l
i —
_
E, ' i
o
CO
J it \
M. B Idg; $— �r� _ �-� I Foundation Bath
j 1>-rc e-
-E -o� # y _
xtenrs on �� 3 rZ Basement 1 Floors i
Extension Ext. Wc[Es Interior Finish
LD -- ---- f-___-__- _ C`�. 7_
cu, Extension Fire Pface
�, - — — --- --- - I -- d X12 Heat
LOpb I.c h y �_ X _ j `f'O -�`�/j`�'-'�� Porch Roof Type
i L __-
`O Porch Rooms ]st Floor
o, Breezeway I Patio — Rooms 2nd Floor '
rI ------ ----
m Garage a _ , > ; 7S 8 Driveway Dormer
LD
Ch
m
! 1
m
oF soaTyo �' v
0
o
TOWN OF SOUTHOLD BUILDING DEPT. -
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: zc U pott-t,�,�- Lavo"r
SVW cK-, revz,-& VV n
aU 1` ?
?�
DATE L INSPECTOR
o��oF SOUryolo
1 \ coulv,a
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) f ELECTRICAL (FINAL)
REMARKS:
DATE' INSPECTOR ?
LOCATION: �� A�/1I 9,D4 r�
_ _ D
(number 8c street) (municipality)
SUBDIVISION: MAP,NO.: LOT(S):
NAME OF OWNER(S): V
OCCUPANCY: tMDmtioA
(type) (owner-tenant)-
ADMITTED BY: ACCOMPANIED BY:
KEY AVAILABLE: SUFF. CO. TAX MAP'NQ. 1000-
SOURCE OF REQUEST:
.Gt.i i GDOa' DATE: ov *,b-ov 14 o
DWELLING
qq
TYPE OF CONSTRUCTION: # STORIES: # EXITS: c3
FOUNDATION: Grt BA E1WiENT:`� '� CRAWL SPACE: 1jhUel�
vn *00 lie ID001w� sfAce
# OF BEDROOMS: IST FLR: ��-- 2N F�L�.�R�°: c 3RD FLR: iv
ter-- -- _ -- --- �, -- - _'- -.--�--
BATHROOM(S): -- "---- TOILET ROOM(S): ' - - `UTILITY ROOM: WOW-e--
PORCH-TYPE:
oW-e--PORCH-TYPE: ,CyV" ApD'EtK,.TYPE: �NV N'ei' PATIO;TYPE:
BREEZEWAY:
FIREPLACE: GARAGE: �
DOMESTIC HOTWATE,'R:.- V TYPt-HEATER: AIRC,ONDITIONING: A/0
TYPE HEAT: WARM AIR: HOTWATEN � or✓
ki
# OF KITCHENS -1,
FINISHED BAS ✓
EMENT: YES NO
OTHER:
ACCESSORY STRUCTURES
GARAGE; TYPE OF CONST.: 00 G foo STORAGE, TYPE CONST.:
SWIMMING POOL: GUEST, TYPE CONST:
OTHER:
VIOLATIONS: CHAPTER 144 &N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION A ART. 'SEC.
r) i i vi '
AA&tx o Vot, Mi ep tj n 7+ 0�•
1� �� Scolds-. - .Gt�'r Q,Ar►i , ,
REMARKS: 66!ft is /VD/li--CnA;Pro,
�'r�'
INSPECTED BY: DATE OF INSPECTION:
TIME START: [t:lo"D AM END:
, , � " , �
o= �.1., {s .L 5
a
5 r1 � `j , .v 4 "` �� `
� _ � t �• t ,
r � � � .
. w � � - _! .-. v
. F t �
r
v
",, � � � .,
• 4 .
. ,y 9 .