HomeMy WebLinkAboutZ-18265FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No Z-18265 Date AUGUST 9~ 1989
THIS CERTIFIES that the building.
Location of Property 55660 NORTH ROAD (COUNTY RD. #48)
House No. Street
County Tax Map No. 1000 Section 44 Block 3
Subdivision Filed Map No.
ONE FAMILY DWELLING
GREENPORT r N.Y.
Hamlet
Lot 2
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-18265 dated AUGUST 9~ 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 DW~hLING WITH ACCESSORY 2 CAR WOOD FRAME GARAGE
A/qD SMUT.T, SMOKEHOUSE ATTAC~FD TO REAR OF GARAGE
The certificate is issued to
NATALIE K. POLIWODA
(owner)
of the aforesaid building.
SUFFOLK COUNTYDEPARTMENT OF HEALTHAPPROVAL NO RECORD - PREEXISTING
UNDERWRITERS CERTIFICATE NO. NO RECORD - PRE EXISTING
PLUMBERS CERTIFICATION DATED NO RECORD - PRE EXISTING
* PT.RASE SEE ATTACR~.D INSPECTION REPORT.
~ng Inspector
Rev. 1/81
Location
Subdivision
N~me of Owner(s)
BUILDI?~ DEPART:.~NT '-
TO%'~[ OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
55660 NORTH RD. (COUNTY RD. #48)
knumoer ~ sZreez)
Map No.
NATALIE K. POLIWODA
GREENPORT, N.Y.
(i,iunicipaiity)
Lot(s)..
Occupancy R-SO
(tYpe)
A~mitted by: SAME
Key available
Source of request
OWNER
(owner-renanz)
Accompanied by: SAME
Suffolk Co. Tax No. 44-3-2
McNULTY SPIESS Date 8/~/89
D%'~LL!MG:
Type of construction wood FRAME
Foundation CEMENT BLOCK
Total rooms, 1st. F1 6
Bathroom(s) ONE
Porch, typeFRONTENCLOSED
#stories ONE
Cellar Crawl space - -
2nd. FI 3rd. F1 - -
Toilet room(s)
Deck, type Patio, type - -
Breezewa~ Garage - - Utility room - -
Type Heat oIt 'Warm Air Hotwater xx
Fireplace(s) NO No. ~its 2 Airconditionin~
Domestic hotwater OFF BOILER Type heater - -
Other SMALL ENTRY WAY AT REAR DOOR.
ACCESSORY STRUCTURES:
Garage, type const. 2 car wood frame Storage, type const,s~all smokeho~se attached
to rear of gara§e.
Swimming pool Guest, type const.
Other
VIOLATIOMS:
.C~APTER 45--N.Y. STATE ~]NIFORM FIRE PREVENTION & BUILDING CODE
Location Descriotion I-~rt~.'l Sec.
I
Remarks:
Inspected by:
Date of Insp. 8/8/1989
· Time start 10:30 end !0:45
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NEW YORK
765 - 1802
11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
NEW CONSTRUCTION ....... OLD OR PKE-EXISTING BUILDING.'~'''~ VACANT LAND.
Location of Property ..............
HOUSE NO. STREET HAMLET
County Yax .ap .o. 1000 Section Q~'flPBlock ~.~'~A. Lo~
Subdivision ....................... Filed ~ap ........ Lot
Permit No ........... Date of Permit .......... Applicant ...................
~ealth Dept. Approval .................. Dnder~riters Approval ..............
Planning Board Approval ................
Request for Temporary Certificate ....... Final Certificate ................
Fee Submitted:
'ev. 10/14/88
CONSENT
TO
INSPECTION
· the undersigned,
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at
· which is shown and designated on the Suffolk
County tax map as District 1000, Section ~J~/~0~, Block 0-5,0o, Lot(Z~ZX~r3 .
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:
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 in'formation 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.
(signature) '
Z-daY O ame)
(signature)
(print name)