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Home My WebLink AboutZ-12652 FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. . Z]. 652. . . . . . . . . Date . . . . . . Ju1y..3� . . . . . . . . . . . . . . , 19 84. THIS CERTIFIES that the buildings. : .W . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . Location of Property . .140. . . ... . . . . . . . . . . . . Pine,Avenue . . . . . . . . Southold House No. Street Ham/ec County Tax Map No. 1000 Section . . . .0 7.7. . . . .Block . . . 3 . . . . . . . . . .Lot , ,010. . . . . . . . . Subdivision . Graose. Hay. Estatpq . . . . . . . . .Filed Map No. . 1,176, ,Lot No. Requirements . for a private one-family dwelling built prior to conforms substantially to the Apglicatiorrfar-BiiiMnrg-Permitlreretaft�re�`>t i�tltfs'aPftC�Zi�t�d p Certificate of OccupancyZ12652 . . . . . .. ri. . . .3. . . . . . 119 57. pursuant to which Ri ildirtg� it No. . . . . . . . . . . . . . . . . . . . . . dated . . . .July 30 . . . .: . 19 8 4. ,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 . . . . . . . . . a private one-family dwelling and accessory wooden storage building. . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . . . . . OTTO MACOMBER & BERNICE MACOMBER, HIS WIFE • • •(owner,lessee-artmarrt! of the aforesaid building. Suffolk County Department of Health Approval . . ,';no. record. . . . . . . _ . : : _ . . . . , . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . no, record, , . . , . . . . . . . . . . .. . . . SEE ATTACHED HOUSING CODE INSPECTION REPORT. Building Inspector Rev. 1/81 BUILDING DEPARTTYTEIiT TOVIN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location 140 Pine Avenue Southold number & street Municipality Subdivision Goose Bay Estates Map No. 1176 Lot(s) 7-10 Incl. Name of Owner(s) Otto Macomber & Bernice Macomber Occupancy R-1 owner type owner-tenant Admitted by: Mrs. Macomber Accompanied by: same Key available ! Suffolk Co. Tax No. 77-3-10 Source of request Mr. Otto Macomber Date 7/16/84 DWELLII IG Type of construction wood framed #stories 1 Foundation cement block Cellar partialCrawl space rest Total rooms, 1st. F1 5 2nd. F1 - 3rd. F1 - Bathroom(s) 1 Toilet room(s) u Porch, type Deck, type Patio, type_ Breezeway Garage one-car Utility room Type Heat oil fired Warm Air Hotwater X Fireplace s) . 1 No. Exits Airconditiorii ng Domestic hotwater yes Type heater tankless Other outside shower ACCESSORY STRUCTURES: Garage, type const,. Storage, type const. wood Swimming pool Guest, type const. Other VIOLATIONS: Housing Code, Chapter 52 Location Description IArt. 1 Sec. No violations where found. Remarks: Inspected by: ate of Insp. July 20 , 1984 Curtis W. Horton Time start 11:45 end 12 : 0.0 FORM NO.6 TOWN OF SOUTHOLD Building Department Town Hall �;outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted up4+eato-to the Building Inspec- tor with the following;for new buildings 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 of Health Dept. of water supply and sewerage disposal—(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site'plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling land use --Pre-Existing C . O. $ 15 . 00 3. Copy of certificate of occupancy $1.00 Vacant land C . O . $ 5 . 00 Date . . . . . . . . . . 7.114.(6. . . . . . New Building . . . . . . . . . . . . . Old or Pre-existing Building . . . ✓< . . . . . . Vacant Land . . . . . . . . . . . . . . /.//,% . .A./yr. X?Z- Location of Property . . . . . . . . . . House No. / Street Hamlet Owner or Owners of Property . . 4peo . !! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No. 1000 Section . . . .1 ./. . . . . . . . . Block . . . . . . . . . . . . Lot . . . 1 . . . . . . . . . . . Subdivision . . . . .f . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . .& . . . . . .Lot No. . . . . . . . . . . . Permit No. . . ... . . . . . Date of Permit . . . . . . . .. .Applicant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . .Labor Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . . Underwriters Approval . . . . . . . . . . . . . . . . . . . . . . . .Planning Board Approval . . . .-. . . : . . . . . . . . . . . Request for Temporary Certificate . . . . . . . . . . . . . . . . . . . . .Final Certificate . . . . . .'11�x . . . . . . . . . . . . Fee Submitted $ . . e*: .a t F � Construction on above described building and permit meets all applicable co es and regulations. Applicant � '' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Rev.10-10-78 CONSENT TO INSPECTION `* the undersigned, Owners) Name(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at �6 L d/ which is shown and designated on the Suffolk- County tax map as District 1000, Section 7, Block Lot /G 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 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. D ate d: (signature) / (print name) (signature) fjj (print name) TOW OWNER STREET VILLAGE DISTRICT I SUB. LOT l.�C � 3�.-� E ors I-perQerr - FORMER OWNER i. N E ACREAGE V 4 ® 2 Is W TYPE OF BUILDING RES. 44) SEAS. VL. FARM COMM. I IND. I CB. I Misc. I Est. Mkt. Value I LAND IMP. TOTAL DATE REMARKS 1XV AGE BUILDING CONDITION NEVV NORMAL BELOW ABOVE FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD X Tillable 1- BULKHEAD Tillable 2 DOCK Tillable. 3 Woodland ° Swampland Brush land----' House Plot Total >v .%.. � ,� .•3.7 t ray c r-:* c �>S l I j j i j i I I i j ,T t ` YLI I I I i I I , ! ! I�h _ �� i 7-1 A Bldg. I 5� � _ � a Foundation � � � � Bath / .t Extension j I Basement Floors =0 e Extension I Ext. Walls - Interior Finish km L Extension j j I j I Fire Place I `5 { Heat Porch I I Roof Type j ! Porch I Rooms 1 st Floor Breezeway i Patio Rooms 2nd Floor Garage ,� � ��D Driveway Dormer ®. B. V 3 7 \ 1 1 � BUILDING DEPART141ENT TORN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT Location number &. street I,iunicipality Subdivision Map No. Lot(s) Name of Owner(s) Occupancy type owner-tenant Admitted by: ccompanied by: Key available " Suffolk Co. Tax No. �°�� 3--�/ Source of request ,.. O Date DWELLIiIG: Type of construction #stories ,( Foundation Cellar Crawl space Total rooms, 1st. F1 2nd. F1 3rd. F1 Bathroom(s) Toilet room(s) Porch, type Deck, type Patio, type Breezeway Garage .e"Z er�d7n Utility room Type Heat '"arm Air Hotwater Fireplace s) No. Exits Airconditioriing Domestic hotwater Type heater Other �— ACCESSORY STRUCTURES: Garage, type const. Storage, type const. W;_,oxx Swimming pool Guest, type const. Other VIOLATIONS: Housing Code, Chapter 52 Location Description lArt. 1 Sec. Remarks: Inspected by: Date of Insp. d %L Time start�f y.3—end Gr