HomeMy WebLinkAboutZ-18340 FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE
Certificate Of Occupancy.
No. . .Z !83.4.0 . . . . . . . .
Date 98.9. . . . . . . . . . . . . . .
THIS CERTIFIES that the building . . .QlfE. FAMILY. Pif4MI!f. . . . . . . . . . . . . . . . . . . . . . .
Location of Property . .
. TqKl�q� AVE. :�E SOUTHOLD
Ho
. . . . . . . . . . . . . . . . . . . . . . . i . . . . . . . . . . . . . . .
use No. Street Hamlet
County Tax Map No. 1000 Section . . . Block . . . . . .05 03
. . . . . . . .Lot . . . . . . . . . . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . . . . . 'Filed Map No. . . . . . . . .Lot No. . . . . . . . . . . . . .
REQUIREMENTS FOR A PRIVATE ONE—FAMILY DWELLING BUILT PRIR TO
conforms substantially to the
CERTIFICATE OF OCCUPANCY
. .APRIL..9 pursuant --. . #ZI8340
. . . . . . . . pur t to which MXX&YgX*MXW. . . . . . . . . . . . . . ... . . . .
dated ..1.989. . . ... . . . . . . . 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.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .
The certificate is issued to . . .RYSSELL A. MALLGREN JR.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . .. ... . .(owner,
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE NO. . . . . . . . . .A/4
PLUMBERS CERTIFICATION DATED: N/A
***SEE INSPECTION REPORT
. . . . . . . . . . . . . . . . . . . . . . . . . . .
Building Inspector
Rev. 1/81
BUILDIi'.G DEP.,=1IENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 3225 YOUNGS AVE . SOUTHOLD
(number & street) (Municipality)
.Subdivision clap No. Lot(s)
Name of Owner(s) RUSELLL MALLGREN JR_
Occupancy R-80 RESIDENTIAL OWNER
type owner-tenant
Admitted by: RUSSELL MALLGREN Accompanied by: RUSSELL .MALLGREN;
Key available Suffolk Co. Tax No. 55-5-3
Source of request RUDOLPH H. BRUER' Date 8/29/89
DWELLING:
Type of construction WOOD FRAME #st'ories 2
Foundation CONCRETE BLOCK Cellar FULL Crawl space_
Total rooms, 1st. F1 2nd. F1 4 3rd. F1
Bathroom(s) ONE 2ND' FLOOR Toilet room(s) --
Porch, type FRONT ENCLOSEDDeck, , type -- Patio, type_-
Breezeway -- Garage -- Utility room --
Type Heat LILCO GAS Warm Air Hotwater STEAM
Fireplace(s) ONE 1st FL-No. Exits 3 Airconditioning
Domestic hotwat.er LILCO GAS Type heater RHEEM
Other MUDROOOM REAR OF HOUSE .
ACCESSORY STRUCTURES:
Garage, type const. NONE Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS: Housing Code, Chapter 4.5' N.Y. State Uniform Fire Prevention
& Building Code
Location Description Art. 1 Sec.
EXTERIOR EXTERIOR SURFACES SHALL BE MAINTAINED INI 1 1242 5 E)
GOOD CONDITION. SURFACES NOT INHERENTLY
RESISTANT TO DETERIORATION SHALL BE TREATED
WITH PROTECTIVE COATING OF PAINT !OR OTHER I
SUITABLE PRESERVATIVE .
I
4.
Remarks: HOUSE IF FAIR CONDITION.
Inspected by: Date of Insp. 8/3189
GAW FISH Time start 11 :00 end 11 :20 a.m.
t
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OF: SO.UTHOI.D
'V'C,J }
a -y I BUILDNG DEPART?IENT
TDWN 'HALL
SOUTHOLD, NEW YORK . 11971
765 — 1802
. APPLICATION FOR CERTIFICATE OF OCCUPANCY „
_ - DATE.
NEW CONSTRUCTION . .`. . . . .OLD OR •PRE—EXISTING BUILDING. --.VACANT`LAND. . . . . . . .
Location of Property. . . . ... . ... . . . . ( - - - - - - -
HOUSE NO. STREET HAMLET
1
Owner or Owners of Property . t�C . . .�f- - - . . .: . . .
P S
County Tax Map No. 1000 Section. Block . . . . Lot . . . . . . . . .
Subdivision. _ . . ... . . . . . . . . . . . . . . . . Filed Map . . . . . . . .Lot. . . . . . . . .
Permit No. . . .. . • . . . .Date of Permit . . . . . . . . . .Applicant . . . . . . . . . . . . . . .:i . .
Health Dept. Approval . . .. Underwriters Approval. . . . . .
Planning. Board Approval .
Request.-, for Temporary Certificate Final Certificate .. .: . ... . - -
Fee Submitted : $AQ!aq . . . . . . . . . .
APPLICANT. �:� . :. . .� .
91s1 yc o .71
rev 10/1088
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J_CNARNEWS , I 9
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El-K\UMENT
---- -
CONSENT
TO
INSPECTION
the undersigned,
Owner(s) Name(s)
do(es) hereby state:
That the undersigned (is) (are) the owner(s) of the premises in the Town
of Southold located at
which is shown and designated on the Suffolk
County tax ma as District 1000, Section ]/� , Block v Lot
That the undersigned (has) (have) filed, or caused to be filed, an applica-
tion in the Southold Town Building Inspector's Office for the following:
�i1CcQ Q, O
That the undersigned do(es) hereby give consent to the Building Inspectors
of the Town of Southold to enter upon the above described property, including
any and all buildings located thereon, to conduct such inspections as they may
deem necessary with respect to the aforesaid application, including inspections
to determine that said premises comply with all of the laws, ordinances, rules
and regulations of the Town of Southold.
The undersigned, in consenting to such inspections, do(es) so with the
knowledge and understanding that any information obtained in the conduct of
such inspections may be used as evidence in subsequent prosecutions for vio-
lations of the laws, ordinances, rules or regulations of the Town of Southold.
D ate d:_ �
(sign ure) %
do
(print ame)
(signature)
(print name)
BUII,DI_:G DEP!AT;',1E T
T01.111\1 OF SOUT HOLD, N. Y.
HQUSIi3G CODE IiiSPECTION REPORT
Location 3.2z,s a,
�rulmoer � s L eez) i-iunicipality)
Subdivision Map No .
Lot(s)
Name of Owners)
Occupancy -$o
GYP e own er-z enan z)
A d:iiLted b l
y -Ac:cdmpan1ed by :
Key available Suffolk Co. Tax No.
. SS-S-3
Source of request '
• .. Date
DIYE- LING;
Type of construction F r, O
r es-tories
�
Foundation /� Cellar
Crawl spac
Total rooms, lst. F1 .3 2nd. F1
54 3rd. Fl
Bathrooms) � Toilet room(s)
Porch, type� _D Deck, type
Patio, type
Breezeway Garage —
Type Heat Utility room
'warm Air Hot-water
Fireplace(s) , No. Exits
3 Aircondi Lioning
Domestic hotwater_��, �.o T
Other Type heater
ACCESSORY STRUCTURES:
NoN E .
Garage, type const. Storm
be, type const.
Swimming pool Guest type ype const.
VIOLATIONS- CHAPTER 45--N.Y. STATE UNIFORZi FIRE PREVENTION & BUILDING CODE
Location De�cri�tion
Art. Sec.
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Remarks
= a e
Inspected by: Date of Insp.
—FX�/AF7
Time start :oo di