HomeMy WebLinkAboutZ-26534FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
pRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 26534 Date: 06/30/99
THIS CERTIFIES that the building DWELLING
Location of Property 45805 MAIN RD SOUTHOLD
(HOUSE NO.) (STREET} (HAMLET)
County Tax Map No. 473889 Section 075 Block 0002 Lot 014
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 26534 dated JUNE 30, 1999
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 WITH ACCESSORY GARAGE & TWO WOOD STORAGE SHEDS.
The certificate is issued to THERESA A WESTERLUND & ORS.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
N/A
H--064740 - 6/24/1999
N/A
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 45805 NLAIN RD SOUTHOLD
SUBDIVISION: M-~P NO.: __ LOT (S) --
NA~ OF OW~R (S): THERESA A WESTERLUND & ORS.
BATHROOM(S)
WARM AIR: *~ HOTWATER:
*WA~R · Dgy~E
~ STORIES: ~-0 # EXITS: 4
CELLAR: PART CRAWL SPACE:
3RD FLR.: O
UTILITY ROOM(S): --
PATIO TYPE: SIDE CONCRRTE
GAP, AGE:
AIRCONDITIONING:
G;tRAGE, TYpE OF CONST.: 1 CAR WOOD STORAGE, TYPE CONST.: 2 OLD WOOD
SWIPING POOL: GUEST, TYPE CONST.:
OTHER:
VIOLATIONS:
LOCATION
CHAPTER 45 N.Y. STATE UNIFOP~4 FIRE PREVENTION & BUILDING CODE
~ DESCRIPTION ART.
NOTE; 2ND FLOOR AREAS NOT HEATED & PLASTER IS
MISSING IN MANY AREAS. IF HEATING SYSTER IS
INSTALLED, TEE BUILDING ~gJST BE INSULATED TO
N.Y. STATE CODE WITH A BUILDING PERMIT.
SIDE DECK EAS BEEN P~EMOVED.
P~S: BP ~5841-ZF~Z~5829{BUSINESS BLDG.)
INSPECTED BY:
REINSPECTED 6/28/99
Fo gr~ No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION' FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by cypewriter OR ink and submitted Co the building
inspector with the following: for new building or new use:
1. ~inal survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or :opographic features.
2. Final Approval from Health Dept. of wa=er supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber cer~ifyimg thac the solder used in system contains
less than l/~O.of 1% lead.
5. Commercial building, industr±al building, multiple residences and similar buildinss
and installations, a cergificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of comp!e=ed site plan re~uiremenr.s.
For exis:ing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
Vprs-exis~ing" land uses:
1. AccuraTe su~;ey of property showing all property lines, s~reets, buildin~ and
unusual nature! or topographic features.
2.. A properly completed applica~ion and a consent to inspect si~ned by the applicant.
If a Certificate of Occupancy is denied, the Building Inspecuor shall s=ace
reasons =herefor in writing ~o ~he applicant.
Certificate of Occupancy - New dwelling $25.00, Additions ~o dwelling $25.00,
Ai~erazions to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions co accessory building $25.00. Businesses $50.00.
Certificate of Occupancy on Pre-e×is~ing Euildlng - $I00.00
3.. Copy of Certificate of Occupancy - $5.00 ove~ 5 years - $i0.00
Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial
June , 1999
Date ..............................
New Cons~ruc:ion ........... Old Or Pre~e~xisting guildinE....X.X~. ...........
Local±on of Property ................. South.old ............... ......
, 58o5 ..............................
House No. S~reet Hamlet
Onwer or Owners of A'. T:. .L
County Tax Mao NO [000, ~ec~zon... 75 .Block. 2 14
' ' . .Lot ......
Subdivision ......................... . .. ....... . Filed Map...... .... ..Lot ......................
Permit No ................ Date Of Pe~it ............... . Applicant ....................... ......
Health Dept. Approval ......................... . Underwriters Approval ........................
Planning. Board. Approval ................. . ..
Request for: Temporary Cer=ificate ........... Final Cer~icate ...........
Fee Submi==ed: $... ~QQ:QQ ....................
~S~22, ...... APPLICA~IT Theresa wester~un
CONSENT
TO
i NS PEC'I*ION
Theresa Westerlund , the under'si~ne¢l,
...... ov ' r(s) ' ........
do(es) hereby slate:
That the undersii~ned (is) (are) the owner(s) of the premises in the
of Southold looated at _,55~_ Main Rqadj__.~0uthold, New York
.... . whlch is shov~ end desiRnMed on the Suffolk
Coun%~ taw map ss Distpict 1000, Section 75 , BI,2ck 2 . Lot 14
That the undersigned (ha~) (have) f~led, or caused to be filed, an
t~on i. the Southold To~ Buildb%g [nspeetoP's O[fice fo~ the fo]]ow~:
l~ter of Dre-exi~o~p~.e_~or a,,t~9~t~9.~p3se, .,f~me gargle and
fr~e shed
That the unders~ned do(es) hereby ~ive consent to %he Bu[ldb%~ Inspectors
of the Town of Southold to enteP u~on the above descPibed property, includin~
any ~nd all but]dtn~S 1ocated thereon, to conduct such inspect{one as ~hey may
deem necessaP3, w~th ~espect to the afo~essid application, inclt~din~
to determine that smd 9pemJses compl3, with ail of the l~ws, o~dlnane.z, rules
~nd regulations of the Town of Southold.
The undersigned, tn eonsentlnR to such inspections, do(es) so w~th the
knowledge a~d undepstandinR that any information obtained ~ the eonduc[ of
such inspections may be used as evidence in sub~.quen{ 9Posecutions fop
lations of the laws. opdJnanee~, rule~ or PeRulations of the Town of Southold,
D~ted: June, ~---.~ ,(,1999.__ _
(si~natuPe)
Theresa Westerlund (print name)
THE NEW YORK BOARD OF FIRE UNDERWRITERS
[:~)?{,C~i? BUREAU OF ELECTRICITY
40 FULTON STREET, NEW YORK, NY 10038
Date JUL[E 24,1999 Application No. onfile i~;'} 165'?~,/~9 ',[
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant na~ned on the above application number is in the premises of
JCT ASS.2CIATES, 45805 t~,IN ROAD, SOUTHOLD, icl
in the following location; [] Basement [] 1st FI. [] 2nd Fl. ATTIC/£!UT Section Block Lot
was examined on ,JlJ~ !7 ~ ~997 and found to be in compliance with the National Electrical Code.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS
OUTLETS FLUORESCENT OTHER
DRYERS
SYSTEMS
NO. OF FEET
S E R V I C
NO OF CC COND A.W.G. A W G NO. OF NEUTRALS
PER $ OF CC COND. NO OF HI-LEG OF HI-LEG
OTHER APPARATUS:
'N~? VISUAl_ DEFECTS: 'An e!~ctrical
survey haB been made o~ the exposed
electrical e~ulpment in the
prenlises ir~dica'ted." "Nc obvious
,_msatisfactory ~ondltion w~s found.
JOE STEPNOWSKI
75E BENNETTS LANE
SOUTHOLD, N~f, 11971
GENERAL MANAGER
This certificate must not be altered in ony manner; return to the office of the Board if Incorrect. Inspectors may be Identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
.J
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