The URL can be used to link to this page

Home My WebLink About1000-122.-5-8 UW1W T 0"'IAIN OF SOUTHOLD 20 Rental Permit 0126 Owner L aurene Herwald Occupied as Single Family Dwelling Located at 105 Kraus Road Mattituck 122.-5-8 Maximum Permitted Occupancy 6 Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection. 5/19/2023 Code tnforcWent Official This Notice must be posted by the main entrance at all times qf so TOWN OF SOUTHOLD BUILDING -DEPT. coo 631-765-1802 INSPECTION FOUNDATION 1ST ROUGH PL136. FOUNDATION 2ND INSULATIOWCAULKING FRAMING /STRAPPING FINAL FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) ELECTRICAL (FINAL) CODE VIOLATION PRE C/ `RENTAL REMARKS: DATE INSPECTOR Town Hall Annex S®�THOLD �® 54375 Main Road , N WN PO Box 1179 Southold, Ifl; Re �cti®B1 NY 11971-1179 " Te1: 631-765-1802 Fax 631-765-9502 Owner Phone S Zip Address� Inspector LEVELS SUB _ _?....._ _ 3 # b ors excluded) w. _. Smoke Detectors ( µ_.— Broom detect _ _ _ _.._. _..__.......... Carbon Monoxide De ® . _...._ tors # wM.� ...A __.�...... .....,..__.�,. __. Eire Extingu shers (#) Exits (#) _�_....a. ...._..__._. .w.,..�__...__,_..._..�.._._.........ww�_ � ...... _�_..._ �� BEDROOMS 2... 3 ... _ _5— Smoke Detector Alarms (#) ....w.. .... ®.. _..... _._... C arbon_Monoxide Alarms (#) Egress (windows) �(Y/N),...._ ..._ �. ''Ellummmiff,a, Y/N CONDITION OF PROPERTY Y/N ._. .._ �_ ! '` Building Interior is clean / maintained BUILDING SYSTEMStained/operational F, ...-- IHeatin s stem ma _ ._ .._... „w Hot water tr m maintained/operational clean /maintained Building Exterior is m� � m� � .. Electrical y_ maintained/operational Pro ert Is clean /safe% maintained w. system _ _Property is clean ....._e/ mint_� Mechanical s stem maintained/operational Handrails & guards present MEMBER In COMMENTS - .. Rental Inspection Form 4/7/2021 v= ETH 'P%Lwft TO N U bUU 4 Rental Permit Permit No. 0126 Owner Laurene Herwald Occupied as Single Family Dwelling Located at 105 Kraus Road Mattituck 122-5-8 Village Maximum Permitted Occupancy 6 Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection. 4/19/2021 f)I-LIZ�11 t-4L-C� Code Enforcement Official This Notice must be posted by the main entrance at all times Town Hall Annex SOUu � TH TOWN 54375 Main Road PO Box 1179 Southold, ars Ze `s � Renu ' s io NY 11971-1179 Tel: 631-765-1802 ) Fax 631-765-9502 SCTM# Date + 1(A 020 , Ownert t tip M_G , - Phone 3 � -(90 -l Address ln(� LAus P-OAN Zip Cid n1A I Tuck Inspector om LEVELS SUB 1 2 3 Smoke Detectors(#-bedroom detectors excluded) / Carbon Monoxide Detectors Fire Extinguishers(#) Exits( ) / BEDROOMS 1 2 3 4 5 Smoke Detector Alarms(#) t I Carbon Monoxide Alarms(#) Egress(windows) (Y/N) Y BUILDING SYSTEMS Y/N CONDITION OF PROPERTY Y/ 3 Heati ig system maintained/operational Building Interior is clean/maintained Hot waters stem maintained/operational Building Exterior is clean/maintained Electricals stem maintained/operational Property is clean/safe/maintained Mechanical system maintainedPostational Handrails&guards present COMMENTS: b II Rental Inspection Form 4/7/2021 T WN OF SOUTHOLDo" Rental Permit S Permit No. 0126 Owner Laurene Herwald Occupied as Single Family Dwelling Located at 105 Kraus Road Mattituck 122-5-8 Address Village s/B/L Maximum Permitted Occupancy 6 Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection. 7/26/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times Town Hall Annex Telephone(631)765-1802 31 6 54375 Main Road Fax�� ;�� ( )765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOU11: LD RENTAL PERMITILIA '�ION Pp � ' every two �R' Rental Permit Fee $200 A lication �: is FFR 2019 Section A. Property Information: Rental Property Address: Tax Map Number: 1000 SECTION w '122 BLOCK_ w ''eeeeeeee mm LOT mmm �8__... SECTION B. OWNER INFORMATION: Property Owner Name e w V r ul e I la' lk'j Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) vvI�hgfO�: Bead-i Roi,�da 32168 Telephone Number(s): 86 6,K) 1671,,3 Property Owner Email Address: . t .... ..._......... .. _............ ........ ...mm_ n_.nmmmm.... Page 1 of 4 Section C Auth(wized Agen,"t Name of Authorized Agent of dwelfing unit, if any.- -111-..............— 2801 Sunset Ddv(), IrJSBI, IVR 32168 Addiress caf Nithoed Agent (nio P.O. Boxes)��, ............... I'll �- "I'll,............. .......... Maihng Addr(?ss of Authc)idzed Agent: , 2801 SUr,[sef DrIve, N&��,, 32168 ....................... I......................... —.............. 386 6t�O-'1678 Felephoiae Number(s�)� . ............ .......... - --------... ....... aUreirie�zz77@girriaO corn Eirrujid Address: ........ ----- . ..... .......... Section 1). Mainaiging Agent Irtforrnation: N/A Narne of Authorized Ag(Mt of dwelfing urift, if any- —-------- ...... ... Address of Authorized Agent (no P'.0. Boxe):_------- ...... ... .... Maihng Address of Authorized Agent 111,.................--....... ----------- ........... Felephone Nurribeir(s): ----------- -------- ............ ----------------- ErnaiiAddress:, ......... ..... SEc n0N E, SITE MANAGER INFORMA I ION: (requirred For renWproperUes,contAiOng 8 r)r Irnoire rentA units) Nairne of hftnia&g Ageira. of dwelhng unit, if aliny: 1,VA .......... ................ ...............'I'll, Addiress of Maru)ging Ageint (no P.O. Illkrxes) . ....... .......... D Maflfing AddireSis of Managing Agent: ............... rdephorwNumber(S)'. . ....................................... .......... ................... ........ ...........---,.. ......... EirnaflAddress: ............... ........... ..................................... . ............. ......... flage 2 of:4 SECTION F. PROPERI YDESCREPTION: Number of Rental Dwelling Units on property: ------------------ ............ ................. For each Rental [)welliing Unit set forth the Rental Dwelling iu nit identifier(for,exanlpe, Unit 1, Unit 2, Unit 3 or Apt A, B, Q the use of each rooM in the Rental Dwelling Unit (for exalnpie, Kitchen, Bedroorn 1, Bedroom 2, Living Roorri) and the dimensions of each room, For- properties with rnkAtiple Rental Dwelling LInits use "Reintai Permit Appkation Addendurn." Mattit,'ux�,k Rental Dwelling Unit Identifier: ----------- Requested Maxirnurrw inunriber of persons alHowed to occupy [MeHing 6 Nurnber Of MOMS ill IRentaP Dwelling Urift: Use and Dimensions of each room in Rental Dwelling Unit: 1 ------------------------ < 11 8' 6"x 8 t' hIg x 12% ",A,i r,)()-r� S' x �m�,y Roic.:,,�ri 29' x '12' ............... ......................... ....... ................... ........................ r r i)t 1�:'fa d j,,o o rn '12' (1 1 �'Vl if.:J,1,,J!Me,, El, J�, �'r'i I x 41, x 8'4,'' 'a ..................................... ........ ............................ ........ ------------------ xIS ------------- .... .............. ----------- ...........................................................................-1-111111................. SECTION G. INSPIECTION: Pursuant to the lown Code othe Towri of Southold Chapter 207 (Rental Properties), a safety inspection by Code Enforcement Officiai is requ6red. If the owneir,chooses riot to Iha~ve said inspection perfonned by the 1-own, a ceiriJficadoin from a NYS kensed airchitect, a NYShcensed pr'01fC5Sional erigineer or a horne inspector who has a valid New or State Uniform Fire Prevention Building("ode Certification is reqiuPred stating that the proped-,y which is the subject of Ithe rental permit application is in coirriphanc-'�e with afli of the provisions of the code of the Town of Southold, the WNs and sanitary and housing regulations ofthe County of Suff(Ak airld Amy the laws adopted by the New York State F'UrIPirevention and Budding("ode Council. forcernent official I am requestirig a saf(ty inspeCtJOII to be performed by a (.",.ode En frorn,the'Tomin of Sotjth6�di Page 3 of 4 i am subrnitth'19 a completed'"Fown Of SOLfthold cemtfication forrnfirom, a ficeinsed til archftect, an licensed professional engineer,or as ficensed home lnspector who has as valid �New York State UnKorm Flire Pirevention Building code C;eirtfflcadoin. SE.:CTION H. DECLARATION: aS�gnature esus sttae notaHzed and ST Baan the owner of the dwelling unit. S'11'ATE, OF NEW YORK) (,"OUNTY OF SILYFFOLK) WAI'&M.11 , cerfify under penalty of peijury, the fdlowing: ............. I arn the owner of the property,identified in "Section A" of this appkation 2. "The property owiner's legal addres s set forth in "Section B" of ths appkation is rny �ega� �address and l understand the'Towaw in will use tl-ie addiress for service pursuant to all A Southold applkable laws and nAes. III fluirther acknowledge that I wifll noffy the"Fown m Building Department of ainy chainges of address withiri five (5) days of any changes thereto. 3. 1 have read and received a copy of Chapter 207 of the COde of the Town ciif Soudio: d and agreed to abide by the same. 4. 1 will notify th(--n Town within five (5) business days s to any chainge to the information regarding Authorized Agent, ManagingAgent, or Site Mvlan a per. ... ....... .... Property Owner's Narrie� ................................... ........ .. ................ ...... ....... Property Owner'sSignature� .... ----------- .............. S- )efore 1, e this da, of ' 2011 y ZA, (Dffidal Notary Pmal k SNgnattjre and Original lNotairy Stamp AIMEE JENNA � r. age 4 of 4, 1Notary Public-State of FloridaCommisuslon#GG 201952My Comm.Expires Mar 29,20221 = Town Hall Annexi% Telephone(631)765-1802 , % �°'/�/ � ilii 54375 Main Road r '' Fax(631)765-9502 P.O_Box 1179 Southold,NY 11971-0959 ��✓✓i��` � BUILDING DEPARTMENT TOWN OF SOUF OLD RENTAL PERMIT APPLICATION ADDENDUM Rental Dwelling Unit Identifier �105 Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: 9. 6rE�r` �1 . aegery Use and Dimension of each room: vni,,i g R,00rrr 1�' x 2', 4<4.r he 1 8' 6" rr 81, o(:xr"r ' rr2', I�'udrr.rrr n 8" 6), rr ��', V :a�r� Hy I�cxs,}¢rr 29 x 121 , ��.axy� i°:rrr rrr,rr°rr i ��2' r:9' 10", V'�{ir�de�r i�r_rdrraoa 9'6"" e� T 2', pia"�a�ltirrt��°i°7 5'd, x 8'4' P�'ti s: ,er R,�s,dre)rrrrr 9 tart x '15', Rental Dwelling Unit Identifier: Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: w„.. -------..u,_,_____. ., Use and Dimension of each room: Rental Dwelling Unit Identifier ., Requested maximum number of persons allowed to occupy each dwelling unit: Number of Rooms in Rental Dwelling Unit: mm. _, ... Use and Dimension of each room: NA. m a 9004 w ;�- TOWN OF SOUTHOLD BUILDING DEPT. coy, 765-1802 INSPECTION. I ] 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) [ ] CODE VIOLATION [ ] CAULKING REMARKS: A "/%c................. r r CO r 4, Z d D m x4 Z w W O D b ,. (n Tm Mm w m C7 m �ti. CD IN CZ u 03 pp rr I ml D r W c D T 2 <� N� D m m Z ai rn pp , .� u n r N 4� c i w D cn ° O r m i Np w a mm a cn m Z Ln LA ET q CD :f, 3 n v v 0 3CL YL M y ..... ,....,,,., .. , ... ® . . Ln m , co coc n -v m Y r y, 0 a � Er r F Z (l dip > I in 00, O o im r O � D c O Z „,, m ` `..` m N ! , r " m k. m m M h ,,,,.,,., ,,,,. ,,,, , i �$ a �, i �.,--_ m ,, i ". ti�y4i',. N n 5 "9 m m e� P , ::� o PPW A Z " y k= n Un ;'r .. ' 7. ni IN Ln Oil II (0 .p -n 9 m u l% 1 a is CD O W t f0 N T 7 3 7 to m ino if �, f , _, _. i w lk- � 1 lz IV RY v NWwirV�� }� c m ' °r 1 Q � � (1 'O (p C 3 0 (° 7 is 0 o ; or o O C) ,c 0 °, -r o �� b 3 O0 i f q o 0 0 rt 3 3 o H N y o 1 _ 1 i 3 ... �..��.... f (D . t .�.,.,.... ......... ....... _> 4 t u 3 Y n 1 � LL� :n. -s V � � I�B rC�lnKXktnl J43- k= t r Y4Z V-i �� L,p� — , , , __ I 6Sf N ILL y f� z x J� o u 1 r 407 �� 3 t tu ECI � l i k cab Q a µd e h � � !f r ! i / IfJ.I /o/� „<.i f,�,,.;r ri,✓ f u, l(rGrw. 'f"� r//;�'?, ,1� f �,i� r ,//�� .�� i f�Ni fe', s �'�i/1,eG'/'/r< r !N, ✓i„% fA�I%6„� ' , f r' Town of Southold 10/11/2020 � uM 53095 Main Rd ' Southold,New York 11971 E EXISTING CERTIFICATE OF OCCUPANCY No: 41526 Date: 10/11/2020 THIS CERTIFIES that the structure(s)located at: 105 Kraus Rd.,Mattituck SCTM#: 473889 Sec/Block/Lot: 122.-5-8 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- 41526 dated 10/11/2020 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 dy�plijp with:attached garage and accessor w��, Notes:BP 2287 addition COZ-2023• 'BP 3148 addition COZ-2583'BP 43619"as built"; C COZ-40421 �.RP 4 2 windows COZ-40606;BP 45305 "as built"deck COZ-41525. The certificate is issued to Herwald, Laurene (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. �ull or'r:c(, Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 105 Kraus Rd.,Mattituck SUFF.CO.TAX MAP NO.: 122.-5-8 SUBDIVISION: NAME OF OWNER(S): Herwald,Laurene OCCUPANCY: ADMITTED BY _ ._.. m..�....... ._ _ .... ........_...__. �_.._. SOURCE OF REQUEST: Herwald,Laurene DATE: 10/11/. ............. 2020 DWELLING: #STORIES: I #EXITS: 3 FOUNDATION: cement block CELLAR. full CRAWL SPACE: BATHROOM(S): I TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: blue...stone.................................... BREEZEWAY: FIREPLACE: I GARAGE: x DOMESTIC HOTWATER: x TYPE HEDI HEATER: electric AIR CONDITIONING: TYPE HEAT: oil WARM AIR: forced hot air HOT WATER: ww.......... #BEDROOMS. 3 #KITCHENS _ .... __ .......�...._. � ..... I BASEMENT TYPE: unfinished OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 2/14/2019 TIME START: 11:00am END: 11:50am FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY October 29 61+ No. ?!_2023 Date ........... 19........ .........1.1--l-1. THIS CERTIFIES that the building located at ....X�fc?4....ICr a,q...a.....R,d ... .... ...................... .......... Street Map No. Block No. .... Lot No. ....... ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... I V� .... pursuant to which Building Permit No. .,F4�7 Z dated ...— was issued, and conforms to all of the requirements — .. --TK of the applicable provisions of the low. The occupancy for which this certificate is issued is ........ Private one "amil dMell-ing .............. ...... The certificate is issued to . Ovnom .............. ............... ..................... ...... (owner, lessee or tenant) of the aforesaid building, ............................. ...... Building Inspector FORM NO. 2 . TOWN OVSOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. SUR.DING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 228'7 z bate ..... .................. �..,..,.�. .....1 19. .6, Permission is hereby granted to: . ......:.:............................::..... ....... . lS...yy�yyiS .............................................. ....,..•....Y +,.'R�T1 ,. ...... ................................... to ...... ................................................... .................f..:f........................................................................................................................................... r - at premises located at .,..•� ► 7�' 3y d................................................ ..........I......................... ,... .........................................iY.......... ��rAM'. ' ... - ...L.........r ...................I........................1...... ........................................ .......................................... ..............................................,...............................x _. pursuant to application dated•......................... a ....y 19.x.., and: approved by� he Building Inspector Fee $.. 00.: .. ...... ... . ........... ...w......... .., ..Building Inspector FORM NO. 4 `OWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. Y. CERTIFICATE OF OCCUPANCY No. 2.583 DateOctober, .. 7 .. . . . . . . 19. . . . THIS CERTIFIES that the building locat ed at d;L9. "19 .44MIP. A.KrSUB .lkPlAfeet Map No. . . . . . . . . Block No. .=. . . . .. . Lot No. . ...XX K. . . . . . . . . . . XattitUck.,. .N.y. conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . . . .Ju).Y. 6 . . ., 1%6. . pursuant to which Building Permit No. .33.48.Z dated . . . . . . . . . . . . . . .J%ty,11.., 19. ,% was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . . . . .addition. to. one. lamiiY -dwellincl . . . . . . . . . . . . . The certificate is issued to . . .A jbext .'ZanoK0k1 . . . . . . . .. . ... . . . . . I . . .. .. . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. ,Suffolk County Department of Health Approval . . . . . . . . . . . . . . . . . . • • . • . . • • • .. . . . . •• . Building of 01 t Town of Southold 6/1/2019 P.O.Box 1179 53095 Main Rd Southold,New York 11971 CERTIFICATE FICATE OF OCCUPANCY No: 40425 Date: 6/3/2019 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 105 Kraus Rd,Mattituck SCTM#: 473889 Sec/Block/Lot: 122.-5-8 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 4/15/2019 pursuant to which Building Permit No. 43649 dated 4/15/2019 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: "as laullt"central air conditioning as AMfigLI fps The certificate is issued to Herwald,Laurene of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 43649 4/23/2019 PLUMBERS CERTIFICATION DATED Authorized Signature � Ftt M Town of Southold 8/8/2019 P.O.Box 1179 53095 Main Rd 01 Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40606 Date: 8/8/2019 THIS CERTIFIES that the building WINDOWS Location of Property: 105 Kraus Rd.,Mattituck SCTM#: 473889 Sec/Block/Lot: 122.-5-8 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 7/2/2019 pursuant to which Building Permit No. 43962 dated 7/15/2019 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: WINDOW REPLACEMENTSTO AN EXJSTlNG ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Herwald,Laurene of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ,e Signature " x a Town of Southold 10/11/2020 P.O.Box 1179 53095 Main Rd , 10 Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 41525 Date: 10/11/2020 THIS CERTIFIES that the building AS BUILT DECK Location of Property: 105 Kraus Rd,Mattituck SCTM#: 473889 See/Block/Lot: 122.-5-8 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated _ 9/28/2020 pursuant to which Building Permit No. � ,4,5305 dated 10/8/2020 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: "as built"deck addition to existin si'n lc-faniil dwelli as a lied for er El a 731/w dated 12/1912019. The certificate is issued to Herwald,Laurene of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED —A-ut i'- attire