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Home My WebLink AboutZ-29408FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 29408 Date: 05/02/03 THIS CERTIFIES that the building DWELLING Location of Property 56125 MAIN RD SOUTHOLD (HOUSE NO.) (STREET) (HA24LET) County Tax Map No. 473889 Section 063 Block 0003 Lot 010 Subdivision FiledMap No. __ Lot No. __ conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF ~CN3P~/qC"fAVu~WB~ Z- 29408 dated 9L~Y 2, 2003 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, ACCESSORY BARN & ACCESSORY WORK SHOP * · ~ne certificate is issued to LESTER M ALBERTSON (OWNER) of the aforesaid building. Rev. 1/81 SUFFOLK COUNT"fDEPARTMENT OF HEALTHAPPROVAL ELEt-rKICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DAr~u *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A Aut~ori z e-d S i~t ~re BUILDING DEPARTMENT TOWN OF SOUTBOLD HOUSING CODE INSPECTION REPORT OCC~3P~NC"f: SINGLE FAMILY AI~Ii-r~B¥: ROBERT A. ALBERTSON SOUTROLD NAP NO.: LOT (S) LESTER M ALBERTSON AC~"~BAMII~ BY: SkME ~3FF. CO. T~X 14AP NO.: 63.-3-10 ROBERT ALBERTSON 04/13/03 DAT~: 05/02/03 DWELLING: ~PE OF C~"I~UC~I(~: WOOD FP~AME FOUNDATION: BRICK & BLOCK 2.0 # EXITS: 3 ACCESSORY STRUCTURES: C~E, R~'PE OF C~ST.: 1 CAR WOOD STORAGE, TYPE CONST.: LARGE BARN WOOD VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTIOE ART. SEC. R]~: BP#2~94-~-COZ 29361 (ADD TO ACCY WORKSHOP) INSPk-rl~3 B DATE O~ INSPECTION: 04/22/03 ,~ORN M. BOUFIS // ~ TINE ~X: 9:30 AM l~: 10:20 AM Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: For new building 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 from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. Bo For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Ocanpancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. Co Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swin~ning pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. CertificateofOceupancyonPre-existingBuilding- $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. April 18, 2003 New Construction: Location of Property: (check one) Old or Pre-existing Building: X 56125 Main Road Southold Street Hamlet Lester M. Albertson House No. Owner or Owners of Property: Suffolk County Tax Map No 1000, Section 63 Subdivision Permit No. Date of Permit. Block 3 Lot 10 Filed Map. Lot: Applicant: Health Dept. Approval: Plmming Board Approval: Request for: Temporary Certificate Fee Submitted: $ /t00~ Underwriters Approval: Final Certificate: ~ (check one) Applicant Signature Issue Date 04/09/2003 Electrical Inspection Certificate Electrical Inspection Service, Inc. Application Number 375 Dunton Avenue 72122H East Patchogue, New York 11772 (631) 286.6642 Issued To: Lester Albertson Street: 56125 Main Road Village: Southold Zip: 11971 Section: Block: Lot: Contractor: Town: Southold Lic. # Was examined and found to be in compliance with the National Electhcel Code. [] Commercial [] NV Defects [] Pool [] 1st Floor [] Indoor [] Basement [] Hot Tub [] Residential [~ Der. Garage [] Attic [] 2nd Floor [] Outdoor [] Addition [] Survey Switches Receptacles Fixtures GFI Heaters 6 6 8 4 Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps A/C Fans Microwaves Furnace 0il Gas Circulators Smoke Detector Bell Transformer Meter Amps Phase UG/OH Jacuzzi / Television CO Detector Bldg. Permit: Other Equipment Detached Shed -Sub Panel 1-240Volt Receptacle (wall) Hugo S. Surdi President Rough [nspeddon: 01/24/2003 ]nspector: Ed Scavelli Final inspection: 04/0812003 [nspector: Ed Scavelli This certificate must not be altered in any manner. Inspectors may be identified by their credentials. CONSENT TO INSPECTION Lester M. Albertson Owner(s) Name(s) , the undersigned, do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold, locatedat 56125 Main Road, Southold which is shown and designated on the Suffolk County Tax Map as District 1000, Section 63 Block 3 , Lot 10 That the undersigned (has) (have) filed, or cause to be filed, an application 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 in subsequent prosecutions for violations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: (Print Name) (Signature) (Print Name)