HomeMy WebLinkAboutZ-30259FORM LTU . 4
- - TOWN OF SOUIHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No_ Z- 30259
THIS CERTIFIES that the building DWELLING
Date= 06/26/04
Location of Property 20955 MAIN RD ORIENT
(HOUSE NO_) (STREET) (HAMLET)
County Tax Map No_ 473889 Section 017 Block 0004 Lot 006
Subdivision Filed Mag 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- 30259 dated JUNE 28, 2004
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancv for which this certificate is
issued is ONE FAMILY DWELLING &ACCESSORY WOOD SHED*
The certificate is issued to STEPHEN H RICFLARD MONROE
(OWNER)
of the aforesaid building.
SUFFOLK COO= DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO_ 2OO6643 6/10/01+
PLUMBERS
*PLEASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
N/A
Au -i d Signature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE IPI3PECTION REPORT
LOCATION: 20355 MAIN RD ORIENT
SUBDIVISION: MAP NO.- LOT (S)
HANE OF OWNER (S): STEPHEN H RICHARD MONROE
OCCUPANCY: SINGLE FAMILY DWELLING STEPHEN H RICHARD MONROE
ADMITTED BY: JOHN I4ICKLES ACCOMPANIED BY: SAME
KEY AVAILABLE: SUFF. CO. TAY MAP NO_: 17.-4-6
SOURCE OF REQUEST: RICHAP.D MONROE 5/18/04 DATE: 06/28,04
DWELLING:
TYPE OF CONSTRUCTION: WOOD
PRA14E
# STORIES: 2.0 # EFIITS: 4
FOUNDATION- STOVE
CELLAR:
CRAWL SPACE:
TOTAL ROOMS: IST FLR_- 4
ZND FLR_: 3
3RD PLR.: 0
BATHBOOM(S)- 1.0
TOILET ROOM(S);
1.0
UTILITY ROOM (S)
PORCH TYPE: OPEN FRONT -SIDE
SCREENS DECK TYPE:
PATIO TYPE:
RREEZENAY:
FIREPLACE:
GARAGE:
DOMESTIC HOTHATER: YES
TYPE HEATER: NAT.
GAS
AIRCONDITIONIHG:
TYPE HEAT: PAT. GAS HARM
AIR: FL.FUR7ACE HOINATER:
OTHER: `REAR STORAGE -
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.:
SN'IIR4ING POOL:
OTHHR:
STORAGE, TYPE COMET.: WOOD SHED OLD
GUEST, TYPE CONST_:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
REMARKS -
INSPECTED BY: �
GARY S.
DATE ON INSPECTION: 05/24/04
TIME START: 10:00 ?-.M @ID: 10:35 AM
Richard W. Monroe
Registered Architect
ARCHITECTURE AND
INTERIOR DESIGN
108 Soundview Avenue
East Northport, N.Y. 11731
Phone: (631) 754-6141
Fax: (631) 754-6141
June 25, 2004
Re: 20955 Main Road
Orient, N.Y. 11957
Hot water heater flue pipe
To whom it may concern_
A visual inspection was conducted at the above referenced location to determine the
status of the metal flue pipe connection to the existing masonry chimney.
The current metal flue pipe extends from the hot water heaters "flue hat" above the top
of the heater approximately 9" to a 90 degree turn. The flue then continues through the
existing rubble stone foundation where it connects to the existing furnace flue at a point
approximately 12" above the hot water heater at a horizontal distance of approximately
4'-0" from the hot water heater- The flue then connects into the existing masonry
chimney -
A smoke test at the "flue har confirmed that there is a draw from the hot water heater
upward toward the existing masonry chimney.
Sincerely,
Richard Monroe, R.A.
;'•
TOWN OFSOUTHOLD
BUILDING DEPARTMENT
MAV 1 9 2u TOWN BALL -
765-1502
_APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must he filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use:
L 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.
B. For existing buildings (prior to April 9, 1957) non -conforming uses, or buildings and `pre-existing" laud uses:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy
is denied, the Building [nspector shall state the reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling 525.00,
Swimming pool $25.00, Accessory building $25.00, Additions, to accessory building $25.00, Businesses $50.00.
�j 2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $25.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Data / 6
New Construction: Old or Pre-existing Building: (check one)
Location of Property: Mflc, S `Z�� <�iya—s
House No. Street Hamlet
Owner or Owners of Property: \� �, E a
Suffolk County Tae Map No 1000, Section C7 Block 4 Lot C.
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: S
Applicant Signature
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BY THIS CERTIFICATE OF COMPLIANCE
THE
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NEW YORK BOARD OF FIRE UNDERWRITERS
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BUREAU OF ELECTRICITY
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40 FULTON STREET — NEW YORK, NY 10038
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CERTIFIES THAT
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Upon the application of upon premises owned by
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RICHARD MONROE RICHARD MONROE
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108 SOUNDVIEW AVE 108 SOUNDVIEW AVE
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EAST NORTHPORT, NY 11731 EAST NORTHPORT, NY 11731
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S
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Located at 20955 MAIN ROAD ORIENT, NY 11957
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application Number: 2006643 Certificate Number: 2006643
Section: Block: Lot: Building Permit: BDC: nsll
Described as a Residential0-599square ft. the
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occupancy, wherein premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
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Basement, Fust Floor, Second Floor,
A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed
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herein, was conducted in accordance with the requirements of the applicable code and/or standard
by the State of New York, Department State Code Enforcement
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promulgated of and Administration, or other
authority having jurisdiction, and found to be in compliance therewith on theDay of
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10th .Tune; 2001.
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Name QTY Rate Rating Circuit Type
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Miscellaneous
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AS BUILT -ABOUT 1965
NViring Devices
and
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Receptacle 12 0 General Purpose
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Switch 7 0 General Purpose
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- Fix -'.re 3 0 _ Incandescent
Receptacle 4 0 GFCI
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Art as built inspection, of the delineated electrical installation, determined that an obvious hazard is not and the installation is believed to
present
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be in comtburtance with the applicable reference standard for the estimated period of construction of the premises wirin_s system.
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seal
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1 of 1
cThis
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certificate may not be altered in anyway and is validated only by the presence of a raised seal at the location indicated.
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DATE
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rillable 3
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FRONTAGE ON WATER
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DEPTH
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CONSENT TO INSPECTION
the undersigned, do(es) hereby state:
Owner(s) Name(s)
That the undersigned (is) (are) the owner(s) of the premises in the Town of
Southold, located at 2a9S ayYt1�•nj i ��_�iZ,�t�l E �:.
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section V� , Block 4' , Lot Co
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 necessarywith
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 lacus, ordinances, rules or
regulations of the Town of Southold.
i
Dated:_
(Signature)
(Print Name)
(Signature)
(Print Name)
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Type Roof
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. . . . . . . . . . . . . . ....
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LOCATION: Re /�`A
(number & street)
SUBDIVISION:
NAME OF OWNER(S):
OCCUPANCY: moi,
MAP NO.:
(municipality)
LOT(S):
' (type) / (owner -tenant)
ADMITTED BY: �, Qd� /'r� f E'.�� �p ACCOMPANIED BY:
KEY AVAILABLE: SUFF. CO. TAX MAP NO. 00- I ,--
SOURCE OF REQUEST: a-�... DATE: -t577 4'
DWELLING: 1,
TYPE OF CONSTRU TION: Woo �� `^�-' `— # STORIES: �" # EXITS:
FOUNDATION: �Tt1% e- CELLAR: CRAWL SPACE:
TOTAL ROOMS: 1ST FLR:2ND FLR: ' - _ 3RD FLR:
BATHROOM(S): T ILE'ri
T ROUM(S): D@►— UTILITY ROOM:
PORCH TYPE;6Pt r e DECK, TYPE: —T PATIO, TYPE:
IW Y: 15),o t FIREPLACE: ----_y GARAGE:
DOMESTIC HOTWATER: TYPE HEATER:- AIRCONDITIONING: �--�
TYPE HEAT: lV AST �A< WARM AIR: A _ OTWATER:
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.:
SWIMMING POOL:
OTHER:
STORAGE, TYPE CONST.:
GUEST, TYPE CONST:
VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
REMARKS:
INSPECT BY-
DATEOF INSPECTION:
TIME START: tJ
� � END: � r