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HomeMy WebLinkAboutZ-25052FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-25052 Date MAY 30, 1997 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 4600 WESTPHALIA ROAD MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 113 Block 11 Lot 21.1 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-25052 dated MAY 30, 1997 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 DNE?~.ING * The certificate is issued to NET~N E. HANSEN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N/A N-836619 - AUGUST 20, 1987 PLUMBERS CERTIFICATION DATED *P?.~%SE SEE ATTA~D INSPECTION Rev. 1/81 ~ LOCATION: 4600WESTPHALIA RD. (number & streeL) SUBDIVISION MAP NO. NAME OF O~DIER (s) H~LEN E. HANSEN BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT MATTITUCK, N.Y. (municipality) LOT(s) OCCUPANCY SINGLE FAMILY (type) ADMITTED BY: HELEN HANSEN KEY AVAILABLE SOURCE OF REQUEST: HELEN HdNSEN (owner-tenant) ACCOMPANIED BY: SAME SUFF.CO. TAX MAP NO. ]000-113-11-21.1 DATE: MAY 27, 1997 DWELLING: TYPE OF CONSTRUCTION FOUNDATION CEMENT BLOCK TOTAL ROOMS: IST FLR. BATHROOM (s) ONE PORCH TYPE - - BREEZEWAY - - DOMESTIC HOTNATER ]iX TYPE HEAT OIL OTHER: WOOD FRA~ 4 TOILET ROOM (s) CELLAR PART 2ND FLR. - - 3RD FLR. { STORIES CRAWL SPACE UTILITY ROOM BECK, TYPE - - PATIO FIREPLACE - - GAEAGE TYPE HEATER OFF BOILER AIRCONDITIONING WARM AIR HOTWATER EXITS ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST. STORAGE, TYPE CONST. SWIMMING POOL , GUEST, TYPE CONST. OTHER: NEW ELECTRIC SERVICE PANEL & ELECTRIC - UNDERWRITERS 8/20/1987 VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. JOHN M. BOUF DATE OF INSPECTION MAY 29, 1997 TIME START 10:50 AM END 11:20 AM Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY '? ~ ~ :~q~ ~ This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of .property with accurate location of ail buiidings, 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 instaiiation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of i% lead. 5. Commercial building, industriai building, multiple residences and similar buildings and installations, a certificate of Cqde Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of cdmpleted site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing al1 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 Inspector shall state the reasons therefor in writing to the applicant. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, .Additions to accessory building $25.00. Businesses $50.00. Certificate of Occupancy on Pre-existing Buildin~ - $100.00 Copy of Certificate of Occupancy - , .25C. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date Hay 23~ 1997 New Construction ........... Old Or Pre-existing Building .... .X ............ Location of Property .... 4.5. .5.0..w. ~.s.t~.h..a.l.i.a...R.o.a.d. ~..Ma.~j.t.~g.,..~y ........................... House No. Street Hamlet Onwer or Owners of Property .... .H.e.i.~.n.~.~Q~DIt ............................................... County Tax Map No i000 Section...$..o. ....... Block.. ~J, ........... Lot.~.~l' Subdivision ...... .n./..a .......................... Filed Map...~/g ..... Lot.. ~/.a ................ Permit No .... n./..a ......... Date Of Permit...D/.~ ......... Applicant... r~/.a ...................... Health Dept. Approval ...... ~ ............... 2Underwriters Approval..nfa .................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate..X ........ Fee Submitted: $....1.0.0... 0..0 ................... Helen Hansen do(es) Im~'el).y state: 'l'lmt [he ~de~'sJgl~od (is) (ave) the owner'(s) o[ the i)t-en~ises iH (he o[ ~;oulh~dd located at 4550 Westphalia Road, Mattituck,~ 11952 ............................................ , whir:h i~; shown and desiRnated on (he Suffolk 'l'ha[ the under'signed (h~s) (~) filed, of caused to be filed au n[~plicn- tio~ iu {he $outhold 'l'owH lh~ihli~lg lu~peel~n,~ t)l'fiee foa' the following: Certificate of Occupancy on Pre-Existing BuiIding 'l'la;~t Ihe unclc~vsig'ned do(~) he~'eb.y ~ ~ c<n~s;ent h) the Ih~ildiuf~ ()l' II~(: 'l'()wll t)[' ~()tttllold [(> elllel" iq)on [lie above dascribed i)r(>per-t,y, i,mlu<ling [~uy [t~tl all buildings local:ed Iher'eon, [o conduct such inspections as they dee~,~ ~ecessary wiLh respect to the afcmesaid al)l)licalion, in(:]udin~ inspecl:io~s [() dt:[~['mi~m that snid pr'emi~es (':onq)ly wilh itll of Lhe laws, ortlinances, rules ~*~1 rel(ulntions of the Town (;f '['he under'signed, in c(msenting to suc:h insp(ections, do(es) so xvith the ISH~:wleclge /u~d untlevst[u]dit~g lha[ any h~[(~rn~al. Jor~ obtained In the conduct o[ i;ur:h im-;l)ec:tions may ])e Hsed hr; evidence in StlbSequell[ pr'osec:utions for rio- (signature) Helen Hansen (p~'iut nnme) 30 ~o ST~ ~ N 71° 50' 50"E ,_~ ' __ FD ICJ i~-~--~-~ I © I I IP CM ~T FENCE CORNER E 0.4' 66 4 TiE= 463 0 WESTPHALIA FM # 745 FILED MAY 10,1921 SURVEY OF LOTS I0,11, 12 l~ p.o. F~E I- ~NC~ 1 61.60' ROAD SURVEYED, 14 MAY I997 SCALE I"= .aREA= 53,540.22 S.F or 0. 77 ACRES MAP OF LOTS LOCATED MATTtTUCK SITUATE MATT/TUCK, TOWN OF SOUTHOL_D SUFFOLK COUNTY, N. Y GUARANTEED TO SURVEYED FOR CHARLES BAXTER Una~'hcr[z:d alteration or addition to ...I%Y~JRVEYED BY survey is ~ violation ef Section 7209 e~ CHAIqLES BAXTER t~e New Yo~ ,State Ed~afion La~ STANLEY J. ISAKSEN, J~ NORTH FORK B~NK P 0 BOX 294 F~DELIT f N~TIONAL TITLE INS CO NEW SUFFOLK, NY 11956 TOWN OF SO~THOLD Gq~l~fdoes Im JEa te~d ~h · re- ~-~'~!I-~ o~ly Io Ifle pecan for whom the su~ey prepared, a~ ~ his behalf ~ ~e ~t~ ccmp~ny~ Govermental Agent, en6[~g i~stitctlcn, if listed hereon, end the cs~:[nces of the lending insfit~i~, ~uarc. ntees are not transferable to addit~nal instit~ions or s:bsaquent ow~ Copi-~s of this survey mop not bec:ring the L~nd Surveyo,~ er~bossed seal shall /, / ~,YS LJc ~o 49273 97R 630 THE NEW YORK BOARD OF FIRE UNDERWRITERS .L.~L)~()~,~ BUREAU OF ELECTRICITY ~,[A~ICA~ CF N828397 ' .~:~L 85 JOHN STREET. NEW YORK. NEW YORK 10038 THI~ ~ERTIFIE~ THAT o~y the el~tric~ equipment ~ ~scri~ ~w a~ int~uc~ by t~ applicant ~m~ on the a~ve appl~atlon number in the prem~es of in the~ollowing location; ~ B~ement ~ Ist Fl. ~ 2nd FI. S~tlon Bl~k ~t ~s exa~nlned on ~'L ]-~ ~ -] 9~ and ~ound tb be in compliance with the requirement,~ Qf this Board FIXTURE OUTLETS RECEPTACLES SWITCHES 9 5 I FIXTURES RANGES ' ICOOKINGDECKS OVENS DISH WASHERS EXHAUST FANS FLUORESCENT vA~Ol~ '. K. V A/~T K.W. A~ T. K.W. I. ~T. ~ K, W. ~T. . P ~ SYST~S ~/I S E R V I ~ ~ 10/~187 ~ICA2~ ~EASE REMIT BY CHE~ OR MONEY ~[~ 15. ~ ~YORK ~ARO OF fiRE UNDERWRITERS ~1 g;RVlCE JlYO ~.~ ectric 9 Larston St. ~elden, N.Y. 784 OTHER APPARATUS: THIS IS YOUR BILL FOR SERVICE RENDERED AND IS NOT A CERTIFICATE OF COMPLIANCE THIS BILL PAYABLE AT THE NEW YORK OFFICE 85 JOHN STREET, NEW YORK, N. Y. 10038