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Home My WebLink AboutZ-39138 guFFOIK Town of Southold 8/16/2017 53095 Main Rd Southold,New York 11971 Py � PRE EXISTING CERTIFICATE OF OCCUPANCY No: 39138 Date: 8/16/2017 s THIS CERTIFIES that the structure(s) located at: 10305 Route 25, East Marion SCTM#: 473889 Sec/Block/Lot: 31.4-12 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- 39138 dated 8/16/2017 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 dwelling with covered porch,brick patio and accessory garage.* Replaces Pre C/OZ-7739 dated 6/24/1977. The certificate is issued to Pedersen, Robert (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 17-45555 PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. %4k A tho d Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: 10305 Route 25,East Marion SUFF.CO.TAX MAP NO.: 31.4-12 SUBDIVISION: NAME OF OWNER(S): Pedersen,Robert OCCUPANCY: ADMITTED BY: SOURCE OF REQUEST: Pedersen,Robert DATE: 8/16/2017 DWELLING: #STORIES: 2 #EXITS: 2 FOUNDATION: brick CELLAR: full CRAWL SPACE: BATHROOM(S): 1 TOILET ROOM(S): 1 UTILITY ROOM(S): PORCH TYPE: covered porch DECK TYPE: PATIO TYPE: brick BREEZEWAY: FIREPLACE: 1 GARAGE: DOMESTIC HOTWATER: yes TYPE HEATER: oil AIR CONDITIONING: TYPE HEAT: oil WARM AIR: HOT WATER: x #BEDROOMS: 4 #KITCHENS: 1 BASEMENT TYPE: unfinished OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: wood frame STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: JOHNJ DATE OF INSPECTION: 8/14/2017 TIME START: 10:05am END: 10:35am 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: A. 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. B. 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 Occupancy is denied,the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool $50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00 Date. �`h 7 New Construction: Old er Pre-existing Building: (check one) Location of Property: /0�30E !/ igj'Al i oasffw '!1'1^Oey House No. Street7 Hamlet Owner or Owners of Property: �olaPG D , P`derr ,S-,Pp / Suffolk County Tax Map No 1000, Section '31 Block 4) Lot oZ 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: $ Applicant Signature CONSENT TO INSPECTION Pe, l-eV S-e.�, 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 /O 3 D 5 41 4f N k 0,0 d 115O S f 94060 /V which is shown and designated on the Suffolk County Tax Map as District 1000, Section 3 I ,Block , Lot U. 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: (Signature) Rtlaer - ]D. lam'd**i- EA) (Print Name) (Signature) (Print Name) Certificate of Compliance ............................................................. ..... ........I........................................... .. .. ...................................... CERTIFIED ELECTRICAL INSPECTIONS, INC. 188 PARK AVENUE AMITYVILLE, NY 11701 P: (631) 598-5610 ...................................................................................................................................................................................... CERTIFIES THAT Upon the application of Upon premises owned by Robert Pedersen Robert Pedersen 10305 Main Road 10305 Main Road East Marion; NY 11939 East Marion, NY 11939 Located at: 10305 Main Road , East Marion , NY 11939 Application Number#: 17-45555 Certificate M 17-45555 Electrical License#: Section: 31 Block: 4 Lot: 12 Building Permit#: Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Wiring for Kitchen, Front Porch, Rear House A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in'accordance with the requirements of the applicable code/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 16th day of August 2017 Name QTY GFI Receptacle - 15 Amp, 120 V 6 Disconnected Exterior Light Fixture - 15 Amp, 120V 2 Branch Circuit- 20 Amp, 120V 6 Electrical Inspector: Anthony Giordano .0 V4CAJ _ APPROVED 0 .......... .0- ............ a�L`� is ertificate is not valid unless raised seal is present. L/ AUG 2 2 20'7 1;UMDING DVT' TOWN OF SOUTHOLD " TOWN OF SOUTHOLD PROPERTY RECORD CARD J OWNER STREETVI LG4GE (} Q D15T, $UB. LOT B l r1 a s GZhG�w - - P eS--a FORMER OWNER N i_ ACR. TOHIV el S W TYPE OF BUILDING .1 V-61� /Vle�. RES. � i SEAS. VL.' FARM CO CS. MICS. MPct. Value o LAND I 1MP. TOTAL DATE REMARKS U) LnLLJ � �� QO a y/7 l8 T �ETzEd p YZ n Y 13 9 S - S. 0 F— --y 0 ua iO AGE BUILDING CONDITION u� m NEW NORMAL BELOW ABOVE LO FARM =Acre Value Per ValueLD ' Acre U0 Tillable N - P' GN 0 Woodland FRONTAGE ON ROAD r �D r~ Meadowland DEPTH m House Plot BULKHEAD 1 Toto! DOCK ■�■n■a■a■�■■■■a■■■■aa■■a ' 5r ■a■i■■aa■E■�a■■■■��lS ENO MEN ■■■■■SEE aa �iiii■ in mom no ■aa■ate■�■�ri■Qs�■a■■■iI�inala■■ ■■�■i■t■■■ill■■�■ili■i� mom ■■i■ IN so ONES m ■a■�!■� at■■!a■■■■■■■a■■■■■■ !s■■ mom, ■aa■■■�a■a■■■■ a■r■■a�il� i■a■■■■■ ■■■■■aa■■■a■■■■■■ �■a�a■a■aa■sof Rooms Ist-Floor. ialsa■■■■■■ ■ !Ext Walfs �rnterior Finis F!re Ploce r Roorns 2nd "m oil 1-IT4 .. .. pf 50Ulyo p��/ -� C ID o l ` cou ti o TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: P iCi C Aye ow 1�m Wir,A Lsmil • DATE INSPECTOR LOCATION: 64W 9M6/ _A� dD1�/ (numSer & street) (municipality) SUBDIVISION: MAP-NO.: . LOT(S): NAME OF OWNER(S): OCCUPANCY: SAMIL type) (owner-tenant), ADMITTED BY: ACCOMPANIED BY: KEY AVAILABLE: SUFF. CO. TAX M 'NO. 1000- — -~ SOURCE OF REQUEST: DATE: DWELLING TYPE OF CONSTRUCTION:y �.#STORIES:' >"' #EXIT FOUNDATION: Irl' $ASgMENT CA 'CRAWL SPACE: # OF BEDROOMS: IST FLR " D 2ND FLT 3RD FLA: BATHROOM(S): 11 TOILET It00M(S): UTILITY R00']Vt: PORCH EO vV00D` '`� DECK, TYPE: .. . l PATIO;TYPE: rl _ct� BREEZEWAY: e FIREPLACE: , in Ww�/ QARAGE: V�• � 1 DOMESTICC_HOTWATER: TYPE HEATER: 1 AIRCONDI'TIONIN : _ TYPE HEAT: L WARM AIR: HOTWATER: . # OF KITCHENS: ota l FINISHED BASEMENT:- YES_ NO OTHER: ACCESSORY STRUCTURES . GARAGE; TYPE OF CONST.: W rl STORAGE, TYPE CONST.: SWIMMING P'O'OL: _ GUEST,'TYPE CONST: OTHER: VIOLATIONS: CHAPTER 144 &N.Y. STATE UNIFORM I';RE PREVENTION & BUILDING CODE LOCATION ft DESCRIPTIQN 04 ART. I SEC. c, My • REMARKS: INSPECTED BY: J 0 J DATE OF INSPECTION: �/ l TIME START: 0 END: �•