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HomeMy WebLinkAboutZ-20637FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-20637 Date APRIL 10, 1992~ THIS CERTIFIES that the building Location of Property 1020 VANSTON ROAD House No. County Tax Map No. 1000 Section 104 Subdivision ONE FAMILY DW~.LLING CUTCHOGUE ~ N. Y. Street Hamlet Block 12 Filed Map No. Lot 11 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-20637 dated APRIL 10~ 1992 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 DWEIJ.ING * The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - APRIL 3, 1992 PLtrMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTAC~FD INSPECTION REPORT. JEAN PLET a/k/a JEAN WENZ Building Inspector Rev. 1/81 Location BUiLDi[[C DEP:?J:-iEUT TO'.',?I OF SOUTI[OLD, ?I. Y. HOUSIXC CODE IiiSFECTION REFORT 1020 VANSTON ROAD C~TCHO~UE, N.Y. ko=moor ~ anreeu) Subdivision ?4ap No. Nmme of Owner(s) JEAN PLET &ANO Occupancy A-I RES. OWNER ~type) Ad,,~itted by: ANGIE JOHNSON (owner- (~enanr) Accompanied by: SAME Key available Suffolk Co. Talc No. 104-12-11 Source of request JEAN PLET WENZ Date MARCH 26, 1992 DF,~LLIMG: ,Type of construction Foundation CEMENT BLOCK Total rooms, 1st. F1 Bathroom(s) I FHLL Porch, type Breezeway. Type Heat OIL Fireplace(s) ONE Domestic hotwater Other WOOD FRAME #stories ONE 1/4 Deck, Garage · Warm Air No. Fz~its YES Cellar 3/4 Crawl space 2nd. F1 3rd. FI Toilet room(s). type Patio, type_COVE.RED CEMENT PATIO · Utility room Ho/water xx 3 Airconditioning.. xx Type heater OFF BOILER ACCESSORY STRUCTURES: Garage, type const. 2 CAR WOOD FRAM~torage, type const. Swim. ming pool Guest, type const. Other ROOM ATTACHED TO GA~AGE WITIIHEAT SUPPLIED FROM MAIN HOUSE ViOLATIOMS: Location Descriution .CIIAPTER 45--N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE Art. Sec. Remarks: BP #20535-Z-CO z-20636 & BP #20536-Z CO Z-20635 · Time start 1:40 end 1:55 BLDG. ~.E~-~'~', 'TOWN OF $~THOi. D Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 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 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. C. 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. ~ Occupancy on Pre-existing Building - $100.00 Certificate of 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ..... . .~./~Z~?. .......................... New Construction ........... Old Or Pre-existing Building ..... ~.. ......... Location of Property...~.~.~ .... ?..~?..~!~ ./~. ..... ~.~ House No. Street Hamlet Onwer or Owners of Property.~7.~.4Y~..P.~..~O.¥~.~.~z.¥.~.-~..... County Tax Map No 1000, Section ...... ~.~....Block...~.g~. .......... Lot...~ ................. Subdivision .................................... Filed Map ............ Lot. / Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters ApProval ......................... Planning Board Approval ........................ ~quest for: Temporary Certificate ........... Final Certicate ........... Submitted: $ ............................. ~..~....~...~~ ..~~ .............. CONSENT TO [NSUECTION O~er(s) Name(s) do(es) hereby state: That the undersigned(are) the owner(s) o~ the premises ~n the ~ // ~5C which is sho~m and designated on the Suffolk County tax map as District 1000, Section ./5~ , Block /~ , Lot That the undersigned (has) (have) filed, or caused robe filed, an applica- tion in the Southold Totem Buildin,~ Inspector's Office for the follow~: That the undersigned do(es) hereby give consent to the Building Inspectors of the Town o[$outhold 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 taws; ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so xvith the knowledge and understanding that any information obtained in the conduct of such inspections may be used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regmlations of the Town of Southold. Da~;d: ~//,~2 ~//~ ~ ~.~/(~sig~ atur eft) ~~~ (print name) (si~natuce} (print name) THE NEW YORK BOARD OF FIRE UNDERWRITERS ~,~.(u: ~ ~ ~ ?, ~ ~; ~'~ BU.E^U or E'ECTR,C,T',' --- 85 JOHN STREET, NEW YORK, NEW YORK 100238 Date AP~,[L ~!,~99~ ApplicatlonNo. onfile ~!~'~77~!,'?~ [t ~t779/~ only the electrical equipment as described below and introduced by th~ applicant named on the above application number in the premises of JE:~F I~!,ET I~NZ, Je)20 ~'gI~TON RD., C{ITCHO<;tt~, F,Y in the fotlowln# location; [] Basement [] Ist FI. [] .?,nd 1'7. GAR/©~JT ,Section Block Lot tvas examined on ~4 ~ ~{ ~ H 2 ~ t ~ 9 q ~ and found to be in compliance u, ith the requirements ~f this Board. F XTURE [ FIXTURES RANGES COOK NG DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS {ECEPTACLES SWITCHES iNCANDESCENT FLUORESCENT OTHER AMT K.W. AMT K.W. ANAT. K.W. ~T. K.W. A,~T. H.P. OR~..s ~U..ACE ~O.O.S ~TU., A.~.A.C..E...P,C,a~.EC'P.~ ,,M,C.OC.S .,~ U.,..,A.E,S M~,~, D,~,.S / SERVICE DISCONNECT j NO. OF [ S E R V I C E . . METER. w NO. OF CC. COHO. A. ~./. G. . NO. OF HI-LEO A. ,W~.. G.NO OF NEUTRALS A, W. G. ANIT AMP TYPE EQUIP I ~' 2w 1 ~ 3w 3 ,~ 3w 3 ~ 4 PER ~' OF CC COHO O~ H LEG OF NEUTRAL OTHER APPARATUS: ,;NC, KB DETgCTOR:-~ 'NO VISUAL DEFECTS~ '~n el~'ct[i<~,al ~ iectric~i equip~q~ ~n the JEAN PLE~ WENZ 1020 VANSTON CUTCHOGUE, ~NIIAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. t~