HomeMy WebLinkAboutZ-25383No Z-25383
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
Date NOVEMBER 25, 1997
THIS CERTIFIES that the buildinq ONE FAMILY DWELLING
Location of Property 4055 WESTPHALIA RD. MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 113 Block 13 Lot 18
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a One Family Dwelling built
Prior to: APRIL 9, 1957
OCCUPANCY NUMBER Z-25383
pursuant to which CERTIFICATE OF
dated NOVEMBER 25, 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 DWELLING WITH ACCESSORY WOOD FRAME GARAGE
The certificate is issued to BARBARA RAACKE
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
Of
Bui ing Ins for
Rev. 1/81
I111IIMING IIEPARTHE'NT
']'OWN OF S011'I'1101.1)
IIOIISING CODE INSPECTION REPORT
LOCATION: 4055 WESTPHALIA RD. MATTITUCK, N.Y.
SUIlDIVISION
NAME OF OWNER (e) ROBERT 6 BARBARA RAACKE ------ -- — —
OCCUPANCY SINGLE FAMILY
(type)—
ADMITTED 1SY: BARBARA RAACKE
KEY AVAILABLE ---------
SOURCE OF REQUEST: BARBARA RAACKE
ty _
(oaner_tenant)
ACCOMPANIED BY: SAME
IIPIr.CO, TAX MAP NO. 1000-113-13-18
-------------- --DA t7? . SEPT. 8 X1997 ---
I)WE].I.TNG:
'"`----- WOOD FRAME ....
'TYPE OF CONS't'RIIC't'ION
FOUNDATION BLOCK _CELLAR_ 3/4 CRAWL SPACE
TOTAL ROOMS: IST FI.R. 5 2ND FLR. 3RD FI.R — —
ISATII ROOM (a) 1 'roI wr ROOM (n) - Irl' I lXI'Y ROOM YES
PoltC11 'TYPE COVERED SIDE 6 FRONT ENTRY DECK, TYPE PAT --
BREEZEWAY FIREPLACE _ GARAGE — —
DOMESTIC 11O'l'WATER YES TYPE IIEATER OIL AIRCONDITIONTNG
TYPE IIRAT OIL—BASEBOARD WARM ATR 1101'WATEIt
03'111? ll :
1 / 1?X ITS 3
1/4
Ar!'lfc:S(lllV c'raur'rnnvc.
GARAGE, 'TYPE OF CONST.
SWIMMING POOL
oTnER:
WOOD FRAME . (ELECTRIC IN GARAGE UNDER GOUND)
STORAGE, TYPE CONST.
GUEST. 'TYPE CONST.
WALL MOUNT
------------------------------------------ --------------------------------------------------
-------------------------------------------------------------------------------------------
VIOLATIONS: CIIAP'1'ER 45 N.Y. STATE UNIFORM FIRE PREVENTION 6 BUILDING CODE
LOCATION DESCRIP'T'ION _ I ART. SEC. -
REMARKS: BP 124474—Z—CO Z-25382 (HEATING SYSTEM)
INSPRCTED BY -_- DATE OF INSPECTION SEPT. 12, 1997 -REINSPECTED
-= ---- TIME s'rnRr f0: 15 AM --ENI) N4Y! 1, 997
MICHAEL J. VERITY —
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
D
nv� PLICATION FOR CERTIFICATE OF OCCUPANCY
A. Th s a e filled in by typewriter OR ink and submitted to the building
ijtppec owing: for new building or new use:
1' rvey 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(S79 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 12 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 c6mpleted 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.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy- .25C.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ... «:T..9?..(k.1t7.......................
New Construction........... Old Or Pre-existing Building..)4.............
Location of Property..YP.SS..... 4_jMZPAAL:/A..90 ...... AlAT.TITO4A.I PY'..1)y.S 7r......
House No. Street Hamlet
Onwer or Owners of Propert7..ehg&4M r ... R iii e -s< :......................................
County Tax Map No 1000, Section..I13........ Block ... t 3...........Lot.1.$..................
Subdivision....................................Filed Map ............ Lot ......................
Permit No................Date Of Permit ................ Applicant .............................
Health Dept. Approval..........................Underwriters Approval. lA �pQ?E!)...•.......•
Planning Board Approval ........................
Request for: Temporary Certificate........... Final Certicate...........
Fee Submitted: $ .............................
Cn -2- JS38�.
4d44 -0L'* .................?.. ..............
APPLICANT
WESTPWINLIA AVENUE
Tifis:45 T eoUN S AVE. - -
Ch
o� 'Q ul
tu
ti4r In
�e f CQ tn
L6_.._
4L,
YAUFF-CA TAX MAP DATA r 10ba-113. q-_lfi Lp
.S�
®9
MAS' ("F= PV0PFe ,',
1
!
SU'iZVk'Y'F.li FO(Z
Al
TOW,i OF 500)
'
�1
AREAf76 AC•
u M4� uMC�'T
1
A5 SURVEYED 1a .
LlC.LAPID SJRVEYORS -� 3(LEC-_tai7Gl2"'1 tti.Y.
r
FORM 168 EL
� Vark varh of Niro 31nbr �V4 tT1,
`II A\ ` K� f�
pp BUREAU OF ELECTRICITY 111VVV UUUiiiJJ7581}
85 JOHN STREET, NEW YORK, NEW YORK 10038
Date April 20s 1966 Application No. Game 43799 N 508584
il4ts Terlifirs,
that the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
V. Le Valley s/s Westphalia Rd,5001 e/o Howard Ave, Mattituck, LI
in the following location; Q Basement F] lot FL ❑ 2nd. FL
= was examined on April 11,1966 and found to be in compliance with the requirements of this Board.
FIXTURE
ECFPTA
SWITCHESDISH
FIXTURES RANGES COOKING DECKS OVENS WASN[RS
[XNAUST FANS
INCAN LUORE5CEN
AMT. I
K. W. I AMT.
I ICW jAm-r.1 K. W. JAMT.1
K W.
AMT.
H. P.
OUTLETS
DRYERS
FURNACE MOTORS
FUTURE APPLIANCE FEEDeRS
SKCIAL RECYr.
TIME CLOCKS
SELL
TRANS•
UNI HEATERS IOULTI,�DUTLST
SYSTEMS
,IQ Posy
DIMMERS
OIL
H. P,
GAS
H. P.
AMT.
NO.
A. W. G.
AMT.
AMP.
AMT.
AMPS.
AMT.
N. P.
AMT.
WATTS !
SERVICE DISCONNECT
NO.OF
METER
EaUIP,
5 E R V I C E
AMT.
AMP.
TYPE
I 02W
1 O 3W
3 0 3W
NO. OF C0. CONO.
3 0 AW PER
A. W.G.
OF CC. GOND.
NO. OF HI -LEG
A, W. G.
OF HI -LEG
O.OFNEUTRA
A. W. G.
OF NEUTRAL
1
loo
1 CB
x
I
1 1
3 1
1
5
OTHER APPARATUS:
W. B. RulandN�`'Wfic+
Mattituck, L.I. ,
STATE SUPXR1NTtNDENT
Per
Lh
s certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified geircredentials.,
f 0NSI IT I'
'I.O
IHSIINC'•I'I()N
---_._.c2r-1 ___ �KE the un(le:rsif;necl,
Owller(s) [diol ok)
(10(0:3) lcreh.y state;
'I•I„ct the on(Ir,r-signccl fe (arc:) Lhc: owns>r(t;) of lhc: prc:lt)ises ill llc 'fowl)
of ,;oWilho]d located <<t _. LO SS.. _` TPjHA_0A ��---...---/YAZTiTucK.
whi(:h iv :;town lilt([ clesif,w(te(I oo ill(::iuffnll;
l;oIll (I,y I;(x Inap as I)I,;lric1 .10011, kw(Atoll
That the uuclersif;ue(I (l;(s) Oulv(:) lil(:<I, or• cnnsc(I to he Hied, ao nppllc:a
Lion to the Southold 'I'owo ISclilcliul; Inspcacico•'s Office for the followiof;;
0.cc06vcy. _. - .PRE FxISTN
' IM1. IhO unelO•e;Jill Wit (I0(ot;) h0l'(:)y Iiiv(: coo;;I:nl. In Ilm Iill ll(Iing Iwipcclor:;
of Ili(: 'I'owo of, Southold to clticr upon Ile) r(hovc cl(:_Icrlhi:(1 proporty, ioc:ln(Itog
ally null all hullclings loc:((l.ocl Ihereon, In conclnct such inspections its I.hey nr(y
(Ic)e(o necessary with respect to Ile arcwc-!;oi(1 application, ineinclini, iospc;cliocl s
I() clolcrollne that said preoriscs comply with all of Ill: laws, orclionnces, rllhrs
incl (•E:I;ulaUoos of th(: 'I'owo (11 ':ioollolcl.
The: undersigned, in conr;enlliff to such insp,;ctlons, do(es) so with lhr.
Iulowl(!df;o aocl undtovshmdlf, lhol any inforn(c(tioll ohlairlecl li the conduct of
:;ucl hl:ipeollons rony he use(I it.; evidttlwe in suhscyucul pr•osecollons for vio-
hilloo::( of Ile Ii:(ws, or(Illanc(a;, ruleri ill' ref;ulill. [or)s of the Town of oot.lo.,l(I.
nalu1.0
lfroal it re)
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
f�C HOUSING CODE INSPECTION REPORT
LOCATION: �J� /gee
number & street municipality,
SUBDIVISION
NAME OF OWNER (s)
OCCUPANCY
MAP NO. LOT(s)
owner -tenant
ADMITTED BY: �����^' 'C_ ACCOMPANIED BY:
KEY AVAILABLE_ SUFF.CO. TAX MAP NO. 1/42C20 -- -
SOURCE OF REQUEST: DATE:
DWELLING:
TYPE OF CONSTRU TION # STORIES # EXITS
FOUNDATION CELLAR CRAWL SPACE
TOTAL ROOMS: IST FLR.2ND FLR. `_ 3RD LF R
BATHROOM (s) TOILET ROOM (s) UTILITY ROOM
PORCH TYPE 0 a--tP DECK, TYPE —'-' PATIO
BREEZEWAY FIREPLACE GARAGE -�
DOMESTIC HOTWATER TYPE HEATER AIRCONDITIONING
TYPE HEAT WARM AIR HOTWATER
OTHER:
ACCESSORY STRUCTURES:"�� .tip \
GARAGE, TYPE OF CONST. aTORAGE, TYPE C
� �
SWIMMING POOL GUEST, TYPE CONST.
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION I ART. SEC.
REMARKS:
C
INSPECTED BY DATE OF INSPECTION
TIME START V
kIAf,
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