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Home My WebLink About22120-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. tu~RTIFICATE OF OCCUPANCY No Z--23197 Date SEPTEMBER 7, 1994 THIS CERTIFIES that the building. AL-k~ATION Location of Property 4375 STILLWATER AVE. uu'i~:HOGVE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 137 Block 3 Lot 3.1 Subdivisio~ Filed Map NO. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 24, 1994 _pursuant to which Building Permit No. 22120-Z dated JUNE 9, 1994 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 REPLACE FRONT STOOP WITH A 6'WIDE WOODEN STOOP ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to HERBERT PLIMPTON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HN.L SOUTHOLD, N.Y. No BUILDING PERMIT (THIS PERMIT rvIUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 22120 Z Date ..................... ~ .............................. 19....~.,/~ Permission Is hereby granted to: County Tax Map No. 'i 000 Section, ,L,~. Z ............. Block .......... ..,~.,,.~... ....... Lot NO ....... .,.'~.,..:. L.....'~...."~-. pursuant to application dated ............. ..~...,,~.,l,..,.. ,~,,,, .~.,,, .............. ] 9...../~,,,y, and approved bythe Building Inspector. Fee $.....~. '~.~'? ....... Rev, 6/30/80 TOWN (IF :;OUTI1OLD BUILD LNG DEPARTHENT TOWN IIALL 765-1802 ~DG. DEPT APPLICATION FOR CERTZFICA'FE OF OCCUPANCY ;_,_ ~TOWN OF SOUT~O.~f~ 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 unusoal natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical iustallation from I~o.~rd 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. Submit Planning Board Approval of completed site plan requirements. -6. 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 ueusual natural or topographic features. 2. A properly completed application and a consent to inspect sig. ned 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, Accessor~ 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 Occupaocy - $5.00 over 5 years - $10.00 .4. Updated Certificate of Occupancy - $50.00 , 5. Temporary Certificate of Occupancy - Residential $15.00, Con~ercial $15.00 ' Date . - ..................... . ........... New Construction ....... - .... Old Or Pre-existing Building ......... llouse No. S t r.eet Onwer 0 ~ I ropert7 ' ~ ~ ~ ~o ~ooo. s~o~ .... J.52 .....~ --. --~0~.:,.-:.~~.',.~ ... , . ... . ......... .... . . .... . ' ''.....:'.~:,~. q.': ..: ,i.'.'~.: .;~....~'>~:~.,.'.',~ ' .I.~:'"?~':"%;:~':~'~'''~'''~'~ '' Ileattb Dc'pc. Approval ¢~ .... Underwriters ,royal Pla.aloE Board Approval Request for: Temporary Certificate ........... Final Certicate..~ ..... APPLIC~T 7~-~802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INS~TION / FRAMING ~I~NAL DATE INSP~ FOUIIDATION (lst) ~OU~4DA TIO;.! (2nd) ~OUGH FRAME &. " ':'?' " "' '.~LUMBING INSULATIOn; PER N. Y. STATE ENERGY CODE 4. FI:;AL ADDITIOI'IA'L COM~IE~ITS: 1 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1802 Examined ..... '~'i~ ...... , 19 .?/~' Approved ..~/g .... 19 .?~e rmit No. ?.~. f.~..~.~. · Disapproved a/c ..................................... BOARD OF HEALTII ..~. ..... 3 SETS OF PLA;tS .......... S U R V E Y--~i~' ~ SEPTIC F 0 R,'I .............. CALL · ~IAIL TO: APPLICATION FOR BUILDING PERMIT Date .............. 19... INSTRUCTIONS ; a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with ali applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. -- (Signature of applicant, or name, if a corporation) ....... '. .......... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, enginee~tracto~ electrician, plumber or builder. Name of owner of premises . ~.. ~:'. ~4/"~.. ~../ZObt2.~../~..,. ................................................... (as on the tax roll or latest deed) If a~r'~j:}a:~O1j.~;ign~, signilXur, eg-g-duly auth~orize~ officer. / ~ ~ -.. _ +- -__~-... --_>...:. -_ ..:.__.< ~ -~-- ~.-._-___..-_~.~ .;- .... ~ _ Builder's License No.."~...~..-~-..~-..~...¢'.'/~:~.. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be'done .................................................. .. X..7 ....................... ' ...... ... .................. . .< .............. House Number Street Hamlet County Tax Map No. 1000 Section .../.~...-2. .......... Block ...3 ............. Lot..-~, ............... Subdivision...}3'3 ~ ~g;~*./J") .............. ....- ................. Filed Map No...?.~.Q... Lot .~... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: occupancy b. Intended use and occupancy .././~,. ,S:>~' ...../c~..}.~./¢.j,,~., BA ~. ............... bJtY-~ ~)(:7. ~... . .................. 3. Nature ofwork (check which applicable): New Building .......... Addition .. -..--.-- ' t a n .......... Repair .............. Removal .............. Demolition .............. O t~K,,W~ork ............... ,cripti (Des on 4. Estimated Cost .... ~ Fee 5. If dwelling, number of dwelling units ......... /. ..... Number of dwelling units on each floor../. ............. · If garage, num bet of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories .............. ': ....... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Sizeoflot: Front .... /..o.cp. .............. Rear ........... /.{.~. ....... Depth .../~,~'. ............... 10. Date of Purchase .................... · ......... Name of Former Owner ............................. 1 I. Zone or use district in which premises are situated., f)~ ~, ~ d.~ ~ ~ 7 .................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: },,2:2 ............................. 13. Will lot be regraded . .bOO .................... "~. ~t~v'i]l excess fill,be removed from premises: Yes No 14. Name of Owner of premisesB ..~. ~.~.v~/1..~Y'..~. ...... ~.~. A'fld~ss,~'~q~J~.r.(---...~AP/?.( t./'~one No. ~.c.,(y.; ~. 72/~!/ ...., Name of Architect ........................... X~tdress ..... ~..w. ~.?..~ .......Phone No ................ Name of Contractor/~'.~z~. ................... Address ~..c:~. ¥/.q~.c ?..r{~..,.'-: ~ Phone .No..~ft .W.'..;~..V.r...' 15. Is this property within 300 feet of' a tidal wetland?'' *Yes ........ No....~%~.... ' · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. STATE OF NEW YORK, S.S COUNTY. ' '~".~"-~05'~ ' ' ' ' ' ' '~ "' ' ' ' "~/ .......... ~- .~.~...~....-~...'"~..-- ."~..~ .'~ ." ......being duly sworn, deposes and says that ...... IZ' (N~me of individual signing contract~ above named. he is the applicant !le is the ......................................................................................... ~nt, corporate officer, etc.) . ~f said owner or owners, and is duly authoi:!zed to perform or have performed the said work and to make and file this tpplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the york will be performed in the manner set forth in the application filed therewith. ;worn to before me~ ........................ dayof..'. ........... · . ,mm [.. .... · -f ................ · No+lilt Public, State of New York ~ '~ignature of applicant) No. 4951364 ' Qualified in Sufi'o k County Commission Expires May 22,