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Home My WebLink About18575-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32045 Date: 12/01/06 THIS CERTIFIES that the building ADDITION Location of Property: 5605 STILLWATER AVE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 137 Block 4 Lot 3.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated pursuant to which Building Permit No. 18575-Z dated OCTOBER 18, 1989 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 SHED ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JAMES DUBON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 . Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL Un, ' DEe 765...1802 i' :' "", APPLICATION FOR CERTIFICATE OF OCCUPAN Y L----. , TO\.\' -,' 1 --.,.......--- - ~~'i - f( ~""'\' hd i\ ! r'O, . \7, r ~,r IJ ~\ ~ t - i .;,Jl j 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: I. 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 sewemge-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: I. 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 I. 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 - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. U I ll. ~ New Construction: Old or Pre-existing Building: / ( check one) Location of Property: 5" 0 ~ 5111\ wAk-v !+V!L House No. Street Owner or Owners of Property: J C\ \l\.o .c, l) L-l 60 n Suffolk County Tal' Map No.IOOO, Section I:) 1. - tf - '2y. 1<-. Block . ; Subdivision Hamlet 04- Lot ~. I Filed Map. Lot: Dateofpermit. fr\(\~ '7 /q13 Applicant:ThellOllre \ d Clvaa:> I JirutaW5.t; I ~ Health Dept. Approval: l'L<1 flLtJ((j Po t V-{'lhllf Underwriters Approval: 1\10 teem d P vQ ('1-1 sh YLq Planning Board Approval: / Request for: Temporary Certificate Final Certificate: \ (check one) j~,ro ~ (~ ~~J~~:Si~:;- Permit No. 054-5- 2. Fee Submitted: $ tJ.-~-1rl{d( Co .cJ(loi.{s- ro.. NO. . TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTH OLD. N. Y. BUILDING PERMIT !THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N! 18575 Z Date ......I..f?./!..(.................................. 19ft.. Permission is hereby g~t1_to~ ~ W~..~.....z;(.~~7............................. .......4:6........!2.~.....~d/t;,.~.-:~.~ ...#if~...../q~....................... 'vZ to..M~~.At.........~~...~~.......r:._~~..+....~.. ...~.~.....~~.If............................................................................................... at premises located at .....f6..t:?...........~~~.......~............................................ ..................................................~d~.............................................................................. ................................................................................................................................................................. County Tax Map No. 1000 Section ...../#...2....... Block ......11............ Lot No. ....:$.::./.......... pursuant to oppllcatlon dated ......("P.../t.~.............................., 19.4.7.., and approved by the Building Inspector. Fee $.....:2~ ~~..m Rev. 6/30/80 . C5 ! Z Z 0 L - l- I: .0 z & C5 ~ &- I L I e:a I- eft Z ..C5 U '-' ....... ...... - iZ III Iii e:a ~ ~ ~ A. Z .. N ;lcn Z Z 0 0 Z ~ ~ C5 Z .. - e:a e:a - eft Z Z . ~ - ~ ~ E i 2 2 E ...., -. ...., ... ~ ....... ....... ....... I: a \-- '\t""'l '\:::::-. "'" ~ L . " III Z Z ... 0 L - z 5 Ill: 0 " ... ~ ~ ;:) ;:) C - o~ ... I- Ill: _ ;: ( L en la U ,..., ,......, z ..." ~ '---' '-- - ,Z LII a IS Iii a. z ...... N - ... ;:) en z z III 0 0 Z - - ~ ~." a ! .. - a en z z & ~ ;:) ;:) ! Ill: f f c ... & = ~ ,..., ,......, ,......, ... '---' '-' '---' Ill: a ~ - d Z ~ Z L 0 - t2 z s ClJ :) :) .... N'" ... ~ en ~ Ie Z ~ !: U - - ... ~ ~ ~ i! III '-" ........ ~ '-- L t-~ A- t;; ~ en z z ;cn .. N - Z Z Z 0 0 - - !c !c - ClJ ~ ~ Z Z Z - .. I en :) :) ~ ~ ~ ~ = ... ..-, ! ..--. ~ '-" '-' ... '-" Ie = ~ - . " II Z ... 0 Z A. - 5 III: 0 z E " ... t ::>> ::>> c - 0 en z .... III: Z - A. III - II. en i" U ~ ,....., ~ z - ..." ~ '--' '-" .z LII " I- t- z to. 9 a. en N - ... ::>> tn z z II 0 0 Z - - = = " - z .. - " " - en =:: z z ~ ~ ::>> ~ III: f c III ~ = ......., III D: " '--' '--' '--' ~ (2nd) =< /I /1 h. ~ I r I I .o1.=:!...:> -"C" ..___e ," .........:.- '* ~I".;.. 1 ~' . . :OUIIOATIO:I - - -- (1 s t) -- :'OUlJOA TI O:J 2. :lOUGH FRAHE & ,PLUMBING 3. !IISULATIOU PER N. Y. STATE: ElIERGY CODE 4. FI:1AL liD;..:=: II ;;;;,'f;'1[UT:; l/ol3t?/..P7 tJ/-"'W~ /Y.f! / / ,p --I I I ~-Y:4 f;..~ A -&, A'L~ I I I . L I, - f ' . cJ.b- ~} ~~ / '-- a. ,f f. "~_ ! /"YL' L J_ j ..II '/,. A~ (/)1 A .L' /rJ:/,ElL "L/ v /7 I' /l tf?, /, /, /) I . v IW::;",^_ -:h /J ,,"_hh fI L' ~~ ~.A.R./ /! "..6 r.;J . / 112, ,"1 . r L/frh Cf). .../5 "":)!/.j o- J AOoTlfZ6u A'L COMMElITS: /' .A /" L 1. i1!D.;. -. ~ /} l - . 0' I I " ;;;~ ~~ .. - ~~ , ~~ ~ ~~ '0 a~ ~ - ~ tl :~ .. . . '" ~.~ ~ ~ :;~ .... " o . ,- . - ~~ C/. '" ." 0-1 "" FORM NO.1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL &OUTHOLD. N.Y. 11971 TEL.: 765-1802 Examined. . Idle[ ..... ..1951 Approved... j~I/f...... 19 ~ermit No.I!.cf:1.~/ Disapproved alc ..................................... ::~: 4f.-#fi (Bu' ing I~~t~r) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY. . . . . . . . . . CHECK .......... SEPTIC FORM .............. NOTIFY CALL M A I1.. 9-qg -5C:;~7 . . . . . . . . . . . . . . . . TO: c(o A-~ /Wl- bJ ~ rr PulL {MP ~~,r .................. .0.. .... ....... ........... Date. . . . . . , . . . . . . . . . . 'r 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 all applicable laws. ordinances. building code. housing code. and regulations. and to admit authorized inspectors on premises and in building for neces~~~. i~~~~~t~~~~'.1 ~~t..V!.:~ (Signature o/;.~:Y;.a:/::; ~ame. if a corporation) .............................................. (Mailing address of applicant) ~t~~~ .~~~t.h.e~ .~CB~ l~~;.e~ .a.=~.. ~~c~~~e~~.. ~~~~.e~~.. ~~~~r~: .c~~~~a.c~~~.. ~l~~~~~i~~.. ~:~~~~~ .o.r.~~i:~~r: Nameofownerofpremises '" .I.~... t).J.~.r~.......... ........... .............. '(a~ In the tax roll or latest deed) If applicant is a corporation. signature of duly authorized officer. ........................... ....... ............ , (Name and title of corporate officer) ALL CONTRACTOR'S MUST~E SUFFOLK COUNTY Builder's License No. ..... (1)~. .. . . Plumber's License No. LICENSED . ......... .... .......... Electrician's License No. ...................... Other Trade's License No. ..................... .::5bOs-' \ h-v. I. Location ofland on which proposed work wilI be done~ .... ~. . . -) ~ (1.~. . . . . ~. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C C/.r.c::tI.<?Cf.tf-? . . . . . .-. . . . . .. House Number Street Hamlet County Tax Map No. 1000 Section 7.! 37.-: ~. :-:-. . .. Block.... 4:-. . ... . .. ... Lot. . f.1€. .34/. .. .'. .. Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. .............. Lot............... (Name) 2. State existing use and occupancy of pre~.ses and i_ntendcd u and occupancy of proposed construction: ~ . ;~'.J a<llfU:' a. Existing use and occupancy ....... . . . . . . . . . . ...."a .'li1lllo"l ".....W\ . . . . . . . . . . . . ~ d(L;<f,t'a~ bIt d d . ..... " " ~)~ ,J< .j' 'f'., r. . n en e use and occupancy ............ .., . ......,........... .~............... 3. Nature of work (check which applicable): New Building.......... Addition J~.... Alteration .......... Repair .............. Removal . . . . . . . . . . . . .. Demolition .............. Other Work. . . . . . . . . . . . . . . cD' . .. (DescriPlion) 4. Estimated Cost. . . . .. . .. / :f)>. 9.Q. . .~. . . . .. .. .. . .. .. ... Fee...................................... " (to be paid on filing this application) S. If dwelling, number of dwelling units. . .~ 'J. . . . .. Number of dwelling units on each floor. . . . . . . . . . . . . . . . If garage, number of cars ........................................................................ 6. Ifbusiness, commercial or mixed ~ccupancy, speci~natuT6A1nd e.xtent of each type of use ..................... 7. Dimensions ofexlstmg structures, If any: Front.. ~:~. Rear.............. Depth............... H~ight .' . . . . . . . . . . . . . . Nun~ber of Stories. . . . ..' : . . . . . . . . . . . .~. :. . '/i);r j,';.' H'" . . . . . . . . . . . . . . . . . . . . . DunenslOns .of Same structure with alteratIons or addll1ons: Front ... ~.Yf:l1IY'. ~ear . . . . . . . . . . . . . . . . . . D~pth '.' . . . . . . ..' . . . . . . . . . . . . !feight . . . . . 'C"_' ~ . iJ1'M.' tt'. . . . Number of Stories. . . . . . . . . . . . . . . . . . . . . . 8. DunenslOns of entIre new construction: Front. . . ~ rVl~.), Rear. . . . . . . . . . . . . . . Depth ............... H.eight .............. ".Inber~tqri.e}-............. ................................... .:........ 9. Size of lot: Front..... 'E" .. . .J~;:'Rear...................... Dewp ... O;C" ..y.. ../. ":, . 10. Date of Purchase, .. .. lo"'P( .~............ ..~ame 9ff<1r:?~Owner ... ~ ~ ~.'t"J14a ~ I I. Zone or use district in wh ch remises are situated. . . . {~~ .}.. . . . . iIi. 7' . . . . . . . . . . . . . . . . . . . . . . . . . . 12. D?es proposed construction violatF 'k~y zoning law, or ma~ce or regulation: ..,:-.!-).......................... 13. WiII lot be regraded ......... .I!J.-q. . . . . . .. . . .. . . Wlil excess fill be removed from premises: Yes No 14. Name of Owner of premises . . . . . . . . . . . . . . . . . . . . Address. . . . . . . . . . . . . . . . . . . Phone No. ............... Name of Architect ........................... Address . . . . . . . . . . . . . . . . . . . Phone No. .... . . . . . . . . . . . Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address ....;. . . . . . . . . . . . . . Phone No. ............... 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No.....-" *If yes, Southold Town Trustees Permit ma~ be rC.!juired. PLOT DIAGRAM . Locate clearly and distinctly aU 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. f'l STATEOFl\E~' ORKC:\ I.V S5 COUNTY OF.. .l-I..'B"O. LI}. . . . . . . . . . . . . . . . .. . . . W . ~. . . . . . . . . . " being duly sworn, deposes and says that he is the applicant ( 'ame of individual signing contract) ..bove named. :leisthe. ........................... ..0.W.f':.!2..(.... ........ .........:: .... ....... .............. (Contractor, agent, corporate officer, etc.) )f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this :pplication: that all statements contained in this application are true to the best of his knowledge and belief; and that the .\'ork will be performed in the manner set forth in the application filed therewith. . ;worn to before me this ..........:.... \.~.dayik...... ,otary Public, ... . . . . . . . . . . . . . . . . ... .,19..~ .....,~~I~....Ylft No. .111101 ), QuIlIIIlIIn Suffolk CauIllY U Comrillalon ~ December 8. 1& ............ (Signature of applicant)