HomeMy WebLinkAboutZ-33792FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEP~-RTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 33792
Date: 06/25/09
THIS CERTIFIES that the building DWELLING
Location of Property 5220 STILLWATER AVE
(HOUSE NO.)
Co~t¥ Ta~ ~p NO. 473889 Section 137
Subdivision
CUTCHOGUE
(STREET) (HAMLET)
Block 0002 Lot 014
Filed Map No. Lot NO. __
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which C~rIFICATH OF
(~2COF~C"f ~E~{ Z- 33792 dated JU/qE 25, 2009
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.* THIS CERT. OF OCC. REMOVES VIOLATIONS NOTED ON
C/O Z4764 DATED 8/29/72 ONLY. SEE WNDERWRITERS CERTIFICATE 7915, 10/11/07.
The certificate is issued to DAVID W & JENNIFER OLSEN
( OWNER )
of the aforesaid building.
SUFFOLK COUNTY DEPART[~glFr OF HEA~TH APPROVAL N/A
Rr.Rc-rKICAL CERTIFICATE NO. #7915, 10/11/07 N~
PL~i~ CERTIFICATION DA'i'~u N/A
Rev. 1/81
Nassau Suffolk Electrical Inspections,Inc.
P.O. Box 549, Aquebogue, New York 4. 11931
Tel: 631=591-3097 Fax: 631-591-3098
Application: 7915 Date: 10/11/07
Issued to: Oben
Address: 5220 Stllwater Ave Introduced By: First Class Electric
Village: Cutchogue License #: 34075-ME
Residenthll [] Commrt:ial
The following was examined and approved up to the above date and found to
be In compliance with the NEC:
Attic I" Floor [] 2'~ Floor [] 3~ Floor Garage Conversion
Basement Hot Tub Addition Detached Garage Pool
Switches Receplael¢ Fixtures G.F.I. Mic~owavc Smoke Detectors
10 8 26 2 I
Fans Dishwasher Washer/Amps D~et/Amps Oven Range/Amps Cat~m Monoxid~
Fumac~ Oil Gas Heat Zones Whirlpool B~I Transformers
Rough Final Meter Amps Pha~e MOtO~
Ins~ction Inspection
10/10/07 I I0/I 1/07
Other Equipment:
Permit #:
This certificate must not be altered in any manner
Form No. 6
TOYVN OF SOUTHOLD
BUILDING DEPAIiTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPAI"
JUN 24 2009
BLDG. DEPT.
TOWN 0[ SOUTHOLI)
This applicafion must be filled in by typewriter or ink and submitted to th~Building Department with the.fo lowing:
A. For ne','; bnilding or new use: 1. Final su]w'ey of propelly 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 installatioo 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 silrdlar buildings and installations, a cei~ificate
of Code Compliance fi-om architect or engineer responsible for the building.
6. Submit Pla]ming Board ApFoval of completed site plan requirements.
B. For existing buildings (prior {o April 9, 1957) non-conforming uses, or buildings and "pre-existing" land nses:
l. Accurate smwey of property showing all properly lines, streets, building and uuusual natural or topographic
features
2. A properly completed application and consent to inspect signed by the applicant If a Cerlificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant
Fees
1. Certificate of Occupancy New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling~ $25.00,
Swimming pool $25.00, AccessoC~ building $25.00, Additions to accessory building $25.00, Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building $10000
3. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporaly--Ceffi.ficate of Occupancy ~ Residential $1500, Comlnercial $1500
Date. 6/24/09
New Construction: Old or Pre-existing Building: X (check one)
Location of Property: __ 5220 St'~ 11-..,ater Ave. Cutchogue
House No Street Hamlet
Owner or Owners of Property: David l,lorthin~_.ton Olsen and Jennifer Naite Olsen
Suffolk County Tax Map No 1000, Section 13'7 Block 2 Lot 14
Subdivision Filed Map. _ kot:
Permit No. Date of Pelnnit. Applicant:
Health Dept. Approval:
Underwriters Approval:
Planning Bored Approval:
Requesi lb]: Temporary Certificate
Fee Submitted: $ ,_.~t...~
Final Ce:~ificate:
(check one)
App icant Si~mture