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Home My WebLink AboutZ-18167FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-18167 Date JULY 5~ 1989 THIS CERTIFIES that the building ONE FAMILY DW~TJ.ING Location of Property 5050 STILLWA'£~ AVE. cu'I~OGUE~ N.Y. House No. Street County Tax Map No. 1000 Section 137 Block 02 Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the requirements for a private one-family dwelling built prior to: Hamlet APRIL 9~ 1957 pursuant to which CERT. OF OCCUPANCY. #Z-18167 dated JULY 5{ 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 ONE FAMILY DW~T~.ING * The certificate is issued to ROBERT J. & SHARON A. DALTON (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NO RECORD PRE F-X?STING UNDERWRITERS CERTIFICATE NO. NO RECORD PRE ~XTSTING PLUMBERS CERTIFICATION DATED NO RECORD PRE EXTSTING *PLEASE SEE ATTACHED INSPECTION REPORT. ~~7/'Su 1 l~ding~i n sp es t o r Rev. 1/81 Location Subdivision Name of Owner(s) BUiLDi?:G DEP::RT:.~[T T0:fM OF SOUTHOLD, N. Y. HOUSI~G CODE Ii.iSPECTION REPORT 5050 STILLWATER AVE. [n~oer ~ szreev) CUTCHOGUE~'N.Y. Map No. Lot(s)_ SHARON DALTON ROBERT & Occupancy R-40 RES. ) A~.~i~.ted by: MARY B. KILKENNY~- Key available (owner-~enan~) -A-- ~ · SAME cuump~nmed b): Suffolk Co. Tax No. 137-2-13 Source of request_ GARY OLSEN "- Date JUNK 27, 1989 D%'~LLI~: Type of construction FoundatibnCEMENT BLOCK Total rooms, 1st. FI WOOD FRAME #stories_ ONE Bathroom(s) ONE Porch, t)~e_ Breezewa~ Type Heat OIL Fireplace(s)_ Domestic hotwater Other Cellar I/4 Crawl space.. 3/4 5 2nd. F1 -- 3rd. F1 -- typeCEMENT XX Toilet room(s) Deck, type. Patio, Garage Utility room Warm Air xx ., Hotwater No. ~¢its 2 Airconditioning ELECTRIC Type heater DAYTON ~CCESSORY STRUCTL~ES: Garage, type const. Swim.ming pool Other NONE Storage, type const. Guest, type const. VIOLAT!OMS: C~PTER 45--N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE~ Sec. Remarks. BP #7414 CO # Z-10348 ' - Inspected by: GARY/~. FiSH ; ' Date of Insp. 7/3/89 BUIZ~ING INSPECTION ·Time start.9:30 end 9:45 FORM NO. 6 TOWN OF SOUTHOLD Building Depa,~,i.ent Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m~ to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposel-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.'00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50. O0 Date . 0.u.l.y..~7.~ .19.8.9. ..... NewC°nstruction ..... Old or Pre-existing Building X. Vacant Land of Property ~.P.~P.. S.l~i.l.l.~,J~r. Av.~r[t[~ qqt~qhq~ ... Location .. , ............................. House No. Street Ham/et Owner or Owners of Property Robert J. De]ton end Sharon A. Da]ton County Tax Map No. 1000 Section ...[.37. ......... Block .... 0.2. ......... Lot ..... ].3. ......... Subdivision ................................ Filed Map No ........... Lot No .............. Permit No ........... Date of Permit Health Dept. Approval .............. U nderwriters Approval .............. ......... Applicant .................................. .... Labor Dept Approval ......... Planning Board Approval ...................... Fee Subm tted $ .l.0.q..0.q .. / Construction on above described budding and permit a~.a'p~ . / i a I ~codesan_.~d regulations. Applicant .... ~~.~. ~~ ~ary el~nner'pqson, ~q. ' ................... R~.~0-~0-?S P. 0. BOX 706' . Cutchogue, NY ]~935 co I J(,7 CONSENT TO INSPECTION Robert J. Dalton Owner(s) Name(s) do(es) hereby state: · the undersigned· That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at Stillwater Avenue, Cutcho§ue, New York - , which is shown and designated on the Suffolk County tax map as District 1000, Section 137 , Block 02 , Lot 13 That the undersigned (has) (have) filed, 'or caused to be filed, an applica- tio.n tn'~h~.Southold Town Bullaing lnspu~, .~ ort.'.o to., +h~, fnllowin~: Pre-£xistin§ Certificate of Occupancy That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, inclpding any and all buildings located thereon, to conduct such inspections as they' may deem necessary with respect to the aforesaid applicatton~ L,~cluding inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections· do(es) so with 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 regulations of the Tomvn of Southold. Dated: ~l/~/~ Robert J. Dalton (print name) (signature) (print name) AFFIDAVIT Re: Dalton to Jahncke Our File # 4902 STATE OF MINNESOTA) COUNTY OF~)ss: Robert J. Dalton, being duly sworn, deposes and states as follows: That I am the owner of certain premises located on Stillwater Avenue, Cutchogue, Town of Southo]d, Suffolk County, New York, designated on the Suffolk County Tax Map as District 1000 Section 137 Block 2 Lot 13. That the house located on said premises was built prior to Apr1! of I957 and accordingly I submit this affidav!t !n support of my applicat!on for a pre-ex!sting Cert!ficate of Occupancy. The former carport was converted into a room for;which Certif!cate of Occupancy No. Z10348 was !ssued. "Robe~ Sworn to before me this day of June, 1989. Notary Publ!c u~ 0 NOTE m' I.,.O, F.IQ'$.~EFEFm ~ I'.'IA.P %~- F-LEE:T~JOQ~ COW FILED Ik4 P,-4E r-~ ,,-- 'C) ~ --r,: ,= QFFiCE .... r k. .... c ,- ,~ -, AS HAP ki0, '"'-"~-~ ~, SU F F, CC). TA~ 1~4A, P DA'FA: 15}0 ~ 1~_7-___~_ - ,,3_, BEACH PCL.- ~0C)O -IBT- ~.- I. Z Ap.Z EC'Z-[ 22 *- SSS ~9 30 ',,,/ ,- L(]T LINES FEE E JCq:_:,,, ,N ,,- : ' 2/