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Home My WebLink AboutZ-19569FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-19569 Date DECEMBER 7~ 1990 THIS CERTIFIES that the buildin~ ONE FAMILY DWELLING Location of Property 3915 STILLWATER AVE. CUTCHOGUE~ NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 137 Block 1 Lot 5.1 Subdivision Filed Map No. Lot No. conforms substantially to the requirements for a Private One Family Dwelling built prior to: APRIL 9, 1957 pursuant to which CERTIFICATE OF OCC. #Z-19569 dated DECEMBER 7~ 1990 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 * The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PI.EASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 ESTATE OF KURTA. KOE~LW.R~ JR. N/A N/A Location t BUI_DI..G DEP.~Ti. LE?iT .. TO;'~! OF SOUTHOLD, N. Y. HOUSIDG CODE INSPECTION REPORT 3915 STILLWATER AVE. CUTCHOGUE, NEW YORK (number ~ s<ree<) Subdivision Map No. Nmme of Owner(s) KURTA. KOEHLER, JR. EST. (Piun~cipatizy) not(=) Occupancy ONE FAMILY RESIDENCE ( type ) ( own er- ~ enan~ ) A~mitted by: PAUL KOEHLER Accompanied by: SAME Key available Suffolk Co. Tax No. 137-01-5.1 Source of request BARBARA K. MERT~,'EXECUTRIX Date DEC. 7, 1990 D3'~LLI~: Type of construction FRAME Foundation CEMENT BLOCK Total rooms, 1st. F1 4 Bathroom(s) l Porch, ~ype SCREENED PORCH Deck, Breezewa~ Garage Type Heat NONE Fireplace(s) Domestic hotwater Other #sTories Cellar Ioz Crawl space 2nd. F1 5rd. F1 Toilet room(s) type · '~az.m Air No. Fz~its 2 Patio, typeCEMENT Utility room Hotwater Airconditionin~ ~ype heat~e~ LP ACCESSORY STRUCTURES: Garage, type const. FRAME (UNDER Storage, type const. Swimming poolPERMIT#6'y85 .CO Z- 19555) Guest, type const. Other BU~J(}{KA~D, CONCRETE _ PERMIT ~8949Z-CO Z-9395 for DEC~I~I]DT~I~.I~I~ KETERATION.; CONVERT~.I~ TO YKAI~ ROoNI} WITIt OIL It~.~-l', &iL VIOLATIOMS: Location .CHAPTER 45--N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE Descriotion I Art. [ Sec. i' I I Remarks: , /?. I~spected ~~z~ Date of Insp. DECEMBER ?, 1990 · Time start 1:45 end 2:10 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 BLDG. DEPT. TOWN OF SOUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-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. 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, Additiohs 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. Certifica_~e_of Occmp~ncy on Pre-existing Building -~lOO.~0 3. Copy of Certificate of O~cup~hcy f $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ~:ew Construction ........... Old Or Pre-existing Building...~'~....~q~..~.. Location of Property. ~t,..~'. ¢~I,,OcL'~t"RJ~ ~~ House No. Street Hamlet Dnwer or Owners of Property..~..~...~.~..t ........ ~'~ .......................... % ......... County Tax Map No 1000, Section...!!~: ...... Block.:~..=~ ........ Lot..~.~.:.~ ............. Subdivision.. ~..~ ~' ~¢,~ ~0 Filed Ma~ ~0 .......................... ............ .... ............. Permit ~ No ................ D~3~7 Permit ................ Applicant. ~H. ~., .~, .~.~]~' Health Dept Approval ~i.~i~ ~ · ~¢~.~ ~2~i ....... ....................... Underwriters Approval...6~.~...~ Planning Board Approval. ~. ~.0. ~ ~_~ Request for: Temporary Certificate ........... Final Certicate....u~. ...... b itt d $ Fee Sum e : .... ...: ...... ..... ....... Y,... ...... ...... CONSENT TO INSPECTION ~ ~. 6fl~-RYZ, gg.~ga~3gt~, ~o'r~f~ ~F K~ ~. , ~he undersigned, Ox~er(s) Name(s) do(es) hereby state: That the unders~ned (is) (are) the owner(s) of the premises in the To~ of Southotd located at ~q~ ~//~ ~, ~ Nq . which is shox~ and designated on the Suffolk County tax map as District 1000, Section /~ . Block --~ . Lot -- 5. That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold To~ Building Inspector's Office for the follow.g: That the unders~ned do(es) hereby give consent to the Build~g Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, ~clud~g inspections to determine that said premises comply with all of the laws, ordinances, rules and regutations of the Town of Southold. The undersigned, in consentLng to such ~sp~ctions. do(es) so x~th the knowledge and understanding that any ~formation obtained in the conduct of such ~nspections may be used as evidence in subsequent prosecutions for lat~ons of the laws, ordinances, rules or re~lations of the Toxvn of Southold. Dated: (signature) u~ (print name) (signature) (print name