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Home My WebLink AboutZ-26000FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 26000 Date: 09/25/98 THIS CERTIFIES that the building SEASONAL DWELLING Location of Property HALYCON AVE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 009 Block 0007 Lot 004 Subdivision Filed Map No. Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 26000 dated SEPTEMBER 25, 1998 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 SEASONAL DWELLING * FISHERS ISLAND The certificate is issued to REV. SMILGA A ZENON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: ~%LYCON AVE SUBDIVISION= N~ OF ONNER {S): R~V. SMILGA A ZENON OCCUPANCY: P, ESIDENTIAL ADMITTED BY: REV. SMILGA KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 9.-7-4 SOURCE OF REQUEST: F~L~NCIS J. YAKABOSKI. ATTY 9/3/98 ~EV. SMILCA A ZENON ACCOMPANIED BY: SANE DATE: 09/25/98 TYPE OF CONSTRUCTION: WOOD FRAME FOUNDATION: STONE TOTAL ROOMS: 1ST FLR.: 4 2ND FLR.: 3 BATHROOM(S): 1.0 TOILET ROOM(S): PORCH TYPE: WOOD FRAME OPEN DECK TYPE: NONE BREEZEWAY: NONE FIREPLACE: NONE DOF~ESTIC HOTWATER: YES TYPE HEATER: NONE TYPE HEAT: WARM AIR: OTBER: STORIES: 2.0 ~ EXITS: ~ CELIa%R: NONE CRAWL SPACE: YES 3RD FLR.: O UTILITY ROOM(S): __ PATIO TYPE: NONE C~RAGE: NONE AIRCONDITIONING: NONE HOTWATER: ELECTRIC ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: SWIPING POOL: OTHER: STOP, AGE, TYPE CONST.: GUEST, TYPE CONST.: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION I ART. INSPECTED BY: ~. A~L~/ DATE ON INSPECTION: 09/25/~$ TIME START: END: P.1 APPLICATION FOR CERTIfiCATE OF OCCUPANCY This application must be filled in by typevricer OR l~k and submitted to the building inspector vith the relieving: for ney building or ney use: 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(i-9 form). 3. Approval of electrical installation from Board of Fire Undet~riters, 4. S~orn statement from plumber certify~n~ =hat the solder used in sys=~m contains 16~s C~an 2/10 of 1~ lead. 5. Commercial buildin~, indus=rial building, ~l~iple residences and similar buildings responsible for the buildin~. 6, Submit Pla~in~ Board ~p=oval o~ co, la=ed sate plan requlr~n=s. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Vpre-~isting" land uses: l. Accurate survey of property shcvtn~ all proper~y lines, streets, building and unusual natural or topographic features. 2. A properly co~pleted application and a consent ~o inspect si~ed by the applicant. I£ a Certificate of 0ccupa~cy is denied, the Building Inspector shall scare che reasons therefor in writing co =he applicant. ¢. Fees · 1. Certificate of Occupancy - New d~elling $2~.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, A~cessory building $25.00, Additions to accessory building $2~.00. Busineases $50.00. 2. Certificate O~ 0ccu~a~cy on Pre-existing Buildin~ - $100.00 3. Copy of Certificate of Occupancy - , ~. Updated Cer=ificate ef Occupancy - $50.00 5. T~porary Certificate of Occupancy - aesidential $1~.'00, Commercial $15.00 Dace ........ 69~P~.~...2~... ~. A~t~ ............ New Construction ........... 01d Or Prs-extsttn~ Buildfn~ ..... ~ ........... ~ ~ ~.~p~&~ ~ Fishers Island Location ef ~rope=t~ ..... ,~ ............................................... House NO. Street Hamlet Onwer or Owners of Property ~: ~ A. Smilga County Tax ~p No 1000, Section..~:)~. ..aa~......,..~'~u 07.00 ....... Lo=.~.9~.QQ~.-~Q0 n/a Filed Map A~ Lot Subdivision ............................................................. n/a Date Of Permit P~ ipplican~ Permit No .................................................... . Health Dept. Approval ...... ~{~ ............... Unde~-*riters Approval... A~ .................. n/a Planning Board Approval ....................... Request for: Temporary Certificate .......... Final Certicace ........... Fee Submit=ed: $..~q~:~ .................. ,,.~.~ ~'~lc,-~s ]¢ ~;¢ Rev. Zenon A. Smilga STATE OF NEW YORK ) ) SS: COUNTY OF SUFFOLK ) AFFIDAVIT I, Rev. Zenon A. Smilga, being duly sworn deposes and says: That I am the owner of premises located at Heathulie Avenue, Fishers Island, New York 06390, Suffolk County Tax Map Number District 1000, Section 009.00, Block 07,00, Lot 002.000 and 004.000, which is improved by a single-family dwelling. That at least one single station smoke detection alarm device is installed on or near the ceiling in this dwelling and that such device is in good working order. That I make this affidavit pursuant to Section 1193.2 of the New York Fire Prevention and Building Code. Subscri~d and sworn to before me ~N.s~"~-day of AJ,~t, 1998. Public Oulllfll, o in Suffolk Co~ty Term Expires 12~11~ REV. :L~NON A. M~L~,/GA c~ STATE OF NEW YORK ) ) SS: COUNTY OF SUFFOLK ) AFFIDAVIT I, Rev. Zenon A. Smilga, being duly sworn deposes and says: That I am the owner of premises located at Heathulie Avenue, Fishers Island, New York 06390, Suffolk County Tax Map Number District 1000, Section 009.00, Block 07.00, Lot 002.000 and 004.000, which is improved by a single-family dwelling. That at least one single station smoke detection alarm device is installed on or near the ceiling in this dwelling and that such device is in good working order. That I make this affidavit pursuant to Section 1193,2 of the New York Fire Prevention and Building Code. Subscri~d and sworn to before me /~s~ ~"~'day of A,g~l;, 1998. Notary Public U Ouellfisc~ in Suffolk Term Expires 12~1t9CI REV. Z~E~NON A. ~A (J JUL 30 '98 04:~?PM SOUTHOLD TOWM HRLL 516 ?65 1823 . P.~ . CONSENT TO INSPECTION Z.e. non A. Smilqa Owner(e) Name(s) do(cs) hereby state: ..., the undersigned, That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at No # Heathulie Ave., Fishers Island, New York · which is shown and designated on the Suffolk County tax map ac District 1000, Section 9 ,,, Block 7~, Lot 2 & 4 That the undersigned (has) (b~ filed, 'or caused to bc filed, an spplicao tlon in the Southold Town Building Inspector's Office for the followingl. Certificate of Pre-existin, g Use That the undersigned do(es) hereby give consent to the Building 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, including inspections to determine that said premises comply with all. of the laws, ordinances·~rules and regaletto'ns of the Town of Southoldo The undersigned, ~n consenting to such inspe.ctions, 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 p~osecutions for vio- lation~ of the laws, ordinances, rules o~' regulations of the Town of Southold. Rev. Zenon A. Smilga (print name)