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Home My WebLink About24051-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO Z-24992 Date APRIL 18, 1997 THIS CERTIFIES that the building ACCESSORY Location of Property 200 (a/k/a ~9) MADISON STREET GREENPORT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 33 Block 5 Lot 22 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 15, 1997 ~ursuant to which Building Permit No. 24051-Z dated APRIL 15, 1997 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 ACCESSORY ONE CAR GARAGE "AS BUILT" AS APPLIED FOR. * The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *ZBA APPROVAL DATED 4/6/62. JOHN & VICTORIA HELINSKI N/A N/A Building In~ctor Rev. 1/81 FORM NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 24051 Z Dote APRIL 15. ! 9.9..7.... Permission is hereby granted to: JO[tN S. & VICTORIA ItELINSKI 9 lqADISON STREET to CONSTRUCT AN ACCESSORY GARAGE "AS BUILT" AS APPLIED FOR. at premises located at ....... .2..0..0....(..a..k..a...~.9..)...~.~...~.O..H....S..?..~...E..T. .................... .~.~A~.0~T.,...]~,.~ ............... County Tax Mop No. 1000 Section ......... 3~ ...........Block ........ ~ ...........Lot No ...... 22 ............... pursuant to application doted ...... ..A~...R.~.L....!..5., ................................ , 19..~,., and approved by the Building Inspector. Fee $ ...........3..5.:..0..0. .... Rev. 6/30/80 mo .... ELD(;, DEPT. 'mW~'! Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 .... i APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 i% 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 c6mpleted si~e 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 ali 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, 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-existin~ Buildin~ - $100.00 ?' 3. Copy of Certificate of Occupancy - , .25C. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date April 14, 1997 New Construction ........... 01d Or Pre-existing Building ................. Location of Property. 200 aka #9 MADISON ST. GREENPORT, N.Y. House No. Street Hamlet Onwer or Owners of Property. JO~N & VICTORIA ~LINSKI County Tax Map No 1000, Section .... %~ ........ Block...~ ............ Lot .... %Z ................ Subdivision .................................... Filed Map ............ Lot ...................... Permit No.a~.~.,~./..~.....Date Of Permit..?/./(~./f~'...Applicant ............................. Health Dept. Approval ......................... JUnderwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... · 25 O0 Fee Submitted: $ ......: ...................... 1 . ~ ~..~....~L~, . APPLICANT FORH NO. I TONN OF SOUTHOLD BUILDING DRPARTI~NT TOWN HALL SOUTHOLD, N.Y. ll971 TEL: 765-1802 BOARD OF HEALTH ............... 3 SETS OF PLANS ............... SURVKY ........................ CHECK ......................... SEPTIC FOI~! ................... NOTIFY: CALL .................. HAIL TO: .................... APPLICATION FOR BUILDING PERHIT INSTRUCTIONS 'Date. APRIL. J4 ....... ,1997.. a. This ~lication mtqt be c~letely filled in by typa~iter or in ink and sul~itted to tbe Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to .~hedule. b. Plot plan slxxcing location of lot and of buildings on prmises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layrmt of p, oFerty must be drmm on the dlagran which is part of this application. · c. The ~ co,red by this ,pplication .~ay not be c~,.,.~nced before issuance of Building Pemit. d. Up~i approval of this application, the Building Inspector will issse a Building Permit to the applicant. Such pemi.'t shall be kept on the pr~dses available for inspection throughout the ~ork. e. No building shall be occupied or used in whole or in part for asy ptu~se whatever tmtil a Certificate of Occupancy shall have been granted by the Building Ins[x-ctor. /Ua'LICATI(lq IS l~tof~ Hfigg to the Building l)epa~h,~,t for the issum~e of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, Nt~ York, and other opplieable [aw,, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for ~,t~al or demolition, as herein described. The a~plicast ag, ees to cu,~ly with all ~plicable l~s, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applic~t, or r~,e, if a corporation) 9 Hadison St. Greenport, N.Y. 11944 (Hailing address of a~vlicant) State whether applicant is o~eer, lessce, a~nt, architect, engineer, general contractor, electrician, plmber or builder. ~ of o~qer of pr~mlses JOl~l & VICTORIA ItgLINSKI (as on the tax roll or latest ~) If applicant is a c~oration, signature of duly authorized officer. (l~ae and title of corporate officer) Builders License No .......................... Plmbers License No .......................... glectriciaas License No ...................... Other Trade's License No ..................... I. Location of land on which p, oposed ~ ~11 ~ ~ .............................................................. 200 a/k/a ~9 ~ISON ST. G~K~ORT, N.Y. ~ ~r S~t ~let ~ T~ ~ ~. I~ ~ti~ .... ~ ......... BI~ ..... ~. ......... ~t .... ~ ......... ~ivisi~ ...................................... Fil~ ~ ~ ................ ~t ............... 2. State ~sti~ ~ ~ ~ of p~..i~s ~ int~ ~ ~ ~ of p,~ ~t~ti~: a. Msti~ ~ ~ <~ ............................................................................. b. Intended use ami occupancy ..... b.c.~¥.GARAfi~.~.'A~.BILI. LT.". ............................................ ~Of ~ ~ ~le;-~ '~OC~,; :' .., , 3. P:~t,re of ~ork (cl~-c.k ~hid, applicable): Nea i~filding .X~ ....... baldition .......... Alteration Repair ............ lima, al ............. I)emol ition ............ a Other 14ork ..... il~~' '~' ',' ........... t,. Esti,mted Cost ..... ~; .5.0.O: .0.0. ........... fee .............................................. (to be paid on filing this applicatiOn) 5. If ck~elling, nt,d~er of d~elling ~mits ............ ~&,~er of t~elling traits on each floor ................ I- If garage, t~mber of ears ........ - .............................. 6. If I~usisess, c~m~rcisl or mized occupm~j, specif~j rmture and extent of earls type of use ...................... 7. Dimensions of existing stnmturea, if any: Front ................ l~ar ............... Deptls ................. Ileight ......................... Htmimr of Stories ...................... Din~rmions of s~ne strtmture with alterations or additions: Front ............... l~ar ............... Depth .................... Ileight .................... l~,dmr of Stories ............... 8. Diuermic~m of entire ne~ construction: Front ................ gear ............... Depth .............. Ileig~t ......................... l~nber of Stories ..................... 9. Size of lot: Front .................... gear .................... Depth .................... I0. lkite of Pt~rdmse ..................... Nm~e of Former O~er ........................................ II. Zone or use district in ~hich premises are sittmted .............................................................. 12. Does propo~l c~truction violate any mining l~a, ordinance or regulation: ........................ 13. 14ill lot be regr~k~d .................... 14ill excess fill be removed fram prmiees: YES 1~ 14. H~nes of O~er of premises ........................... /~lress .............................. Plmlm 1~ ............... Nm~ of Architect .................................... /~klress .............................. Pbene No ............... I~rm of Contractor ................................... baldress ............................... Iqgme No ............... 15. la this pmparty within 300 feet of a tidal ~tlm~d? * ~ .......... ~ .......... ·IF YES, salJ'rllalD ~ ~Vllb-i ,l~s I~IFF HAY BE I~]IIII~LD. PI.OT DIAGRAH l~cate clearly m~l distinctly all buildings, ~hetlmr existing or proposed, ~ indk:ate all set-back dimensions ~rnn properl~j lines. Gi~ stn~et m~d block nmtmr or description according to deed, m~l sho~ street m~nes and i~lieate · amtber interior or corner lot. ~IY (X? ..,... ~. ....... [.. ..... L(~ ~ ( L~C [ ~ t .l~irq~ duly ~n~, delx)~s a~ ~ys tirol he is tl~ a~licmnt (~ of it~ivi~[ signing c~tract) 0L'O . ............... (C~[rac~or, ngen~, cor~r~e officer, appl ice, ion; [ha~ all s~a~n~s c~aJ~ in ~h~s ~i~1 iea~ion ~re ~n~ [o fl~e bes~ of his ~l~ ~m Lo ~re. m this / , ....... ..... .... (Sig~ml~re of Rpplicant) C~RE ~ G~