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Home My WebLink AboutZ-20235FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-20235 Date SEPTEMBER 20~ 1991 THIS CERTIFIES that the building ONE FAMILY DW~.TJ.ING Location of Property 2125 HYATT RD. (PRIVATE RD. #18) SOUTHOLD~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 54 Block 1 Lot 9 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-20235 dated SEPTEMBER 20~ 1991 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 DWE. T~.ING WITH ACCESSORY SHED & PUMP PIT. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTHAPPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLRASE SEE ATTACHED INSPECTION REPORT. Rev. 1/81 ANTOINETTE HEILSHORN ~/~ N/~ ~ ~ / ~il~ing -I~n s-p~c tot Location BUILDIiIG DEP~MRT:.~NT '. T0~'~I OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT 2125 PRIVAT~ROAD~I81tYATTRD. SOUTltOLD, N.Y. [numoer & streeT) Subdivision Map No. Name of Owner(s) ~-~OIl~'l-r~. ~EILSHOI~ (i,iun±cipality) Lot(s).,. Occupancy I FAMIL¥ (COTTAGe) [type) owner- v enanv ) Ad.mitred by: BARBARA HcELROY Key available Source of request Accompanied by: Suffolk Co. Tax No. GARY OLSEN, ATT~ · Date SAME SEPT. 121199! D~'~LLING: Type of construction Foundation Total rooms, 1st. FI F~ #stories ! X Cellar Crawl space 2nd. Fi - - 3rd. Fi - - Bathroom(s) l Porch, type CLOSED IN Breezeway Type Heat ELECTRIC Fireplace(s) ! Domestic hotwater Other Toilet room(s) Deck, type Garage 'Warm Air No. ~cits 2 ~ CEMENT Patio, Utility room Ho twat er Aircondition~ng Type heater ELEc~IC ACCESSORY STRUCTURES: Garage, type const. Storage, type const. Swimming pool Guest, type const. Other ~OOO FRAME ROOF OVER PUMP PIT VIOLATIONS: Location EA'f~-RIOR .CHAPTER 45--N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE Descri:tion J-Ar-r-'c-. ] Sec. (P~PAIR PUMP PIT ROOF ) I J 1242.5 (d) NO ACCESS TO S 'ACE [ I Remarks: BP ~20152-Z CO Z-20~4 ISSUED FOR FRONT PORCH ENCLOSURE -z . Da. re o£ Insp. SEPT. 18, 1991 Inspected b TR~hiS~. F{SaER ' Time start 9:25 end 9:55 AM FORM NO, 6 TOWN OF SOUTHOLD · Building Department 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 I~ 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 disposal-(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 pzoperty 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 $25:00-- BU$INgS$ $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. $"50.00 Date September , 199! NewConsl;t'uct±on ...... Old or Pre-existing Building . .X .......... Vacant Land ............. Location of Property ........... Hy.att .Ro.a.d,. .............................................. So~thold, New York House No. Street Hamlet Owner or Owners of Property ~p.t pj p.e.t.t .e He1 lshorn ,., County Tax Map No. 1000 Section 5.4 k 1 9 .............. Bloc ............... Lot ............... Subdivision ................................. Filed Map No ........... Lot No ............. Permit No ........... Date of Permit .......... Applicant ................................. Health Dept. Approval ........................ Labor Dept. Approval ....................... Underwriters Approval ......................... Planning Board Approval ..................... Request, for Temporarl/ .................... .F/hia~lal Certificate ., .~. ................. Certificate Fee Submitted $..1,0.0.. O0,, /~ ~ Construction on above described'building and perm~~ cod~nd regulations Gary Flannel' 0i~sen, [:sq. ' R..~o.~o. Ta P.O. BOX 706 Cutchogue, NY 11935 CONSENT TO INSPECTION Antoinette Heilshorn · the undersigned· Owner(s) Name(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at Hyatt Road, Southold, New York · which is shown and designated on the Suffolk County tax map as District 1000. Section 54 . Block 1 . Lot 9 . That the undersigned (has) (have) filed. 'or caused to be filed, an applica- tion in, Tm Southold Town Bull(~ing lnsp~;Lu~ .,: Or.~:.. ~.~,. +h. ~nlloavin~: I story frame dwelling and detached shed 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, r'~,les and regulations of the Townof 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 Town of Southold. ~'' (signatur6) Antoinette Heilshore (print name) (signature) (print name)