HomeMy WebLinkAboutZ-26754FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 26754
Date: 10/26/99
THIS CERTIFIES that the building DWELLING
Location of Property GREENWOOD RD
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 012 Block 0001
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- 26754 dated OCTOBER 26, 1999
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
(HAMLET)
Lot 013.005
The certificate is issued to ANTHONY B. & MARJORIE HELFET
(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
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: GREENWOOD RD FISHERS ISLAND
SUBDIVISION: MAP NO.: -- LOT (S) --
NAME OF OWNER (S): ANTHONY B. & MARJORIE HELFET
OCCUPANCY: RESIDENTIAL ANTHONY B. & MARJORIE HELFET
ADMITTED BY: ACCOMPANIED BY:
KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 12.-1-13.5
SOURCE OF REQUEST: ~TEPHAN HARM. ATTY 10/5/99 DATE: ~Q/26/99
TYPE OF CONSTRUCTION:
FOUNDATION: GRANITE STONE
TOTAL ROOMS: 1ST FLR.:
BATHROOM(S):
PORCH TYPE:
BREEZEWAY:
DOMESTIC HOTWATER:
TYPE HEAT:
OTHER:
WOOD FRAME
2ND FLR.:
TOILET ROOM(S):
DECK TYPE:
FIREPLACE: NONE
WOOD
YES TYPE HEATER: ELECTRIC
WARM AIR: HOTWATER:
# STORIES: 2.0 # EXITS:
CELLAR: 100% CRAWL SPACE: __
3RD FLR.: ~
UTILITY ROOM(S): --
PATIO TYPE:
GARAGE:
AIRCONDITIONING:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.:
SWI~4ING POOL:
OTHER:
STORAGE, TYPE CONST.:
GUEST, TYPE CONST.:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION ! DESCRIPTION ART.
SEC.
P. EM$~RKS: BP ~10740Z-COZ-12541 (ADD&ALT)
INSPECTED BY: ROB- - ' ' ' --'
DATE ON INSPECTION: 10/23/99
TIME START: END:
Form No. 6
TOWN OF SOUTIIOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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:
i. 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.
5. 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, 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-existing Building - $100.00
3. Copy of Certificate of Occupancy - $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 October 4~ 1999
::ew Construction ........... Old Or Pre-existing Building ........ ~ ........
Location of Property...jO ........ Greenwood .Road Fishers Island
House No. Street Hamlet
Onwer or Owners of Property..~p~bppy.~ Helfet and Marjorie M. Helfet
Couoty Tax Map No 1000, Section. 012.00 01.00
............. Block ................ Lot 013.005
Snbdivision .................................... Filed Map ............ Lot ......................
Permit No .... ~ ......... Date Of Permit...~ .......... Applicant... N/A
Health Dept Approval..· N/A
· · ...................... Underwriters Approval N/A
Planning Board Approval. N/A
~{equest for: Temporary Certificate ........... Final Certicate...~ ......
Fee Submitted: $..~QQ..qq .....................
~_~__~ ~~ ~,~~ Stephen L. Ham, III
_a ............................................. :..
(~'~fO APPLICANT