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Home My WebLink AboutZ-26000 FORM 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 FISHERS ISLAND (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 * The certificate is issued to REV. SMILGA A ZENON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. Buil ing Ins ector Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: HALYCON AVE FISHERS ISLAND SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S) : REV SMILGA A ZENON OCCUPANCY: RESIDENTIAL REV SMILGA A ZENON ADMITTED BY: REV SMILGA ACCOMPANIED BY: SAME KEY AVAILABLE: SUFF. CO. TAX MAP NO.: 9.-7-4 SOURCE OF REQUEST: FRANCIS J. YAKABOSKI ATTY 9/3/98 DATE: 09/25/98 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 2.0 # EXITS: 2 FOUNDATION: STONE CELLAR: NONE CRAWL SPACE: YES TOTAL ROOMS: 1ST FLR.: 4 2ND FLR.: 3 3RD FLR.: 0 BATHROOM(S) : 1.0 TOILET ROOM(S) : 0.0 UTILITY ROOM(S) : PORCH TYPE: WOOD FRAME OPEN DECK TYPE: NONE PATIO TYPE: NONE BREEZEWAY: NONE FIREPLACE: NONE GARAGE: NONE DOMESTIC HOTWATER: YES TYPE HEATER: NONE AIRCONDITIONING: NONE TYPE HEAT: WARM AIR: HOTWATER: ELECTRIC OTHER: ACCESSORY STRUCTURES: GARAGE, TYPE OF CONST.: STORAGE, TYPE CONST.: SWIMMING POOL: GUEST, TYPE CONST.: OTHER: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION a DESCRIPTION i ART. i SEC. REMARKS: INSPECTED BY: ✓ DATE ON INSPECTION: 09/25/98 ROBERT E. eAY TIME START: END: JUL `e •�:$t1 e4:cbrri 5UU 1 HULV 1 UWN HRLL 516 765 1 t1e::; r 'E TOWN OF SOUTHOLD$UILDING DEPARTMENT TOWN HALL SFP 4 765-1802 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: 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. S. 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. B. 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. 1 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 425.00, 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - t .25+c. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15:00, Commercial $15.00 Date . . . . . .. 4Vgyp� .24 . . 4 . ��$. . .. . . . . . . . . New Construction. .. . . . .. . .. Old Or Pre-existing Building. . . . .X. . . .. . . . . . . Location of Property.. ... . j?eathuliq. &v��,�. F shers. Island.. . : . ... ... House No. Street Hamlet Onwer or Owners of Property.. . . . . . . Rev. Zenon .A;. Smilga . , . . . , . . . . . . , . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . 009:00 ,. . .Block. .07.00 . . , . , . , ,Lot 8 PA .QQ4...OQO Subdivision. . .n/a. . . . . . . . . . . . . . . .. . . . . . . . . . . . . .Filed Map. . n/.a. . . . . .Lot. . . . . P.al . . . . . . . . . . . . . Permit No. . . . . . . . . . . . .Date Of Permit. nf a. .. . . . .. . . .Applicant. . . P. . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . ..n/a . .. . . . . .. .. . . . ..Underwriters Approval. . . .R/.a. . . . . . . . . . . . . . . .. . Planning•Board Approval. . . .. . .. . .. . . . .. . . . . . . . . Request for: Temporary Certificate. . . . . . .. . . . Final Certicate. . . . . . . . . . . Fee Submitted: $ 100;00 f. . . .9441- . . . . . . . . . . . . . . . . . . . . . . . Q� � � a�6 Rev. Zenon A. Smilga Ga STATE OF NEW YORK ) SS: AFFIDAVIT COUNTY OF SUFFOLK ' ) 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 1 193.2 of the New York Fire Prevention and Building Code. REV. NON A. MI GA Sud and sworn to before me 7�9'tday of A it 1998. r %116tary Public allotery Public Stets of Now York No.4900569 Quatlfl®a In Suffolk Co ty Torm Expl'res 12131, STATE OF NEW YORK ) SS: AFFIDAVIT COUNTY OF SUFFOLK ) 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. �W- .1 4. ,4, rem REV. NON A. MI A Subscr d and sworn to before me s day of A t, 1998. N rotary Public fHOMA9 P:DORM A -Notary Public State of Now yprk No.4a06S60 Oustlflea In Suffolk Cohty Term Expires 12131, JUL 30 '98 04:27PM SOUTHOLD TOWN HALL 516 765 1823 P.2 CONSENT TO INSPECTION Rev. Zenon A. Smilga the undersigned, Owner(B) Name(s) do(es) hereby state; 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 as District 1000, Section 9 Block 7 Lot 2 & 4 That the undersigned (has) (b filed, 'or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following:. Certificate 'of Pre-existing 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 regulations of the Town of 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. Dated: August , 1998 �j,(/V3fto A. MK aignatu e Rev. Zenon A. Smilga (print name) (signature) (print name)