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Home My WebLink AboutZ-40384 .� F04 Town of Southold 5/15/2019 53095 Main Rd Southold,New York 11971 o PRE EXISTING CERTIFICATE OF OCCUPANCY No: 40384 Date: 5/15/2019 THIS CERTIFIES that the structure(s) located at: Off Oriental Ave, Fishers Island SCTM#: 473889 Sec/Block/Lot: 12.-2-11 Subdivision: Filed Map No. Lot No. conforms substantially to the requirements for a built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 40384 dated 5/15/2019 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: wood frame one family dwelling-.* Notes: BP 12924 3 additions to dwelling COZ-25356;BP 23865 deck addition COZ-25359 The certificate is issued to Kadushin, Charles&Boulanger, Ghislaine (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED w *PLEASE SEE ATTACHED INSPECTION REPORT. . Auth rized Signature BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: Off Oriental Ave,Fishers Island SUFF.CO.TAX MAP NO.: 12.-2-11 SUBDIVISION: NAME OF OWNER(S): Kadushin,Charles&Boulanger,Ghislame OCCUPANCY: ADMITTED BY: John Doucette SOURCE OF REQUEST: Kadushin,Charles DATE: 5/15/2019 DWELLING: #STORIES: 1 #EXITS: 2 FOUNDATION: cement block CELLAR: partial CRAWL SPACE: partial BATHROOM(S): 1 TOILET ROOM(S): 1 UTILITY ROOM(S): PORCH TYPE: DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: x TYPE HEATER: oil AIR CONDITIONING: TYPE HEAT: oil FHA WARM AIR: HOT WATER: #BEDROOMS: 2 #KITCHENS: 1 BASEMENT TYPE: unfinished OTHER: ACCESSORY STRUCTURES: GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: SWIMMING POOL: GUEST,TYPE OF CONST: OTHER: VIOLATIONS: REMARKS: INSPECTED BY: MIKEV DATE OF INSPECTION: 5/9/2019 TIME START: 1:45pm END: 2:15pm Form No.6 �f?' TOWN OF SOUTHOLD DD BUILDING DEPARTMENT TOWN HALL APR - 4 2019 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 10ILDILt"3T^'`i"i TOWN OF SOUMOID This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. 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. 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. ' B. For existing buildings (prior to April 9,19S7) 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 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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00 Date. 6 $4 2 e-19 New Construction: Old or Pre-existing Building: ✓ (check one) Location of Property: /5��2 2/ q E✓ h es5' sf� House No. Street Hamlet Owner or Owners of Property: 0/(If P_ CGS �*/] VGA -///-1 Suffolk County Tax Map No 1000, Section / Block _Z_ Lot I/ Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ %0 ac q3 V-7 av ]icant Signature C��pL7.eaa CONSENT TO INSPECTION g-4 e5e 1 AcG the undersigned, do(es) hereby state: Owner(s) Name(s) That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold, located at �6,-Z Z /&,'V i z 6 X7C s5- lac on A ' , which is shown and designated on the�Suffolk County Tax Map as District 1000, Section Z , Block 2 , Lot That the undersigned(has) (have) filed, or cause to be filed,an application in the Southold Town Building Inspector's Office for the following: C o-r _ 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 in subsequent prosecutions for violations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: ignature) C R L69 (7 i (Print JZ) e) (Signature) (Print Name) f5 • nSy ,t• r b+ l'z Isr .r C7 1 d � M r � I~ ryo SMAAECi Aft CA 11240 .'}til D e7/0At „ r SCALE sv-Rvtry Nov. PLAN/ GF /�;��vStff�A !?nc.•� �:.:'!�.:� �o.�/'1 D.rL+7 Y .'S�"CT/�13�_/ �_.,�t'•�,..t..i_t�.—2.—L Oa'"' /� --4�- acA TOWN OF SOUTHOLD PROPERTY R Rpd, 9 . OWNER STREET VILLAGE DIST. SUB. LOT FORMER OWNER N E ACR. S W TYPE OF BUILDING �gr- I va L RES. SEAS. VL. IIARM s COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS 141 o (7000 "s-, 0 5-7 !ate r 7too 2 BP Ile ' I gING DIT1p 7 /all ca. p��—o t--ITZ:18 NEW NORMAL BELOW �130V' E FARM Acre Value Per Value Acre Tillable 1 Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD House Plot DEPTH BULKHEAD DOCK Total MEMO ■■■■■■■■■■■■■■■■■■■ Owl em , I _ Hary■■■■■ii�r�i®f�■■EEE■E■..■ - . ;:;,..: ,�M\fill■■��■■■M�M��■ ..■.■■■.. _ - ■■.■C. .■.■EMM■■.......■.. ■■■■ei�=siiEEMiiiE■i■■■E■ : .. r - Basement •• ExtensionExt. Finish Fire PI.ace ' creation oom, Rooms 2nd. Floor, •• • 0. B. -_ OE SOUIyo� # # TOWN OF SOUTHOLD BUILDING DEPT. `ycoum a 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: 1,ce- C. O. • DATE INSPECTOR LOCATION: u Gam• �Q'L`'�'� number & street) (municipality) 'SUBDIVISION: MAP,NO.: LOT(S)- NAME OF OWNER(S)': OCCUPANCY: type) Q 4r (owner-tenant)- ADMITTED BY: 't' __ACCOMPANIED BY: KEY AVAILABL . SU F. CO. TAX MAP'NO. 1000- SOURCE OF REQUEST: DATE: 7ftl �_7 -2-0/r DWELLING TYPE OF CON'STRUCTI'ON: #STORIES: # EXITS: FOUNDATION: tASgMENT: l CRAWL SPACE: # OF BEDROOMS: IST FLR: 2ND FLR: _ 3RD FLR: BATHROOMO: TOILET ROOM(S): - UTILITY ROOM: PORCH.TYPE: 'i DECK, TYPE: .. : . PATIOJYPE: BREEZEWAY: FIREPLACE: GARAGE: DOMESTIC HOTWATER: _ ✓TYPE HEATER: 0'`� AIRCONDITIONING: TYPE HEAT: �e /� WARM AYR: HOTWATER: # OF KITCHENS: FINISHED BASEMENT:- YES NO OTHER: ACCESSORY STRUCTURES GARAGE; TYPE OF CONST.: - STORAGE, TYPE CONST.: SWIMMING POOL: - GUEST,�TYPE CONST: .___ OTHER: VIOLATIONS: CHAPTER.144 &N.Y. STATE UNIFORM FARE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC, REMARKS: INSPECTED BY: DATE OF INSPECTION: OS'�09 / TIME START: D: �ff�