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Z-41531
o'oS�FFOt Town of Southold 10/22/2020 �Gy 53095 Main Rd C* Southold,New York 11971 PRE EXISTING CERTIFICATE OF OCCUPANCY No: 41531 Date: 10/13/2020 THIS CERTIFIES that the structure(s)located at: Bell Hill Ave,Fishers Island SCTM#: 473889 Sec/Block/Lot: 9.-3-4 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- 41531 dated 10/13/2020 was issued and conforms to all the requriements of the applicable provisions of the law. The occupancy for which this certificate is issued is: seasonal wood frame one family dwelling with covered entry and garage under.* Notes: BP 7496 accessory garage COZ-6221;BP 44339 electrical survey COZ-40934; BP 45320 "as built"additions/alterations COZ-41530 The certificate is issued to Gaillard Wm D Rev Tr&Ano. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *PLEASE SEE ATTACHED INSPECTION REPORT. • Autho ' ed Signatuke- BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: Bell Hill Ave,Fishers Island SUFF.CO.TAX MAP NO.: 9.-3-4 SUBDIVISION: NAME OF OWNER(S): Gaillard Wm D Rev Tr&Ano. OCCUPANCY: ADMITTED BY: Tom Shillo SOURCE OF REQUEST: Gaillard Wm D Revoc Trust DATE: 10/13/2020 DWELLING: #STORIES: 2 #EXITS: 1 FOUNDATION: block CELLAR: CRAWL SPACE: BATHROOM(S): 1 TOILET ROOM(S): UTILITY ROOM(S): PORCH TYPE: covered entry DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: GARAGE: under DOMESTIC HOTWATER: x TYPE HEATER: electric AIR CONDITIONING: TYPE HEAT: none WARM AIR: HOT WATER: #BEDROOMS: 3 #KITCHENS: 1 BASEMENT TYPE: 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: 2/28/2019 TIME START: 1:00pm END: 1:40pm Form No.6 TOWN OF SOITI'HOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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%Iead. 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 9,1957)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 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$15.00 Date. fo7 New Construction: Old or Pre-existing Building: (check one) ��C Location of Property: ��(v � ,ol P �d�r�� e • Y I ✓ � '�S LG,-_ House No. Street ? ,[�� 1 Hamlet Owner or Owners of Property: 7/ drti. a �- �r ' i cc�`l - ,Qr-o�7-( Suffolk County Tax Map No 1000,Section_ L? Block 3 _ Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: _ Planning Board Approval: Request for: Temporary Certificate Final Certificate: _ 'Y (check one) Fee Submitted:$ l �p Applicant Signature CONSENT TO INSPECTION the undersigned, do(es)hereby state: Owner(s)Name(s) { That the undersigned (is)(are)the o Ter(s)9f the pre es in the own of Southold, located at �/,/ � 1� %s� ' �� which is shown and designated on the Suffolk County Tax Map as District 1000, Section T Block - , Lot-- That ot-_That the undersigned(has) (have) filed,or cause to be filed,an application in the Southold Town Building Inspector's Office for the following: j G - CC- Lt�C 6t /Q V, , e 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: t 22i / - C (Si ture) a4 �u LL (Print Name) (Signature) (Print Name) William D.Gaillard 17 Meeting House Road Greenwich,CT 06831 203-661-4716(phone&fax) 203-921-5406(cell) (kandwgaillard@optonline.net) January 22,2019 Southold Building Department Town Hall Annex Building P.O.Box 1179 Southold,NY 11971 Att'n Ms. Conme Bunch Re: Fishers Island Ctf of Occupancy Dear Ms Bunch: Since you were unable to find a certificate of occupancy for our Fishers Island cottage located at 556 Bell Hill Avenue,which we discussed by telephone and email last week,I have completed to the best of my ability an application for a new such certificate. This application,together with a survey showing the property in question (marked in yellow),a signed consent to inspection and my check for the indicated$100 filing fee,is enclosed. This property was originally owned by my father,William D. Gaillard,Jr.,and he is the owner designated in the 1974 Ctf.#Z6221 which you sent me,covering a separate garage constructed on the site subsequent to the 1972 survey date The principal building on the property(pictured in the survey)predates 1957,and if an occupancy certificate was issued for it,that certificate appears to have been lost I would greatly appreciate it if you could arrange to have this application processed promptly,Ietting me know if there is any other information that you need. Your department will have to contact me in advance to arrange for the necessary inspection,since the cottage is a summer home which is currently unoccupied and locked up. Whatever guidance you could give me on the probable timing of this application process would also be appreciated,since we must also apply for a rental permit under the new Southold rental law. Many thanks for your help S erely yours, Enclosures :. _ - ■■■■■■■■■ ■■ N■■■N■MEMO■ n INN ■.NN . . =E■E�•NHNM=■■N 000■ ■■■■ _ ' ■■■■■■■A■■■■■E■■N■NMN■■■■ '�` ■■ EEEW-M ■■S M■N■EE N■N ' ■■■■ ■E■�■■■■■'t■■■ ■■■■ ■■■ ■■E EOE■■■E■■■EE■NM■■■ ■E■� rom NOM ONE N ESENNN■■NNNNNN:M . :MEM N■■NNEN■NNNM::SENNMNE■N I Rooms . Fli :) AFFIDAVIT STATE OF CONNECTICUT) JAN 2 7 2020 ss. Greenwich, CT. COUNTY OF FAIRFIELD ) `' The undersigned,William D. Gaillard (the"Affiant"), of Greenwich, Connecticut, hereby makes this Affidavit under oath, in good faith and under penalty of perjury, of sincere belief and personal knowledge that the following matters, facts and things set forth are true and correct, to the best of my knowledge and belief: 1. The Affiant, together with his brother,Peter S. Gaillard, owns a seasonal dwelling located at 556 Bell Hill Avenue on Fishers Island,NY(the"Property")having a Suffolk County tax number of#473889 9.-3-4. 2. The Affiant has personal knowledge of the Property,having spent portions of nearly every summer either there or at neighboring family-owned homes since the 1930's, and he is very familiar with the last 45 years of the Property's history. 3. The date of original construction of the Property is unknown to the Affiant, but to his knowledge it preceded 1950 and was likely to have occurred many years prior to that. The Property's second floor porch and railing covered by an overhanging roof, as shown in the attached middle photo, dates back to the Property's original construction. 4. In the mid-1970's, the Affiant's parents acquired the Property, and they then proceeded to renovate it so as, among other changes,to extend the second floor porch and railing to the south and east beyond its original section, as shown in the attached bottom photo. 5. The dimensions of the foregoing extended porch and railing were substantially identical to those of the original porch and railing, and the Property's railings remain today unaltered from how they were originally constructed. IN WITNESS WHEREOF, I have hereunto set my hand this day of January, 2020. /,,x t"eL k: �/ William D. Gaillard Sworn to before me in Greenwich, Connecicut this day of January, 2020. ss°2 9 No Public g , �,t.,p7^:r •rn .__. -r-: �-- .__. - _ _ _ int r K _ p9- F SOUK,°lo # # TOWN OF_SOUTHOLD BUILDING DEPT. 765-1802 1,NSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE &CHIMNEY [ ] FIREZAFETY INSPECTION [ ] .FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] E CTRICAL (FINAL) [ ] CODE VIOLATION [ PRE C/O REMARKS: cal 09 'ov 101, l DATE �� INSPECTOR2"4-c.,�_ Wz/4-.-�_ LOCATION: - (number & street) (municipality) SUBDIVISION: - P•1�1' LOT(S): .. NAME OF OVVNER OCCUPANCY: (type) (owner-tenant) ADMITTED BY: _ ��''"` ACCOMPANIED BY: KEY AVAILABLE; SUP`F. 'CO. TAX MAP'1I0. 10 0- - 3- SOURCE OF REQUEST; r DATE: O/ ii DWELLING TYPE OF CONSTRUCTION: ��"`� � STORIES; -# EXITS: ' ' FOUNDATION; ASEIVIEN�'; CRAWL SPACE: # OF BEDROOMS: 18T FLR: 2ND FLR.: .� 3RD PLR: BATHRO'OM(S): 4 TOILET PwowS): UTILITY ROOM: PORCH,TYPE: DE-CKI TYPE: �� PATIO;TYPE: BREEZEWAY:' FIREPLACE; GARAGE; v DOMESTIC HOTWATER: TYPE PLATER: , , AIRCONDITIONING: TYPE HEAT; WARM AIR: _ , HOTWATER: '1 4 OF KITCHENS: ``•. „ FINISHED BASEMENT:- YES_ NO OTHER: ACCESSORY STRUCTURES . GARAGE; TYPE OF CONST.: _ STORAGE,TYPE CONST.: SWIMMING P'O'OL: UEST,'TYPE CONST: . OTHER: VIOLATIONS: CHAPTER.144 &N.Y, STATE:UNIFORM FSE PREVENTION & BUDDING CODE LOCATION -DPISC PTION ART. SEC, r •D. � �l 07 br REMARKS: INSPECTED BY: DATE OF INSPECTION: TIME START:, ���, _ END: !' �� N�F e 9r. z9 �• 4 5,44 z4, „�• �� 1 3z ,� Y c3 . �1 © z.�o . ,y 53 0 • � �,C7Iq V�O o t��►., 1 E 1-E G � � U Coo C= 1,9 a '�1S 1 ti(o lJ "'t d lA O` -� C��.A.N W coo�pl t�1n,c'E Dt ST�1�1 C ESr�E � J© H N Y COAST M�.�*�..su cz.ED �rrc�M, U . S �' Al,,W D C FA DET I G Sv Z V aY TZ i - � �. ► J p,1.lGU LAT10�1 STATIc�tl " 05 �. GO 1 Z w W,' 2ct g8o�l 3 , ©�, SHOWIWG PAZCELS TO CCONVE.Y�i� Cl 4=>. SFoq ,z8 • TCD MAF,,-IE LEE E G Al L LAS D J-OH N PL L\NT EN GA 1 LLAZD ,C�• iV D to WI LL I AM D. GA1 LL_ AZD , j z . �.T FISHF- FS ISLAND - NEW YOKVV - - aCAl....t= 1 40 'FT C H A.N'D t_E V,- P,4 Ltd EK ,e. V l t4G NCOt�W tCH, Cdt-,l KA r-CTICU` - f.O , ► 9 7 Z