HomeMy WebLinkAboutZ-39809 Town of Southold 8/1/2018
cdoy 53095 Main Rd
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Southold,New York 11971
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 39809 Date: 7/31/2018
THIS CERTIFIES that the structure(s)located at: Off Mansion Hse Dr,Fishers Island
SCTM#: 473889 Sec/Block/Lot: 9.-1-14
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- 39809
dated 7/31/2018 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 one family dwelling with covered wood porch and accessory wood frame shed.*
Note: BP 1023 addition/alteration COZ-539:BP 1291 addition COZ-1930.
The certificate is issued to Peck,Pamela
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 9-1-14
PLUMBERS CERTIFICATION DATED 6/14/2018
*PLEASE SEE ATTACHED INSPECTION REPORT.
u o ed Signature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: Off Mansion Hse Dr,Fishers Island
SUFF.CO.TAX MAP NO.: 9.-1-14 SUBDIVISION:
NAME OF OWNER(S): Peck,Pamela
OCCUPANCY:
ADMITTED BY: Laurie Finan
SOURCE OF REQUEST: Peck,Pamela DATE: 7/31/2018
DWELLING:
#STORIES: 3 #EXITS: 3
FOUNDATION: piers&stone CELLAR: partial CRAWL SPACE:
BATHROOM(S): 2 TOILET ROOM(S): UTILITY ROOM(S):
PORCH TYPE: covered wood DECK TYPE: PATIO TYPE:
BREEZEWAY: FIREPLACE: 2 GARAGE:
DOMESTIC HOTWATER: X TYPE HEATER: 2 electric AIR CONDITIONING:
TYPE HEAT: None WARM AIR: HOT WATER:
#BEDROOMS: 5 #KITCHENS: 1 BASEMENT TYPE: unfinished
OTHER:
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST: wood frame shed
SWIMMING POOL: GUEST,TYPE OF CONST:
OTHER:
VIOLATIONS:
REMARKS:
INSPECTED BY: JOHNJ DATE OF INSPECTION: 6/13/2018
TIME START: 9:20am END: 10:00am
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Form No.6 D
TOWN OF SOUTHOLD MAY 1 4 2018
BUILDING DEPARTMENT
TOWN HALL
765-1802 BUDDING Dom.
APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOUTHOLD
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, 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. May 10, 2018
New Construction: Old or Pre-existing Building: X (check one)
Location of Property: 220 Upper Shingle Hill Road Fishers Island
House No. Street Hamlet
Owner or Owners of Property: ESTATE OF PAMELA S. PECK
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Suffolk County Tax Map No 1000, Section 009.00 Block 01.00 Lot 014.000
Subdivision ' N/A Filed Map. N/A Lot: N/A
Permit No. N/A Date of Permit. N/A Applicant: N/A
Health Dept.Approval: N/A Underwriters Approval: N/A
Planning Board Approval: N/A
Request for: Temporary Certificate Final Certificate: X (check one)
Fee Submitted: $ 100.00'
P�l 6-116"l�S �.�,y,G..,. �• cam„.�
Applicant Signature
Stephen L. Ham, III
CONSENT TO INSPECTION
ESTATE OF PAMELA S. PECK
By Jeffrey E. Peck,, Co-Executor ,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 220 Upper Shingle Hill Road, Fishers Island
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section 009.00 , Block 01:'00 , Lot 014.000
That the undersigned(has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following: Pre—Existing
_Certificate of Occupancy for Single-Family Dwelling and 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
1 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: April-39 , 2018
(Si re)
Jeffrey E. eck, Co—Executor
(Print Name)
(Signature)
(Print Name)
_ pF SOUr�,ol
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Town Hall Annex Telephone(631)765-1802
54375 Main Road y Fax(631)765-9502
P.O.Box 1179 • �� roger.rich ert()-town-so uthold.ny.us
Southold,NY 11971-0959 Q
�ycOUN�Y,��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Pamela Peck (Off Mansion House Drive.)
Address: 220 Upper Shingle Hill Road city,Fishers Island st: New York zip: 06390
Budding Permit#: Pre-CO Section: 9 Block: 1 Lot: 14
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: AS BUILT DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor Basement X Service Only
Commerical Outdoor X 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey X Attic Shed
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency FixtureSIA Time Clocks
Disconnect Switches Twist Lock Exit Fixtures TVSS
Other Equipment: "AS BUILT" - "ELECTRIC SURVEY" - "NO VISUAL DEFECTS"
Notes: Storage Shed Contains - UG - Direct Burial Feed to 1- Receptacle and 1- Wall Lights.
30A Electric Hot Water Heater in Basement of Main House.
Inspector Signature: ( Date: June 28, 2018
0-Cert Electrical Compliance Form.xls
5�v �(k�' TEL. 765-1802
s O� TOWN OF SOUTSOLD
OFFICE OF BUILDING INSPECTOR
o T P.O. BOX728
TOWN HALL
• Ol ��0�' SOUTHOLD, N.Y, 11971 '
C E R T I F I_2 A•-T I O N
Date
Building Permit No,
Owner
(please print)
Plumber �{A�
(please print)
I .certify that the solder used in the water supply 1 system
contains less than 2/10 of l% .lead- ys
. (plumber's signature)
Savor to before me this
—:Fday of
ary Public
Notary Public, ll/ice County 67ZZ 3
ytrt�ot.r BUILDING DEPARTMENT-ElubW Inspector
TOWN OF SOUTHOLD
Town Hall Annex-54375 Main Road-PO Box 1179
+ � ► Southold, New York 11971-0959
Telephone(831)785-1802-FAX(831)7859502
mer.richertD-town,wuthold.nv.us
APPLICATION FOR ELECT111M INSPECTION
REQUESTED BY: Date:
Company Name: hM,
Name:
License No.: email: salmi d Sg�(s
Address:
Phone No.: M00 803 2 b
JOB I'SITE INFORMATION: (m IMormatlon Required)
Name: 'AMe4tt Ve
Address: 01 p !J s
Cross'Street:
Phone No.: S
Bldg.Permit#: �(� 4 Oman:
Rax.Map District: 1000 Section: ; Block Lot:
41
11
BRIEF DESCRIPTION OF WORK(Please Print Clearly)
Circle All That Apply:
Is job��ieady:for._.lrm n?:, ~� NO Rough In Fined
Do you need a Temp Certificate?: YES/ NO Issued On
Temp Information: (AY Wormavon wwlred)
Service Size 1 Ph 3 Ph -Size: A #Meters Old Meter#
i1
New Service-Fire Reconnect-Flood Reconnect-Service Reconnected-Underground-Overhead
At Underground_Laterala_. 1_.__2_ ._ H Frame Pole Work done on ServIce? Y N
Additional Information:
D 0VIE
PAYMENT DUE WITH APPLICATION
JUN ���U'46�' D
�' .',`
BUILDING DEPT. !� yo
TOWN
TOWN OF SOUTHOLD 0
Scanned with CamScanner
MATTHEWS & HAM
ATTORNEYS AND COUNSELORS AT LAW
45 HAMPTON ROAD
SOUTHAMPTON, NEW YORK 11968
PHILIP B. MATTHEWS
( 631-283-2400
1912 1992)
FACSIMILE 631-287-1076
STEPHEN L. HAM, III
e-mail:Matthamesq@aaLcom
BARBARA T. HAM
May 10, 2018
Mr. Michael Verity
Town,of Southold Building Department
P. O. Box 1179
Southold, NY 11971
Re: Application for Pre-Existing Certificate of Occupancy
for the Estate of Pamela S. Peck
(SCTM No. 1000-009.00-01.00-014.000)
Dear Mike:
In connection with the application for a pre-existing Certificate of
Occupancy for a single-family dwelling and shed at 220 Upper Shingle Hill Road on
Fishers Island, I have enclosed the following:
1. Completed Application for Certificate of Occupancy, signed by me.
2. Consent to Inspection, signed by Jeffrey E. Peck, a co-executor of
the Estate which owns the property.
3. Survey of the premises prepared for the prospective purchasers,
Brian and Elizabeth Wilhelm, by CME Associates Engineering, Land Surveying &
Architecture, PLLC, dated April 10, 2018.
4. My check to the Town of Southold in the amount of the $100
application fee.
Access for an inspection can be arranged through Laurie Finan who can
be reached at (860) 803-2963.
Please let me know if you need any further information or documentation
before you can arrange for an inspection and issuance of the pre-C
u
M AY 14 2098
EUI>fMM DEPT.
TOWN OF SOMOLD
Mr. Michael Verity Page 2
May 10, 2018
Thank you for your attention to this matter.
Sincerely,
-���•�. cam...,
Stephen L. Ham, III
Enclosures
TOWK OF SOUTOOLD: 06
OWNER STREET VILLAGE DISTRICT SUB. LOT
F¢RMtR OWNER _/� N I ACREAGE ,
J�'1�"�-��Pe f r� W TYPE OF BUILDING
k4. f SEAS. VL. FARM comm. I IND. CB, I MISC.
LAND IMP: TQT L- DATE REMArp
RKS
G 6 G L//-o J - �� o - %�� .l" -�. I 1 r�o '� ��r, -`irt `y
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C - - 9�T C. ck 4v pi's T s fi LIZ
boo y3oo _ ggoo
AGE BUILDING CONDITION - ,6&Pt' 4!3 t n
NEW NORMAL BELOW ABOV
I W*
- -
I Farm Acre Value Per Acre Value
Tillable 1
Tillable 2 -
1 Tillable. 3
+
Woodland
Swampland
House Plot
i
Total
'
g i
_ *4p,
P,
IJ
M. Bldg. ` — -- Foundation Bath
l an- Ib�Clr = 2y� ; . 6D Basement . .._ _. .... Floors
Extension Ext. Wails ; $ Interior Finish �"r�
Extension Fire Place Heat Fat ,
Porch �-a, Attic
Porch Rooms 1st Floor
r
Breezeway Patio Rooms 2nd Floor
Garage Driveway
O. B.
i ,
Z� VQ S � �� �l� ,P�- �•�• r �, d
OF SOUIyo� l' ` • `
* # TOWN OF SOUTHOLD BUILDING DEPT.
co 765-1802
.INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND - [ ] INSULATION
[ =t]
FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
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(FOUND)E 5�300SOfF LOCATION MAP SCALE 1 "=400'
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DRAIN
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N/F ` EASEMENT AREA SHED _
JOSHUA A. RIGHTS o ® POLE
LEUCHTENBURG FOR�COTTAGES ^ ' #393\ J
MAP REFERENCES
(COTTAGE "C) A & C o
' �^ 1.) PLAN OF MANSION HOUSE COTTAGE SITES FISHERS ISLAND, N.Y. SCALE: Q
GRAVEL
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PARKING \ 0 1"=40' DATE: JAN. 1949 BY CHANDLER & PALMER ENGINEERS = O Y
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NOTES ME U —� U J
/ IRON ROD °' � � 1.) THIS SURVEY WAS PREPARED FOR THE PARTIES AND PURPOSE INDICATED w w Ld Z
N/F (FovND) >�� >� 20 HEREON. ANY EXTENSION OF THE USE BEYOND THE PURPOSED AGREED TO m (1) Z
FRANK R. LYON G' 's "'p, < BETWEEN THE CLIENT AND THE SURVEYOR EXCEEDS THE SCOPE OF THE >
& NATALIE DUPONT LYON o EXISTING `�'y o. �� o Z O
11 RESIDENCE LF F Q, ENGAGEMENT. Q = _
(COTTAGE "8") �. � ^� 2.) !T !S ^, V!OLAT!ON OF THE STATE EDUCA7!0N t nAl FCR `!Y PEF?s Io �- _ Li! (n
MONUMENT ow ,� ` ✓ UNLESS ACTING UNDER THE DIRECTION OF A LICENSED LAND SURVEYOR, TO w
(FOUND) ALTER AN ITEM IN ANY WAY. Ld W
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40 3.) ONLY COPIES OF THIS SURVEY MARKED WITH THE LAND SURVEYOR'S = Q C4
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SIGNATURE AND AN ORIGINAL EMBOSSED OR INK SEAL ARE THE PRODUCT OF J li N
4i (COTTAGE A ) �\ THE LAND SURVEYOR.
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P 4.) COORDINATE DISTANCES ARE MEASURED FROM U.S. COAST AND GEODETIC
N Io SURVEY TRIANGULATION STATION "PROS". Z
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Z 5.) SITE IS IN THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLK TAX MAP
��. POL 1000, SECTION 009, BLOCK 1, LOT 14. m
MONUMENT 0/w _ #392 N 3323.08 6.) TOTAL AREA = 18,594± SQ. FT. (0.43± ACRES).
(FOUND) 12' �/W �— W 2352.80 r
POLE -15 " A�� 7.) SITE IS LOCATED IN R-40 ZONE.
5. m
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OF PAVEMENT H�NGLE N� L
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PRIVATE ROAD_
CERTIFlED M.
12' BRIAN WILHELM w
ELIZABETH WILHELM — o
FIDELITY NATIONAL TITLE INSURANCE
IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR TITLE
SURVEYS OF THE NEW YORK STATE LAND TITLE ASSOCIATION.
TITLE NO. 7404-000065 w
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N/F NOW OR FORMERLY Q
R.R. RAILROAD SPIKE
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QUALITY CONTROL CERTIFICATION
GROUP REVIEWED DATE
. DATE: 04/10/2018
PROJECT MANAGER '
30 15 0 3 SCALE: 1 it = 30'
ENVIRONMENTAL
GRAPHIC SCALE IN FEET
CIVIL
STRUCTURAL SHEET: 1 OF 1
ARCHITECTURAL
LOCATION: -
( mber & st et) (municipality)
SUBDIVISION: MAP-N-0 LOT(S):
m
�
NAME OF OWNER(S)': `+ A' 2ti
OCCUPANCY: t �iMveill
(type) (owner-t(mant)•
ADMITTED BY: L�i1 r�P/ , f�lW ACCOMPANIED BY:
KEY AVAILABLE: SUEF. CO. TAX MAP'NO, 1000-
SOURCE OF REQUEST: DATE:
DWELLING
-TYPE OF CONSTRUCTION: N TORTES;-�_# EXITS:
FOUNDATION �7 S�Dh-� : $AuVMENT. 1N 111 'CRAWL SPACE:
# OF BEDROOMS: I T ftpu ' 2ND FLR: �Qf(i 3RD PLR: l 1 rfoe
Iry
BATFIRO'OM(S): l TO LET AOOM(S): UTILITY ROOM:
PORCH-TYPE:C� III�O •ECK, TYfPE: PATIO;TYPE:
v
BREEZEWAY:' , FIREPLACE;,`�. _ GARAGE,; _r. 0
DOMESTIC IIOT ATER: TYPE FIEATE �'� �C�AIRCONDITIONING:
TYPE HEAT: WARM AYR: . HOTWATER:
# OF KITCHENS-:_ I ,
FINISHED BASEMENT; YES NO
OTHER:
• • J
ACCESSORY STRUCTURES '
GARAGE; TYPE'OF CONST.: STORAGE,TYPE CONST.:
SWIMMING POOL: -__ GUEST,*TYPE CONST:
OTHER:
VIOLATIONS: CHAPTER 144 &N.Y. STATE°UN.IFORM Fn PREVENTION & BUILDING CODE -
LOCATION FISC PTION ART. I SEC
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REMARKS:
INSPECTED BY: h :
0� . � J S DATE OF INSPECTION.
TIME START: KIWI _ END: Or