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Home My WebLink AboutZ-16949FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certi[icate O[ Occupancy No. Z-16949 Date June 2, 1988 THIS CERTIFIES that the building s ONE FAMILY DWELLING Location of Property NE CORNER OF HEATHULIE & BEACH AVES. FISHERS ISLAND h3~s~ ~/d ........................................................ Street Ham/et County Tax Ivlap No. 1000 Section 9 .Block I 1 .Lot 9. l Subdivision ............................... Filed Map No ......... Lot No .............. Requirements for a private one-family dwelling built prior to conforms substantially to the April 23, 1957 CERTIFICATE OF OCCUPANCY ...................... pursuant to which t~:l~woat~No .... Zr169.49 ........... dated June ~, 1988 ............................ 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 DWELLING & GUEST HOUSE~ · The certificate is issued to ESTATE OF DOROTHY M. RUSSELL ~ow.e~:>~ii~ ..................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 *THESE TWO DWELLINGS CAN ONLY BE OCCUPIED BETWEEN MAY 31st AND THE 15th DAY OF SEPTEMBER AS THEY DO NOT HAVE SUFFICIENT HEAT SYSTEM. Location BUILDING DEP~ZRT;,~NT -. TO'¢fN OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT NE CORNER OF HEATHULIE & BEACH AVES. FISHERS ISLAND ~numoer & streeT) Subdivision Name of Owner(s) Occupancy R- I (type) Admitted by: LEFT OPEN Key available ~ Source of request Map No. ESTATE OF DOROTHY M. RUSSELL (Municipalizy) Lot(s) OWNERS (owner-zenanv) Accompanied by: MR. DIXON Suffolk Co. Tax No. 9-]1-9.1 STEPHEN L. HAM III . Date May 23, ]988 D!'~LLIMG: MAIN HOUSE Type of construction Wood framed Foundation H. Tile & Cement Cellar Total rooms, 1st. F1 9 2nd. F1 #stories 2 Crawl space 3rd. Fi Bathroom(s) 4 Porch, tSrpe roof over Breezeway Type Heat NONE Fireplace(s) Domestic hotwater Other Toilet room(s) Deck, type Garage · Warm Air No. Exits 5 Yes Pantry, large attic Patio, typ~ Slate Utility room x Hotwater Airconditioning.. ~ype heater ~gas ACCESSORY STRUCTURES: Garage, type const. ONE CAR WOOD Storage, type const. Swimming pool Guest, type const. Other 2nd Dwelling located on the property. VIOLATIONS: Location Housing Code, Chapter 45 N.Y. State Uniform Fire Prevention & Building Code Descriotion I Art. I Sec. BOTH DWELLINGS HAVE A FIRE & SMOKE DETECTOR SYSTEM. THESE TWO DWELLINGS CAN ONLY BE OCCUPIED BETWEE~ MAY 3]st AND THE ]5th DAY OF SEPTEMBER AS THEY DO NOT HAVE A SUFFICIENT HEAT SYSTEM. CH 45-PART 1000 1000. 1 b Remarks: Inspected by:~Date of Insp. May 3], ]988 Curtis W. Horton ; 'Time s%art ]0:00 arvnd 1]:30 am Location Subdivision N~me of Owner(s) Occupancy R- 2 (type) Ad,mitred by: LEFT OPEN Key ~vailabl e Source of request BUILDIL~G DEP~LRTi,~NT TO'~%[ OF SOUTHOLD, N. Y. HOUSING CODE INSPECTION REPORT NE CORNER OF HEATHULIE & BEACH AVES. FISHERS ISLAND ~n~mser & szreev) (i,lunicipalizy) MaD No. Lot(s) ESTATE OF DOROTHY M. RUSSELL OWNERS ~ owner- ~ enan~ ) Accompanied by: MR. DIXON Suffolk Co. STEPHEN L. HAM III T~ NO. Date 9-~]-9.2 May 23, ]988 D%~LLING: GUEST HOUSE Type of construction WOOD FRAMED Foundation Block & Stone Total rooms, 1st. F1 7 Bathroom(s) 3 Porch, type Breezewa~ #stories 2 Cellar Crawl space 2nd. Fi 3rd. FI Toilet room(s) Deck, type WOOD Patio, t~-peSLATE Garage Utility room Type Heat 4 ELECTRIC HEATM~rm Air Hotwater Fireplace(s) No. Exits Airconditioning Domestic hotwater YES ~ype heater ELECTRIC Other ACCESSORY STRUCTURES: J Garage, type const. Storage, type const. :~' Swimming pool Guest, type const. Other VIOLATIONS: Location Housing Code, Chapter 45 N.Y. State Uniform Fire Prevention & Building Code DescriDtion t Art. Sec. Remarks: Inspected by:~~ate of Insp. May 32, ]988 Curtis W. Horton ; -Time start20:OO amend 12:30 am FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ~~ to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5. Updated C .O. $ 50.00 Date .. May.. 23 .... 198~ .......... NewCons truction ...... Old or Pre-existing Building .... X ....... Vacant Land ............. Location of Property NE Corner of Heathulie and Beach Avenues, Fishers Island House No. Street Ham/et Owner or Owners of Property Estate of Dorothy M. Russell County Tax Map No. 1000 Section 9 Block 11 Lot. 9. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ....... N. ,/.A. ' .Labor Dept. Approval ..... .N/.A. ............... Underwriters Approval ....... N./,A .............. Planning Board Approvaf ....N/.A. ............... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ . .5.0...00 ...................... Construction on above described building and permit meets all applicable codes and regulations. Applicant ~..~[..~"/~' ~ Stephen ~J~'~{~'n{; i'II, &~ '~t~)~:~'~'~'~ ......... Rev. 10-10-7,9 Estate of Dorothy M. Russell STATE OF NEW YORK ) COUNTY OF SUFFOLK ) ss.: AFFIDAVIT STEPHEN L. HAM, III, being duly sworn, deposes and says: 1. I am an attorney at law, duly admitted to practice in the State of New York. 2. I represent the Estate of Dorothy M. Russell (Thomas W. Russell, Jr., executor), the owner of the real property shown on the survey annexed hereto. 3. Upon information and belief, all of the structures shown on the attached survey were constructed prior to 1957 and have remained in their current locations without change or modification since 1957. 4. I make this affidavit in order to induce the Building Inspector of the Town of Southold to issue a pre-existing Certificate of Occupancy covering the two single-family dwellings (one of which consists of three structures connected by an open patio and covered alleyway) and detached garage shown on the annexed survey, knowing he will rely upon the truthfulness hereof. Subscribed and Sworn To Before Me this 20th day of May, 1988 Not ~.~ Public E. JANE ALLE~ NOTARY PUBUC, State of New York No. 524916,%'86 Qualified in Suffolk COunty Commission Expires Dec~ber 28, 1989 Stephen' L. Ham, III /