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HomeMy WebLinkAboutZ-30221 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- 30221 Date: 06/02/04 THIS CERTIFIES that the building DWELLING Location of Property CRESCENT AVE FISHERS ISLAND (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 006 Block 0001 Lot 002 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- 30221 dated JUNE 2, 2004 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 WITH COVERED PORCH.* The certificate is issued to JENNIFER RUSSELL & ANO (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. u or' ed S gnature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT LOCATION: CRESCENT AVE FISHERS ISLAND SUBDIVISION: MAP NO.: LOT (S) NAME OF OWNER (S) : 'JENNIFER RUSSELL & ANO OCCUPANCY: SINGLE FAMILY JENNIFER RUSSELL & ANO ADMITTED BY: ACCOMPANIED BY: KEY AVAILABLE: YES SUFF_ CO. TAX MAP NO_: 6.-1-2 SOURCE OF REQUEST. STEPHEN HAM, ATTY DATE: 06/02/04 DWELLING: TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 3.0 # EXITS: 0 FOUNDATION: GRANITE STONE CELLAR: PART CRAWL SPACE: PART TOTAL ROOMS: 1ST FLR.: 12 2ND FLR_: 8 3RD FLR_: 6 BATHROOM(S) : 8.0 TOILET ROOM(S) : 0.0 UTILITY ROOM(S) : PORCH TYPE: COVERED DECK TYPE: PATIO TYPE: BREEZEWAY: FIREPLACE: 2 GARAGE: DOMESTIC HOTWATER: YES TYPE BEATER: AIRCONDITIONING: TYPE BEAT: OIL FIRED WARM AIR: HOTWATER: 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 DESCRIPTION ART. SEC. REMARKS: 1 INSPECTED BY: DATE ON INSPECTION: 05/17 04 ROBERT E W TIME START: END: 4.. Form No.6 TO`'VN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1902 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%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) noii-eonforining uses,or buildings.and"pre-existing"land uses 1. Accurate survey of.property sliowirig all property lines, streets,building and unusual natural or topographic features. r �1 2: A properly completed.application arid 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$25.00,Additions to dwelling$25.00,Alterations- -dwellina.$25.00 a Swimming,pool $25.00,A.ccessory,building$25.00,Additions_to accessory,building$25:00 Businesses $SO;OQ. 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. April 21, 2004 New Construction: Old or Pre-existing Building: X (check one) Location of Property: (no Fishers Island House No. Street Hamlet Owner or Owners of Property: Jennifer ;Russell,..Sarah F. Russell and.Thomas. W. Russell, III Suff6lk County Tax Map No 1000, Section 006-.00 Block . 01.00 Lot 002.000 Subdivision n/a Filed Map.. . n/a Lot: n/a. Permit No. n/a Dat(eof Permit. n/a. Applicant: . ri/a Health Dept.Approval: n/a: Underwriters Approval: n/a Plannirig`Board Approval: m/a , Request.for: . Temporary Certificate Final Certif cafe , X. (check one) Fee Subiuitted: $ '00,.00 l� d Applicant Si iature . gi . _ Stephen L H CONSENT TO INSPECTION Stephen L. Ham, III, as attorney for Je n' er R se 1 S ah Russell and �'�omas Kgsel IRiI , the undersigned, do(es)hereby state: Owner(s)Name(s) . the attorney of That the undersigned (is)�=) the owner(s) of the premises in the Town of Southold,located at .(no #) Fox Avenue, Fishers Island which is shown and designated on the Suffolk County Tax Map as District 1000, Section 6 , Block 1 , Lot 2 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 a single-family dwelling i 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: April 21, 2004 : y`i.�. [. • v tt (Signature) Stephen T. Ham, III as agent (Print Name) (Signature) (Print Name) A. Bldg. 1111-10e) Foundation Both xtensi• i• •• xtension • Interior • Porch Roof Type Heat •• Rooms Ist, Floor #46 reezeway •• •.. arage Driveway - TOWN OF SOUTHOLD PkOPERT'Y RECORD CARS � OWNER STREET VILLAGE DISTRICT SUB. LOT FORMER OWNER eu�ssel� - N � E � ACREAGE TGrOI 1�[S 6�J r 1 j _ S , W rr TYPE OF BUILDING 3 � Yi0 e - Y u- GOVA RES. � SEA . VL. FARM COMM. I IND. I CB. I MISC. I Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS��✓ls 5� .�R w ss G✓ s p� Re f 7/7 r?r Ali .e seaod D d 1 7 9a zz z — 1151� I - 12uS�2 �-o s5e NIL, z -L I Zo3 3�$-� .l heel S r ' �� DG —L. 1 ZD 3 7q-- & sse I AGE BUILDING CONDITION e- NEW NORMAL BELOW ABOVE FRONTAGE ON WATER 2r 2 F 7 W � Farm Acre Value Per Acre Value FRONTAGE ON ROAD a K,o 7Y',4 skee t t Tillable 1 BULKHEAD t Tillable 2 DOCK f JY — !Z Tillable: 3 .�� Woodland Swampland Brushland House Plot Total Mr. Michael Verity, Building Inspector Page 2 April 21, 2004 Please let me know if you need any further information or documentation before you can arrange for an inspection and issuance of the pre-CO. Thank you for your attention to this matter. Sincerely, Stephen L. Ham, III Enclosures i A c s7'oNE ABUrMEN�- � °F4 'c°2M�E DOCk o� s Mod Gy,o6 2p,' .7 O ` MoFI � G N 0 © to N b M p O 1 Q 42/4L f/oLF /;a c/< ! r r ! i � t I w 1 � I � 1 � � I r JN41d¢.34 V , J /2°03so /2.0 8 Mo qV� s�! saM W ,333... i e°8 N 3998.oo' all ` 1V .317.S. I-f' So"w G / y�,rZ`rQY c-Eier-/may 7Hlr THrs GUARAn/.T-E 7-0 T.vE 7/T4Z 641AR,4IV 7- & co q n/Y PL An/ D� �ieOP.E�2T y Orc ,Va. J.9w. 3/, t9�oz FIJHEU' ISLAND, NE Yo,e,K_ nisr,4,vc,Es 4,eE SCALE : 1 u = 40 FT. CHANDLER PAILMER,,ENGRS, MFASU.eED ,�RoM U f G0447- Aao 6.EoOZ4,-iC JAR VE J/ S�/.q NG lr,C A T/ON cSrA r,o,�/ rrP�G13/r AM 114L t