HomeMy WebLinkAboutZ-32952FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
NO: Z- 32952 Date: 03/31/08
THIS CERTIFIES that the building DWELLING
Location of Property 15345 MAIN RD EAST MARION
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 023 Block 0001 Lot 005
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- 32952 dated MARCH 31. 2008
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 SINGLE FAMILY DWELLING WITH ATTACHED GARAGE*
The certificate is issued to ROBERT W GILLISPIE, III
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPART14MT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
Aithorized Signature
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 15345 MAIN RD EAST MARION
SUBDIVISION: MAP NO.: LOT (S)
NAME OF ONNER (S): ROBERT W GILLISPIE, III
OCCUPANCY: SINGLE FAMILY DWELLING ROBERT W GILLISPIE, III
ADMITTED BY: ROBERT W. GILLISPIE III ACC@@ANIND BY: SAME
RST AVA31JURA: SUFF. CO. TAY MAP NO.: 23.-1-5
SOURCE OF RNQUERT: ROERT W. GILLESPIE III DATE: 03/31/0
DWELLING:
TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 2.0 # EXITS: 4
FOUNDATION: CEMENT BLOCK CEId,AR: FULL CRAHL SPACE:
TOTAL ROCKS: IST FLR.: 3 2ND FLR.: 5 3RD FLR.: 0
BATHROON(S): 2.0 TOILET ROOK(S): 1.0 UTILITY ROOK(S):
PORCH TYPE: GLASS ENCLOSED DECK TYPE: ONE PATIO TYPE. SLATE
BRHBZERAY• FIREPLACE: 2 GARAGE: 2 CAR
DOMESTIC H0INATER: YES TYPE HEATER: AIRCOEDITICNIIRi:
TYPE HEAT: OIL NARK AIR: NOTIULTER: XK
OTHER: REAR ROOFED OVER ENTRYWAY
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.: STORAGE, TYPE CO OT.: SMALL SHED
SWIMMING POOL: YES -1973• GUEST, TYPE CONST.:
OTHER: *BP#4964-COZ-5096 (INGROUND SWIMMING POOL)
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
INSPECTED BY: y O�� M=p� DATE ON INSPECTION: 03/24/08
GEORGE GILLEN TIME START: RED:
Form No. 6
TOWN OF SOUTHOLD r
• 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:
l . 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.
or existing buildings (prior to April 9, 1957) non -conforming uses, or buildings and "pre-existing" land uses:
l . 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 $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
Swinuning pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, 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.
New Construction: _ Old or Pre-existing Building: / 1 F4 (check one)
Location of Property: t53A-5 a;L(() 124 �a
House No. Street Hamlet
Owner or Owners of Properly: {
-
Suf,olk County Tax ylap No 1000, Section C 2, 3
Block Lot
Lot
Subdi�isi°n _Filed Map._ Lot:
Permit No. Date ofPermit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate
D4
Fee Submitted: $ ((�(�
(--tta,cw ,
64,c- � `f0 Lf -3
C0f-3.)-g52
Final Certificate: _ (check one)
oz -os -o$
Applicant Signa u
CONSENT TO INSPECTION
Z. t t �197– , the undersigned, do(es) hereby state:
Owner(s) Name(s)
That the undersigned (is) the owner(s) of the premises in the T wn of
Southold, located at i 5 34EAICA-, S AUC" �O fa -e> f -a 6,fi'VI
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section TJZ3 , Block C>1 Lot 6 S
That the undersigned (has) OW filed, or cause to be filed, an application in the
Southold Town BIIu''ildinInspector's Office for the following: p
0 A.um A k'\ni,t--� t
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: 3 — (g – o
(Print Name)
(Signature)
(Print Name)
ode 0 TOWN OF SOUTHOLD
0
PROPERTY
RECORD CARD
OWNER
STREET rJ
VILLAGE
DIST.1
SUB. LOT
l ' .. _ SIL
n
Des
FORMER OWNER
E%
AGR. %f,34
S
W � f
TYPE OF BUILDING
IJOVI
SEAS.
VL
FARM
COMM. CB. MICS. Mkt. Value
LAND
IMP.
TOTAL
DATE
REMARKS
400
a
tD v
1v 00
fP ' J Z�
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Ka 23- !- 3r71a
vA, 4m at
Du
3 o
/b 70U
Sas 7
6 O O
3 o a
s
AGE
BUILDING CONDITION
NEW
NORMAL
BELOW ABOVE
FARM
Acre
Value Per
Acre
Value
Tillable
FRONTAGE ON WATER
1 loQ
Woodlorw
FRONTAGE ON ROAD
- 4i
Meodowkmd
DEPTH
o 1,7 a
House Plot
BULKHEAD
Total ^ ^ I
DOCK
LONG
ISLAND
"8g°540 E SOUND
HIGH WATER
4NE ihl5 n. ' 6g. %j .
BARRIER BEAQp
HIGH WATER LINE
%IIS DA r,
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URVEY OF
DESCRIBED PROPERTY
SITUATE
EAST MARION, TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
SURVEYED FOR: ROBERT W. GILLISPIE III
TM# 1000-023-01-005 GUARANTEED T0 -
ROBERT W. GILLISPIE III
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URVEY OF
DESCRIBED PROPERTY
SITUATE
EAST MARION, TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
SURVEYED FOR: ROBERT W. GILLISPIE III
TM# 1000-023-01-005 GUARANTEED T0 -
ROBERT W. GILLISPIE III
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- A=38.05 S 70'2810 W
MAIN ROUTE 25
AIN ROAD N
1, 28 FEe 08 CORRECT NAME SPELLING
SURVEYED BY
STANLEY J. ISAKSEN, JR.
P.O. BO 294
NEW SU FOLK. N.Y. 11
631-7 4-5835 /J
Lic. No. 492737 08R1661
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MIN
GUARATOVTES WE NDICAPERS N HERE OM SHALL SURVEY
ONLY TO WE PERSON FOR NHOM ME SURVEY
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THE NEW YORK STAT£ EOUCARON LAW
COPIES OF THIS SURVEY MAP NOT HEARING
TH£LANO SURVEYGRE EMBOSSED SEAL SHALL
NOT BE CONSIDERED TO BE A VALID TRUE
COPY.
SURVEYED. 05 FEBRUARY 2008
SCALE 1"= 60'
N
a
AREA = 193,390 S.F.
O
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OR
V
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N/F DELANO
4 4398 ACRES
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TE TO ..+� aao R=2898 , 129.41
- A=38.05 S 70'2810 W
MAIN ROUTE 25
AIN ROAD N
1, 28 FEe 08 CORRECT NAME SPELLING
SURVEYED BY
STANLEY J. ISAKSEN, JR.
P.O. BO 294
NEW SU FOLK. N.Y. 11
631-7 4-5835 /J
Lic. No. 492737 08R1661
LOCATION: ✓' �-c�t ,� u`�•
(number & street)
SUBDIVISION:
NAME OF OWNER(S): 1�,o
OCCUPANCY:
MAP NO.:
(municipality)
LOT(S):
(type) % (owner -tenant)
• T
ADMITTED BY: ACCOMPANIED BY: L_,,4 . ,
KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000- A3
SOURCE OF REQUEST: DATE: 3 —) g -- 0 S,
DWELLING:
TYPE OF CONSTRUCTION: _ # STORIES: a2 # EXITS:
FOUNDATION: CELLAR: CRAWL SPACE:
TOTAL ROOMS: IST FLR: 3 2ND FLR: S 3RD FLR:
BATHROOM(S): TOILET ROOM(S • / UTILITY ROOM:
PORCH TYPE: ,Irr ✓✓J,,,c DECK, TYPE: 0u.Q1 PATIO, TYPE: � - '-
BREEZEWAY: FIREPLACE: 2� GARAGE: s7 �y,L
JDQMESIIC HOTWATER: TYPE HEATER: AIRCONDITIONING:
WARM AIR:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST.:
SWIMMING POOL: yeS'
OTHER:
HOTWATER:
STORAGE, TYPE CONST.:
GUEST, TYPE CONST:
VIOLATIONS: CHAPTER 144 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
t f
t
REMARKS:
INSPECTED BY: DATE OF INSPECTION: /` GG�,Ua
TIME START: ?__ J END: