HomeMy WebLinkAboutZ-39349 Town of Southold 11/17/2017
53095 Main Rd
Southold,New York 11971
4
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: 39349 Date: 11/17/2017
THIS CERTIFIES that the structure(s) located at: 715 Pike St,Mattituck
SCTM#: 473889 Sec/Block/Lot: 140.-2-22
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- 39349
dated 11/17/2017 was issued and conforms to all the requriements of the applicable provisions of the law.
The occupancy for which this certificate is issued is:
wood frame one family dwelling with covered porch and accessory cottage_*
Notes:BP 8478 10 x 10 accessory shed(C/O not required for this size shed); BP 41994"as built"alterations to an
existing one family dwelling(front house)COZ-39348.
The certificate is issued to Gildersleeve, James&Diane
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
l
PA rized Signature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 715 Pike St,Mattituck
SUFF.CO.TAX MAP NO.: 140.-2-22 SUBDIVISION:
NAME OF OWNER(S): Gildersleeve,James&Diane
OCCUPANCY:
ADMITTED BY:
SOURCE OF REQUEST: Gildersleeve, James DATE: 11/17/2017
DWELLING:
#STORIES: 2 #EXITS: 5
FOUNDATION: brick CELLAR: partial CRAWL SPACE:
BATHROOM(S): 2 TOILET ROOM(S): UTILITY ROOM(S):
PORCH TYPE: covered DECK TYPE: PATIO TYPE:
BREEZEWAY: FIREPLACE: GARAGE:
DOMESTIC HOTWATER: x TYPE HEATER: gas AIR CONDITIONING:
TYPE HEAT: oil WARM AIR: HOT WATER: x
#BEDROOMS: 4 #KITCHENS: 1 BASEMENT TYPE: unfinished
OTHER: This page is for main house
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST:
SWIMMING POOL: GUEST,TYPE OF CONST:
OTHER:
VIOLATIONS:
REMARKS:
INSPECTED BY: JOHNJ DATE OF INSPECTION: 8/22/2017
TIME START: 9:30am END: 10:00am
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 715 Pike St,Mattituck
SUFF.CO.TAX MAP NO.: 140.-2-22 SUBDIVISION:
NAME OF OWNER(S): Gildersleeve,James&Diane
OCCUPANCY:
ADMITTED BY:
SOURCE OF REQUEST: Gildersleeve,James DATE: 11/17/2017
DWELLING:
#STORIES: 2 #EXITS: 2
FOUNDATION: brick CELLAR: partial CRAWL SPACE:
BATHROOM(S): 1 TOILET ROOM(S): UTILITY ROOM(S):
PORCH TYPE: DECK TYPE: PATIO TYPE:
BREEZEWAY: FIREPLACE: GARAGE:
DOMESTIC HOTWATER: x TYPE HEATER: gas AIR CONDITIONING:
TYPE HEAT: gas WARM AIR: HOT WATER: baseboard
#BEDROOMS: 3 #KITCHENS: 1 BASEMENT TYPE: unfinished
OTHER: This page is for accy. cottage
ACCESSORY STRUCTURES:
GARAGE,TYPE OF CONST: STORAGE,TYPE OF CONST:
SWIMMING POOL: GUEST,TYPE OF CONST:
OTHER:
VIOLATIONS:
REMARKS:
INSPECTED BY: JOHNJ DATE OF INSPECTION: 8/22/2017
TIME START: 9:30am END: 10:00am
Form too_6
TOWN OF SOUT[IOLD
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%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$15.00
Date. CY-a l y — 7
New Construction: Old or Pre-existing Building: i/ (check one)
Location of Property:
House No. Street1 Hamlet
Owner or Owners of Property: _T A me- �}�+ 0.� �' ' d ec,I e_(f,se,
Suffolk County Tax Map No 1000, Section JA/00-0 Block add Lot _?ADoor
Subdivision Filed Map. Lot:
V Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary`Certificate Final Certificate: (check one)
Fee Submitted:$
Applicant Signature
LS�L'�O V L5 CONSENT TO INSPECTION
D
AUG 1 4 2017
BMMING DEPT.
TOWN OF SOUTHOLD
`A,–,gf+�- �_ r=. G61AC' ,51c--%:fV,1�rthe 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 ?)_ ' Q;p-s-e- 5T' o-• t(9S2 ,
which is shqwp and designated on the Suffolk County Tax Map as District 1000,
Section Block A , Lot -�_
That the undersigned (has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following: C o � roy-
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: �' `� — �-7
(Signature)
tT� s Y C l IdAm
(Print Name)
F A244L4e-1
Z..�lg2
(Signature)
2innI0- a-, Gl lA&<-sleeve-
(Print Name)
,moi
Pr--C C"O p
Pex Affidavit
I, James H. Gildersleeve retired plumber reside at 715 Pike Street front house have installed a
pex pipe to the outside faucets using no solder joints.
lit
James H. Gildersleeve
SCTM #
TOWN OF SOUTHOLD PROPERTY RECORD CARD ,
OWNER STREET7/S- VILLAGE DIST. SUB. LOT
ACR. �s REMARKS
TYPE OF BLD. / J
"e tr 711 /`� — L. fozr:ib" et/e
PROP. CLASS
2-
10 est.,
LAND IMP. TOTAL DATE
4
FRONTAGE ON WATER HOUSE/LOT
BULKHEAD
TOTAL
�+ l ,2 a 'TOWN OFI``'�': ` ECO
ST
iCi�RDr t �
/`7,I , _
OWNER STREET `— VILLAGE DISTRICT SUB. LOT
FORMER OWNER N E ACREAGE zrs
a W TYPE OF BUILDING
RES. 4,1,9' SEAS. VL. FARM COMM. I IND. I CB. I MISC. I Est. Mkt. Value
1
LAND IMP. TOTAL DATE REMARKS
7�LO, Pei?
d �zo e:4
l
I C-1-1a r r`�e8WS1PEVO C �I 9,,-sfee(u 4i/D -�
r Z o o C, 700 i a s` o
a- 2 1 —wa s G(1&1-skeve, rly 6uz, �
AGE BUILDING CONDITION ,
NEW NORMAL BELOW ABOVE FRONTAGE ON WATER
Farm Acre Value Per Acre Value FRONTAGE ON ROAD
Tillable 1 BULKHEAD
Tillable 2 DOCK
Tillable 3
Woodland
Swampland
Brushland
House Plot
Tota I
T
33kk1 t.r.iy. j, i
- z ,BLS' - •;�' , ... -` � i 1
! , t —�
rM. t,��a;c�
FFT iftl - I I C�1 G�
044 3P
• - - I I � I � I I � I i�—�--i ,
M. Bldg. ;��/ � Foundation s c Both
Extension r' ! 2x I Basement Floors
I P/M 67
Ext. Walls Interior Finish
Extension 5 ,.� �. �,�a _ -----
1
Extension Fire lace rV a LK
Heat
Porch I Roof Type
G x s ! Porch Rooms 1st Floor
I
Breezeway _ , , w Patio Rooms 2nd Floor
Sarage Driveway Dormer T
- I
0. B.
t x'X 1.11
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�I SURVEY , OF
51TUATE: MATTITUGK
TOWN: 5OUTHOLD N
SUFFOLK GOUNTY, NY W s E
5URVEYED 06-28-2017
SUFFOLK GOUNTY TAX # I
1000 - 140 - 2 - 22 S
CERT=TO
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MONUMENT FOUND
Area = 17,810 50 FT OR 0.41 AGRE5 JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STREET N.Y.S.LIC.NO.50202
GRAPHIG 5GALE 1"= 30' RWERHEAD,N.Y.11901 369-8288 Fax 369-8287
REF.CAUsersUobn\Documents\My Dropbox\17\17-152.pro
75' ke.., S4-.
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couM 1 N
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
( ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL [ ] ELECTRICAL (FINAL)
REMARKS
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DATE W INSPECTOR
1
LOCATION: Val�v-
(number
& street) (municipality)
SUBDIVISION: _ MAP-NO.: _- `LOT(S): .,
NAME OF OWNER(S)':
OCCUPANCY: S IN
(type) (owner-tenant)-
ADMITTED BY: ACCOMPANIED BY:
KEY AVAILABLE: SUET. CO. TAX MAP'NO. 1000^ 19a x-Aa
SOURCE OF REQUEST: DATE:
DWELLING
TYPE OF CONSTRUCTION: � � # S ES �! # EXITS:
RT _
FOUNDATION� � BASgME T: CRAWL SPACE:
# OF BEDROOMS: 1ST.FLR: —'19+ 2ND FLR: _ 3RD FLA:
BATHRO'OM(S r1P�' TOILET ROOM(S): UTILITY ROOM:
PORCH.TYPE: DECK, TYPE: PATIO;TYPE:
BREEZEWAY: IREPLACE: QARAGE:
DOMESTIC HOTWATER: TYPE HEATER: � AIRCOND IONING:
TYPE HEATS WARM AIR: HOT'WATER:
# OF KITCHENSi���1��.
FINISHED BASEMENT. YES NO
OTHER:
'
ACCESS STRU �.pCTURES
pL
GARAGE; TYPE OF CONST.: STORAGE,TYPE CONST.: W
SWIMMING POOL: GUEST, TYPE CONST:
OTHER:
VIOLATIONS: CHAPTER 144 &N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION D CRZPTIO ART. SEC.
fU Vlv
el!civ
v v
attk QJS vire S�1hCi
REMARKS:
INSPECTED BY.f nU S J P�('S��( DATE OF INSPE"CTION; koid,�V,
TIME START; % 0 END:
Coin w ��►���
LOCATION: � �l
(number &'street) (municipality)
SUBDIVISION: MAP.ND'.: LOT(S): ..
NAME OF OWNER(S)': wii&6CSz&yg::f
OCCUPANCY: • •
(type) (owner-
tenant)-ADMITTED BY: ACCOMPANIED BY:
KEY AVAILABLE: SUFF. CO. TAX MAP'NO. 1000% Q -
SOURCE OF REQUEST: DATE:
DWELLING
TYPE OF CO STRUCTI'ON: #STORIES: #EXITS: J
FOUNDATION: l` , BASVMENT: CRAWL SPACE:
# OF BEDROOMS: IST FLR: 2ND FLS 3RD FLA:
BATHROOM(S): TOILET ROOM(S): UTILITY ROOM:
PORCH.TY4 ✓ �CK, TYIPE: .. . PATIO;TYPE: 4
K D 4W&7G_AyR_'�A`G`E:Iq�\f
BREEZEWAY:' FIREPLACE:
DOMESTIC HOTWATER: � TYPE HEATER: AIRCONDITIONING: _
TYPE HE ���I/ WARM AIR: , , 'HOTWATER:
# OF KITCHENS: 00.V
FINISHED BASEMENT:- YES NO
OTHER:
ACCESSORY STRUCTURES �D Y-lo
GARAGE; TYPE OF CONST.: STORAGE, TYPE CONST.: Wc;a
SWIMMING P'O'OL: GUEST,'TYPE CONST:
OTHER:
VIOLATIONS: CHAPTER 144,&N.Y. STATE UNIFORM FIRE PREVENTION &BUILDING CODE
LOCATION DZ$CRIPTIO1 ART. SEC.
t Q. ^., othav
w. ATEEd r vv l
REMARKS:
INSPECTED BY:J dv% DATE OF INSPECTION: U�
TIME START; • V END: �,