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Home My WebLink About5913-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED Certificate Of Occupancy Z-15519 De..c.e.m.b. er ]8.,. 19 8..6 No .................. Date .......................... One family dwelling with deck addition, THIS CERTIFIES that the building . .a.c.c.e.s.s.o. ry. j~a.r.a.~e.,..i.n, gLr. o.u.n.d..pp.o.1..&..f.e.n.c.e..e.n.c.lp.s..-are 4790 Main Bayview Road. Southold, New York Location of Property /~Os~ b/ol ............................................" '"'" ' ' " 078 04 Street 030 Ham/er County Tax Map No 1000 Section Block Lot · M/o Corey Creek Estates 4923 16 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore f'ded in this office dated *SEE BELOW ................... ·. ,. 19... pursuant to which B~lding Permit No ..................... . dated ............................ 19..., was issued, and conforms to all of the requirements of thc applicable provisions of thc law. The occupancy for which this certificate is issued is ......... One family dwelling with dormer, deck addition, accessory garage, inground pool DANIEL & HELEN WEBER The certificate is issued to ........................................ of the aforesaid building. M/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO.. ~.57.1.3.7 <house), 591285 .(.a.c.c.e.s.s.o.r.y .g.a.r.a.g.e.) 591285 (pooI) Buildinglmpeetor *Permit #5913Z dated May 30, 1972, issued May 30, 1972 - One family dwelling with dormer. NOTE: 2nd floor not finished. Permit #11051Z - dated March 3, 1982 Rw.l~1 issued March 12, 1982 - Accessory garage. - Permit #]2004Z - dated October 26, 1982, issued Nov. 5, 1982 - Inground pool & fence enclosure, - Permit 15266Z dated September 15, 1986, issued September 16, 1986 - deck addition FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Cerlificnte Occupnncy No.~1~917. ...... Date ........... ])ea .1 ........... , 19.72 THIS CERTIFIES that the building located at Ba,~ti~ .Road .&. 0~eT. ~ tr~eet ' Map No. C oriy. Cit l~[lock No ........... Lot No. ~ .. 8oll*6ho].d..N,Y · ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. ~.. 30, 19.72. pursuant to which Building Permit No. ~.~.l~.. dated ......... ~ ..... 30..., 19.72., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . l~i~t&t~..O1~. £Uily..dwelling ...................................... '. The certificate is issued to l)alXt~l. ¥~hb~r. & .~if~. .0~mr~ .................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...!.O~..:..~*..]. ~.~.. i bY..R*. ¥.i.~..~... UNDERWRITERS CERTIFICATE No..1..'~.137 .... 197.2 ....................... HOUSE NUMBER.. ~'~0 ...... Street..~&]r..~..'le¥. ~ ................................ 6~ Core}- Creek Lane Building Inspector · O~ ~qO. 2 TO~N OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5913 z Permission is hereby granted to: Atl~.l~...]~g,Z~Z..:.C..~m.t,~.~t,,t~l..g.<~llL.A/~ Daalel Yelm~ & .Ill.. lll~.....llt,~..]~&~ .............................. ...... ~ ......... Z,.~. ...................................................... to ....J~l~....~...~..~....~v.~l~J~tl ................................................................................. at premises located at ..~i~..~ ....... ~'..~e~..~r~ ....................................................... ................................ Jej~,'A~ ..~ml...&..¢.eJ'~'...C:~eelc../,,~e .............. J, eat, lm~ ................... pursuant to application dated .......................... J~.~. ......... ~0 ........ , 19~..., and approved by the Building Inspector. Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Southold, N. ¥, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector with the following; for new buildings or new use: i. 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 installations, 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 in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date ......~. L~ .-T../. · .~....~.....~- ~ ..... New Building .................... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ..~//~7~..~......~...o...~...~.~.....~..~...X:.~...~...d~'..../~.:...~....~..../....~-~'~.....~..~ ............... Owner Or Owners Of Property .~....1~-.~..~...~..........~.....~...t...~....~........~....~l[..q~..~ ............................. ~..,. ..... Subdivision I~...~..?....~.?~....~.g.~...~_~...'~.._-~.....~..~ot No....../..~..... Block No ............. House No ............. Permit No. ~T. JL~.~..... Date Of Permit .6-./~.lT.~m..Applicant .... ..~.:......~...- .~....~ ................................. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Sworn to before me ~his ................ day of ....~;.r.T~.-..-TT.. ............ Nota~_~ublic ....... ~.~.... C~n~ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ~ Fee Submitted $ ...~..(.(~..O. ..................... Construction on above described building ar~ p i,~ets ~ ap,,~eoble, ~e~anjJ,~gulations. ROBERT W. KIEl:ER Not~y Public State of New ~ No. 52-2108010 Suffolk County T~ Ex~im Merch ~0, 19~ FORM NO. 6 TOWN OF SOUTHOLD ~uilding Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted i ~ to the Building Inspec- tor with the following; for new buildings or new usa: 1. Final survey of property with accurate Iocatio. n 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 p~'operty 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.Updated C.O. $15.00 Date ...A~..~ .................../~-O~ New Cons truction ...... OJd or Pre-existing Building ............ Vacant Land ............. Location of Property ..... (~.~-.....(-."g-~...C,~....L.....~3~'... House No. (~ Street Hamlet Owner or Owners of Property I~.~ ~. b0~ ¢~,.. ~ L~ ~ County Tax Map No. 1000 Section ...? °c~ Block ~- Lot.. ,~..c~. Subdivisi°n '~'.-g~. · · · . · .(~. · · .~...~.....Filed Map No... ~. ~.Z..-~..Lot No ........... Permit No ........... Date of Permit .......... Applicant ............... Health Dept. Approval ........................ Labor Dept. Approval ....................... . Underwriters Approval ........................ Planning Board Approval ..................... . Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $.. .,/.J..~. ......... Construction on above described building and permit meets all applicable codes and regulations. Applicant .................................................... SUFFOLK COUNTY DEPARTMENT OF HEALTH H. DoRefer~nce APmICATION mR APPR~ TO mNSTRUCT PR~A~ S~AGE DISmSAL SYSTEm rote Approval to constmct slid systems is reque, t~,pertinent data here~th: 1-Applicant ~,~ ~ ~ Phone~gF~° 6-Sub div~z~y C~ Address ~ ~ / ~,~,~d. ~ ~h, ~.~ /, 7 ~ .7-Section 2-Detail~ p~pe~y location ~/& ~ ~-k /~ 8-~t No. /& Hamlet ~l~/~ To~ ~oXd 9-Private well? 3-~blic ~ter ~pply ~me ~ Distance to nearest ~in ~-Log St~e~ ~tdgh//o fg. Lenggh~l~ ~. (also enter on cen~ plo~ plan 5-~elli~: Single Family I~ I T~ Family? I /Cellar? ~,/~lab? /~1 Crawl S~ce? lO-Pro~s~ sysg~: Septic tank g ~Precast ~Cess~ols ~ ~Shallow ~ols il-Septic ~ i~ide dimensions: Volvo Gals.Length ft. Width ft. Liquid depth ft. 12-Precast sections: ~J~Number~Sq~re Ft. Cesspools: Block sizeL incs.D ~s.H ins. Total blocks below inlet: ~1~2 ~T P~N 0 -- Data Feet 0 2 6 8 i0 12 ~ ~ Street aee<y c~F~/' Z,~, , ~ o e The Undersigned CERTIFIerS: "Construction of authorized installations will be in aceo~l, anee with the Su£f'olk County H~alth Departments' current Standa~l.s, Bulletins, and amendments thereto, covering Private Sewage Disposal Systems". / / ~h, mor or Buildor FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Department, that an adoquate and satisfactor7 Sewage Disposal System can be installed on this Plot. Date ~~ (10/65 Revis.) S-15 Signed APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS INSTRUCTIONS: Applications must be submitted in triplicate 1-Means Owner or Builder. Address to which mail should be directed. 2-Means detailed description of property location, together with street ~a~e and distance to nearest intersection of main thorofare, also Hamlet/Village & Township 3-Enter name of Public Water Supply District, together with the distance to their main. ~-Enter Length and Width of I~t under appropriate heading, also enter these dimensions on center plot plan shown on the face of this application. 5-Dwellings: Check-mark "V" items applicable to the proposed new dwelling. 6-Name of sub-division ?-Section Number 8-Lot Number 9-Private well: Enter "No" if Public water supply is available. Enter '~es" otherwise. PROPOSED SYSTEMS: Answers to Items number 10, 11, & i2 please consult the Suffolk County Health Department's Standards, Bulletins and Amendments for Sewage & Waste Disposal Facilities. i.e., Part II-Residential Sub-surface Disposal Systems covering Cesspools Part III " " " " # # Septic Tanks Part IV " " " " " " Unusual soil conditions Part ¥ " " " " " " Shallow Leaching Pools PLOT PLAN: The following information is required concerning the Applicant's Lot: Lot size-Length and Width in feet to be indicated at the Lot lines of the heavy lined square in the oenter of Plot Plan shown on face of this application. Surface waters-Streams, Lakes, & Bays, etc., located within a distance of 50 feet of Applicant's Let lines, must be shown on the plot plan also. Wells and Cesspools now on adjacent lots must be shown on the Plot Plan together with the distance to the Applicants proposed Sewage Disposal Systems and Well. Where no Buildings exist on adjacent lots, state "Vacant" on the plot plan. Streets adjoining applicant's lot to the right, left or rear, enter street name. WELL LOCATION: To locate the well & sewage disposal systems on Applicant's lot, the following Standards must be observed: Well-100 feet minimum distance from the nearest cesspools Well-25 feet minimum distance from rear, and rear sides of property lines Well-10 feet minimum distance from front, and front sides of property lines Well-50 feet minimum below grade for well point Well-40 feet minimum into ground water for well point Well-4 feet 6 ins. minimum below grade to well head and lateral water pipe ~ESSPOOLS LOCATION: Upon determination of the Sewage & Waste disposal "type of systems" required, the following Standards must be observed for the ~a~n of same: -o Cesspool-10 feet minimum distance from lot lines to center of cesspoo~ Cesspools exterior must be 100 feet minimum distance from nearest wel ~-. Septic tank exterior must be 75 feet from nearest well ~-~ Cesspool "Center" must be 12 feet minimum distance from nearest water ~ne Cesspool "Center" must be 15 feet from house foundation ~,~ Cesspool exterior must be 50 feet minimum distance from surface Waters~St~ams~, Lakes & Bays, etc. Cesspools must be 20 feet minimum distance from large trees Cesspool center to Cesspool center must be at least 16 feet Cesspool cover top to grade must be held to minimum of 1 food to maximum of 2 feet Bottom of Cesspool to ground water must be held to minimum of 1 foot NOV 2 ? lg;' The ~e~,,a~ disposal ~d ~ater supply facilities foF this location have been inspected by this d~pa~tment %o be satisfactor~ er ~f ¢ene~I En~n~ Ser~ces SURVEY FO~ DANIEL. W~B£R A T BAYVII~W TOWN OF $OUTHOLD SUFFOLK COUNTY, N.'~ SCALE: I"= 40' FF.B. 3, 1972 MAY 19,19;'2 JULY 18,197~ ; S~'P'K 18,1972 REFERENC£ MAP OF COREY CREEK ESTATES FILED AU8 IS, 1967' FILE NO. 4D~3 eUARANTE£D TO' CHt~A~O TITLE INSURANCE COMPANY SO&/TN~LD SAVlNI$ lANK DANIEL WENR LAND SURVEYOR P BUILDING DEPARTMENT '- r · /~ TOWN CLERK'S OFFICE ,. - / /7 ~' ~'~ ~ /~'-,~ ~' -h) ........... ............ Appli~tion No ............................. A~roved ................ ~.~.....t: .............. , 19.?.~. Permit No..~[..~.~..~ ...... Di~pp~ a/c ................ ~.....~ .......... ~ ................................................. ........................ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted irt duplicate to the Building Inspector. . ~' b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stree~r areas, and giving a detailed description of layout of property must be drawn on the diagram wl'dch is part of this appUca~on. c. The work covered by this application may not be commenced before issu~lnce of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. SuchI~mit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pumuant ~ the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or ,demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. (Signature cf applicant, or name, if a corporation) .... ....... .... (Address of applicant) ///7~ ~' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...~....~...'...?:'....V~...m..~.......~...~:.....~...!..~...l~'.........~t~.....~..'~....~..'.="F~ ................................................................... ':.,, If applicant isJ;~ corporate, signature of duly authorized officer. ~ (Name and title 'of corporate officer) 1~4 ~'~ ,N,- ,~'c~ ~x,~. 1. Location of land on Which__ proposed work will be done. Map No.: ..~.....rJ~K~...~-R4~...~... Lot No.: I(¢=, Street and Number1---' ~ ~/'t~/l,'~e3u~. ,.~'Oc.,'3=/f~.-~.~ /Y~' Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~.~...7~.. ~...~.....~.~... ........................... b. Intended use and occupant,' ....../......~...~..~.,..~....~...?..-~.....Cr../.../~'..~., ........... ; .................................................. 3. Nature of wo~k (check which applicable) New Building Repair ................. Remora! .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ....~.../~...~....~.1~......~7~ .............. Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling umts ......... ~ ...........Number of dwelling units on each floor ............................ If garage, number of cars ........ ~...~.....~_...r~... .................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ......... ~ .................. 7. Dimenr:dons of exist!ng structures,~,if any: ~ont'. .................. .%, ..... Rear ................................ Depth .................... H~ight~ ......... Number'o~es ......................... '~; .............................................................. Di'rnension/o'~rne structure ~ alte'~tions or additio.c~: Front~, .................................. Rear ............................ Depth ................................ Height .......................... Number of Stories ................................ 8. Dimensions of entire new constructian: Front .......... ,.~.(c~..'. ............... Rear ............................ Depth~m',',~.~...'...~,[: ..... Height .../..~..f.~...~'.... Number of Stories .............. .~.....~..~....~.....~..~....~....O.. ......... ~ ..............(~4~-..~....e:~'....~',~..~.x....~....~. ' 9. Size ~:/~ot~.'~t ..../../...~....~ ............... ?,ear ......... //.~.. ................. Depth .....m~.~....-~ .............. 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ ! 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construct;on ~iolate any zen ng aw ordnance or reau at on-L. 13. Name of Owner of premises .~..,.....V~...~..'~ .............Address ..~ID.O.~,L,~...~ Phone No ........... - ...... Name of Architect .......... ~ .................................... Address ..................... ~ ................. Phone No ..................... Name of Contractor .~..,....~_.~...~..I..=~.~t~l.l~j~......Address ~*~t~l.,.y:n~.,..~.~.....~.~.. Phone No.7~/;...~.../..7....7·. PLOT DIAGRAM Locate clearly cnd distinctly all buildings, whether existing or proposed, and indicate all set-back dimensicns from property lines. Give street and Wock number or description according to deed, and show street names and indicate whether interior or cc;met Jot. STATE OF NEW YORK, tSS COUNTY OF ..~.~.~./~..-------------------~, ........ f ' · ................ ~'."/~'-.-~).~.,~...~..~ ................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the .............................. ~.4¢~.~~..~ ................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all staternents contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Swam to before me this ......... ................ · County (Signature of applicant) Iq~r~EBICK W. i~lcll N°TARY PUBLIC. State of Nov ' ~o. 52'7597250; Suffolk Co ~ Comwllsslom Expires l~rarek ~0 11~.~,~ Unauthorized altet~t/en or addition to this survey is a violation o~ section 7209 of the New York Slate Educmien Law. Copies of this survey map not bearing the land *urveyor's inkea' sea~ or embossed seal shall not be considered to be a vafid copy. ~uaranmes m certJ/icafions indicated hereon shall run enly to persen for whom the survey is prepared, and on his behalf to the t/tie company, gevernmenta~ agency and ~ending institution Iisi'ed hereon, and to the assignees of the lending institution. Gumantee~ or certifications am not transferable to additional institutions or subsequent owners. ,/ 6 .L-OT 17' -, SURVEY FOR DANIEL WEBER AT ~ tI'VIE*W TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. SCALE: I"'~ 40' FF.B~ 3,1972 MAY l',1972 JULY 18,197~ SEPT. I~, 1972 REFERENCE ' MAP OF COREY CREEK ESTATES FILED AUB. IS, IBeT FILE NO. 4B~3 eUARANTEED TOT CNICA~O TITLE INSURANCE COMPANY SOUTHOLD EAVINe$ BANK DANIEL WEUR LAND BUBVEYON ~IVEBHEA~, N. ¥. 0 Z F F_. cO~'T E.,L ~ V