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Home My WebLink About13291-z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. . . . . . . . . . . Date . . . . . . . . .December .6. . . . . . . . . . ., 19 .Q5 THIS CERTIFIES that the building . . . . additions.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Location of Property . . . ,1425 . , . . Gull. Pond Lane Greenport Nouse No. Street Hamlet County Tax Map No. 1000 Section . . . . .35. . . . .Block . . . . . . . . . .4 . . . .Lot . . . . .11, , , , , , , . , Subdivision . . . Fordham.Acres. . . . . . . . . . . .Filed Map No. 3519, ,Lot No. . . . . . .15 conforms substantially to the Application for Building Permit heretofore filed in this office dated .12. . . . . . . . . . , 19$4, pursuant to which Building Permit No. . . . . 132912, , , , , , , , , dated . . . . . yTuly, 19 , , , , , , , , , , , , , , 19 . 84,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 . . . . . . . . . Addy t7 orfs .to. .an, existing, dwellin. •. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to NORMAN J. & LEE D. WIEDERSUM . . .ow( . . . . ner,MAA . . . . . . . . . . . . . . . . . . . . . of the aforesaid building. Suffolk County Department of Health Approval . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . . . . . . .19683.194. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector Rev. 1/81 1 FORK NO. $ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N913291 Z Date .......,7cr.4.�-.........1... ............. 1 Permission is hereby granted to: . .. .... ....., ..1o ��a .... -1-zd.,. kA. .'-o..ua....W......... A/,32............//sr7 to ........ .......ba...... C.� tk1G.� ......... � 1-,r �. .......................................... ...................(............. ... ... ... ....... .. at premises located at .cif .1.. ........4s�+ .J!..,�lQ�..... wi/1� ............................ ................................................................................ ..........................��/zc,�!t .- . - ...... .a.,$ ............................ x... ..1..5 ................. County Tax Map No. 1000 Section ....0J.5-..7..... Block ..0. .......(.. Loot No. ..0//.............. pursuant to application dated ........ .(.,.. ........Lz............... 19P...T, and approved by the Building Inspector. Fee $.. .. O ........................ .. ................................................. B idling Inspector Rev. 6/30/80 FORM NO.6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted as N�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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15. 00 i 3.Copy of certificate of occupancy $1.00 ,Q 4 .Vacant Land C.O. $5 . 00 Date 44 e • •� New Building . . . ?�� • . • . • Qd or Pre-existing Building • • • Vacant Laannd� . . . . . . . . . . . . . Location of Property .I ,J G.4. . .Z . Street��•�i • • • •"�—' ' '"HaTmet Hous �•s Owner or Owners of Property . /l/�? A • s'+•• ^ '��•' ` 5� County Tax Map No. 1000 Section . . . . . �..S. . . . . Block . . . . .�. . . . .. . . Lot . . . . • • • • • • • Subdivision,05—! ?'Owoo .yy • A4r .Filed Map No.,-5 �—V • . .Lot/No.. I. • •_• • • • • �.��jr i 70/�Poz_,!i��Applicant_o_�_� - Health Permit No. . . . . . . . Date of Permit Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . .Labor Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . . Underwriters Approval . . . . . . . . . . . . . . . . . . . . . . . .Planning Board Approval . . . . . . . . . . . . . . . . . . . . . . Request for Temporary Certificate . . . . . . . . . . . . . . . . . . . . .Final Certificate . . . . ..x X . . . . . . . . . . . . . Fee Submitted . . . . . Construe ion on above described building and per eets all applicable `odes and regulations. Applicant . . . . . . Rev. 10.10.78 TEL. 765-1802 �p��Fa�CpO TOWN OF SOUTHOLD y< OFFICE OF BUILDING INSPECTOR c T P.O. BOX 728 u' yc TOWN HALL SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N Da' el- CiY Building Permit No. Owner 41,040.4W VU/,G Oe✓�E �7� s`✓ please print) Plumber �d% ✓�� N please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (pl mber , s signature) Sworn to before me this _day of L r , ,t 9 —. 19 i4�Notary public Notary Public / ' v-l— County 1001413 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY -' 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date March 19, 1985 Application No.onfile 307859-84 N 683194 THIS CERTIFIES THAT _ only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of Norman J. Wiedersum, 197 Gull bond La . Greenport,N.Y. in thefollowing location; ❑ Basement ki 1st Fl. ❑ 2nd Fl. garage Section Block Lot +i was examined on March 14, 19[85 and found to be in compliance with the requirements of this Board. +F FIXTURE FIXTURESCCUU RANGES COOKINGDECKS OVENS (DISHWASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT MyA R� AMT. KW AMT K W. AMT KW AMT. K W AMT. H P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECTT TIME CLOCKS BELL; UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT K W. OIL H P. GAS AP AMT. NO A.W G. AMT AMP, AMi AMPS. TRANS. AMT. H.P NO.OF FEET AMT WAii$ tt l 30 SERVICE DISCONNECT NO.OF S E R 'V I C E METER NO OF CG COND. A W.G A W.G A.WG I`I` AMT AMP' TYPE EQUIP. L$aw 1$3W 3$�W 3$4W PER$ OF CC GOND NO,OF H4LEG OF HIAEG NO..OF NEUTRALS OF NEUTRAL fyF 'i OTHER APPARATUS: Panels : 1-24 cir. 125amps--- Wrack ltg. 4 ' , 4 lites-- Harold H. Haupt-Southold Ele . Crittens Lane GENERALM R 5outhold,N.Y. 11971 lie. 792.E Per—, This certificate most not be altered in any manner; return to the office of the Board If Incorrect. Inspector$ may be identified by their credentla . 001101 FOR d- IL151NO AM'ARtWNT.NIS COPY OF CER�IfICA f� a' tJ T NOt it D I;N ANY MANNER. z THE NEW YORK BOARD OF FIRE UNDERWRITERS 1 AGN 3. 1(!/0 1 G)013 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NY 10038 Date ,TIJIX 22,1996 Application No.on file 1"090596/96 N 39i9O5 THIS CERTIFIES THAT only the electrical equipment"described below and introduced by the applicant named on the above application number in the premises of 11Rt 7IEDBIR.SUM, 1425 GUMi POND LANE, GREENPORT, Id.Y. in the following location; ❑ Basement ❑ Ist Fl. ❑ 2nd Fl. OUT .Section Block Lot was examined on ,JiILY 18,1,996 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES I RANGES COOKING DECKS I OVENS I DISHWASHERS EXHAUST FANS OUTLETS ECE►TACLES SWITCHES INCANDESCENT.FLUORESCENT OTHER AMT K.W. AMT. K.W AMT. K.W. pMT K.W. AMT. N.P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ISPECIAL R1C'PTJ TIME CLOCKS I UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. ' AMPS TRANS. AMT. H.P. SYSTEMS qMT. WAiiS NO.OF FEET SERVICE DISCONNECT No.OF S E R .V 1 C E AMT. ANP. TYPE METER I N]W 1$3W 3.e 3W 3,e'AW NO.OF CC COND. A W G. NO.OF H4lEG A W.G NO OF NEVTRglS AWG FOUIP. PERS OF CC.COND Of W.r OF NEUTRAL 1 1t� t C43 1 2 2/0 1 2110' OTHER APPARATUS: M 00ROSKI BLEC. INC. LTC.#2991E aur L L 425 MONSFLL TANE (mm-Hf.7GUt'', NY, 11935 GENERAL MANAGER • 11 r Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectqs may be,identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATES MST_,MOT, BE,ALTERED, IN ANY MANNER. 1TF1aD INSPECTION DATE COMMENTS FOUNDATION ( 1st) FOUNDATION ( 2nd ) O 2 . 1613/,FY Pr th,- p/-r o 1 ROUGH FRAME & �404i jAd SI n PLUMBING �y Twsv 1 .w A r, 3 . im H INSULATION PER N . Y . STATE ENERGY 11 07 C,0 D E a . FINAL -- o � ADDITIONAL COMMENTS . 4/77 ' Oz�� H H J •' x _ rs m ro 3 M-1802 BUILDING DEPT. f [ ] FOUNDATION 1ST t I ROUGH PLOD. [ ] FOUNDATION 2ND [INSULATION [ 7 FRAMING [ ] FINAL,, RKMARKS: i 4 4 I 4 5. i DATE 1 Z/ INSPECTOR 4 765-1802 BUILDING DEPT. INSPECTION ' [ I FOUNDATION IST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ I INSULATION [ ) FRAM [ I FINAL . REMARKS: k DATE . INSPECTOR z , •FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765.1802 Examined . . . . . ?Z/ 1. . . . . . . ., lI1 ` Received . . .7l : . Approved . /! . . . . . . . ., 1 Permit No. I,;,d?l. Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . r� (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . . . . .Uul.y J.4 . . . . . .. 19 . .$4 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector,with 3 sets of plans,accurate plot plan to scale. Fee according to schedule. b. Piot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. - d. Upon approval of this application,the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout 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 pursuant to 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, housinpi code, and regulations, and to admit authorized inspectors on premises and in building for necessar tions. (Signa`tugre of ali�yBnt, or n me if a corporation) ZA (Mailing address of applicant State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . I . . . . . . . . . . . . . I . . . I . . . . . . .Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . Norman •J., & Lee Wi edersum • . , , . . . . . • . . . . • . . . . : (as on the tax roll or latest deed) If applicant is a porporation, signature of duly authorized officer. (Name and title of corporate officer) *Items Below to be Completed at a La Date_ Builder's License No. . . .7d Plumber's License No. . . !!. . . .`!. . . . . . . .`f. . . . . . Electrician's License No. Other Trade's License No. j� 1. Location of land on which proposed work will be done. . . "r 411, •P4nd ,Lan@, ,Grp@npgrt: .New ,York , • , , . • . , J7 . .J!L 7 . . . . . . . . .GUI.[, .P.ONQ .LANE . . . . . . . . . . . . . . . . . . . . . .QRUNRORT. . . . . . . . . . . . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . . fI � �~ . . . . . Block . . . . .4 . . . . . . . . . . . . Lot . l. . . . . . . . . . Subdivision . . . . .FQrdbdm.AQre5 . . . . . . . . . . . . . . . . . . . Filed Map No. . ,3519 . . • . . . . . Lot .1.5 . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . Private Residence• , , , _ , • „ . . . . . . . . . . . . . . . . . . . • . , , • „ • „ • • • • . . . . . I . . . I . . . . . . . . . . . . .?C7Ya�e.Residence. ,��'� ,li��✓.�<llCl?,✓.C�:�. .". . . . . . . . . . . . . . . . . . IOII appacable): New Building . . . , ... . . . . Addition . . XX. , . , . . Alteration , . XX, , , , , . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . , . (Description) 4. Estimated Cost . AZQ,.QQQ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . .r . . . . . . . . . . . . . . . . . . , . . , . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . Ifgarage, number of cars .2-.Car. .Garage , . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . occupancy, specify nature and extent of each type of use . . .r1Q . . . . . . . . . . . . . . 7. Dimensions of existing structures . 6. If business commercial r mixed 'if any: Front ,.',; .,, :; . .fi1',-fi". , Rear i j.._ ;51,',-6"Depth Height . . of Stories . . .#. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . , . .. . . . Dimensions of same structure wrth!alterations or additions: Front .7.4'.-1•Q'; . . , , , , , , , Rear . . . .741.-.1011 ' ,4'.- . .': . . . . . . . Depth .55'•,6': . . . . . . . . . . . . . . ..Height . . . .1$'. fi': . . , . . . . . . . . . Number of Stories . . .1. . . . . . . . . . , . , , . . . . , 8. Dimensions of re new on: Front . . . . . . . . . . . . . Rear . . . . . . . . . . . . . , . Depth . . . . . . . . . . . . . . . 9. Sze of lot Fon... . . . . 5 Nu b1 r1uf Stories . . . . .1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Height � u ' . 7 Rear . . . . .102,23' . . . . . . . . . . Depth , . . ,219. . .Average . . . . 10, Date of Purchase , 5QPWOe , . , ,, AN! . . . . . . . . . Name of Former Owner Dr: Guy Ni,cosi•a 11. Zone or use district in which premise's are situated . . . . ,Residential 12. Does proposed construction violate any zoning law, ordinance or regulation: . .No . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . .No . . . . . , . . . '. . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes o 14. Name of Owner of premises Norman .d,. .&.dee .WiederrEmss . .197 .W l ,Pond ,Lan(Phone No. . A47 -.1099 , ,(5 6) Name of Architect .Norman .j. .Wiedersum. . . . . . . Address 1455 .ueGS .HWY.WdURR e No. . .582-5100 , , , •" Name of Contractor .94, MQd$Qq . .'; . . . . . . . . . . . . . . . Address 136 ,Frgnt ,St;Greenpq�,tone No. . ,477-0591 • , . . . I PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. J � 0 �___ itril�•� I � Vj i q1, 2 i GST�4 '3J ' io'` LdT'/te 2CAR Q STATE OF NEW YORK, S SvY3 / COUNTYOF .�.U�P.o . . . . . . `��✓ Ll�/ TVl • • • • • . . . . . .,. . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Heis the . . . . . . . . . . . .U.( /�tCrF�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) and is duly authorized to perform or have performed the said work and to make and file this application; that all statements 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. Sworn to before in this la. . /.dayof. . . .`�. . . . 4 ., 19tc f Notary Public, !/✓ i}�i�y� ��GG�Lf/ ?�c, County CIf t 1J I ( /MARK MATt" . . , . . . . . .Jr. .-Y l M'f�lRSUM NOTARY PUBIjIC, State of New York ' No.463929¢Quai, in Suffolk , a4 Fxi�lifpr Nnrch folk CoC 8'� �__.___.�____--_- ►�..L) . 1. 4 'i 11 . 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