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Home My WebLink About6350-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-30114 Date MARCH 31, 2004 THIS CERTIFIES that the building. DWELLING Location of Property 600 COREY CREEK I_ANE SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 78 Block 4 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 26, 1973 pursuant to which Building Permit No. 6350-Z dated JANUARY 26, 1973 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 A1-FACHED GARAGE * The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A CYNTHIA B. SCHMIDT ROBERT VILLA - 6/6/1973 N-090560 - 5/16/1973 *NOTE: THIS UPDATES CO Z-5184 DATED JUNE 6, 1973. Rev. 1/81 I~OB, M NO. t TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEIZl' ON THE PJ~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 6350 Z Date .................... ::~T~.....2~ ................. , 19~,~... Permission is hereby granted to: ....... .~.~...~.~. ~,~ ..~ .. & .o.a..:l;.n.¢. ....... '. .................. t m,4~d new one family dwelling' 0 ..~.~ .~ .................................................................................................................................................. pursuant to application dated ........................... ~.~0, ....... ~.~ ......... , 19.~,~.., and approved by the Building Inspector. Fee $.~..q .~.. ........... I - ,:.Y CON TRUCTI,,~,"4 -- ~ j ¢;,*~;SPC:;~:L CONS,RUCTION ~ J C~LLA~, CONSTRUC'I'ION FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at ...(Jorey .~l'e.ek. DI~ ........ Street Map No..O.O.r. Oy. ~k .]~lleck No ........... Lot No...8... ~..O~..t.h~)!d.. N.~Y~ .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ Jail...26 ..... , 19.73. pursuant to which Building Permit No.6~0Z... dated ....................... J~ 26 , 19. ?.~. , 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~.!?.~..t,o...~A~... The certificate is issued to .E~,. Tobit. & .8ohm..XI~c ........ .0~r ................ of the aforesaid building. Suffolk County Department of Health Approval (owner, lessee or tenant) .... · Iune..6,. 19.73.. b3~ .It,. ~illa. UNDERWRITERS CERTIFICATE No ..... 11.09.0 60 .... }lay..16...1973 ................. HOUSE NUMBER .... ~,O~ ..... Street... ~.O~..(~F~k .DF ............................. Building Inspector Form No. 6 TOWN OF SOUTHOLD 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: 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 buildii3g, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect ~ engineer responsible for the building. 6. Submit PImming Board Approval of Completed site plan requirements. Bo For existing buildings (pri~'r 'to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all propeEty 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. Co 3. 4. 5. New Construction: Location of Property: Owner or Owners of Property: Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelliug $25.00, Alterations to dwelling $25.00, Swirmning pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. Certificate of Occupancy on Pre-existing Building - $100.00 Copy of Certificate of Occupancy - $.25 Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Old or Pre-existing Building: ~ (check one) House No. t Street Ha~et 7~ Block ~ Lot Suffolk County Tax Map No I000, Section SubdivisioyL, .. ,, ff. Health Dept. Approval: Pla~ming Board Approval: Filed Map. Lot: Date of Permit. /~/~! , /73 Applicant: Underwriters Approval: Request for: Temporary Certificate Final Certificate: Fee Submitted: $ /~,){')~ ~5)~ (check one) Applicant Signature FORM NO. 6 TOWN OF SOUTHOLD Building Delm~tment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspector 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 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 $5.00 3. Copy of certificate of occupancy $1.00 New Building ..... .~ .......... Old or Pre-existing Building ............................ Vacant Land ............................ Health Dept. Approval ....~..J..~../..~.,~. .................... Labor Dept. Approval ................................................ Underwriters Approval J~...~..?~...C~.~.~..~,. .............. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ....~ ......................... Construction on above described building ond/~.~rmit mee~ all app.~icable codes and regulations. Sworn to before me this TERRI LEE El,AK NOTARY PUdLiC, State of New York ~mission Expires ¢~arch 3~, ~ (stamp or seal) SUFFOLK COUNTY DEPARTHENT OF HEALTH APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEH 1. Applicant z~ 2. Property location ~:~'4 ~/ (.,~ 66~ Village ~ Township ~, ,~./ 3. Public Water Company name 4. Lot size: Width /~':r~ feet Length ~¢g~ feet 10. Sewage Disposal~ystem: B. ~.L~aching pools: Number ~--Precast/¢OBlock Special 6. Section I 7. Lot No. ~ 8. Private well 9. Public water Distance to main (Enter on center plot below) The undersigned be in accordance aras thereto." If private well fill in blanks below: Tank capacity ~Gals. Pump G.P.M. _~ Total well depth Depth to G.W. Amount of water in well Test Hole Date Data Feet 0 2 4 6 8 10 12 14 16 18 CERTIFIES: "Construction of authorized installations will with the Suffolk County Department of Health's current stand- Owner or Builder FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the 'Health Department, that an Disposal System can be installed on this plot. Date /~3 Signed adequate and satisfactory Sewage S-15 Revised 4/1/72 The sewage disposal and ~,~a.. facili%ies for this location ~:~ve been inspected by this department and found %o be satisfactor~~ ~. Chief of Gener~,l Engineering /_o-/ 7 40T P,~.APJNG TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ........... , ,,., ...... ........................................ , ................. .~:¥:¥~ Di~r~ o/c~~~, ........................................................................................... INSTRUCTIONS a. This application must be completely filled in by t?pewriter or in ink and submitted in triplicate to the Building Inspector, wit~ 3 sets of plans, accurate plot plan to scale. Fee acc6rding 'co schedule. \ b. Plot plan showing location of loc and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of properS/ must be drawn on diagram which is part of this application. 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 issue a Building Permit to the applicant. Such permit,shall be kept o 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 granted by the Building Inspector. APPLICATION tS HEREBY MADE to the Building Department for the issuance of a Building Permit, pursuant to the Building Zone Ordinance of the Town of Southold, Suffotk 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, and to admit authorized inspectors on premises and in buildings for necessary inspections. ............ (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · ............... ~.~.:~.~..~ ........ :.., ........................................................................................................................................ Name of owner of premises ........... ~...~......,~...~.. ................................................................................................................. {Name and title of corporate officer) Su,der'= Ucense No ..... ~Z..-Z./.~/....~..~.~.~..~ ......... Plumber's License No ......................................................... Electrician's License No ..................................................... Other Trade's license No ................................................... ~. ~o~t~on o~ ~and on which propo~d wot. Street and Number .CI~..~.I~..~.......~..~.~'~.......~...~...~....~.. ....... ~..~.....6{....~....~.......~.,~... ............ .~ ~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................................................................................................................................... ? 5~'~/ ......... .......................... ~/. ....... ~..~.~..~. .................................................... ~. ....... b. Intended use end occul~ancy Nature of work (check which applicable): New Building ....................... Addition ..................... Alteration ............... Repair ......................... Removal ........... Demolition ........................ Other Work .................................... .............. (Description) 4. Estimated Cost .............................................. Fee ................................................................................................. (to be paid on filing this application) / n each floor 5. If dwelling, number of dwelling units "'7 ........... Number of dwelling units o ......................................... If garage, number of cars ............................................................................................................................................ 6. If business, commercial or mixed occuoancy, speci~d exten~l~ac~ of use ...... ~llllll~....~llr ...... 7. Dimensions ~ll~l~ing structures, if any: Front ...~.~. ........ ~.~. Rear '"~r .................. Depth ............. .~ ...... ~ ........ Height ............................................. Number of Stories .......... ~ .................... ~ Dimensions of same structure with alterations or additions: Front .......................... Rear ......................................... Depth ......... He ght . . N of Stor es ............... ............................... 8. Dimensions of ~r)_tir~ new construction: Front ......................... R~ear ............................ Depth ................................. Height ...................... '~ ')'~1"~,~' ............... Number of St/o~;i~:~ ............................................ ~_.~:~.~,. ............................... 9. Size of lot: Front ...)~7.~; ..................... Rear .......................................... Depth .................................................. 10. Date of Purchase ..................................... Name of Former Owner .................................................................. 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................................................ 13. Will lot be regraded .............................. Will excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premises ....................................................................................................................................... (Address) (Phone No.) Name of Architect ....~ ........... .~......~ ................... ~,.~....7...~/......-.~.~]..;~-,..~..~;~.~...;~.-.-.-)~.~.~.~ ..i~-Z~-~.._..-Z... Name of Contractor ................................................................................................................................................... (Address) (Phone No.) 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 wheth- er interior or corner lot. (~ame o[ in~ti.id~al ~i~Jng contract) He is the ....................................................................................................................................................................................................... ~Contractor, agent, corporate o~'fieer, etc.} of said owner or owners, and is duly authorized to ~rform or heve ~rformed the said work and to make and file this a~li~tion; that all statements contained in this application are true to the best of his k~kgE~edge and belief; and that the work will be performed in the manner set forth in the application filed therewith. JUDITH T. ~O · ' -0344963 k ~ount/ · N°tary Public~"~ '~C°unW ~~'~'~';~ ................................... DESIGN .~1190 Q HOME PLANNERS, INC., DETROIT 44'-5" I LIVING I_IVING 190 x 154 DINING F~VlII-Y 114x II4 BATH VANITY ENTRY BED RM, 10Ox 90 MASTER BED RM, I1~ x 15,4 lIED RM, 13Gx I0o GARAGE 15e x 254 n ers,. in.c. 16310 GRAND RIVER AVENUE DETROIT ,~ MICHIGAN 48227 ][¸ iL4VA 7ION 3: (' ll 1 I£ L C L.£:T . SIP& QUANTITY &' MATERIAL , CEILli&~N I UNIT MEA~. (TYPE a~l/er SIZE) Nasonry~_Block / ~ ,~ PCS. Unit Concrete Slabs Lb~E~R 11 Cu. Yds. 11 Wall Lin. Ft. Ft. 2 Roof Pos, Lin. Ft. Ft. 21 Units 2100 Ft. Lin. Ft. 2 Corner Masonry_Blocks 0 ~SO~ ~and Foundation Costing FonndationVents Brick ~and Mortar Metal Wall Ties ;I-8" Steel Lintel Nelded Wire Reinforein Fill Gravel Ce~nt lfardner M~mbrane Desi_f~!Stress of 18' - O"F__loor Beam 10' - O" " 2 x t Trin~er~ 2 x - O" Floor Joist Plates 2 x 12 x 161 - O" Reinforced with one Steel Flare - Oara~_Roo£ Beam x 10* - O'Header 2 x 10 x 1 ~ - 0" He der 8 x 10' O" Header UNIT COST cted 42 44 Lin. 63 10~ - 0" Studs 62 - O" Studs s3 Plates 64 - O" j~b Facln[ Pc. x 10" Head C. asin[ Pc. x~Crom UNIT~ COST s 7 42 43 Floor & Cetli~ Ins~lation I/allboard Holdtite ~__~ll Nails Ft. Metal D_!~ll Cornerbe~d TILEWONI~ Tile er Holders Towel Ber___k Kitchen & FRail 6 x 16t - OW Cellini Joist 67 6 x log 0# Rafters 2§! Roof ~eathlng INTERIOR TRI~I ' Floor 290 1100 53 SS 1 Pc ~ I Pc ~7 58 Finish ~L~rd~are Ft. Co~nice O_verhmn~ Soffit FloorinO oor Tile Felt Lbs. Nails 1 Front 63 Sheet Me~ & Mold Interior Doors 2-Panel Colonial Overhead~oor Double Wide 2 Inte~rior x Flush Inte~i~ . Interio x id Wood 9O 92 93 Interior . . . . with Door ~s 2 Sets I Sot UNiT 2 2 Sides POS. i Bese 1 Pc PC I Pc Pc Base Base Rase Lin. Ft. 64 66 67 71 74 75 77 87 93 Pint LbS. LbS. Lbs. Lbs. 2 Lbs. x 32" x 21" Lavato~Cabinet ;2" x 21" " " ~0 x 21" Plastic x 21" " # x 72" ~ Ca~'tnet ____ Me 1 n P Lock Set x 12" 2-Shelf . Cbs in Door Flush Pull Lock Sets l~tte Door C~lide Trick 8d " " ~lum. Sinker ~ Nails 10" Joist An les MATERIAL LIST HOME PLANNERS, 1NC. PLAN No. 16310 GRAND R{VER AVE, · DETROIT 27, MICHIGAN ';4 .il¸ 6:0" $:/%/ /d.i,.e8,, \ b'd' 4:o'' ':,'HOME PLANNERSi: ANC. .L~.o..., 15310 GRAND .RIVER 'AVE, ,~ DETROIT 27, MIDHI~AN - ' ~.~ R:. -OEa~ , . ' '