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Home My WebLink About28475-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28614 Date: 07/24/02 THIS CERTIFIES that the building ALTERATIONS Location of Property: 65 COREY CREEK LA SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 78 Block 4 Lot 30 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 12, 2002 pursuant to which Building Permit No. 28475-Z dated JUNE 17, 2002 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 ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DAVID SIEGEL (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1055498 05/28/02 PLUMBERS CERTIFICATION DATED 05/28/02 MARK BURKE uth ized /Signature Rev. 1/81 FORM NO. 3 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) PERMIT NO. 28475 Z Date JUNE 17 , 2002 Permission is hereby granted to: DAVID SIEGEL 1382 STONY BROOK RD STONY BROOK,NY 11790 for . "AS BUILT" ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 65 COREY CREEK LA SOUTHOLD County Tax Map No. 473889 Section 078 Block 0004 Lot No. 030 pursuant to application dated JUNE 12 , 2002 and approved by the Building Inspector to expire on DECEMBER 17, 200 Fee $ 300 . 00 - Auth ri ed Signatu ORIGINAL Rev. 5/8/02 FormNo.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT --s—2 s-z 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$25.00, Additions to dwelling$25.00, Alterations to dwelling$25.00, Swimming 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- $25.00 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00 Date. /law Z /ff/j..t7, New Construction: Old or Pre-existing Building: i / (check one) Location of Property: C7 S C<Et r Ctet-high ' c�- - House No. Street Hamlet Owner or Owners of Property: �/�✓ice s/,y /1G Suffolk County Tax Map No 1000, Section G7e Block o 4 Lot 02o Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: o ei3.c r- p1 Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ -- -"-- �� Applicant Signature MW ,24 '02 VA 1:2C'PM SOUTHOLD BUIL Di NG 631 765 g-,O- P,1 i v*qf F04 i 61102 Town Hell,55095 Main Road P.Q. Box 1179 _ Faz(63 � 5.18 7elaphona(531 1 Southold.New York 1197I-0959 y�rjl � �aO� 802 BUILDING DEPARTMENT TOWN OF SOUTHOLD CE RTII3ICA'T i :, N Date:_ ZDO?i Building Permit No. Owner: V/D (please print) Plumber: Al (please print) I certify that the solder used in the water supply system contains less than 2/10 of I% lead. (Plumbers 8ignatuie) Sworn to befor me thim�� day of_ 20 U v NOTgR No BSC StaO oN QualN '0160602 e o New York 4 Terra Exeir is Suffolk Count Aires March 8, 2 Notary Public, County 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 SBUREAU OF ELECTRICITY 5 5 40 FULTON STREET — NEW YORK, NY 10038 5 55 5 CERTIFIES THAT S 5 Upon the application of upon premises owned by 5 5 DAVID SIEGEL SIEGEL DAVID S 5 65 COREY CREEK LANE 65 COREY CREEK LANE S 5 SOUTHOLD,NY 11971 SOUTHOLD, NY 11971 5 5 Located at 65 COREY CREEK LANE SOUTHOLD, NY 11971 5 5 Application Number: 1055498 Certificate Number: 1055498 5 5 5 SSection: Block: Lot: Building Permit: BDC: NS11 CS 5 Described as a Residential occupancy, wherein the premises electrical system consisting of 5 5 electrical devices and wiring, described below, located in/on the premises at: 5 5 First Floor,Outside, 5 5 5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was 5 5 found to be in compliance therewith on the 28th Day of May,2002. 5 5 Name OTY Rate Rating Circuit Tvoe reJ 5 Alarm and Emergency Equipment 5 �Sensor 1 0 Smoke C 5 Appliances and Accessories 5 5 Exhaust Fan 3 0 F.H.P. 5 5 Electric Heater Baseboard 1 0 .5 KW 5 5 Electric Heater Baseboard 1 0 .75 KW 5 5 Wiring and Devices 5 Cj Receptacle 7 0 General Purpose 5 5 Switch 7 0 General Purpose 5 5 Fixture 1 0 Incandescent 5 fj Lighting track 3 0 FT 5 Receptacle 2 0 GFCI rCj5 5 5 ME 5 seal 5 5 S C 1 of 1 ME 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 5 O ini_L �_ � JPjrJrP _PLLLj1-JrIWE.1��:111: iJr�Jr� Jr �rJrJ�rJrJcn�I�IrJrJrJ�rJ�rs�nrP�I�I�rrJrJrJ�IrJ�rJrJ�rJ�rJ�r��nr nil o Unauthorized adoration or addition to tFde survey is a viola• q tion of sect ion 7208 of the New York State Education L&%-,F. I;:,_ ///9/� y Copies of this survey map not bearing the land surveyor's inked seal or embossed seal shall riot be considered to be a J� G valid copy. Q _ 1,5�„ LCA is/o Guarantees or certifications indicated hereon shell run only / 5 to the person for whom the survey is prepared, and on his behalf to the title company,governmental agency and Ion- ding institution listed hereon, and to the assignees of the tending nstitution. Guarantees or certifications are not i ;ransfcrab!e to additional institulions or subsequent owners. I i i 1500 0o AV ,�.0� ..a •r 59 d,9� I �` � I I c, CID__ i Y\ .,f i Y° i. • �eJ m ♦a lir 6 - p Z LOT 1 0 1 2330,'' I i 0 NEty -- I SURVEY FOR P4�®ERT A YV0 REFFhENCE : DANIEL WEBLR y Q� add 9' MAP OF COREY CREEK ESTATES \�i * T BAYVIEW FILED AUG. 15, 1967 FILE NO.'4923 i A * � OWN OF SOUTHOL,D 1 w O u"U,aR..K7EEU T0: SUFFOLK COUNTY, N. 1. O `" ' �• CHICAGO TITLE INSURANCE COMPANY 0* IS 6 J� SOUTHOLD SAVINGS BANK SCALE I" = 40 lANO6 ' S , 2[s�1 DANIEL WEBER FEB. 311972 Ft B. 25, /58.' MAY 182 1972 JULY (B11972 LAND SURVEYOR SEPT. 1811972 N.Y.° LIC.HO.28725 RIVERHEAD, M-Y. BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: 6 /02 APPLICANT: �L 6�t 1,6 v y DATE SUBMITTED:-? h L /02 SCTM#DISTRICT: 1,000, SECTION: 26 BLOCK: � LOT: lo A/ STREET ADDRESS: (S CQ -,, CCU I CITY: y�g�,��o�� SUBDIVISION: y� I-p" j PROJECT DESCRIPTION: NQ; /1.J1p y� „, ' i ESTIMATED PROJECT COST: ARCHITECTS-� Lir i ,u FAST TRACK? �K D SINGLE & SEPARATE CERTIFICATION-REQUIRED? MO NOTES: COTS 40,000SF-100-24.Lot recognition.(CREATED before June 30, 1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/83 ZONING DISTRICT: f -qJ CONFORMING? A REQ. LOT SIZE: W,000 ACT. LOT SIZE: 21 REQ. LOT COV. 0 Wo ACT. LOT COV. REQ. FRONT�0 PROP. FRONT REQ SIDE ACT. SIDE REQ- REAR_ IZ PROP. REAR / REQ. EIGHT PROP. HEIGHT WATERFRONT? /(/4 DESCRIPTION: PANEL #: _Ag�K FLOOD ZONE:------ "� APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES oro, (BED #): DTE:_/_/_ PERMIT#:R10- TOWN SEPTIC RECEIPT: Y ol® NEW YORK STATE DEC: PRE-DEC 9iv75 YESor SOUTHOLD TOWN TRUSTEES: YES or TOWN ZONING BOARD APPROVAL: YES or TOWN PLAN. BOARD APPROVAL: YES or gQ TOWN HISTORICAL PRE (SPLIA): YES or IV NYS ENERGY: YES OR NO EGRESS (18 H min.? 4 sq total) VENT(SQ. FT. x 4%) LIGHT (SQ. FT. x 8%) BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z- , HAVE PRE CO'S : Y OR N BP -Z/C/0 Z- NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF INIT OTHER TOTAL TOTAL: z ” SF FEE E --- 1. ( SF)- (_SF)= SFX $ _$ +$ S +$ 2. ( SF)- ( SF)= SFX$ =$-+$-+$-= $ N1208IERT O'BRIEN _ P.E CONSULTING E NGINEERING SERVIC 2074 MAIN ROAD, P.O_ BOX 456, LAUREL, NY948 631-298-52! June 27, 2002 Town of Southold Building Department Town Hall Southold, New York 11971 Attention: Gary Fish Re: Siegel Residence 65 Corey Creek Lane, Southold, NY 11971 SCTM No. 1000-078-04-030 Dear Gary: Please note that an energy calculation was not submitted for the above- captioned pool cabana conversion drawings. The use of the structure is only intended for the summer months and will not be heated or air-conditioned. The Supplylines the bathroom toilet and sinks will be drained prior to winter and blown out. The waste traps will be filled with non-toxic anti-freeze. for If you have any questions regarding the above, please feel free to contact me. Very truly yours, Robert O'Brien P. E. COMPLAINT REPORT i 1RR�o z NAME DATE ADDRESS %7,00 Co z Cy C,?C�x 1„1/ Sou PHONE# C..3/- HOW RECEIVED, TEL MAIL IN PERSON LOCATION OF COMPLAINT NATURE OF COMPLAINT 114 �� t��✓ �� i•� �. ASSIGNED TO INSP. DATE REMARKS ® ` f ACTION TAKEN FILE # (IF APPLICABLE) RE-INSP DATE M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 LATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY 00, REMARKS: DATE 0 � INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ) FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ) �INUTION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR FIELD INSPECTION REPORT DATE COAMENTS �c FOUNDATION (IST) H a ------------------- O FOUNDATION(2ND) any �s rk � z 0 o- rk ROUGH FRAMING& , y PLUMBING c� } INSULATION PER N.Y. y STATE ENERGY CODE 04 AAo.941 6-r FINAL rAfl Jtoe el�;2!= ADDITIONAL eOMMENTS O z m H G p z . x Lx d TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following, before applying: TOWN HALL Board of Health SOUTHOLD, NY 1971 3 sets of Building Plans TEL: 765-1802 Survey PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees Examined 20 Contact: Mail to: Robert O'Brien P. E. Approved 20 Main Rd P O Box 456 Laurel,NY 11948 Disapproved a/c Phone:-298-5252 Building Inspector ? APPLICATION FOR BUILDING PERMIT ,c:.' Date June 6, 12002 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspection with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. 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 a 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 what-so-ever until a Certificate of Occupancy is issued 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, ad 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 remises and in building for necessary inspections. Signature of applicant or name, if a corporation) 2074 Main Road, P. O. Box 456 Laurel, New York 11948 (Mailing address of app rcant State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Engineer Name of owner of premises David Siegel (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: 65 Corey Creek Lane Southold NY 11971 House Number Street Hamlet County Tax Map No. 1000 Section 078 Block 04 Lot 030 Subdivision Filed Map No. Lot - (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Residential b. Intended use and occupancy Residential 3. Nature of work (check which applicable): New Building Addition Alteration X Repair Removal Demolition Other Work (Description) 4. Estimated Cost $3.000.00 Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units 1 Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type use. 7. Dimensions of existing structures, if any: Front 58' Rear 58' Depth 24' Height 24' Number of Stories 2 Dimensions of same structure with alterations or additions: Front Same Rear Same Depth Same Height Same Number of Stories Same 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front 110' Rear 110' Depth 133, 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: no 13. Will lot be re-graded no Will excess fill be removed from premises: YES NO 14. Names of Owner of premises David Siegel Address 65 Corey Creek Lane Phone No. 765-6822 Name of A..�et Engineer: Robert O'Brien P.E. Address 2074 Main Road Phone No. 98-5 Name of Contractor Address Phone No. 15. Is this property within 100 feet of a tidal wetland? *YES NO X • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ) RnhPrt O'RriPn P F being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the Engineer (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 statements contained in this application are rue 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 me this <ot*, day of 20 0 �— r NRWA CARLINO Signature of Applicant Notary Public, State of Newyallt No. O1 CA6018746 Qualified in Suffolk Cowdy Commission Expires January is,20.Q,L + t '-1- - i ' It III��111 i 5r ttR"CER f° N o , PLUMBING ON LE'A CONTE' r�R PLUMBINa CERTIFICATE OF O CUPAN - -- -- l� '=- - �:' i — -- -- -- -- q - -- --- -• _ LMS N - --O a- SYSTEM NNtT Altfit S �A10#t�' '�/�. XCE . _ _ % LEAD. rod' aL I0 of l �y _ O'L.6�IS N _ VICES AS TO PART:9 N.Y. STATE BUI, DING CODE. ! ,� li If copper tubing is us 1 J P OVED AS NOTED for water distributin DA 6 l y z B R& L&�--- `� Aping shall I - ---- ---- i -- _ ---- - - --- - -- -- ;----gam : -_-- - --- T--- 1 ,-fi---- f tYp S K or L onl- ----- � T - - \- - i- - mac, --- s✓. I---- -- ,�« IOTE BUI LDING D AR MENT AT --- \a o ? ! �` UNDERWRITERS CERTI E 765-1802 AM TO 4 PM,FOR THE FOLLOWIN INSPECTIONS: 1. FOUND TION - TWO F�EQUIRED I 3 -1 TIEICA FOR POU ED CONCRETE 2—RpUGH -FRAMING&�LUMBIN.G-- f a INSULATION } -- TR N MUST. AL , CONFORC.Q. 4 FIN { F. .wrtcs I ALL CON TR TION SH LL MEET THE REQ IREM' $ Ol�THE N.Y.STATE C i UCTI ENERGY I -- CODES. OT RESPONSIN.E FOR USE IS UN URN DESIGN CQNSTRUCTI N om: f E . . . . . . �ITHOUT CE TIFICAT Ni t o f � 1 E d OF QCCU ANCY a I 4 4,,9t;_,� t.-Z— Ti BRIEN P.E. * CONSULTING ENGINEERING SERVICES Main Road, Laurel. N.Y. 11948 z f t7 -2. . ^ /x01.4 a — � 7 - G 4 -0—rd ti CLa Sa/' -firfN'LriC Gr�'� sus'1 7�,, ° 2OWN c.cFalc ,Sa✓rEydc D /✓ . ry t r A N F�$SIO - SCALE �� DRAWING NO. SHEET _-1 - -'-'-_.-- •-T-:--. - DATE --