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Home My WebLink About12004-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CerlJlricate Of Occupancy Z-15519 December 18, 86 No .................. Date ................................,19... One famxly dwelling wxth deck addzt~o , THIS CERTIFIES that the building . .a.c.c. qs.s.o.r~ .Ka.r.a.~q,..i.n. Kr.o.u.n.d..p.o.o.1..&..f&n.c.e..e.n.c.l.o~;ur e 4790 Main Bayview Road. 8outhold, New York Location of Property House NO. 078 04 Street 030 Hemle~ County Tax Map No. I00O Section ............ B|ock ............... Lot ................. M/o Corey Creek Estates 4923 ]6 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 Building Permit No dated ............................ 19..., was issued~ and conforms to aH of the requirements of the applicable provisions of tim law. The occupancy for which this certificate is issued ig ......... · .One family dwelling with dorm.e.r., d.eck, addition, accessory garage, inground pool 2' 'f3h'c'e' ~hE~tb~h%:h'. .............................................. ' ......... DANIEL & HELEN WEBER The certificate is issued to ..................... ................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO...N.5.4.1.3.7..(.h.o.u.s.e.).,. 591285 (accessory 'garage ) 591285 (pool) Building Inspector *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 n~.l/8l issued March 12, 1982 - Accessory garage. - Permit #12004Z - dated October 26, 1982, issued Nov. 5, 1982 - Inground pool & fence enclosure, - Permit 15266Z dated September 15, 1986, issued September 16, 1986 - deck addition N°. ~800~, 7. Permission is hereby granted to: Foz~t ~o. o TOWN OF s~ou.m~, · ~ BUILDING DEPARTMENT TOWN HALL SOUTHObD, N. ~, ~HIS PE~IT MUST BE KEPT ON THE PR~IS~S UNTIL ~ULL C~PL~ION OF THE WORK AUTHORIZED) , ~', of premises ,located at .L ¢%~ To~ Mop Uo. lO00 S~,o~ ......O-.Z~.... Bi~ .~...~.~. ..... !Lo~ No. ;,~.~. ......... Building ~qspector, F:ee $...f.. ,~ .... pERMiT NCLUDES APPROVAL TO REN~oVE EXCESS FiLL ABOVE PREMISES BU REGP, ADiNG ;LO C~S~bQL ~(~F~S, RUCTION C~LL~E CoBSTEUCTION FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.~]J.~9 .......... Date .... ~Ia~c.~h. 7..q,9 ,~5 ............... 19... THIS CERTIFIES that the building .&.~ce.gs~r~. .................................... Location of Property...~,79..0, .~.~..i.~..B.~..~..5;e.~....Rd... ............. ¢.o.~.~.h.. ,o.e.d.:..~...Y... ..... House No. Street Hamlet County Tax Map No. 1000 Section 075 . .Block 0/4 .Lot 030 Subdivision.. ~or~. Or.e. ek. E~.~;a~. ....... Filed Map No. /+92,~....Lot No ...... .q.6 ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated October 26 19~..~. pursuant to which Building Permit No. . J 2.0.Qq'~. dated . N.o.~.emb.em. 5 ............... 19~2., 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 ......... For an inground pool & £ence enclosure The certificate is issued to ... Dan±cZ .~.. & .Heleax .Weber? ............................ (owner, lessee or tenant} of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO .... Building Inspector Rev, 1/81 CHICAGO TITLE INSURANCE COMPANY Gentlemen: Copy of Certificate of Occupancy Incorporated Village of: Survey Attached. Chain of Title: 00802746 12/27/85 $3,00 %PPROVAL REQUESTOR sal 8813/74 ~3.00 FORM NO. · TOWN OF 80UTHOLD Building Daparzmenz Town Hall Sou:hold,"" AP ~.,C~-,T O,, FOR C,.R~ I, iC~TE Or OCCUPANCY Instructions This application must be filled in typewriter OR ink, and subn~itted in duplicate to the Building Insp: tot with t~,e following; for new bui!dings or new use: 1. Final sub/e,,' of property with accurate location of all bulJd[ngs, property lines, streets, and unus~. 2. Final aoprova or H~,th Dap,. of water supply and sewerage dispose -(S-9 form or equal). 3. Approval of e!ectricel installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and simiiar buildings and instal tions, a certificate of Code com. piiance from the Architect or Engineer responsible for the buitdin 5. Submit Planning Board approve of compla~ad site ptan requirements where appdcable. Fcr existing buildings (prior to April ~957), Non-conforming uses, or buildines a~d "pre-existing land uses: 1. Accurate ~n~ey of peopert¥ showing all prooerty lines, streets, buildings and unusual natural c topographic features, 2. Sworn statement of owner or previous owner as to usa, occupanc,/ and condition of buildings. ,3. Dat. e of any hous..,g code or safety inspection of buitdincs or premises, or other pertinan~ inform~ :ion required to prepare a ce~ificate. ../ 1. Certificate of occupancy $5.00 2. Cartdicate of occupanc,/on pre-existing dwelling or land use S5.00 3. Ccoy of cerdfic:te of occupenc,t $1 ~ ~]"' Date t) .9..~ ..... New ~a~-ng '~ ...... Old or Pre-existing ,'" (' ' ..... Buliclng~,,:) ........ : ~Vacant Land ............. Owner or Owners of Property ~ /. ~~ ' ' ....................... Lot Health Dept. Approval ........................ Labor Dept. Approval ........ .............. "' Undee,vriters Approval ............... ' .......... Planning Board Approval Request for Temporary Cerdficet · e .................... Final C~rtificate ................. Fee Submk~ed S ~ ~ above described buildi¢~q and perm *'~ ..... *~u¢.'-h~ COMMENTS FIELD I~SPEC~ION ~ 1. FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY FINAL ADDITIONAL COMMENTS: i iw LOT i 1' 8adRVE}' ~r~Ft . · :~NIEL. :WE'BIZR FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 E×amined ..A&~....O:-.. .... 1..~-? Approved , .~..o..~.,,, .~. ..... 1 ,9~.. Permit No/.~.QO ~'.~ ApplicationNo.~..~..(~..~-~ ....... Disapproved a/c ..... % ~ _ ....... :: ~,~.. r) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This apphcation 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. Plot 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, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. _ . .. .............. (Signature of applicant, or name, if a corporation) · 5.h~ k....~..4 .~.~.<....%.~.~..~... ~ ,..%~..~,. ~. ,' (Mailing address of appl~ant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... .c.,?~~ .............................................................................. Name of owner of premises ~..~.[Y-.'~....~.,....kC3..*': .Y?~...a,~. .................................................. (as on the tax roll or latest deed) If appli~!ignature of..duly authorized officer. ~ame and'fl~x~ corporate officer) '' Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... PERMIT INCLUDES APPROVAL TO REMOVE EXCE'~S FILL FROM ABOVE PREMISES BY REGRADING LC,T t.,,/ DR~VEW/~Y .tON' TRUCTION CD-$PC, OL CL~NS~ RUCTION CELLAR CONSTRUCTION ~ OTHER 1. Location of land on which proposed work will be done .................................................. ~t;~;; ~,I'u;l~;r ~'~F(~' ;~/:j'~;7~.' ..................... I~n'l;; ....................... County Tax Map No. 1000 Section .~....O..T?.~. Block ....0. ~ .......... Lot....t~....~...~.Q ..... Subdivision .~.~.?r.x(. ~Ju~.¥L, ~.,~,o,~-~,.;_s, Filed Map No. O~,~ Lot \ (o ......... dq'ahi;) ............................................. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ----~-, -~~,, ~\ b. Intended use and occupancy . ..'~..~.~t~.. ~.'Y. ........................................................ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved . .~..o..~.....,~-. ..... 1 .9~.. Permit No/.~.O. O~.~ Application No. ~..~..(~...'~ ....... Disapproved a/c ........ ~ ......... ,, .......... / APPLICATION FOR BUILDING PERMIT Date...~.9./..~...~. ..... , INSTRUCTIONS a. Tins 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. Plot 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, housing code, and regulations, and to admit auth°rized inspect°rs °n premises and in building f°r necesT. '.m.sp. ~s.'.~vN~t~ ~o C._~,,~..~.' ........................ (Signature of applicant, or name, if a corporation) . .s..h~ 5....~..,~ .~Y~...~. ~...~.. ~,...~. ~..~. ~. (Mailing address of apph~cant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ~.~~~ .............................................................................. Name of owner of premises ~..~.~.%~....~.,.....k~...~...a~ .................................................. (as on the tax roll or late&t deed) '~q[Name and'tt~,~ of corporate officer) ' · 0 Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... PERMIT INCLUDES APPROVAL TO REMOVE EXCE~Jt~ FILL FROM ABOVE PREMISES BY REGRADING LOT v DRIVEWAY CON, TRUCTION CESSPOOL CONS, RUCTION CELLAR CONSTRUCTION 1. Location of land on which proposed work will be done .................................................. ~;;;; ~;;; ~'~;' ~¢~/~-'~7 '~' ..................... ih~;;i ....................... County Tax Map No. lO00 Section .~...~. Block...q~ .......... Lot...~.9.~0 ..... Subdivision ~... ~.. ~>~ ........ FRed Map No. ~ ........ Lot..~ ........... (Nme) 2. State:exis~g use and ~cup~cy ~f prem~es and intended use and ~ccup~cy ~f pmp~d constm~ti~n: b Intended u~ ~d occup~cy ~q~ 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .... , ...... Repair .............. Removal .............. Demolition .......... Other Work . ~? ...... 4. Estimated Cost .................................... Fee ................................. ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units - '-----'~ Number of dwelling units on each floor. 7.;. If ga b f rage, nnm er o cars .% .. ;: ................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . ~.~- ............. 7. Dimensions of existing structures, if any: Front -------'--- Rear. .-~=..~:.~-:... Depth ~ . Height ..... ~;. 7C"2'~ .... Number of Stories ......... : ............................................... Dimensions of same structure with alterations or additions: Front ........ ~-~,,-77-'.., ,., Rear , .... ~.,-': ......... Depth ~ Height ~-- Number of Stories 8. Dimensions of entire new construction: Front .... . .... .......... Height .... .~.-:-. ....... Nu~m,ber of Stories .................... ' ....... ' .......... ~' .................. 9. Szeof.lot Front ..~.~.?..5 .... ' ........... Rear ...11.O...~-. ............ Depth [~..~.%..?.? .............. 10. Date of Purchase .tO/)~&[. ~..Z~..: .................. Name o,f Former Owner ............................. 1 1. Zone or use district in which premises are situated..~.t. ~.i.~.,v..~. ~ ................................ 12, Does proposed construction violate any zoning law, ordinance or regulation: . .~.eb. ............................ 13. Will lot be regraded ...~.o. ...... , ................. Will excess fill be removed from premises: /Y'7'~e~' No 14. Name of Owner of premises .~..~.o.x.-~¢...%~.~.. Address .~.%...~.~..~. ~ .C..~...%,. Phone No. '?6.%. 7 .'~.x.~.~> ...... Name of Architect .......... : ................. Address .................. Phone No ................ Name of Contractor ~.~g..v:~...q~. ?..r~..~...~.....~..~.,. Address . .~?( .~. ?. :~.4 .~.%.~.~. ~Phone No. ~.? ~?.c/.c[.~.~,~.... PLOT DIAGRAM Locate clearly and distinctly all ibuildings, 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. STATE OF NEW YORK, ~ S COUNTY;~OF .... .~~ ...... .~..!! ~.~' '-' .~.....'~..~.T[../.al..G).. being duly sworn, deposes and says that he is the applicant xx (Name'~,o~,individual signing contract) above nam~l. , He is the ................................................................... (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 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 me this ........................ day of: ................. . . . Notary Publi ~L .~. ~ .~.. ~. ~ .~ ........ ~mty ! NOTARY PUBLIC, State of New York . Ne. 52.4524771 ........... ~ommisslon Expires March