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Home My WebLink About11051-zFORM NO. ~, TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED Certificate O[ Occupancy No Z-155~9 Date December 18,. . . 19 8..6 One family dwellin~ with deck addition, THIS CERTIFIES that the building . .a.c.c.e.s.s. qr.y. ~a.r.a.F~e.,' .x.n.&r.o.u.n.d..ppp.1..&..f.e.nF.e' .e.n.c.l.o.s..~re 4790 Main Bayview Road, Southold, New York Location of Property · House No. 04 Street 030 Ham/er · 078 County Tax ~ap No. I000 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 fded in this office dated *SEE BELOW 19 pursuant to which Building Permit No dated ............................ 19..., was issued~ and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which fids certificate is issued iS ......... One family dwelling with dormer, deck addition, accessory garage, inground pool DANIEL & HELEN WEBER The certificate is issued to · ..................... idv;do;,'t, YdF Y,19X .................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N54137 (house), 59~285 (accessory .g.a.r.a.g.e? UNDERWRITERS CERTIFICATE NO ........................................... 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 #II051Z - dated March 3, 1982 R~.I/O1 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 TOWI~i oF~ $OUTHOL~~ BUILDING-~DEPARTMENT TOWN HALL · $OUTHOLD, N~Y. BUIL~DiNG F, EII~I~ ~ r (THIS PERMIT MUST BE KEPT ON TR,E' PI~EMIsES UNTILiFULL COMPLETION OF THE WORK AUTHORIZED)~ N°. 11051 PermissiOn is hereby granted to: ........ ................ ,. ~ '~'.,:.~.~ ..4.' -<~:~<:~ ~o ..... :~.qZ~. ....... ~.~.~. ...... ~ ........................................... .~,~.~..5~z~ ~~....~.~Z~...~. ......... J~.~ ......................... pursuant ~to ~pplicotion d~ted ..~m.C~...~ ........... }....~......, 19~., ~nd :~pprov~ bv the BuilidSng Inspector. FORM NO. Building Depar~men~ Town Hall AP ~.,C~,~ ,ON FOR CERTIFICATE OF OCCUPANCY lnstru ct}one ' · This apolicat[on must be filled in typewriter OR ink, and subr~itted in duplicate to the Building Insp~ tor ,.rich the following; for new bui!dings or new use: 1. Final sun/e'/ of property with accurate Ioca[ion of all buildines, properzy lines, streets, and unusL 2. Fins* approve of Health Dept. of water suooty and sewerage disposal--(S-9 form or equal). 3. ACpro,/ai of electrical installation from go~d of Fire Unden~vriters. 4. Commercial buildings, Industrial uudmgs, Multiple Residences and similar building~ and instal' tions, a certificate of Coda compliance from the Architect or ~ng,n~.r responsible for the nu,om 5. Submi[ Planning Board approve of completed site plan requirementswheraappticabte, Fcr existing buildings (prior to April 1957), Non-conforming uses, or buildinas land uses: ~ p ~..~stm~ 1. Accurate ~zey of peoperty showing all prooerty lines, ~reets, buildings and unusual natural c topographic features. ' 2. Sworn s~atement of owner or previous ovvner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildincs,or premises, or other pertinent inform: tion required to prepare a ce~ifica~e. / 1. Certificate of occupancy S5.00 2. Car~dica~e of occupancy on pre-existing dwelling or Iand use $5.00 3. Copy of certificate of occupancy Date .. Ne,v Building .... ~.. ' '' · ' · .: .~.~.. Old or ~re-e~Istmg Budding(SC) ........ ~ ZVacant Land ~7~0 ~?..~,,~£c~..,~,..,'~.,.,. .",-~l ' ~i.~ ~,v ............. Owner or Owners of Property County Tax Map No..lO00 Secdon ......... Block ........... Lot ................................ ........... Health Dept. Approva~ .......... ' ..... Labor Dept. Approval Undec,vriters Approval ............. Request for Temporary Certificate .................... Final Certificate ~ - Fee SubmittBd S Constructmn on above described hu[Idim and~er~p- .......... ~;~, ..... ., ,~.~%?.~ ..... . .............. : . .,/... . . .. .' , · ~N~CTiON DAT~ COUNTS FIELD FOUNDATION (ls2) ...... ~o~o~ I ROUGH F~E & PLYING STATE E~GY CODE . FINAL -~ ~DITIONAL CO~TS: _ .,, " , ' ':"/';:': "' '" ' ' "' ' :'~ ;"'"'; % ''~" / ~DANIEL" WEBER '.-.-,-:~.~A~ O~ CO~ ~ ~r~s ' * : ' *' ' ;~I~D AUG. 15,1967 ~:~LE ~. 49~3 ~AT .~YVIEW . ," .. ,~.t -,-.~L. /J~;~ICAGO T~TLE '~URANCE COMPANY ~_'*': -,~' :; ~; ,~ ~;',~'~T~CD SAVINGS ~ANK ' ,.. -:.;, ~NIgL~, . WEBER THE NEW YORK BOARD OF FIRE UNDERWRITERS II~ BUREAU OF ELECTRICITY ~ j~t'lt.~l.~j~ 26, 3~983 85 JOHN STREET, NEW YORK, NEW YORK 1OO~8 THIS CERTIFIES THAT only the electrical equipment as ~scribed b~low and introduced by t~ applicant named on the above eppl~t/o~ ~mber ia the premises of D~el Web~, C/o Corey Cr~ ~ & ~y Vi~ Ave,, ~t~ld, N.Y. in thefollowlng Iocatio,~; ~ a~,¢,,~t ~ ~t ~'l. ~ s.d ~'t. ~ge, ~tsi~ s~¢uo. Block Lot ~ o~.mi.*d oa J~ 24, ~983 and found to be in compliance with ta~ &equirements of tai~ Bo~d. FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS FIXTURE OUTLET~ SWITCHES NCAHDESCENT FLUORESCEHT 7 2 5 DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS= 1-G.F.C.I. E R V I C NO OF CC COND, A W, O. NO` OF HI-LEO A W, O NO. OF NEUTRALS A W. O, 1 4 1 4 O. P. Weber 65 Corey Creek Lane Southold, N.Y., 11971 GEN Per~ y~. This certificate must not be altered in any manner; reFurn to the office of Fhe Board ff incorrect, Inspecto~'~ may he identified b co~ FOR ~U,t~,.~ ,E.~RT~EHT~ TH,S c~.~ o~ ~,~,~,~ ?p~ ,-gL~ ~E.~o..,~ ~.Y ~..a. . ,3 12 Concrete Grade Sial Slab-on-Ground Construction: Floatlt T+L-~wood' frame construction asbestos I~J~ "Il _aedmeter heat;nc] duct. if used ~,~.~i~,:~'~'~ ,.?.....~~ 9~d~ {~ (~,~ ~ r, * ~~ T ~" mln. ~id ~~' ~ graded ~ravel ~ll or insu~a- ' crushed stone tian, R~ ~4' min., b" max. - 4" m;n. Slab.F°undation %1 / / "" ~ , FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 E×amined. A~.~/~...~. ;..~., 19 ..~./ Approved .~.~.,5..d~..~..../; _.'~.,~19..~../. Permit No../.t(. ~. ~7./..~/ Disapproved a/c ..... ......... ....................... / (Buildtfg Inspector) APPLICATION FOR BUILDING PERMIT Application No..//'..ff~.~.'~,/. ......... Date ................. , 19 . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 issue 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 buildings for necessary inspections. ................ (Signature of applicant, or name, if a corporation) · .c..~ 5. ~..~.7...q.~ .~.*.~.../v....~¢./...0.(( .... ~Mailing address of applicant) /J,/~. ?D' ?/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . .~_~.~../.~.Z.....~.....~_(/(?..-~.,~. ........................... - ..................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. --'-' ~.. ~.~...g~.... Plumber's License No .... ':7':': 7 :'~-57~-. .......... Electrician's License No...-.~7-7'~.~.- ?. ........ Other Trade's License No. 1. Location of land on which proposed work will be done .................................................. ~ ~7 ~.~/.c. ~... ............ ~.~..~..z¥. House Number Street Hamlet County Tax Map No. 1000 Section .... .~. y..o~.,.3 ....... Block .................. Lot...4~. .............. Subdivision .0. o..~,.7..~.,.q.~.-~.~...~.~.~ .~..~.~.s ........... Filed Map No. ?. ~..~.~. ....... Lot.../.6. .......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... .-77'. '..:-777-.. ~. .................................................... Intended use and occupancy ~..~..~-~,~r/.':ff?.°.'e ~.~.,~ b. 3. Nature 'of work (check which applicable): New Building . ~/ Addition Alt~eration ' '~ R pal Rem val De olitio Other We k e r .............. o ..... . ........ m n .............. r (Description) 4 Estimated Cost.. o~ o , Fee i (to be paid on filing this application) 5. If dwelling, number of dwelling Units ... ?~.'~ ......... Number of dwelling units on each floor...~'~/.'~ ........... If garage, number of cars ..... . .................................................................. 6. If business, commercial or mixeO occupancy, specify nature and extent of each type of use ...~. ................ 7. Dimensions ofexisring structureS, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure wl~h alterations or additions: Front ................. Rear .................. Depth .................... i.. Height ...... 7...: ........... Number of Stories ..... 777 .............. 8. Dimensions of entire newconstmction: Front . .~.~. ?. ?.'. Rear . .~..~..~: ....... Depth . .~..~.: Height' ..../.~ .......... Number of Stories . .o.~..~ .................................................." 9. Size ofilot: Front .../.~..7~ .o~..c.' .......... Rear ..... [./.o..' Depth ~-33. 3o ' 10. Date of Purchase ......... Oe.~- 3o~.;./.~. ?! ............... Name of Former Owner W~Z~,~ ............................. ...... 11. Zone or use district in which pr{mises are situated ~'~'s t d~t, ,t,.,~/_ 12. Does proposed construction violate any zoning law, ordinance or regulation: . .~.q ............................ 13. Will lot be regraded .. ?.? .... '..: ................ Will excess fill be removed from premises: Yes 14. NameofOwneroforemises~>,'~~''¥~ '~' /"/~'~ Address &r'~-,a:~>(¢,t~/~ ~ Ph,,neN,, PLOT DIAGRAM Locate clearly and distinctly alllbuildings, 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, COUNTY OF..,~.,.~.t~.t~.~.~.~ .... ... S.S .....'-" - P. ...................... (Name of individual signing contract) above named. being duly sworn, deposes and says that he is the applicant 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 ail statements conthined 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 b~fore me this ............... ~,~..~..day of...,,~..'~.,~ Notary Public, x ...... County OTAR¥ PUBLIC St.~", ~. .~0. 4/1~¢~I: Sui;'~[ ~ ]~ (Signature o f applic~t)