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HomeMy WebLinkAbout15266-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hail Southold, N.Y. Certificate Of Occupancy No .... .Z.l.~.~J.7 ....... Date September 99 , 19.8~ deck addzLzon THIS CERTIFIES that the bmlding ................................................ Location o£Property ...6.5...C.o. re.¥. Creek Lane Southold, oN. Y. House No. Street Hamlet County Tax Map No. ]000 Sechon 9.7.8. ........ Block 04 ......... Lot 3 0, M/o Corey Creek Ests. 4923 16 Subdivision ............................ Filed Map No ......... Lot No .............. conforms substant~ally to the Apphcat~on for Building Permit heretofore f'fled in tlns office dated .S.q p.t.e~e r, .1.5, ..... 19 ~3.6. pnrsuant to wtuch Braiding Permit No. 1526.6 Z September 16, B6 dated ......................... 19 . . . , was ~ssued, and conforms to all of th~ reqmrements of the apphcable prows~ons of the law The occupancy for which tlus certfficate is ~ssued m ........ .d.e .o.k..a.d..~.z t.~. o..n..~.o...e x.~.s .t .~ ~.g. ?.ne..f .a.~.L~.y' .d.w?.~. ~. ~.n.g. ....................... The certzficate ~s issued to Danzel & Helen Weber (owner, ~J~eYo~ YeC$~x}x of the aforesaid building. Suffolk County Department of Health Approval ....... .N./..A ............................. UNDERWRITERS CERTIFICATE NO. N/A Rev -~,,/ Bml&ng Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDIHG PERMIT fi'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15266 Z Perm~ss;on is hereby granted to' County Tax Mop No 1000 Sect,on . ~"~...~ . Block pursuant to apphcahon dated . ....~'~...~ .J ~/~ Budding Inspector ..... 19.~. J~, and approved by the Building Inspector Rev 6/30/80 FORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED Certificate Of Occupancy December 18, 86 No. Z-15519 Date .................... 19 One family dwelling with deck addition, THIS CERTIFIES that the building . .a.c.c. qs.s. qr0r..g.a.r.a. Kq,..i?.Kr.°.u.n.d..p.o.o.l..&..f.e.n.c.e..e.n.c.lp.s.-dre 4790 Main Bayview Road. Southold, New York Location of Prop~ty ~ ~j~ ..................................................... . . . 078 04 $~er 030 H~ler County Tax Map No. 1000 S¢¢hon ............ Block ............... Lot .............. . . . M/o Corey Creek Estates 4923 Subdivision ............................... FHed Map No ........ . Lot No .............. conforms substantmlly to the Application for Building Permit heretofore fried in tMs office dated *SEE BELOW ............... . .. , ., 19 ... pursuant to wMch Braiding Permit No ...................... dated 19 was issued' and conforms to aU of the requirements of the applicable provmmns of thc law. The occupancy for which this certificate is issued is ......... One family dwellzng wzth dormer, deck additzon, accessory garage, inground pool · ' ~ 'f~hh'e' ~nh~h'r~'. ..................................................... ° ' ' ' ' DANIEL & HELEN WEBER The certificate is issued to ..................... fo.v~n.e;,./~ys~tgX ..................... of the aforesaid building. N/A Suffolk County Department of tlealth Approval .......................................... UNDERWRITERS CERTIFICATE NO.. ?.5? 137, .(h.o.uy.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 a~.~l ~ssued March 12, 1982 - Accessory garage. - Permit #12004Z - dated October 26, 1982, issued Nov. 5, 1982 - Inground pool & fence enclosure, - Permxt 15266Z dated September 15, 1986, issued September 16, 1986 - deck addztion FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 Instructions This apphcation must be filled in typewmter OR ~nk, and submitted m ~ to the Budding Inspec- tor w~th the following; for new buildings or new use: 1. Final survey of properW 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 comphance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed rote plan reqmrements where applicable. For existing buddings (proof to April 1957), Non-conforming uses, or buddings 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 buddings or premises, or other pertinent ~nforma- tion required to prepare a cert~fmate. C. Fees: 1. Certdmate of occupancy $5.00 2, Certificate of occupancy on pre-existing dwelhng $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 .g~ I~. b~ 5. Updated C.O. $15.00 Date. ~. .~ .................. NewConst, ruct, zon ...... Old or Pre-existing Building / Vacant Land Location of Prope~y .......... ~ ~ Hou~ NO. ' Xt~et ~ ~Ham/et Owner or Owners of Prope~ ~ ~ ~ ~ ~ ~ ~ OounW Tax Map No. 1000 Seat/on ~ Bloak Lot.. ......... Permit No ........... Date of Permit ......... AppIicant .................................. Health Dept Approval ...................... Labor Dept. Approval ....................... . Underwriters Approval ........................ Planning Board Approval ....... Request for Temporary Certificate .................... F~nat Certd~cate ....................... Fee Submitted $..~?~8;Q...~. ~(e.~. ....... Construction on above descmbed budding and permit meets all applicable codes and regulations. Applicant ....'9¢~.~..."-~-fi..': .............................. R~v. 10 10-78 FtELD~'~NS~ECTION FOUND~TIO~ (1st) COMMEI]TS # FOUNDATION (2nd) 2, ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FINAL Disapproved a/c .. FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL gOUTHOLD, N.Y. 11971 TEL. 765-1B02 TOWN OF oOUT~IOLD Received ........... ,19. ; ~', 19 ~(~ Permit No / ,.~ ~b (e ~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .... INSTRUCTIONS a. Tins application must be completely filled in by typewriter or m ink and submitted to the Budding Inspector, 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 pubhc str or areas, and giving a detmled descnphon of layout of property must be drawn on the diagram which is part of this al cation. c. The work covered by tins application may not be commenced before issuance of Budding Permit d. Upon approval of tins apphcahon, the Building Inspector will issued a Budding Permit to the apphcant. Such pe~ shall be kept on the prenuses avadable for mspectlon throughout the work e. No bufldmg shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupa shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Bufldmg Department for the issuance of a Braiding Permit pursuant to Buflchng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable _Lq~vs, Ordinance Regulations, for the construction of bufldmgs, additions or alterahons, or for removal or clemohtlon,t~e~n descnl The applicant agrees to comply with all apphcable laws, ordinances, budding code, hogsm~:{;ode,~f~[~' ~lat~ons, an{ admit authorized inspectors on premises and m bmldmg for necess~oectlons -- -~'~ ( S lgna'~(urd, q~'~) "~ ' orporahon) ..... .?' , ..... State whether apphcant is owner, lessee, agent, architect, engineer, ~eneral c~tr~c[or~Ge~nclan, plumber or buff( · o M~'~.-. ............ .ox' ' Name oe owner or ,remlses /./-..zrs,,., (as on the tax roll or late~oj[~l~vED AS NOTED 2 If apphcant is a corporation, signature of duly authorized officer Builder's L~cense No Plumber's License No Electrician's License No Other Trade's License No (Name and title of co~(}rale of tiger') Location of land on which proposed work will be done House Number Street County Tax Map No 1000 Section Subd,wsmn ~o~f ~ (Name) Block Filed Map No P/~aP-~ ~OTI~ BUILDING DEPARTM~T AT ~054802 9 AM TO 4 ~ ~R THE g OLLOWING IN~PEC~ONS: FOU~OArlON ~10 REQ~RED ~OR ~UR~O ~'ONCRE'ffi ~ ROUG~ ~AMIN(~ & ~UMBING ALt , rH~ ~EQUIP~MENTS ~ THE N,Y ¢ . lot . .. Lot . / ~ .. State existing use and occupancy of premises and intended use and occupancy of proposed construction a Exxsnng use and occupancy f/,q/a/~ ~ .~: p .~.a~ ~ ........ b Intended use and occupancy ~'~"~ ¢ 3 Nat,ure of work (check which apphcable). New Buddmg .. Addltmn /~/~ce}L Alteration Repmr ....... Removal ......... Deraobt~on ......... Other Work .......... (Description) 4 Estimated Cost . ~..dd..? ........... Fee .......................... (to be paid on Filing th~s apphcation) 5 If dwelling, number of dwelhng units ..... d, ~,c. ..... Number of dwelhng units on each floor ............. If garage number of cars If business, commercml or m~xed occupancy, specify...~,nature and extent of each type of use.. ' .............. Height ....... Number of Stones ~-~. --1 ........................ Dunensions of same structure with alterations or addmons Front .. ~ ~' ..... Rear .. ~.~.. Depth ~ ~ ' Height -'~ '~-~- Number of Stones. 8. Dunens~ons of entire new construchon Front ....... Rear ........... Depth ............ Height ........... Number of Stones ...................................... 9 S~ze of lot Front / az-?' . . . . Rear..././.o ............ Depth ~..3? ............. 10. Date of Purchase .... 4'~7~ .......... Name of Former Owner .//~/.~.,:,..~.o?.,*:...~. ........ 11. Zone or use district m which premises are situated ,. tO.. qfi.;..d..eff.~<.y.~ .................................... 12, Does proposed construction violate any zoning law, ordinance or regulation' /¥/¢ ................ 13. Will lot be regraded .... p/cl. ............ W~ll excess fill be removed from premises. Yes 14. Name of Owner of remises ~>~/~/¢/_ /o kvi~/3~kldress /'Joy >3/ .;o,~/,4o.~d Ph,,n~ lq,, ;~33~ Name of Architect ~5'~4 ~ .......... Address .~/e...~7'~. ..... Phone No ......... NameofContractor .-Y/~..~..~ ............... Address..f..~,~x..* ........ PhoneNo ............. 15. Is this property located wzthinl00 feet of a tidal wetland? * Yes ..... No~<... · If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and all bmldmgs, extstmg distinctly whether or proposed, and,~,,kndicat. property hnes Give street and block number or descnpt~on accordmg to deed, and $t10~ street names mtenor or corner lot. all set-hack danenstons from and mdicate whether ~ATE OF NEW YORK, OUNTY OF ,5%..~'P~Z.R... S S ../-(..ZzZ.~-~'' IA(.~?'./~..~. ..... being duly sworn, deposes and says that he is the apphcant (Name of lnd~wdual slgmng contract) bore named. e is the .......... ~-.~',.~ ~,~',~- ..... (Contractor, agent, corporate officer, etc ) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file thru )phcatlon; that all statements contamed m this apphcatton are true to the best of his knowledge and belief; and that the ork will be performed in the manner set forth m the apphcation filed therewith.