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Home My WebLink About22040-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. ~ERTIFICATE OF O~CUPANCY No Z-23147 Date AUGUST 8, 1994 THIS CERTIFIES that the building ADDITION Location of Property 4015 MAIN BAYVIEW ROAD SOUTHOLD, NY House No. Street Hamlet County Tax Map No. 1000 Section 78 Block 2 . Lot 16 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 18, 1994 pursuant to which Building Permit No. 22040-Z dated MAY 5, 1994 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 AN ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to WILLIAM & MARISA HARNE¥ of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS OERTIFICATE NO. PENDING PLUMBERS CERTIFICATION DATED Rev. 1/81 (owner's) N/A AUGusT 4, 1994 Building Inspecto/ FG~M NO,3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. No 22040 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~ate ............................................................ 19. .. Permission is hereby granted to: ,,~ · ~ / , ~ , / .~..,..~.:. ............. z~,.... ~.-~.,. .................... · ....~, ...~.~..; ............................ ~.~ ~, ,~ ........... ......................................................... CountyTax Map No. 1000 Section ....... .~..~.. .......... Block ........ ~ ............. Lot No...Z.~.. ................... pursuant to application dated .........~.., ~./...~.. ................................... 19..~..~.. ....... and approved by the B~l, lding Inspector, Fee s..Z~ ....... Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN t}ALL 765-1802 PLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lihes, 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 building~ ~ 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 a 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 Buildin~ - $100.00 3.Copy of Certificate of Occupancy - $20.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial ~15.00 Date ............ New Construction ........... Old Or Pre-existing Building. (.~7~.~..(~... Location of Property...~.~./.~. .... B~.~] ~.~ ~ ~.~p.~.~.~ House No. Street Hamlet Onwer or Owners of Property..L,k)[q ........... ~.. . ......................... County Tax 000, Seetion...-7. ........ Bloc ...Z .......... Lot .... ........... Subdivision .................................. Filed Map ............ Lot ..................... Permit No..~.O~..~..Date Of Permit... Health Dept. Approval ..................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate....~. ..... Fee Submitted: $ ............................. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] RO/~GH PLBG. [[1] ;OjMN~;GTION ZND [[,~]/~lSU~ FiNA?TION 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: DATE [ ] FINAL BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] I.~ULATION FRAMING~ [ ~I~INAL 765-1802 BUILDING DEPT. INSPECTION ] FOUNDATION 'IST [ ] ROUGH PLBG. J FOUNDATION ZND [ ] INS~LATION / ]FRAMING ~.,F'INAL DATE INSPECT~~ 765-18~2 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ! INSULATION / FRAMING [ ,~INAL~ RE,lARKS.- ~ "~ ~ ~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ~,] ROU~~BG. FOUNDATION 2ND [~]/INSULATION [ ] FRAMING [ ] FINAL DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [~]/~RAMING [ ] FINAL REMARKS: DATE -~////~/~/'~' INSPECTOR_~~~%/~ 765-1802 BUILDING DEPT. ON INDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE-*~///~/~ INSPECT~~ OUNDATIO.~; ( 1 s t OU~;DATIO:! (2nd) :OUGH FRAHE & .FLUMBING [NSULATIO~ PER N. STATE E:IERGY CODE ADDITIO};AL COMME}ITS THE NEW YORK BOARD OF FIRE UNDERWRITERS 1001071 BUREAU OF ELECTRICITY J~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date AUGUST 1/9,1994 ~lpplication No. onfile 06233494/94 N 323240 ~I~ ~Y, MAIN BA~I~ RO~, $og~lo~ ~ N.Y. in the following location; ~ Base--hr ~ Ist FI. ~ 2nd t3. OUT Section Bilk Lot ~s examined on ~U~$~ 04,1994 and found to be in compl~nce with the NaaonM Elect~cal Code. FIXTURE OUTLETS RECEPTACLES SWITCHES ~N¢ OE$CEN1 OTHER 8 15 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS At, AT K W, OIL H. P, GAS H.P. A~T NO. A* W G RANGES iFECIAL REC'PT COOKING DECKS OVENS DISH WASHERS TIME CLOCKS I BELL IUNIT HEATERS I MULTI-OUTLET ~ . EXHAUST FANS DIMMERS ANAT. WATTS 2 600 SERVICE DISCONNECT I NO, OF I METER OTHER APPARATUS: M(YI'ORS, 1-F H.P. G.F.C.I:~! S R I C E G & S CONTRACTOR BOX 215 SOUTHOLD, NY, 11971 LIC.#578-~ GENERAL MANAGER 11 COPY FOR BUILDING DEPARTMEi'~,IT. THIS COPY OF CERT~FICATE MUST NOT BE ALTERED JN ANY MANNER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 . .~..~...,~, TEL.: 765-1803 Examined ......... , 19~..~ Approved .... ~ ....... 19 .~. Permit No. ~. ~-~..~. '~. ~ Disapproved a/c ................ , ..................... i (B~ilding ~pector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tkis 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 scal~. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or a cas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cati~. c. he work covered by this apph~at~on may not be commenced before issuance of Build~ng Permit. d. Upon approval of this applicatign, 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 6r used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Buildingi Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Towni of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regl~lations, for the construction of bhildings, additions or alterations, or for removal or demolition, as herein des~cribed The applicant agrees to comply with {ii applicable laws, ordinances, building code, housing code, and reguia[ions, and to admit authorized inspectors on premises and in building for necessary ins~ ~ . · -- (Si!.~lure of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, less'ce, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ .C. ,, i ................................................................. Name of owner of premises (a on the tax r t If applicant is a corporation, signature o:f duly authorized officer. (Name and title of corporate[officer) Builder'sLicenseNo..~C'~V.~.;'./J/'M~....~.L.a'~ {A~C~..~~'' 0~50~0 ~ No .......... .............. Other Trade's License N9. :~[~,.~0.~ ~ 1. Location of land on which proposed~work will be done. House Number 'Street Hamlet ,O00S ,on .......... ............ ............. Subdivision .................................... Filed Map No ............... Lot ............... (Nan e) State existing use and occupancy of }remises and intended use and occupancy of proposed construction; a. Existing use and occupancy . q ........ b. lntended use and occupancy g3. ....... 3. Nature of work (check which applicable): New Building .......... Addition v' After,lion ~'' 4. Estimated Cost ....... CP (.O r,D . Fee . / ~ 0 cd CD ...... ~q57~j~..t~ (to be paid on filihg $ Ifdwellin,, numberofdw 11' C~_) · .~ ,,, , ~ e ~ngunit.~s.., ......~ ...... Number of dwelling units on each floor' ff.~l.). .... ·n garage, numoer Gl cars ...... ~ ~'~ ................................................ 6. If business, commercial or mixed O~pancy, specffz4~ure and extent of eacll type ,6[ use .... ~ ............ 7. Dimensions of,existing structures, ifany: Front...~,.~.'~.t..'~. .... Rear ~.~.~ ~'~[ Depth. ~, ~ '' Height . .o~.c]. ......... Number of Stories ...... .~.... ........... 112.. i. iii. J il ............ · Dimensions of same structure with alterations or additions: Front ..~ fO...J ......... Rear ...~.¢.., .~. ........ ~, ~D.epth ...~(D;,..~,.. ............. Height .... ~ .............. Number of Stories .... .(~ ....... ~ ........ ~. ~v~mens~ons o~ ennre new construction: Front ...L~.~,~ ........ Rear .... I. ~.. ........ Depth ... [(-.q ......... Height ... J.'2-. ........ N,umber of Stories .... ~ ........................... -~ . 9. Size oflot: Front . . .l. ~.t~. . .~I Rear IL] I 5-(~) ..... l~ept~ .... .~/f4'.~','~.) ....... 10. Date of Purchase ............................. Name of Former Owner ............................. 1 1. Zone or use district in which premises are situated ............................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ... .~./2) ................... ........... ' .......... '....,..,q.., 13. Will lot be regraded ...~/.) ................... Will excess fill be removed from remises' Yes 14. Name of Owner of pre~mjses .~., ~.~. Address ~t/~ ,'~ ,~b ~ ~ame0~Arcmtect a~'._.~.,~ v,.~g.~...o~. Address ~,~,.~,/~.. '~.AC~~., ~"~ · tv~' . ,¢( ..... ~- ','~./ .... ,.v..'~,.......-~- .... :.gl'non'eno...1 ....... Name of Contractor ..13.~×]..N' ~ Du, ].~.~Addre~X75"q'~'~,~ ~_~o~., .. ~z~--~,~.'--~.' Is - · · . '? ....................... -~-~[, ....... ~ ..... rnone va>r...~.c...~..t .... 15. this property w~th~n 300 feet of a tidal wetland, *Yes ~ ~ · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions ~om property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or coruer lot. ¢:F CO~v~PLETE FOR SYF~['E CONSTRUCI'~ON · ENERGY CODI~L~ ~KJT f~ESPONS~E~LE FOR STATE OF NEW/YORI~, s , COU__U_N]'Y OF .~~. S.S . .-~..C? Q .~..~.U)...~Q,AQx.. C/~..O ~..~.. ................ being duly sworn, deposes ~d says that he is the applicant (Name of individual signing contract) above named. He is the ~ ~ ~ ~ ~ ~:-~) ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perfom or have perfo~ed the said work and to m~e ~d file this application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the work will be perfo~ed in the m~ner set forth in the application filed therewith. Sworn to before me this ........ /..~'~ ...... dayof ~ ......... ,19~( ' Nota~ Public, Stat6 o{~ow YO~ ~ ..... No. 4951364 ~ // (Signature of applic~t) ~u~lified in 8u~Ok ~ounty ~ ~ Commission ~x~iro~ g~ay 2~ ~ ~ '~ AREA = 1.2891 acres o CERTIFIED TO ~ FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK MANUFACTURORS HANOVER TRUST COMPANY AQUEBOC3UE ABSTRACT CORORATION WILLIAM H. HARNEY III MARISA J. HARNEY Prel~ared in accordance with the minimum atan~larde for title aurveya aa eatabliehed by the LI.A.L.8. and approved and adol~ted f-or auoh uae by The New York State Land Title Aeaociation. 13A YVIEw ROAo SURVEY OF PR OPER T Y A T SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, 1N6. Y. 1000 - 78- 02- Scale 1" = 50' Dec. 8, 1989 ~ /p~ONl¢~~yoN. Y.S. LIC. NO. 49618 RS, P,C. (516) 765 - 5020 P, O. 80X 909 MAIN ROAD SOUTHOLD~ N.Y. 11971