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Home My WebLink About10745-zFORM NO. 4 TOWN OF £OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Seutho[d, N.Y. Certificate Of Occupancy No..Z.l.q973 .......... Date ...... ~p.r}.l..2.9 .................. 198.2.. THIS CERTIFIES that the, bnilding ................................................ Location of Property .. 6 5 2.5.0 ........... H ~ ~4q..I~ 9 g.d ................. .~.p.e. ~ r~l>.qr .t ...... House No. Street Hamlet County Tax MapNo. 1000Section ..QS~ ....... Block ...Q? .......... Lot ...Q~).2 ........... SubdMsion ..... X ......................... Filed ]V[~p No...~. ..... Lot No...~ ........... conforms substantially to th~ Application for Building Permit heretofore filed irt this office dated ...... X .............. , 19 ... pursuant to which Building Permit No....* .s.e.e...b.e.l.qW ....... dated ....... X .................... 19..., 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 .. ~ ...... r.es ~.a. ur a.n.t...~.i.~.h~..a.dA ~..~5.o.n.s.. 5..a. ~..~.e?.a. ~..~ ?.n.s...a.s..! ~..s ?fi.: ............. The certificate is issued to .......A. 1. j .a.n..~. ~..<~.t.y...c ??.p. ?r.~.~.~. ?.~...~.n. ?.. ................. (owner, I~ of the aforesaid building. Suffolk County Department of Health Approval . .~ P.. I~S..F. $.RI~.I.T...Np.....~.~...0. 1. .3.0.5.2. ]..&. .... Permzt No.02549, 110'* UNDERWRITERS CERTIFICATE NO... hi .- g..5 8 99.8. z~ ................................... *B.P. 10745 g~ 6/23/80 to construct roof over existing deck " 10717 Z,, 6/10/80 to construct laundry room addition to existing restaurant " 11021 Z, 1/26/81 to make alteratio~ to kitchen & restaurant facilities ~,~ Building Inspector **Permit To Operate A Service Food Establishment Rev 1/81 1~'0~ ]gO, '~ TOWN OF SOUTHOLD BU{LDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNT{L FULL COMPLETION OF THE WORK AUTHORIZED) N? 10745 Z Date . .,*Y'..~-. .......................... , 19. Permission is hereby granted to: ........ ~ ~.....l(~-~.~ ..... ~, .l~..c_ .... .x~ .d~ ......... x at premises Iocoted et .~0 ........ ~Z.~...~.7 .............................................. ......................................................................................................... 7. pursuont to opplic~t,on dated ...~ ...... ~ ................. , ]9.~ end opproved by the Building Inspector. ~=ORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposat-(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 compliance from the Architect or Engineer responsible for the building, 5.Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate sur~ey of peoperty showing all property lines, streets, buildings and unusual natural or topograph ic features. 2.Sworn statement of owner or previous owner as to use, occupar~cy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare,a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certihcate of occupancy on pre-existing dwelling or [and use $5.00 3. Copy of certificate of occupancy $1.00 Date ..... New Building ............. Old or Pre-existing Building(X) , _/J('_, -- ~ rVacant Land -i ........... Owner or Owners of Property ................ . / County Tax Map No. 1000 Section ~ '~ ~ Block .................... Lot ..... ¢. ¢ ........ Subdivision ...... ; - · .~ ............ ed Map No. %. ........ Lot No .............. .......... P mit ....... Ap¢i¢ t ,¢, Health Dept. Annrnval/(I~ ~ /~a~/ ' ......... ' .................. Labor Dept. Approval ...................... Unde~riters Approval . . · ~.~ ........... Planning Board Approval .................. Request for Temporary Certificate ..................... Finat Certificate ........ - ......... Fee Submitted S ............................. Construcdonon ' ' p rr~i,_'~'ne~ ~PP~i, ca.~e_~codes/~C~regulations. above described budding and er ~ e ~s all 'c Applicant ...... ~ :~... ...~ .¢...~ .%, .................. Rev 10-10 78 FIELD INS~ECTI'0N COMMENTS FOUNDATION FOUNDATION 2. ROUGH FRAME & PLUMBING (2~) INSULATION PER N.Y. STATE ENERGY COpE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No., ./.~. ~¢5 ...... 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 promises 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 ln buildings for necessary inspections. /¢~xt ~f}) ]~ (Mailing address/of applicant) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . /// ~ on the tax roll or latest deed) If ap:~co~o~;, signa~t¢~;.duly authorized officer. (Name and title of co,orate offic]r) Builder's License No...,*~/~. % ~ Plumber's License No~, ....................... Electrician's License No. ~.. O~er Trade's License No .... :..... ............... 1. Location of land on,wh~, proposed work wilLbe, done~ ................................................. House Number Street Hamlet County Tax Map Nb, 1000 Section O Block Lot ~O Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy ~f premises and intended use and occCpancy of proposed construction: b. Intended use and occupancy. · · ~~ · · .,7~. ¢?eq~.~ .(¢.. Z' r .................... 3. Natu~'e of work (check which applicable): New Building .......... Addition .......... Alteration R pair Re yal ~ D moliti Other Work (Description) 4. Estimated Cost ................................... Fee ...................................... :~ / (to be paid on filing this application) 5. If dwelling, number of dwelling units .... . .~./,d2~ .... Number of dwelling units on each floor ................ If garage, number of cars .............. ~..~/t ................................... ). · · ~: ...... ~ · · 6. If business, commercial or mixed occupancy, specify nature and extent of each t~pe of~s~ ... 7. D~ensions of existing stmcture~, if any: Front .... ~ .... Rear .. ~ Z/~ Depth.. ~.&...q ....... Height .... ~. ~ ...... Number of Stories ......... ~ ........ ~..: · .~. D~ensions of same structure with ~terations or additions: Front .... ~.~ ....... Rear .... 7~..~Z. · Depth ....................... Height .............. Number of Stories .... ~. ~. ~..( ....... 8. Dimensions of en~iregRw.~onstmction: Front ...... ~ ~. ..... Rear ..... ~ ~ ...... Depth .... .~ ....... Height ....~ .~. (~.q~ Number o~ Sto~es ..... ~ ....... ~. ........................ ... ~., ........ 9. Size of lot: Front...f~.~.~ ........ Rear ...~ ~.J.'~.~ ....... ~th ..;~..~.~, ..~ ..... 10. Date of Purchase .... ~./2~ ....... Nam~of, Fomer OKner ~(..~Mq~..~,. ..... , . . '.'' '. i .r . ~ [ 11. Zone or use d~stnct ~n which p~mi~es are atuated ....... ~ .... Kd~ ........ ~. · · ~ ...................... 14.13'12' ~~lf~~f~~~~~~~~s PLOT DIAGRAM Locate 'clearly and distinctly ~l! bulldogs, whether existing or proposed, ~d, indicate ~1 set-back d~ensions from prope~y ~nes. Give street and black,number or desq~ption according to ~ed, and show street names ~d indicate w~ether intefi )r or corner lot I ~0 (N~. ~ ~ STATE OF NEW YOR~ ~ ~. slg~mg ~ontract) ntractor, agent, corporate officer, etc. of said owner or owners, ~d is duly authorized to perform or have perfomed the said work ~d to m~e ~d ~e this application; that all statements cofftained ~ this application are true to the best of his knowledge and belief; and that the work will be perfo~ed in the m~her set forth ~ the application filed ~erewith. Swam to before me this ~ Qu~Iffmd m Suffolk Couq*y ~mmlssl~n Explros March 30, MAIN ROAD _g BoAT '5- LAT. 41°0~ LONG. 2'2°25 'z, is " AREA .INES= 3.2~' ACRES