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Home My WebLink About13876-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-15923 Date July 8, 1987 THIS CERTIFIES that the building RENOVATE & ADD DECK TO EXISTING RESTAURANT 43715 County Road (/48 & 2785 Hortons Ave. Southold,N.Y. Location of Property ...................................................... House No. Street .... County Tax Map No. 1000 Section 059 .Block 03 .Lot 30 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated April 15, 1985 .. pnrsuant to which Building Permit No. 13876 z dated.....AP r i ...... 1 16 .' ....198. 5 ........... 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 ......... RENOVATION 6, DECK ADDITION TO EXISTING RESTAURANT AS APPLIED FOR The certificate is issued to LEWIS L. ED SON ..................... ?oYn'e;, Ygg ;GI, 9 x ................... of the aforesaid building. Suffolk County Department of Health Approval ......... N / A UNDERWRITERS CERTIFICATE NO. N 692685 N/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 FO~M' NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 13876 Z Date ...~ ........ /..~. .............. , Permission is hereby granted to: _ , ....... .......... ~...o....x....~..~ ................................................... ot prem~os located at .~.~..'/..L~...~.~....~.~...'/..~.b.....~..~ ....... ....~0...: .............. County Tax Map No. 1000 Section .....C~...~...~. ........ Block ......~......~ ........ Lot No......~....~....C~.. ......... pursuant to application doted ............. .J.~,~ ............... , 19.~..~.., and approved by the Building Inspector. Fee $/.~.:...../...... Building In.~ector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~a ~aa~aJ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property wi[h accurate location of all buildings, property lines, streets, and unu~Jal 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 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 iprior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pZ"operty 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 i~ousing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of oc_cupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $ [ 5.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 Date .......................... NewC°nstructi°n v/ OIdorPre-existin uilding .... Vacant Land Location of Property .~ House No. Street Hamlet Owner or Owners of Property ....... ~ ............... county Ta× Map No. 7000 Seotion ....~...--'~.~. ..... Block ... ~..,.7.. ...... Lot...~..~'.~ ........ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No/~.~::.~.~,. ~ Date of Permit .. ~../1~....~pplicant~./~'///.~.4~....~..~',~,~'. ~,~ .......... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ............ Planning Board Approval ...................... ~equest for Temporary Gertifieate ..................... Final Gertifieate , ~ .................. Foe Submitted $ . .'~ .~...':'T .................... Applicant .~.. ~,f.... ~...~-~-?.. ............. ' ........... Rev. 10-10-78 ~ ~so~ COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: 765-t~02 BUILDING DEPT, INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000314 BUREAU OF ELECTRICITY, · THIS CERTIFIES THAT Rl~s ~af~d Cafe, Nor~ ~d FIXTURE FIXTURES RANGES ~o~KING DECK~ OVENS DISH WASHER~ EXHAUST FANS OUTLETS SWITCHES INCANDESCENT FLUORESCENT 9 3 7 2 DRYERS SYSTR~,S NO. OF FEET OTHER APPARATUS: Motors; 1-F S E R ~V I C NO OF NEUTRALS A. WG 3/0 B.IS Elect2tc Sttllwater Avenue Cutchogue, N.Y. 11935 Lic, 2670 This certificate must not be altered in any manner; return to the office of the Bgard if incoi'rect. Inspecto ~ ~COPY~OR B~ILDIN(~ Per may be identified by their 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .~. ~.7..., I9~.~'"' Approved .~. i.'~..., 19~Permit No../..~.?.7.~.. ·~'' Disapproved a/c ..................................... ................................ .... (Building Inspector) APPLICATION FOR BUILDING PERMIT ti e c e :i_ve d ........... ,19... Date ............. INSTRUCTIONS a. This 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 authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, ~ name, if a corporation) .. ¢~.o..,...¢~.... g ~,...~x~.,..m... ~;%..<% (Mailing address of applicant) \1 q g ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ... L_~..s. 5..~.~.. ...................................................................... Name of owner ofpremises ...~..~: .tM. (~. [-. ~.g..o..r~. ......................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. · .............. (Name and title of co¥15orate officer) Builder's License No .......................... Plumber's License No....~..O~.\'.~..~<e .~ ........ Electrician's License No.. ~'-~.5.%.~ ......... Other Trade's License No ...................... X/ °Oc~ 14" ~ ~ ................ 1. Location ofland on which proposed work will be done .... ~.~....~...~.~...~. ff 3r ~g/~ 55.{~.'.~...t~..~.~..~{'~. House Number Street Hamlet County Tax Map No. 1000 Section ...0..~..~..~. ......... Block .... 0.% .......... Lot...O...°Q..~. .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use aud occupancy of proposed c6nstruction: a. Existing use and occupancy... 0 .~-. ~.~..~...P1~..~.. ................. . ............................. b. Intended tee and occupancy .... ~.¢.~.~...~.t~.t.~{~o~..~...~... [. ~q..~..~ ......................... 3. Nature of work (ch_~ck which applicable): New Building ..... ' .....Addition .... Alteration .... Repair .... ~.. ...... Removal .......... Demolition ...... Other Work ...... L. -4[ ~-'5-'-7x~,'t~'--., (Description) 4. Estimated Cost . ..~_(-J..o...c(. ......................... Fee ...................................... .i ~ (to be paid on filing this application) 5. If dwelling, number of dwelli~g units ............... Number of dwelling units on each floor ................ If garage, number of cars ... i ..................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7 Dime i of 'stingstructffres ifa Front Rear Depth · ns ons exl , ny: ......................................... Height ............... Num her of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................. : .... Height ...................... Number of Stories ...................... 8. Dimensions of entire new con§truction: Front ............... Rear ............... Depth ............... Height Nt~mber of Stories · 9. Size of lot: Front ......... i ............. Rear ...................... Depth ...................... 10. Date of Purchase ......... ~ .................... Name of Former Owner ............................. 1 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction v{olate any zoning law, ordinance or regulation: ...................... 13. Will lot be regraded ............................ Will excess fill be removed' from premises: Yes No 14. Name of Owner of premises . ~ .................. Address ................... Phone No ................ Name of Architect Address Phone No Name of C~ontractor ....... ! .................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and bloc t number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ~ S.S COUNTY OF ................ ............................ . ..................... being duly sworn, deposes and says that he is the applicant (Name of individual si ning contract) above named. He is the ......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dOly 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 manfier set forth in the application filed therewith. Sworn to before me this HELEN ~. DE VOE "~ NOTARY PUBLIO, State o[ N~ Yark ..................., .~~ .~~ No 4707878, Suffolk Co,untu ''(~' 'g pp · ) Term ~×~),res ~larch 30, 119~''7 J[ ~ ' 'li~in't' If copper tubing is used for water distributing system; piping shall be ol~ types K or L only SOLDER USED IN WATER S UPPL Y sYSTEM CANNOT EXCEED 2/10 of 1% LF_gAD, PLUMBER CE,~T,r.~ICAT[O.V ON LEAD CONTtL'NT BEFOR,~ CERTIFICATE OF OCCUPANC~ A,-,az,~D AS NOTED FEE:/r,"~, J eY: 'V. 5'.£, 765-180° 9 AM TO 4 PM FOR THE