HomeMy WebLinkAbout26234-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-26989 Date: 03/15/00
THIS CERTIFIES that the building ALTERATION
Location of Property: 55700 MAIN RD SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 62 Block 3 Lot 7
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 13, 1999 pursuant to which
Building Permit No. 26234-Z dated DECEMBER 29, 1999
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 TO REMOVE BAR & INTERIOR RENOVATION TO EXISTING RESTAURANT AS APPLIED
FOR.
The certificate is issued to ROY LOCASCIO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 2613 02/29/00
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
horized Signature
Rev. 1/81
FORM NO. 3
TOWN OF 5OUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 26234 Z Date DECEMBER 29 , 1999
Permission is hereby granted to:
MARY ELIZABETH GILBERT
3650 EUGENES RD
CUTCHOGUE,NY 11935
for
INTERIOR RENOVATION AND REMOVE BAR AS APPLIED FOR.
at premises located at 55700 MAIN RD SOUTHOLD
County Tax Map No. 473889 Section 062 Block 0003 Lot No. 007
pursuant to application dated DECEMBER 13 1999 and approved by the
Building Inspector.
Fee $ 150 .00
cL.a.tQ
Author & Signature
ORIGINAL
Rev. 2/19/98
TOWN OF SOUTHOLD --C23V ''�
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the buildinf
inspector with the following: for new building 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 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 buildii
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 ai
"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 Buildine - $100.00
3. Copy of Certificate of Occupancy - .25-v
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . . 1 .. . ..Qv . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . . . Old Or Pre-existing, Building. . . . . . . . . . . . . . . . .
S'ZI? oO In/q/ACJ / D , Svu7T/-/o&/)
Location of Property. . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
House No. Street Hamlet
Onwer or Owners of Property. . .�D y . C. . . . .. . Q.
County Tax Map No 1000, Section. . . . a. . . . . .Block. . . . . . 3. . . . . . . .Lot. . . . .7. . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed
q Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . .
Permit No .'3./ . . . .Date Of Permit. .�:' �.ql./• . .Applicant. . .�......�. ... • • • • • • • • .
Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . /
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. ./ . . . . . .
Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . _
APPLICANT
00? /v
` SUFFOLK COUNTYDEPART'; e . T F IA1T SERVICES
ROBERT J.GAFFNEViY } CLARE B.BRADLEY.M.D.,M.P.N. TO OPERATE A FOOD- ESTAB LISHNI NT
•+�C.i SUFFOLK COUHEl(ECUTIYE • Yy/ • COMMISSIONER
To THIS PERMIT WILL EXPIRE UPON THE DATE SPECIFIED OR UPON A CHA!4W<W OPERATIOR.
THIS PERMIT IS NOT TRANSFERABLE AND IS GRAFTED SUBJECT TO CGMPLIANCE WITH THE
SUFFOLK COUNTY
DEPARTMENT OF HEALTH SERVICES PROVISIONS OF ARTICLE 13 OF THE SUFFOLK COUNTY SANITARY CODE AND ALL APPLICABLE STATE,
LOCAL AND MUNICIPAL LAWS,ORDINANCES,CODES,RULES ANIS REGULATIONS.
IF THE FACILITY IS SERVED BY AN ON-SITE WELL THE DISINFECTION REQUIREMENT$OF THE
STATE SANITARY CODE ARE WAIVED PENDING CONTINUA SATISFACTORY COMPLIANCE
WITH THE PROVISIONS OF PART`S.
a
._. t _ r• I .D. 4 2613
ESTABLISHMENT NAME: ROP X 1,40 R.'OY 'S WESTERN STEA
ESTABLISHMENT ADDRfSS• ' � HA I N ROAD
�'" t: �
r _r,
OPERATOR'S NAME:
ROY' LOCAISCA01 PRESIDENT I
b. ISSUE DATE: <<►2;29 00
EXPIRATION DATE: <:', r `: ' /o i f
T IAL '
SM omc
RQPINO; R *S S s HSE.", IN ;.
P.q, 9F 1X 54b
SgUT14MD
sb µ
NY 1 lq7l �
+ a
r -
y
1f
FIELD INSPECTION REPORT DATE COMMENTS___________1___
i
it — -�
FOUNDATION ( IST) II IIj_ ,
II III
II
FOUNDATION (2ND)
II II _
� 11
ROUGH FRAME S
PLUMBING
rr n
It
III p
I
INSULATION PER N. Y. y
STATE ENERGY
CODEit
III ii
II CU/'
n �1 a+—.. dd)
1 H
II n
FINAL I
Or—
II
ADDITIOONAL COMMENTS:
-----------
J� Did
' I„I
---- -
b
y
DATE: 19 CERTIFICATE NO.
TOWN OF SOUTHOLD
Fire Safety Standards
For Areas of Public Assembly
This Is To Certify That The Place of Assembly
Known as
Name of Place of Assembly
Conducted as L'S-(A U R A NT
Place of Assembly -Cabaret- Lounge, Discotheque
Located at 55100 MAIN ROA011 SOUTHOLD SuffOLK
Address City,Town,Village County
OCCUPANCY
(Allowed Capacity)
TOTAL
— 47
Is in compliance with the requirements of Executive Law, Section 399 - C, New York State Uniform Fire Pre-
vention and Building Code, and the ordinances of the Town of Southold applicable thereto and rules adopted
thereunder.
Signature of Building Inspector
Title
This Notice must be posted by main entrance at all times.
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLB
[ ] FOUNDATION 2ND [ ] INS ION
[ ] FRAMING lQ;> [ , FINAL
[ ] FIREPLACE CHIM Y
DATE INSPECTO
\ 765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ j INSU ION
[ ] FRAMING [ INAL
[ ]
FIREPLACE
,^& CHIMNEY
REMARKS: �iggy/ � ®�
DATE �___ INSPECTOR
DEC 1 31999
BOARD OF HEALTH . . . . . . . . . . . . . . .
LOG.L) "'T FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
TOWS Sw --�' TOWN OF SOUTHOLb SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971 p
TEL: 765-1802 NOTIFY: p pay---
CALL
Examined.................. 19.... '� MAIL TO: . . . . . . . . . . . . . . . . . . . .
Apprwed..17,/y.q......., 191?9 Permit No. a... .
...... ....................................
Disapproveda/c .................................. ....................................
........................................... ..........
(Building Innspec
APPLICATION FOR BUILDING PERMIT t ! n
Date.tlw. . . 1� . . . . 19. ! !q
.
INSTRUCTIONS
a, This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wit
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 m st be drawn on the diagram which is part of
this application.
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.
APPLICATRN IS HEREBY MAIZE 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, or name; if a corporation)
...................................................
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
nwue(4-
.....\./.................;....................................................................
Nature of owner of premises ...Il S..L O e A S C'I O
...............................................................................
(as on the tax roll or latest deed)
If applicant is a corporation, signatrre of duly authorized officer.
.........................................................
(Name and title of corporate officer)
Builders License No. .........................
Pltnbers License No. .........................
Electricians License No. .....................
Other Trade's License No. ....................
I. Location of land on which proposed work will be done..............................................................
57061HkiK3 ZD ( RTzs � SoucrH0L-p
. ....... ........... .......................... ......... ...............
.............................
House Naber Street Hamlet
County Tax Map No. 1000 Section ...4�.-%........ Block ...... ......... Lot ...7......:....
Subdivision ...................................... Filed Map No. ............... Lot ...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy �£S`.... (Z 1N (,,..j..,�,}?� .... `.�
............. ... . ...... ... ...... ..
J
b. Intended use and occupancy f. a��kt LrC�N ( S�' M o v..: o t- G.k ...
....
le): New building .......... Addition .......... Alteration ... ..... ..
Repair ............ Ramval ..... Demolition ............ Other Work ................i..................
Nature of work (check winidn appy
(Descriptign) 1
Estimated Cost .......
.........'....... fee ......................................... ....
(to be paid on filing this application)
if dwelling, number of dwelling mits ............ lumber of. dwelling :mita on each floor ..... .... ... . ...
Ifgarage, cumber of caro IIF ...............................
if business, caamrcial or mixed'occupancy, specify nature and extent of each type of use.. EST....... fC N.
Dimensions of existing structures, if arty: Front....2'."........ Rear ...Z e....... Depth .. .. .........
Ileigt ......................... Uxd)er of Stories ........Z .. ..........
ht
Dimensions of same structure witim alterations or additions: Front ......b M .. Rear ... ...... .... ..
Depth .................... Neight .................... Ndmier of Stories ...............
Dimensions of entire new construction: Front ................ Rear ............... Depth . ...... .......
Ileiglit .........................'Number of Stories .....................
Size of lot: Front ............�'........ Rear .................... Depth ....................
r lr cwnb¢r'1 5 1—i p r? G.t. .. t3.... C�
0. Date of Purchase ...............i 1.... Name of Forcer Owner ....... ..•. .... .
I. Zone or use district in whichprlemises are situated ..............................................................
2. Does proposed construction violalEe any zoning law, ordinance or regulation: ........................
3. ......... Will excess fill be removed from premises: YES NO'
14. WNames lof Oanere regraded ..S �c'I`(' C c> C P SCI c? Address (.���..PR2tc p OG &L&+1,hc1) 69 6S.35
home No. .7.. ....
Namof Architect ..............L..................... Address .............................. Phone No. .............
Name of Contractor .............i,...................... Address ...............................Phone No. ....... ......
15. Is this property within 300 feet! of a tidal wetland? * YES .......... NO .. ....
*IF YES, SUMUD MN TRUSTEES PM41T MAY BE W4ARMI
PLOT DIAGRAM
locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions
from property lines. Give street and block ember or description according to deed, and show street names and indicate
Aiether interior or corner lot.
SfACIb OF N /XaK
C�}f SS
OOl1NlY (7f W .... ....�R I
...........lY............................................being duly sworn, deposes aril says Lhat he is Lhe applicant
(Name of individual signing contract)
above named,
Ileis Lhe ........ ..... .�. IL......... ....................................................... ..
(Contractor, agent, corporate officer., etc.)
of. said owner or owners, and is duly TLhorized to perform or have performed time said work and to make and file this
application; that all statanents contained in this application are true to the test of his krwledge and belief; and
Lhat the work will be performed in the manner set forth in the application filed therewith.
Sworn Lo befo ne this � p
........r ` `day of .,.....`..e,.:.. 19 ....
Notary Pub is .... 4 G •...,..... ....... ..........................
(Signature of Applicant)
RE L aRof
Np�ry o o11 Stere of Neer York
No o1131.4879605
Qusl11W in Suffolk Com
commission Expires Dec.8,
m
_ trIMWR—O—AV
IMY.S Rh. PBI
KK
ROAD
> KOFH
M A / N R O A D ( N. Y. S. Rte. 25) , KEr MAP
�nnc c°re 63.50'
N. 86'55'00" E.
m.n
ii a`o„ya � I �J a {ac
/ 0
TEST HOLE Npz
DEBRIS
is, m
G 34SILTY SAAR
0K GRAVEL
SL TY SATO
I� LKr% GFA VQ £ ® tl Slara�eJ ; 't
WATER N 3 �A
COAFSE 1n
VERY COARSE 4, O 9.9' �'
T,
DESIGN FLOW � C s 86'12.50' W.
S CAPACITY, 38x!5 da = 7 : gal,( Ist. GAJ 25.48'
EATING CAA 1T al./ 5 0 ,
P 9 y 9
1140 sq./l. x 0.04 gal./day/s.L 46 gaU 2nd. II.J Z \ N101F y11lLCEN$Kl
Total l
flow 6 6 al.
ro g
LEACHING
G es idenc
616 ,gaA+ l.5 gypd/s.025.74 s.l. = 16.3 v.11. req'd.
existing 1 (2) 80 x 6' e.d. = 12 v.f.
new (1) 8'0 x 6' e.d. = 6 v.I.
Total Depth = 18 v.l.
APPROVED BY
PLAN OF PROPERTY PLANNING L�V1%D
TESSAT� HOLE "DESIGN FLOW s LEACHING CALCULATIONS AN /T{,/Y LOCASCIO TOWN ': F SOUTHOLD
PREPAREDDFO SHELLEY KEHL' BAN YL ENTITLED
VAN TUYL, P.C. DAT NOV o 19y9
F No, cio 96 - of AT SOUTHOLD
scoffs. RE
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y.
1000 - 62 - 03 - 07
Scale: 1",= 20'
AREA = 4012 84ft Mar, 19, 1996 (Final SCDHS.)
BEM = 1370 sq.ft (each floor) SEPT 29, 1899 (Mpdate)
CONTOUR LINES ARE REFERENCED TO ), -��' p
FIVE EASTERN TOWNS TOPOGRAPHIC MAP `' R pf,k1
ZONING DISTRICT HBjF or N 40 3 0 1999
SuN , MFF o
PARKING Souf,a�;c Tc+.vn
ANY SECTION
209 F" TWAWN TO TMS SURVEYW A VIOLATION 5 STALLS EXISTING
C1'' SECTAf PER
S C THE NEW YORK STATE EDUCATION LAW
WCEPT AS PER SECTION �ppySf/BOIVISON 2. ALL CERTFICANnOMS
N ARE vgqCLW Par TMS MAP ANDS COPIES TW.REOF OM Y F LOT COVERAGE
SA%`DyAP aW COPIE,S REAR TIE NIPRESSED SEAL OF THE SURVEYOR _�,
SIGNA'MAPPEARS HEREon! BLDG. 34% /r� , i !, N.Y.S. LIC, NO. 49618
tffiirbLY TO COWLY MYTH SAW LAW THE TERM 'ALTERED BY' PARKING 32%
RE 1 W RYAANY AAO ALL SURVEYORS UTL2NG A COPY LANDSCAPED 12X YORS, P.C.
OF ANOTHER SW7V5 MAP. .TERMS SUCH AS INSPECTED'AAV ( 5020
EYOR
9FOrAFMT-TO-DATE'ARE NOT CJ COWLUNCE WITH TNT LAW. P. 0. BOX 909
1230 TRAVELER STREET
SOUTHOLD, N.Y. 11971
96-133
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,!�
BUILDING PERM T_' REVIEW CHECK J--,IST
Applicant/ Date
Owners Name: Reviewed: �Z 29Lg q
Architect/ Date
L�
Engineer: L. 1 t A-f it _ _ Submitted: 14A3
SCTM #:
District: 1,000 Section: < - Block: 3 Lot:
Project _ p f Subdivision
Location: Jt- 7y�� Met,-, {/ _ L�C [ r Narne:--
Single&separate Required
certification: (Yes/No)_
Req
Zoning District [Lot size- Actual J [Lot coverage Proposed J
Req Req. Req
[Front Yard Proposed: ) [Side Yard Proposed: [Rear Yard Proposed J
Project Description:
AGENCY PERMITS Permit
REQUIRED FOR REVIEW N.A. NO YES Number
Suffolk County Health Dept. of
New York State D. E. C. ./ r
Town Trustees 101,
Town Zoning Board approval:
Town Planning Board approval:
Flood Plane Elevation ???
Flood Zone:
ote : f
n Vt,a V— !'V h o Ja 't-� a n re t.-i^U✓, ✓'