HomeMy WebLinkAbout23310-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
$outhold, N.Y.
CERTIFICATE OF O~uu~ANCY
No Z-24442
Date JUNE 19, 1996
THIS CERTIFIES that the building
Location of Property 5025 MAIN ROAD
House No.
County Tax Map No. 1000 Section 35
Subdivision
ACCESSORY
GI~EENPORT, NEW YORK
Street
Block 2 Lot
Filed Map No. Lot No.
Hamlet
11
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 14, 1996 .pursuant to which
Building Permit No. 23310-Z dated MARCH 18, 1996
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 ACCESSORY PDMPHOUSE "AS BUILT" IN REARYARD OF ISLAND END
~OLF COURSE AS APPLIED FOR.
The certificate is issued to
of the aforesaid building.
FLOYD KING, JR.
(owner)
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
~/a
N-382715 - APRIL 10, 1996
lding Inspec~r
FORM NO.3
TOWN OF $OUTHOLD
BUIt. DING DEPARTMENT
TOWN HAU.
$OUTHOLD, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date .................... ~ ..........................................
Ne 23310 Z
Building Inspector,
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Ao
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 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 buildings
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.
Bo
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
Vpre-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.
Fees
i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swin~ning 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 - ~ -25~'
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00~ Commercial $15.00
New Construction...~. ..... Old Or Pre-existing Building .......
Location of Property ............. ~. ..... ~ ............................
House No. Street
Onwer or Owners of ~ ..... ~, ~o~D /~,~*i- .x¥?~.. ...............
.;...
Subdivision ~. Filed Map Lot
Permit No ..... Date Of Permit ................ Applzcant ...........................
Health Dept. Approval ..................... .. ... Underwriters Approval .........................
Planning Board Approval .......
Request for: Temporary Certificate ........... Final Certicate .... ~ ....
Fee ~ubmitted: $ ............ ~ ............
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
April 30,
1996
Mr. Robert Brown - Architect
P.O. Box 521
Greenport, NY 11944
Re: Floyd King - Island End Golf & Country Club
Prem: 5025 Main Road, Greenport - SCTM#1000-35-2-11
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
xx An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
xx The check is not on file. $50.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 23310-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
THE NEW YORK BOARD OF FIRE UNDERWRITERS l
1195(399 BUREAU OF ELECTRICITY
~-- 815 JOHN STREET. NEW YORK, NEW yORK 10038
Date APRIL 10,1996 /Ipplication 3!o. on file 88~97395/95 N 382715
THIS CENTI~IES THAT
o~y the electrical equipment ~ ~sc~bed below a~ int~uc~ by ~ applicant ~d on the a~ve application number in the prem~es of
ISLAND END GOLF COURSE, ROUTE 48, GREENPORT,
in the foliowlag location; [] B~,ement [] Ist FI. [] 2nd FI. O[~T Section Block
,~s examined on MARCH (37,1996 and found to b~ ih ~ompliance with the National Electrical Code.
Lot
FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS
FIXTURR
OUTLETS EWITCHEE FLUORESCENT OTHER
DRYERS
~THER APPARATUE:
E 'R
NO2 ~a E~C~'iOND'
E
A W. G NOOF NEUTRALS A W G.
OF HI-LEG OF NEUTRAL
3/(3
STEP DOWN TRANSFORMER-1
I(3(3A DISCONNECT 5(3 AMP-q
48(3 %; PUMP 5(3 H.P.-i
MOTORS; 1-50 H.P.
TRANSFORMER: 1-3(3 KVA
G.F.C.I,-1
JIM SAGE ELEC. INC~
350 MARINE PLACE
MANAGER
'This certificate ml~U]~N[~ORIJerec:~ an~ter; return to the office of the Board if incorrect. Inspectors may be ~Ldzentified bf their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
I;()IIHI)A'r[oII (I~iT)
IIOU(;II FIIAIII~ &
I'I.IIHII
II'I,~HII.^'I'IOFI I'l';II ti. ¥. ~
$'I'ATI[ F, tt Ir. lt(; y
(;()1)1~
lift 1.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION I ST [ ] ROU~.BG.
[ ] ,IREPLACE,,~HIMNEY /
REMARKS~ ,~
DATE /~~ INspECTO~~
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1802
Disapproved a/c ........................
~TION FOR BUILDING PERMIT
BOARD OF HEALTH ...........
3 SETS OF PLANS ...........
SURVEY ....................
HECK ............. ;''
SEPTIC ... .......
NOTIFY
CALL ....................
MAIL TO:
BLDG. DEPT.
INSTRUCTIONS
a. Tkis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, ~vith
sets of plans, accurate plot plan to scale. Fee according to schedule.
§. Plot/)lan sh6wir~g location of lot and of buildings on premises, relationship to adjoining premises or public stree
or areas, and giving a detailid description of layout of property must be drawn on the diagram which is part of this appi
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 perm.
shall be kept on the premises available for inspection throu~out the work.
e. No building shall be occupied or used in whole oran part for any purpose whatever until a Certificate of Occupanc
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 th
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c
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 t,
admit authorized inspectors on premises and in building for necessary insp~t~
(Signature ot applicant, or name, if a corporallon)
(Mailing address ofapph* ' "cant)
State
whether
applicant
is
owner,
lessee,
age~n~neer, general contractor, electrician, plumber or builder
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ..........................
Plumber's License No .........................
Electrician's License No .......................
Other Trae s L~cense No ......................
I. Location of land on which proposed work will be do~e.
House Number Street~ Hamlet
County Tax Map No. 1000 Section ............... Block ....... : .......... Lot .......
Subdivision ..................................... Eiled 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 ....... ... .. . ."..... .
b. Intended Use and occupancy
3. Natu.re of work (check which applicable): New Building ...~.' ..... Addition .......... Alteration
R :ur .............. Remo I D lift ........ i '
ep va .............. cmo on ............ Other
4. Estimate'd Cost ... ' .... F
(to be paid on filing this application)
If dwelling, number of dwellingl units .
5. · .............. Number of dwelling units on each floor ................
If garage, number of cars .... ~ ..........
6 If bus:nyss commerczal or mzxed occupancy ......................
· · , specify na!ture and extent of each ty. pe of use ...................
7 D,mens~onsof existing structures if any: Front l~ n /~~ ..................
Height ]].'~.~. Number of Stories J. ....................................
.......... wiith alterations ......................................................
Dimensions of same structure or additions: Front Rear
Depth ~ ' Height ............................
.......... ~ ........... Number of Stories
8 Dimensions of entire new construction: Front ...................................
Height Nmqber of Stories ............... Rear ............... Depth
Size oflg : ............. ' ........................................................
· Front ........... ! ........... Rear ....
I0 Date of Purchase I .................. Depth ......................
· · .......... , .................. Name of Former Owner .............................
11. Zone or use district in which premises are situated
12. Does proposed construction viol'ate any zoninc, law '..'-~,..'_'n'.].. .......,' '.: ...... ,'/~ ..........................
i ~ =, u~umauce or regulation' .,-q~ ..........
13. Will lot be regraded ~.t? , . ................ i'.~______~
., . ' ..... ~i1';'x.'o k'.:,'.' :..' '. ...... Wdl excess fill be removed from premises: Yes
amc of. Contractor ......... i ............ Address ................... Phone No ............. '.. '.
Ii. Is th:ts property loca=ted '~'t~i'~..~O0-'feet of a tldal ~etland? ~¥ES..'~.HO .... '
:~If yes, Southold Town. Trustees Permit may be required
, PLOT DIAGRAM ' CT01~
Locate clearly and distinctly all ibuildings, whether existing or proposed, and. indicate all set-back dimensions from
property Lines. Give street and block humber or description according to deed, and show street names and indicate whether
interior or corner lot.
STAT~ ?F N 'FrW-YORi~&'--
......... ~' -~.: -~..~..- .~..e~...xtTx ............. being duly sworn, deposes and says that lie is the applicant
(Name of indivldual signing contract)
above named.
] (Contrac~,.~.~agefi~,~.c' rporate officer, etc.)
of said owner or owners, and is duly i~uthorized to pe~r~bave performed the said work and to make and file this
application: that all statements contain'ed in this application are trne to the best of his knowledge and belief; and that the
Work will be performed in the manner s~t forth in the application filed therewith.
Sworn to before me this
Oualified in SuffOk County
Comm ssion Expires December 8, 19.,-. v (Signature of applicant)
~M TO 4 P~ FOR THE
.OWIHG INSRECTIONS'