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HomeMy WebLinkAbout21307-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22342 Date MAY 19, 1993 THIS CERTIFIES that the building REPAIR Location of Property 3800 DUCK POND ROAD CUTCHOGUE N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 83 Block 2 Lot i Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 5, 1993 pursuant to which Building Permit No. 21307-Z dated APRIL.6, 1993 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 REPAIR WORK ON MOTEL EAST RESTAURANT & MOTEL WEST CAUSED BY WINTER STORMS. The certificate is issued to POND ENTERPRISES, INC. (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building nspector Rev. 1/81 FORK NO. f TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT i (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL I COMPLETION OF THE WORK AUTHORIZED) 4 N Date ..~.........4~ 19Y.3 NO. 2130? Z f i Permission is hereby granted t ~'..jJ...... . ~I TL / lLf { of premises located at 3.(7...Iw..... 1.! ! ~..4 { A...... . ...~1...................... f County Tax Map No. 1000 Section ..9-3 Block ........tom,....... Lot No. .......I i - pursuant to application dated . t.l~ 19.d•.? and approved by the f Building Inspector. i Fee $...L..t` I Building Inspector f i f Rev. 6/30/80 0 "Member - Long Island Tourism & Convention Commission" Resort Motel & Restaurant (516) 734-6370 DEPOT LANE ON L.I. SOUND (516) 744-1448 R.R. #1, BOX 161 H CUTCHOGUE, N.Y. 11935 f cd ~ ~T a o h v it p 7G N1 (rl~~~I `7 T~ 0 NAY 1 S 0 a , OLD DEff, Rl Vacation Paradise on Long Island Sound 95.2" (10901-5~ 1E\\' YORK STATE DEPARTMENT OF ENVIRONx1E\TAL CONSERVATION SEC PER.NI T .NUb10E R ® EFFECTI\E DATE l6m-I S' FACILITY.PROCRnM NUMBER(sl /2 2114 Z PERMIT EXPIRATION DATE Under the Environmental Conservation Law (ECL) L /31/93 TYPE T OF PERMIT (Check All Applicable 9o•es) KINew ?Renewal ?MOddicatlon ?Pmma to Constmc, ?Pe.mn to Operate Article 15, Protection of Title 3. Water ~ SArticle POES 17, Titles 7, 8: a HArticle 27, Tie 9: 6NYCRR azardous Waste Management Pr a Article 15. Title 15: Article 19: Article 34: Water Supply Air Pollution Control Coastal Erosion Management Article 15, Water Transport 15. M neld Land Title Reclamation F oodplain~ Management Article Title e Articles t Long Island Wells Freshwater Wetlands 6NYCRR380: Radiation Control Wild1eSc15, enic land Recreational Tidal Wetlands Other: Rivers Article 27, Title 7; 6NYCRR 360: 6NYCRR 608: Solid Waste Management Water Quality Certification PERMIT ISSUED TO TELEPHONE `LUMBER Z~V_ d ba, earl, e-a-yt 5el- lS ADDRESS OF PERMITT'E S)wre"CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER tcf, (ar tsi~, ~yy NAME AND ADDRESS OF PROIECT,FACILITY U00 Z~ d . Cc~a!cG. LOCATION OF PROJECTIFACILITY COUNTY TOWN, 6/ d cl WATERCOy-URSE,W[ETLANO NO. NYTM COORDINATES C) t' DESCRIPTION Of AUTHORIZED ACTIVITY ~R11emo'v'eand replace in the same configuration linear feet of eapistin damaged / {-C-kVq lot~and place `Q cu. yds. of backfill, e/ l.UV O ye O r `F res+Q ra~ C v Ct~t-hl wrr+w,.~ , By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (See Reverse Side) and any Special Conditions included as part of this permit. e tonal PERMIT ADMINISTRATOR AOOREss Regulatory Affairs - Region One, Bldg. 40 SUNY Robert A. Green Ston Brook N.Y. 11790-2356 AUTHORIZED 51ONATURE OATE Page 1 of 6 TRUSTEES w' a SUPERVISOR John M. Bredemeyer, III, President SCOTT L. HARRIS Albert J. Krupski, Jr., Vice President Henry P. Smith Town Hall John B. Tuthill 53095 Main Road William G. Albertson P.O. Box 1179 Telephone (516) 765-1892' Southold, New York 11971 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD cnASTAL EROSION HAZARD AREA AND TOWN WETLAND EMERGENCY AUTHORIZATION(S) Applica ion No.SCTM,#1000- Name: PDwU c~fC'r~Y~SeS T _ ~~p /~<z~-G«~6~>r /rode/ Date: December 21, 1992 RESOLVED that pursuant to the Town Code in relation to Coastal Erosion Hazard Areas, Chapter 37, Section 20, 21 and Town Code Chapter 97, Wetlands, the Southold Town Trustees, as Administrator, have determined that the activities proposed by your emergency activity request are necessary to protect property and important coastal natural resources. DESCRIPTION OF ACTION: r yF /7 Cn~,6 /ini7FtJ ~ .~ii.r- ~~f/'Y ~~.?r^'?.,i .ice ^J. i r`r. /~N+.l 5+.!';i /r~0 i=orl`~^l- r~iz/~~O'>r~, lir`''/N•"~ Reasons supporting this determination:" '4"•i/1 1. An on site inspection has been conducted by the board of Trustees or their authorized representative. 2. The Trustees have considered the emergency request and find that if the work is not completed as authorized and measurable loss of property and important coastal natural resources is likely to occur. This authorization is not a permit. You must complete the coastal Erosion and wetland permit process where applicable for all authorizations given under this section. This authorization should not be considered a determination made for any other department or agency. Form No. 6 I\ TOWN OF SOUTHOLD BUILDING DEPARTMENT W TOWN HALL 765-1802 BLDG. DEPT (O OFSOUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY k. 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 2110 of 17 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. 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. 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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10,00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date y.~.7f.~ :w Construction........... Old Or Pre-existing Building. r nation of Property..3 ©D ....'K Itc( (JtM Q .rt d:......... 4.f.. G[LO U /V, House No. 1,. Street Hamlet F.el .~C~ wer or Owners of Property... ~ ~ C7. unty Tax Map No 1000, Section.... .,....Block....... ,,,,,.Lot.,...... bdivision.............. .Fi}eed Map............ Lo1t............. rmit Noa1 3E?'7 ,Date Of Permit..416,(,{;-3,.Applicant. ~~^`~.E~ 9 ~01 . 11th Dept. Approval........ .......Underwriters Approval...... inning Board Approval..........'.............. Juest for: Temporary C~egrtiifficate........... Final Certicate. Submitted: 001"A Ff, f A~i( J P? SL( ~~ec. ysyB/ APPLICANT C 0 CU3 If a Form No. 6 TOWN OF SOUTHOLD 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 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. 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: 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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ~.~f ew Construction........... Old Or Pre-existing Build}'ng. ` ocation of Property..3e00........ ~GIC~~ pClu C 2d. 4 Gc 0000 U /U House No. Street Hamlet .iwer or Owners of Property Po ~.I .'f / S QJ )unty Tax Map No 1000, Section..... Block Lot... / ibdivision............................ sled Map.......... Lot. !rmit No,13.0. •7. :.Date of Permit.. .....Applicant.. 6 ` !G7 ( Z' kc" 1A m1th Dept. Approval ! .Underwriters Approval.. anning Board Approval.......":- / quest for: Temporary Certtiffiicate........... Final Certicate.:"....,,,,, e Submitted: $...~e .a~.!! 7e~....0.......... o S(GC APPLICANT a ~ F=OUNDATION ( 1st) ti ~ONNDATION (2nd) _ - m r o ~ o ~OUGH FRAME & -PLUMBING y m 1. a n y11SULATION PER N. Y. I -3 STATE ENERGY CODE m FINAL ADDITIONAL COMMENTS: s ra N Z ~ A O ~S • r Z ' m ^e H 130,\RD OF HEALTH FORM NO.1 3 SETS OF PLANS TOWN OFSOUTHOLD SURVEY .BUILDING DEPARTMENT CHECK TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 TEL.: 765-1802 1: OT IFY 7 CALL . . . . . Examined . 19/..J tIAIL TO: g Approved ` (O... , 197Permit No...a' Disapproved a/c _ . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date 19 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. - ................4C4.~ / :.`t~...... (Signature of applicant, or name, if a corporation) AJI (Mailing address of applicant) 11-7 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...........:©~c~ Vl (?Jl h d.I...... .nJ r uu b9~i3~lPC T-,,C . .D. .S. Name of owner of premises 1,{ (u (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. . r-- Electrician's License No. Other Trade's License No . Location of land on which proposed work will be(done . ) . 1 . Houseo~ C-) .e.e ~lC~ ~dLt~ n J. ie. Number Street Hamlet / County Tax Map No. 1000 Section I'// C. 3. Block Lot .7.` . Subdivision (N..a..me.)................ Filed Map No. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy t~ L b. Intended use and occupancy O~~t~ 3. Nature of wol (c}6ck which applicable): New Building........... Addition Alteration Repair I/..... Removal Demolition Other Work . APi~®~ . AA, (Description) 4. Estimated Cost 4/ Fee ~ S~e~i.4.~.............. . (to be paid on filing this application) S. If dwelling, number of dwelling units , , , , , • • • • , , , , Number of dwelling units on each floor , If garage, number of cars . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . 'hi ' .T L d t~RfT~f'" 7. Dimensions of existing structures, if any: Front . . Rear Depth .......Height • • Number of Stories . . . Dimensions of same structure with alterations or additions: Front • Depth.... Rear..... Height Number of Stories . 8. Dimensions of entire new construction: Front . Rear Depth Height Number of Stories. 9. Size of lot: Front . ~ t7~~............ Ream. or . Depth 717 . 10. Date of Purchase . . ~•,7 ' f Fortner " " Owner fl . . . . . . . Name of . A ,Gaze UI . ~d~/~ D • • • ~Cc~(ft~er-~j 11. Zone or use district in which premises are situated Q.T.? 12. Does proposed construction p1violate any zoning law, ordinance or regulation: .#V R 13, Will lot be regraded (l/ •V,''... Will excess fill removed ro 14. Name of Owner of premises . . KGs ~C~a ZcU ~v er I3 es: Yes No d Address .1( Ali Php e No. 7 ;/,fL Name of Architect d?®bto f G . > e i f?'t Address ~yCe• NIGrr G` ~ioe No. 9~ Name of Contractor ftl fC, , f 0..k , , , , Address . G f y Phone'No. 15. Is this " property within 300 feet of a tidal wetla ti nd? * ;d Yes o N......... *If yes, Southold Town Trustees Permit may be re . 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 number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW OR S'S . / OUNTY OF 0 . t s . .4. • being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) bove named. Ieisthe....... P.~,... ° ~...~12.~• C (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ppiication; that all statements contained in this application are true to the best of his knowledge and belief; and that the •ork will be performed in the manner set forth in the application filed therewith. worn to before me this t~ . X ( 19 .d~aayy~ of. otary Public,5 unt HELENE D.'HOR~ y Notary Public, State of New York No. 4951384 Qualified in Suffolk County Commission Expires May 22,18 (S~gnature of applicant) O A ~ GONG. ~D~TIC~ D~T I C~ Go,JG . To r wG~~ wG~d ~ r~.~ ~ - MoTF- L R~~TDL1l~.bNT- I r GCCNG W bLK. GGI--~G W bLK~ I GONG W b ~Ic ~ I ~Kfo ~rl r OE ,--K, aelwa- 1 o N EtI b' COOC,. 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