HomeMy WebLinkAbout19508-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19828 Date APRIL 3, 1991
THIS CERTIFIES that the building ACCESSORY
Location of Property 1080 MAIN BAYVIEW ROAD
House No. Street
County Tax Map No. 1000 Section 70 Block 7
Subdivision Filed Map No.
SOUTHOLD, N.Y.
Hamlet
Lot 18
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 25, 199~ pursuant to which
Building Permit No. 19508-Z dated NOVEMBER 9, 1990
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 STORAGE SHED AS APPLIED FOR.
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
INC. L.I. CHAP. N.Y.S. ARCH. ASSOC.
'~/B'ulld~in~gi'~nspector
Rev. 1/81
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_ 19508 Z
Pe~nission is hereby g~nted to: ~ // /? ~ , / /
~ . ........... ................ .././..F..z../..
.............
.................................
premises
County Tax Map No. 1000 Section ........ .~...~,.. ....... Block ........... Z .......Lot No ......... .~.~-. ........
pursuant to application dated ....... ~.~.~.~..~.....~.... ............................ , 19..~.ZO.,, and approw~J by the
Building Inspector.
Fee $ ........................
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN ~LALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
'!pre-existing" land uses:
~. 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 - $i00.00
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
New Construction ........... Old Or Pre-existing Building .................
Location of Property 1080MAIN BAYVIEWRB: SOUTHOLB, N.Y.
House No. Street Hamlet
INC.'LONG ISLAND CHAP. N.Y.S. ARCH. ASSOC,
Onwer or Owners of Property ..................................................................
?? B1 k 7 ,S
County Tax Map No 1000, Section ........ ;... oc ............... Lot .........
Subdivision .................................... Filed Map ............ Lot ......................
Permit ~ ,9508-Z ..... Date Of Permit..~:.?~.!~? .... INC.L.I.C}IAP. N.¥ S. ARCR. ASSOC.
............... app~mcann .................... : ........
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $ ...... . P:PP ..................
. .... ................
¢ O APPL CA
PLANNING BOARD MEMBERS
Bennett Orlowski, Jr., Chairman
George Ritchie Latham, Jr.
Richard G. Ward
Mark S. McDonald
Kenneth L. Edwards
Telephone (516) 765-1938
PLANNING BOARD OFFICE
TOWN OF SOUTHOLD
TO:
From:
Date:
RE:
Thomas Fisher, Building Inspector
Bennett Orlowski Jr., Chairman~O~
November 7, 1990
Request for waiver of site plan
Drossos Motel Ltd.
ScTM$ 1000-45-1-13
Indian Museum
SCTM~ 1000-70-7-18
Jefferson Temple Church
SCTM~ 1000-101-1-10
HARRIS
Supe~isor
Town Hall, 53095 Main Road
P.O. Box 1179
Southotd, New York 11971
Fax (516) 765-1823
The following is in response to your request for the
Planning Board's comments on a waiver of site plan requirements
for the above referenced properties:
Drossos Motel-The Board would like the applicant to
submit a more detailed drawing showing the relationship between
the parking for the restaurant and that for the motel. The
sketch should also show the locations of the motel building, and
the miniature golf course, relative to the restaurant.
Jefferson Temple Church-The Board will waive the site plan
requirements for this accessory tool shed provided the required
set backs are met for this zone.
Indian Museum-The Board will waive the site plan
requirements for this accessory tool shed provided the required
set backs are met for this zone.
765-180Z
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
OUNDA~ION ( ~ st)
OU~{DATIO:~ . (
OUGH FRAME &
-FLUMBING
I~SULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONA'L COMMENTS, .
TOWN OF S¢)Uv~
Examined./// . ........ ,
FORM NO. 1
TOWN,OF SOUTHOLD
BUILDING~DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765.1802
Approved. ,//./~. .......... 19,~...~. Permit No/f.~..~..~./ .....
Disapproved a/c .....................................
(Build, ti,fig Ins]~ftor)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
BOARD OF HEALTH
3 SETS OF PLANS
SURVEY
CHECK
SEPTIC ...................... FORM
CALL ....... . ....
~TO: ~c~.~- ~Z ~
Date .Oi~.+. · · 194 .~.
a. Tlfis application must be completely filled in by typewriter orin ink and submitted to the Building Ihspector, with 3
aets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of th/s appli-
caQon.
c. The work covered by this application may not bc commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector. '
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for )emoval or demolition, as herein described.
The applicant agrees to comply with all applicabqe laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectom on premises and in building for necessary inspections.
.... d' · -,, · .- vq,-'. I.'t .~..~...r'l-~.¢.lex, Hl~,$'~ ev ......
· (S~gnamre ot applicant or name, ifa corporanon)
.. . P...O.. B.o.~ .g~9..$.~.,,.+.%.4&,. u.'/ .... I.L~ 7I ........
(Mailing address of applicant)
State wh~ther applicant is'owner, lessee, agent, architect, engineer, general contractor, electrician, pinmber or builder.
............................................................................. ~.~ ..............
· ~,', .: (as on the tax roll or latest deed) OA~a~:,a ~
If applicant is a'~o3pom'fion, signature of duly authorized officer.
.. M
(Name and title of corporate officer)
Builder's License No ...... .0~ ...........
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work xvill be done;
..... I.o..B.Q.. :..~..~. :',~... ~ .¥ ~.,.e.~ ................... ,%.0.,4-
House Number ' Street, Hmnlet .........
County Tax Map No. 1000 S~ction ...~).7. O ......... BlOck . .~7. .............. Lot...1.8. ........ '
Subdivision Eiled Map No. .
(Name) ............................
2. State existing use and occupancy of premises and intended use and OccuPancy of proposed construction:
A. Ex±sting use and occupancy....t~..~ .~'.q:.~.%.~. ........ . .....:.~2.'.e .,.~.~'~,,~ ..................
B. Intended use and occupancy. . .,~.~9 ~'.~.~' ...... ,.;..oq~¥ ~ .... ~..~'t'~l~ .~1~% .. ', ................
3. Nature of work (check which apl31icable): New Building ....
Alteration
.. Addition ....................
Repair ........ ~..... .R~mo~al .............. Demolition .......... ,. . Swimming( .,P~q~. ..............
Tennis Court ....... Accessory Building. ~.. ...... Fence ....... Other Wo~I~...~ ..........
(to be paid on filing this application}
$. It' dwelling, number of dwelling dnits ............... 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 ...................
7. Dimensions of existing stmcture~, if any Front ....... .~..~'.... Rear ....... ~.O ...... Depth .~.,19 ........
Height 14'~.~ Number of Stories ...I. ..................................................
Dimensions of same structure wiih alterations or additions: Front ................. Rear ........ ; .......
........
Depth ...................... Hmght ................ t ..... Number of Stories. . ....
8. Dunenmons of entire new constrnctmn. Front .......... Rear ............... De~h ....
9. Size of lot: Front .... .{,~(~...i ........... Rear . .].-'~.(~ ........... · ....
/..q..6! q Name of Former Owner
10 Date of Purchase., .. .. .....................
Zone or use district ' ' ~ ' '
11 m which premises are mtuated ..........
12. Does proposed construction violate any zoning law, ordinance or regulation: .. b/. 9 ..........................
13. Will lot be regraded ........ i ................. ~'/~ Will excess fill be removed from premises: Yes .... Nok'
· ress ................... Phone No. 7.§' ' ' ' ~ .'. ,C.~ 7.7.
14. Name of Owner of premises .~.,.!.t..~...~...~..~..~?..~'.%1, o..~(l'd ....
Phone No
Name of Architect .......... : ................. Address .....................................
Name of Contractor ......... l ........ i ........ Address ..... .
15.Is this property localted withzn 300 feet of 'a' ti~'l' ....... PhoneNo ......... :> ....
wetland? *YES .... NO.~. · .
· If !res Southold Tow~ Trustees Permit may be required.
· 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 YOR, I~, __c7,~ I t d ~, o
(Name of individual sign' ~g contract)
above named.
APERO D tIS
76~-1802 9 AM ~ 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION , ~ ~0 REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSU~TION
4, FINAL CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL ME~
THE REQUIREMEN~ OF THE N.Y.
STATE CONSTRU~ION & ENERGY
CODES. N~ RESPONSIBLE FOR
DESIGN OR CONSTRU~ION ERRORS
being duly sxvorn, deposes and says that he is the applicant
13e is the · (Contractor, agent, corporate officer, etc.)
of said owner or owners, and is d(ily authorized to pegform or have performed the said work and to make and file this
application; that all statements con,tamed in this application are true to the best of his knowledge and belief; and that the
work w~l be perforated in the m~qer set fort ~ in thc application filed therewith.
Sworn to before me this
............ ....
.. ........ ;