HomeMy WebLinkAbout17932-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19277 Date AUGUST 7, 1990
THIB CERTIFIES that the building REPAIR
Location of Property 28400 HAIN ROAD CUTCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 102 Block 6 Lot 17
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Buildiing Permit heretofore
filed in this office dated MARCH 16, 1989 pursuant to which
Building Permit No. 17932-Z dated MARCH 17, 1989
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 RECONSTRUCT CHZr~AiEY TO RESTAURANT AS APPLIED FOR.
The certificate is issued to WILLIAM J. SMITH
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Bu' ding Inspector
Rev. 1/81
F08M MO. ~
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)
fl 017 9 3 2 Z Date .....~..Q~{:1-.i(1.....1..~ 19.L7..9
Permission ~s hereby grunted to• q~ ,
.....~.f.':!:1. Jim'....... ~/.ti:'.:'.al.S.l.:.l.
at premises located at ..a..~.AL~??.....~ Q~^^........ ..~.rS<1.L...M..F.-~
. .
County Tox Map No 1000 Section J 4. ~-r:'... ,11 'Block gqLot No. . ~ . ,
pursuant to application dated ..~S~.l.s.~,. 1..Ya 19.~~....1., and approved by the
buildin/g Inspector.
Fee 5
Bu ing Inspector
Rev 6/30/80
i _ Focm No. 6 l
I TOWN OF SOUTHOLD
~ ~ BUILDING DEPARTMENT ~
- Z ~ TOWN HALL
765-18U2 ~Ch ~ y~
BLDG. DEPT, t Z v
TOWN OF SpUp{pEp AppLICATION FOR CERTIFICATE OF OCCUPANCY
1. 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 18 lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or eagiaeer
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 o£ 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 Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Uccupancy - $50.00 ,
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date AUGUST 7, 1990
:;cw Construction..,....s,.. Old Or Pre-existing Building... X............
Location of Property..2~G,~Q.MAIN,ROAD..CUTCHOGUE, N.. Y: r
House No. Street Hamlet
Onwer ar Owners of Property „ WILLIAM J: SMITH _ _ _ _
County Tax Map No 1000, Section...~.~......Block.,...Ya..........Lot..,.~.~....,.__.,..,,,
Subdivision ....................................Filed Map............Lot.,....................
PermiC No.179~2Z.. .,,Date Of Permit. 317(t39,,.....Applicant...~Z~~X~,~r. ~MITi~...,...
f{ealth Dept, Approval ..........................Underwriters Approval...
• i
Planning Board Approval .
Request for: Temporary Certificate........... Final Certicate...~C.......
Fee Submitted: $,...:~25.AD ~ ,
c~~c.,~aoaaq, .......G~~,~
ANz
• TEL. 7G5-I 802
~oS~EF~iK~oa TOWN OIL' SOTJTIIOLi)
~ OI'T'ICE OC' BUILDING INSPECTOR
~ .~.r ~+jE
,g~ rn P.O. BOX 728
~ ~ts~ra%c~"? ~ TONN IIALL
O~Ol ~ apt- SOUTIiOLp, N.Y. 11971
August 7, 1990
William J. Smith
P.O. Box 1238
Cutchogue, N.Y. 11935
To 4Thom This May Concern,
We are unable to complete your Certificate
of~Occupancy because of the following reasons.
/_y/ An agplication for Certificate of Occupancy ,
is not on f11C. (ENCLOSED)
/_//NO Underwriters Certificate on file.
The check is (Ipxi/not on file. ) $25.00
No tIcalth Dept. t•.pgroval on file.
No final inspccLion has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Iluilding Permit I) 17 4 3 2 Z (RESTAIIRANT)
i3uilclinq Dept.
fIO Plumk~er Selcler Certificate on file.
( all pcrtnit~ involving plumbing being
iasucd aft.cr April 1,19II4 )
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ROUGH FRAME &
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I1ISULATI0f7 PER N. Y.
STATE ENERGY
CODE I _
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FINAL
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ADDITIO1fAL COMMENTS: x i
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7 q / 765-1802
C / 3 BUILDING DEPT.
1 NSP~CTIQN
[ ]FOUNDATION iST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING ~ ~ FINAL~y~~
REMARKS:
~ ~'l~ ~
DATE 3 ~7 ~ INSPECTO ~
~lSlt ~U~~I..e g
R-,~5'
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765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATi ST [ ] ROUG LBG.
[ ] FOU ATION 2ND [ ] 1 ULATION
[ . RAMING ~ FINAL
REMARKS: ~ p ~yw~,.~~.p-t,~~
eTi.`, Y C~C.IM.,
DATE s fNSPECTOR~ Ir~.L r~ q 1~-(z/L
U ~ri.u l.v t ~c-zv
HOAFD OF HEALTH
3 SETS OF PL.1N5
FORM NO. t SURVEY .
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORP1
TOWN HALL ~ ~
, SOUTHOLD, N.Y. 11971 NOTIFY 2
- TEL.: 7651802 CALL ..I7~°~~~: ~!~-Q
Examined . ~•~!-~X~. l Z !9$~. MAIL T0: •
r\pproved .~.t?:+.:~.. ! Z I9~~ Pcrmtt No..{ 7 ~ ~2"~' ~
•D
...i
Disapproved arc MAR 16
B44G DEPT
TOWN OF .SOUTHOLD
(Buddtng Inspector)
APPLICATION FOR BUILDING PERMIT
r _
Date ~ .f~a 15 c~
INSTRUCTIONS
a. Tlus appltcatton must be completely filled in by typewnter or to ink and submttted to the Budding Inspector, with
sets of plans, accurate plot plan to scale. Fee accordtng to schedule.
b. Plot plan showing location of lot and of buddtngs on premtses, relattonshtp to adlommg premtses or public stye:
or areas, and gtvtng a detatled descrtpttnn of layout of property must be drawn on the dtagram whtch is parr. of ttus app
canon.
c. The work covered by ttus agphcanon may not be commenced before Issuance of Building Petmtt.
d. Upon approval of flits apphcauon, the Bwldmg Inspector will Issued a Building Petmtt to the applicant. Such pent
shall be kept on the premtses avatlable for mspectton throughout the work.
e. No buAdmg shall be occupied or used m whole or m par[ for any purpose whatever until a Certificate of Occupan~
shall have been granted by the Building Inspector.
hPPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bwldtng Permit pursuant to ti
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other appltcabie Laws, Ordlnances
Re^ulattons, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descnbe
Tlie appttcant agrees to comply with all apglicabte laws, ordinances, buildwg code, houstn~ code, and regulations, and
admit authpnzed Inspectors on premtses and ut building for necessary Inspections /
~ ' - , (Signature or appli~ t, or name, If a corporanon)
• (Mailing address of applicant)
State whether appttcant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builde
......~W.elf"/t
Name of owner of premtses .1i4?.~X4h1.M••.J•.~•~<rlY•,••••
(as on the tax roll or latest deed)
If appl+cant Is a corporanon, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's Ltcense No . .
Plumber's Ltcense No . .
Electnctan's Ltcense No .
Other Trade's Ltcense No .S~'d.4H.L.. • • • • • • • • • • 1•/T~
1, Locatton of land on whuh proposed work will be done. ...?y1?<''!r6:!"?,ye GJTr/~¢f~i,.E' ^,rY ~~Sr,~~"
.
1{ouse Number Stree[ Hamlet
County Tax Map No 1000 Section .IJJI.....•••.•••.• Block ....1rj.......... Loi..t~{
Subdivts+on Filed Ivtag No. Lot .
(Natiie)
2 State e~tshng t+se and occupancy of grem+ses and attended use and occupancy of proposed construction
a. ECtsttng use and occupancy ....i~l:•~.~V
: ~ ~ . . . .
b. Intended use and occupancy K~tfi~.Ad^!~ • • ~~+7• f,~i7vt•, , , , , , , , , , , , , , , , , ,
.
3. Nature of work (check w htch applicable). New IIuddtng Adddton Alteraiton
Repatr Removal Dcmohuon Other Work atE.K cN~+7~J&,I
(Dcscnptton)
c
4. Eshmatcd Cos[.....ISOOr Fee....................................
(to be patd on filing [fits apphcauon)
5. If dtvclhn„ number of dwelling untts . Number of dwelling amts on each floor .
Ifgara;c,numbcrofcars
6. If business, commerctat or mt~ed occupancy, specsfy n tore and extent of eac type of use ..R.fas":^.':~'~ .
7. Dtmenstons of extsung structures, tf any Front . , , ~ Rear . Depth . .
Hut_itt ..............NumberofStoncs.....................
Dtmenstons of same strliciurc with altcrattons or addtttons Front Rear .
Dcpih IIctght Number of Stones .
Dtmenstons of entire new construction. Front ..S`.f•P~~., Rear tw'la....... Depth . S.c"4=....... .
Height ,r,.tonE........ Number of Stones ...JICri3f'~ .
9. Stzeoflot Front Rear Depth
10. Date of Purchase ..~~~~~Q4 ......Name of Former Owner .4P:j~'{~~G£ .~rt°:i:~........... .
I I. Zone or use dtstrtct to whtclt premtses are st[uated .
12. Does proposed construction violate any zoning law, ordinance or regulation. ..N.R .
13. Will lot be regraded .......A04 Will excess flll be removed from premtses. Yes L~
14. Name of Owner of premtses .ia)d411~!<37.SPtYiF!°i...... ,Address !.h".N .r'~a.@~ P.E.C.~~NJG... Phone No ~~u:~r1 ~t .
Name of Archt[ect .Address ..Phone No. .
Name of Contractor . ~.u ~DD{~1`t • ............Address l~~;f,~::r?YG f1L~'°4~F. .Phone No.. (.~/~Q.. .
IS.Is this properCy located within 300 fee[ of a tidal wetland? *YES.... O
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAbI
Locate clearly and dtstmctly all buddmgs, whether extsttng or proposed, and rndicate all set-back dtmens:ons fro
property fines. Give street and block number or descnptton according to deed, and show street names and tndtcate wheth~
intenor or comer lot.
*t ( t
b ~ )
R; NGtiS ~ ~
'`',~aS? ' ~`r ,~A~P1P,~R'O`^YQED AS NOTED
~s~r a,"'K t.r~t."~'~i'~~~° DA : =1.i-~I..~.d-B.P. # 7 31~
'4i~y FEE /11D. 8Y. ~'s•
~ ~~C ~ 765 1802 U9LA M TO 4PPM FORTTHE .
{ FOL OWING INSPECTIONS '
1 P~U(~QATION TWO RE(lUIRE[)
llll,,. ; i~.80URED CONCRETE
~ J~. i¢yR FRAMING & PLUMBING
~,r5~l~ s IN noN
4 FI A - CONSTRUCTION MUST
8F COTJSPLETE FOR C O
ALL ONSTRUCTfON SHALL MEET
THE EQUtREMENTS OF THE N Y.
CONSTRUCTION & ENERGY
r,OQES NOT RE5PONSIE:LE FOR
CrES!GN DR CONSTRUCTION ERRORS
id a.9~
~"~ts A ~ C~'`~`~c
STATE OF \E1V YORK, S S
COUNTY OF
~.'.°"'`R".'.'J . S'Y, being duly swam, deposes and says that he is the apphca:
.
(Name of mdn [dual stgnmg contract)
above named.
fe is the 3a??~L~ d;~t/~/t,~ .
(Contractor, agent, corporate officer, etc.)
~f said owner or owners, and is duly authonzcd to perform or ]tavc performed the said work and to make and file t1'
Pphcauon, that all statements contained to tlus apphcauon are true to the best of fits },nowledgc and belief, and that tl
vork will be performed m the manner set Cor[h in the apphcauon filed theruwtth
•ivom to before me [fits
.....~`r' day of ,/t7.'Cr~.<.~j .,19~~/. ,may ~djLl,~,~~
~ rjtGG
.otary Public, ...~::`:u""' ~ . ~ County %7
NELENKDEYOE ~ ($tgnature of apphcar
~Nua47676I8, SIk~CoutdY p/
Term Lxptres Msrch 3D, 19 -L/