Loading...
HomeMy WebLinkAbout17819-Z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22222. Date MARCH 26, 1993 THIS CERTIFIES that the building ALTERATION Location of Property 10095 (#7) MAIN ROAD MATTITUCK N Y House No. Street Hamlet County Tax Map No. 1000 Section 142 Block 1 Lot 26 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 9, 1989 pursuant to which 14191-Z & Building Permit No. 17819-Z dated FEBRUARY 10, 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 ALTERATION TO STORE #7 FOR EXISTING RESTAURANT AS APPLIED FOR. The certificate is issued to ALAN CARDINALE (owner) of the aforesaid building. •SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-078615 - NNE 28, 1989 PLUMBERS CERTIFICATION DATED N/A ~ A_ ~ Building nspector Rev. 1/81 FORM NO. f TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N ~ 017 819 Z Date ~A~'^.....~ Q 19.~ 1 Permission is hereby granted~~t++a: n I J~ ...!o. f p.~.,~ to ~~~G 1 ~...Q~~F~?~-!J. II ~ ct premises located at ....S.O. ~.9..ti~. ~'V),C1*-,.. ~~I yyl i ...~1a......(~? Q~.......~.:...... .................~...........I...................................................... Caunty Tax Map No. 1000 Section ......~.`~o?,,,,., Block ~.I.......... Lot No......~.W. q c~ pursuant to opplicotion doted ...~~!.....1 19d.9..., and approved by the Building Inspector. Fee S . I~-~U"~ ~ Bwlding Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT h~~'iR ' ~ I~`~ 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 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. 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. 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 Euilding - $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 ~¢t.G.'/~1/ ~ ~(~9 3 dew Construction.... Old Or Pre-existing Bui~, .ocation of Property~4C „ / • • ~jy~, . House No. '~u" Street••s~..~.•••`"®//~~,.„~, Hamlet nwer or Owners of Property. •~~f~• • • • ounty Tax Map No 1000, Section.•l ......Block...f!.. ........Lot...°~?. ubdivision.• " " " " 9/ qZ ............................Filed Map............Lot...... armit No.?:7~•/,9••.•,••Date Of Permit.. ~j •••••••.......Applicant.,-~G`/(xZ•~;~G ~alth Dept. Approval....... f•••• " ..Underwriters Approval... p 7u 6 f _anning Board APProval 'quest for: Temporary Certificate......,. Final Certicate.• - e Submitted: ~Q:OlJ ~ SGT - . ~~z~. APPLICANT i I j ~ i _ ! ; - cD £a ~ ~ I i ' I ! f i ~Q ~ ~ _ ..n o i /~fr O I ~ ~ h ~ H I a ~ O E--.S,h--~ ~----1 _ _ G I ; ~ 14 i i,eis~ ~ > h~~ ~ I ( NO~tH1S SS3M1~tlM i_. h'._1 ~I I y 1:3 O ~ ~ aais~ I Z3z33d3 311 t11.~ 20 sfauvr+ boot ~a Auyes $2 _ ~ ° ~l ~I~ GI Aw - m i i aJ~uVM 3'IBUJ~ 2 = /~/T, ~ Nouuls Wy3JS R `m I ~V'"~ ~I ~~I_.. ~C "~IbOM I ~4 _ ~ ~L lanai VM :c10d 12121b~ nano - - „~a~ 3rd y,b { a ~nm~ rv3eo 3NO'hy' ~ vn ~ ~~A y JJ nun V V i iblAW3 ~g~y?1o1S~ , , I j 9121~3b ANis niin NI-A1bM i ~ i i ~ • - ~ I i I i i i' i I i _ i I - ~ L,ti wJ i ~ _ nO o ~~fJ --8->sl~ ~~o . . i ~ N ~ a Q - O~w~ z O E--s,h ~r ~------1 i 0 e G I - I IL V __ssaallvM ~ ~ ^ h!~ ~ ~ ary ISI ?13z33d3 31t,u1~ Zo ~ ~ ~ ?fOVM ~ ~OqQ 313 AHaJS P.2 i ~l I 91 GI , W ap ~ ~ ^1 . i... P 5e;a'ivM 3i 8V1 Z ~ ~ ~ Nouuls WH31S R h~ , . ~ h SA ANi. VM i21 Od 12121b^ n3no „roe ana~ i3a v Ja 3N~b' as vn } tr~nr+oo n3no of ~ Z ~ ' ,aa/ueA 1~9H?lo1S; , . I 91b~3b Hrvls 1;°Y~ NI-A1VM i i i . _ I i I I j _ - , I ' j ~ I a 1 ~ J ~ ',i~~ ~j 4 r ~ _ _ . nO o i ~fJ 8~~ ~~Q = o O _ ~ ~ ~ O^ alai E--s,d D 9 a z gy I I ~ y~ ,i6~S~ ~ ~Y I_v~ . , I ~ _~NO,lbls _ ssaal~tlr~ _ - i hl ~I ~ l ~ o ~ o 71d ~S~ 713z33d3 3'~£~a1~ 20 ~ iuvra ~ boo~7 ~aAuyes L ~=L ~31~ G I ~w _ ~ ~ 9 ! Ila uuli ~ i ~}az~~M 3'19U1 L _ ~ Nouuls U1H315' R qte ~ ~ ~ ~ ~1boM ~ ~ , r - -rnn~ 3naL ~a 3 ~avq ~~ab0 + ~ n~o n~o 3NO;'v z 1 ~;s' nl ~t~,~A yy .h1OW3 ~~Vd,, ~g~y?1o1S~ 91?Jd321 Arvis 1;°Y~ NI-AIbM i t BOARD OF HEALTH . t FORM N0. 1 3 SETS OF PLr1NS SURVEY ii TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM . € TOWN HALL " " " " - SOUTHOLD, N. Y. 11971 NOTIFY UT!~IQ~O.° TEL.:7G5-1802 CALL Examined ~ C 19 3 9 MAIL T 0 : • - • • ~ ~ ~-a Sri Approved , ~ ~ _ 19 49, Permit No. , l ;7 ~.I,q Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT 7 ~yg Date ~ 15°. INSTRUCTIONS a. Tltis 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 bIADE 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;%r name, if a corporation) . ..IPA.-..B.~.x.~.a.~~....~-~~.n.~-~.~~c,.~. fir.. (Mailing address of applicant) ~~95~ State whether applicant is owner, lessee, agent, architect, engineer, genera] contractor, electrician, plumber or builder. e.~st°..~................................. Name of owner of premises ....,(;v /l/ Y.¢!~ Nom. 1 , , , , (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate o icer) Builder's License No . . . . . Plurnber's License No . . Electrician's License No . . Other Trade's License No, 1. Location of land on which proposed work will be done. ~ ~Q r n l.'.'. y/ ..1~~ .1. ~-~a ~u.c~ . House Number Street. ~ , Hamlet ~ ~ ~ County Tax ,1fap No. 1000 Section . ~ Block l........ Lot ....a . Subdivision Filed (•Iap No. . (Name) Lot State existing use and occupancy of premises and intended use and occu anc p Y of proposed construction: a. Existing use and occupancy ..s. , , D~Gr (J ~.-Q~ yt b. Intended use and occupancy ~ ~ 3. Nature of work (check which applicable): New Building . , , , , , , , Addition ~ :j..:. ° Repair Removal ~ N; :v, , • • • • • • • Demolition ~~i~ _ T 1......... 4. Estimated Cost . ~ ~~Q •O6 ` ~ (~cscription) Fee........ 5. If dwelling, number of dwelling units , (to be pai application) • • • • • Number of dwelling units on each Moor . If garage, number of cars . . 6. If business, commercial or mixed occupancy, specify nature nd extent of each ty e of use . ~ ~ ,$'y-~ y~ • • • • • 7, Dimensions of existing structures, if any: Fron[ . , ~ r, , pp /4!t•` .Height ../.'Y.:..... t.•... Rear ....~.v.~..~~.... Depth ...5.`/..:a • • . Number of Stories Dimensions of same structure with alterations or additions: Front ~ ~ ' ' ' ' Depth a Rear yam. . •y- • • . IIcight . , , . Number of Stories . • • ~ • 8. Dimensions of entire new construction: Front , • • ~ ' ' ' ' ' ' Height . , , , , , , , Number of Stories . • • • • • • ~ ~ - • • ' • • Rear Depth • • 9. Size of lot: Front Rear ' . Date of Purchase Depth • ..........•••••••••••••••..,.NameofFormer Owner 1 1. Zone or use district in which premises are situated . . • ~ ' 12. Does proposed construction violate any zoning law, ordinance or regulation: 13. Nilllotberegraded ..o4la;~ ~a Y d, 14. Name of Owner of premises ......~Q, , , , , ,g AddressXC~©.Fll be ove~from premises: Yes Name of Architect •~X• - • • - do€~hone No.. v"? 9P-j,3 3 Name of Contractor , , • • ' ' ' ' ' ' • • • • Address ......Phone No. p', 15.Is this property located within • • -'Address ........Phone No. *If yes, Southold Town Trustees Permitemay bearequiredetland? *YES....NO v 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 comer lot. ~9'Ff-_ ys STATE OF NE1V YORE, COUNTY OF . S.S _ 9 (Name of ~vidual signi~ ont act) ' ' ' ' • • being duly sworn, deposes and says that he is the app]icant above named. ~ He is the ..........~?~~~2I~3:~.!4! / (Contractor, agent, corporate officer, etc.) ' ' ' ' ' ' of said owner or owners, and is duly authorized to perfc~m or have performed the said work and to make and file this aPPlica[ion; that all statements contained in this applic~tjon are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this Notary Public, , e ~ •v~... County v HELEN K. DE VOE ~ •,+t• - ~ _ NOTARY PUBLIC, Stare of New York ' ' ' No.47G7878, Su9folk Caanty Si;nature of applicant) Term Expires Mztch 30,15