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Home My WebLink About34012-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town xall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33145 Date: 07/09/08 THIS CERTIFIES that the building ADDITION Location Of Property: 4545 MAIN RD GREENPORT (HOUSE NO.) (STREET) (HAMLET) COUnty Tax Nap NO. 473889 Section 35 Block 2 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 25, 2008 pursuant to which Building Permit No. 34012-Z dated JUNE 25, 2008 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 HANDICAP RAMP ADDITION TO AN EXISTING RESTAURANT AS APPLIED FOR. The certificate is issued to ROBERT J HEANEY of the aforesaid building. (OWNER) SIIFFOLR COIINTR DEPARTMENT OF HEAI,TB APPROVAI, N/A ELECTRICAL CERTIFICATE NO. N/A PLDMBSRS CERTIFICATION DATED A thorized Signature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. 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. Swom 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" laud uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or Copographic features 2. A properly completed application and consent to inspect sigred 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 Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. 'T'emporary Certificate of Occupancy -Residential $15.00, Conunercial $15.00 Date. New Construction: /~ (~ / fold or Pre-existing Building: Location of Property: I ~ ~T ~~ House No. Owner or Owners of Property: ~ cy Suffolk County Tax Map No 1000, Section Subdivision Permit No. ~ `T~~ Health Dept Approval Pla~ming Board Approval: Request for: Tempor ry Certificate Fee Submitted: $ ~ ~ ~ ~ ~ ~_ (check one) ~~ o U T~ ~5 Street , ^ ~~~~~ V1 ~~S Block 2- >° Lot <~ Filed Map. Lot Date ofPennit. ~ "~~ -~Applicant:~~ ~~ t~~~5~ `/1G. Underwriters Approval: Final Certificate: ~ (check one) Applic Signature ~ ~- 1Z- Q ~ 1 l c~5, ~vl c. FORM NO. 3 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) PBRMIT NO. 34012 Z Permission is hereby granted to: ROBERT J HEANEY Date JUNE 25, 2008 PO BOX 196 GREENPORT,NY 11944 for CONSTRUCTION OF A RAMP FOR ACCESSIBILITY AS APPLIED FOR at premises located at 4545 MAIN RD County Tax Map No. 473889 Section 035 pursuant to application dated JUNE Building Inspector to expire on DF~F'MUFu Fee $ 250.00 GREENPORT Block 0002 Lot No. 008 25, 2008 and approved by the ~~ ~nno ORIGINAL Rev. 5/8/02 3'~01~-~ TOWN OF SOUTFIOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING ~f FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION REMARKS: DATE 7~ S r ° 8 INSPECTOR ~~ ;~ `f ~~~ FIELD INS ECTION REPORT' ~ DA'I'I I wlrunr,i~ i u ,.,. ~ ~ ~ FOLiNDATION (1ST) Z ~ ~ FOUNAATION (ZND) 3 z ~ Q I \ rn ROUGI$ FRAMING & PI! UNIBING y - -_- ~ ~ , ~ -:- :.. -- _ . - - ~~ INSFJLATI01~'PERN.Y. STATE FiNERGY CODE - -- --~- _. ~i y __ q __._ ~ 1 ~ ~ r ~~ 1 T~INAL ADDITIONAL CONIMENT'S i O 2 m ~ n ^n ~ s z x .~ x d b ,~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval PERMIT N0. .~., ~ ~ (2- ~% Examined , 20~ Approved J , 20_ Disapproved a/c Expiration , 20. .._ _, I ~ ~ _ l' Mail .J ~ APPLICATION FOR BUILDING PERMIT 1~,+~ Date ~ll ne` I , 20 ~~ ~` ~:. ~ ~ INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 waterways. 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 issue a Building Permit to the applicant. Such a 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 what so ever until the Building Inspector issues a Certificate of Occupancy. £ Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. 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. ~R~ 2 1~ ~ ~\~1 e rs,I~ c.- . (Signature of applicant or name, if a corporation) ~a go x Sss, GP-1- . (Mailing address o applic t) State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~ o b H e A ti~ e, (As on the L If applic t is a co rat' ,signature of duly authorized officer ~~ e5 (N e and title of corporate officer) Builders License No. I ~3 o I H L Plumbers License No. _ Electricians License No. Other Trade's License No. 1. Location"of land on which proposed work will be done: House Number Street Survey Check Septic ] N.Y.S.] Contact: Hamlet County Tax Map No. 1000 Section ~ S Block 2 Lot g Subdivision Filed Map No. Lot BUILDING PERMIT APPLICATION CHECKLIST or latest deed) (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~e.S~'a ~nro~ n~- - b. Intended use and occupancy ~ ~- 5 +'a v r c~ n t 3. Nature of work (check which applicable): New Building Addition /~ Alteration Repair Removal Demolition Other Work ~ o ~ (Description) 4. Estimated Cost 2 ~ ZOQ ' Fee 2 ~~ , Q Q (To be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars HGr, d; ~°~~P 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. ~ a rn p 7. Dimensions of existing structures, if any: Front Reaz Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Depth Height Nurr of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Reaz Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises aze situated 12. Does proposed construction violate any z 'ng law, ordinance or regulation? YES NO_ 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetlands YES NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAYBE EQUIRED. b. Is this property within 300 feet of a fidal wetland? *YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 13. Will lot be re-graded? YES_ NO Will excess fill be removed from premises? YES NO~ as C' P+' 14. Names of Owner of premises <6 H Mahe. Address ~S ~ 5~ ~o ~i-e Phone No. U ~ 7 ' ~ ~ i ~ Name of Architect Address Phone No Name of Contractor ~`~ Q-$`' ~ 1 Q e r s Address ~o i3oX 555 Phone No. '-f ~! -1 _2 ~ o n CTpt . 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF SJFFo t~ C (Rq 1 ~ ~ tc (-(-'[ ~~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the Cc.~wT~QcTo~ (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application aze tme to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. ~ N w ~ to N c o h ~ Q N w fl O II ~ C ~ h U~ ~ ~. _ _ ~ ~,tP h iV g•r~~~' ~ ,~'R9PQ5~A a ~)A(T/On/ ~~ ~ kl t- u --~ -A V /' {~ n ~' 6f~ ~ fir. ~ /at4.0. ~i~ N c s.g~°aizo"W.-~ M,~i i ~v ; R c? ,g n uNauiµoRlzm AnmAnoN oR ADDmoN (O THIS SURVEY IS A VIOIgTION OF BEC1pN 7104 OF TEK NFW YORK STATk FOI1GATbN lAW SL~~21iEYE'O ~n~Z GE"C~RGE,aNO~.MATMELLAS i-/EE.~1R C~R>E'ENV~RT N.Y `s .s = lY~~'r~1.14~~e~i7~ :~ =iron P~i°e ..y~ ., GuAt~iaa~-~e~~/ ~ -the G.lr,~:c-.. y~ Ti'f~~ /nsuravrce CohaPOh/~ ~~d Ltncd T u s--G `Cosyr~c+~ rr~r~ .. Sur,V~°C~ed :Feb. >4, t97,2 ~~~ ~yi~ ~~~ ~ ~~~ LiceNsc d '~na .SuY ve~1gr~ .l~Y~ p.~t~t1r't, /1/PW ~'QY~ . THE LANG SURVEYOR'S IN..U SIAL C0. EMBOSSED SEAL BXALL NOf C6 CON$IDgp t0 BF A yA11D AUE CpRY GUAAANTEE$ (NWCAJFD HCRSON SHALL 0.08 ON1Y TO THE v[.SON fOR V/HOIA 7µC (yRy0.'~ IS VAFFA:m, AND OEI 1115 f 7WIF f0 77ER ' lttlf COIAYnNi', GAVEpUF~HfAI A4iACY AND 1fN01NG INSfitUTION USieU 16',aRA. ABOk ' THE ASSIGn!_B Oi THE lENORlG F/xU ' 'J.J, GUAP,AFTFES A~.E NAi i„Ai.f44UBit ' ~ .. ..a. i' 3 .t ~ _ . .~ /,. ~..q.~it...vc.Ol ~.B~i lA`3F.~.:~ rl' e.F4Bf.4 . vl~.. b~~r~ Town of Southold ~ Erosion, Sedimentation t8r Storm-Water Run-off ASSESSMENT FORM fib! ~ Paocearr uocniioN: s.c.T.m. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER, GRADING, DRAINAGE AND EROSION CONTROL PLAN District Section Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. Item Number: (NOTE: A Check Mark (.~) for each Question is Required for a Complete Application) Yes No ---------------- ------------------------------ Will this Project Retain All Storm-Water Run-Off Generated by a Two (2") Inch Rainfall on Site? ~ ^ (This item will include all run-off created by site clearing and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) L Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? / ^ This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFlowl 3 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? 4 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of ^ Five Thousand (5,000) Square Feet of Ground Surface? - rj Is there a Natural Water Course Running through the Site? ^ / Is this Project within the Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Beach? J~ s Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vertical Rise to ^ / One Hundred (100') of Horizontal Distance? ~e 7 Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Off ^ into and/or in the direction of a Town dghtof-way? Will this Project Require the Placement of Material, Removal of Vegetation and/or the ConsWction of any Item Within the Town Right-of-Way or Road Shoulder Area? (This item will NOT include the Installation of Driveway Aprons.) 9 Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse? ^ NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark In the Box, aStorm-Water, Grading, ~G Drainage & Erosion Control Plan Is Required and Must be Submitted for Review Prior to Issuance of Any Building Permit! EXEMPTION: Yes No Does this project meet the minimum standards for classifcation as an Agricultural Project? Note: If You Answered Yes to this Ouestian, aStorm-Water, Grading, Drainage & Erosion Control Plan is NOT Required) STATE OF NEW YORK, COUNTY OF ....Sl/.E~7F.rQ..U..~.......... SS That I, ........ ............ ~Q%.. ~ ~AClkI..G.I.?r .................. being duly sworn, deposes and says drat he/she is the applicutt fur Pem~it, (Na of intlivitlual signing Do ument) ~ ¢-- Md that he/she is the .............~d~ ti!..°.:5-................................................................................................................... (Owner, Contractor, Agent, Coipoate OKcer, eta) Onmer and/or representative of dte Owner of Owner's, and is duly audtorized to perform or have performed dte said work and to make and file this applicadon; that all statements contained in this application are trite to the best of his knowledge and belief; and That the work will be performed in the manner set forth in the application filed herewith. Sworn to befQore me dtis; ....................(... .~~-~ clay of .....~dl~!.~..................... , 20..Q.~ ~ ~~~ ~ Not ry Public: o/APPbcant) FORM - 06/07`- rvu~i, Nou01 FA4973285 rv rO16 Qualified in Suffolk County / ~ Commission Expires Oct. 15, 20 ~