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HomeMy WebLinkAbout35634-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ball Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-35634 Date: 06/17/10 THIS CERTIFIES that the building FIRE REPAIR Location of Property: 30840 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 103 subdivision Filed Map No. CUTCHOGUE (STREET) (HAMLET) Block 1 Lot 3 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 10, 2010 pursuant to which Building Per.it No. 35634-Z dated JUNE 10, 2010 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 FIRE REPAIR FOR AN EXISTING TAKE-OUT RESTAURANT AS APPLIED FOR. T~e certificate is issued to JAMES HOMAN of the aforesaid building. ( OWNER ) SUFFOLK COUNTY DBPARTMENTOF }~2%LTHAPPROVAL N/A ELECTRICAL c~KTIFICATH NO. 34412 06/17/10 PLUMBERS CKKTIFICATION DA'i'~I~ N/A //o/ed S/gnature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. For new building or new use: II~l 1. Final survey of property with accurate location of all buildings, properly lines, s~L~e~ anc~st~alTna~l or topographic features. I 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 l~rm)./. 3. Approval of electrical installation from Board of Fire Underwriters. / [ Bt0G. DEPr -- 4. Sworn statement from plumber certifying that the solder used in system contain~Llz,~;: 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 lir~gs, streets, building and unusual natural or topographic features. ,~ : 2. A properly completed application and copsent to in~pect signed by the applicant. Ifa 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. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. Old or Pre-existing Building: i~l~us~'N ~. Street' (check one) Hamlet New Construction: ~ Location of Property: Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision PermitNo. ,.,~,~4 Date of Permit. Health Dept. Approval: Block / Lot Filed Map. Lot: Applicant: ~.fa,,~J'~J .~2~r~/'~,../ Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: Fee Submitted: $ ~~3o_ ~ b~Z~x-~ (check one) A~plicant Signature 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) PERMIT NO. 35634 Z Date JUNE 10, 2010 Permission is hereby granted to: JAMES HOMAN (BRAUNS) PO BOX 738 CUTCHOGUE,NY 11935 for : FIRE REPAIR FOR AN EXISTING BUILDING AS APPLIED FOR. at premises located at 30840 MAIN RD CUTCHOGUE County Tax Map No. 473889 Section 103 Block 0001 Lot No. 003 pursuant to application dated JUNE 10, 2010 and approved by the Building Inspector to exl~ire on DECEMBER 10, 2011. Fee $ 250.00 Authorized Sigr~ure ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]RO~GHPLBG. [ ]~ION 2ND [ [ .~MA~ ING~TRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] fiRE SAr~, ( INSPECTION [ ]mERESb'TAXTCONSmUCnON [ ]flREREmTANTFENETRA'nON REMARKS: ,/-'-r~ ~_ (_~- INSPECTOR COIVIM~ITS ~1 ~OUNDA~ON PLUMBING IN/~JLATION PER N. Y. STAT~ EI~GY cODE ADDITIONAL cOMMENTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examine~-"~ /~ , 20 / O Disapproved a/c Expiratio~ ~ ,20 // PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health ~'~ 4 sets of Building Plans Planning Board approval Survey Check t~ ~ ~ Septic Form N.Y.S.D.E.C. Tmstees Flood Permit Storm-Water Assessment Form Contact: Mail to: BIOG. DEPI. a. This a!R~l~it~lll~lllJIST l~g con Build~-g Inspector ~hone: ~PLICATION FOR BUILDING PERMIT INSTRUCTIONS pletely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets o dans, 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. f. 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. X , ~(Signat~of~pplicant or name, if a co~oration) (Mailin8 address of applicant) t~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~ ~/O/q~:~,-q' /J¢O'~ (As on the tax roll or latest deed) If applic~a~t is a ,cprporatio_n, signature .of duly authorized officer x ~ (Naj~e and title of corporate[officer) ~ Builders License No. ~ t~)~ '~ ~' -~ ~/ Plumbers License No. Electricians License No. Other Trade's License No. Location of land on whic~J~roposed ~;~a~ will be done: t 3o oc o /'t o ,.t House Number Street CountyTax Map No. 1000 Section lO~ Subdivision Hamlet l~lock l Filed Map No. Lot } j 2. '~ Lot 2. State existing use and occupancy of premises and~ intended use and occupancy ofproppsed construction: a. Existing use and occupancy b. Intended use and occupancy. 3. Nature of work (check which applicable): New Building_ Addition Alteration Repair ~, Removal Demolition Other Work Estimated Cost '~> [~)/~ Fee If dwelling, number of dwelling units If garage, number of cars (Description) (To be paid on filing this application) Number of dwelling units on each floor If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front ~- 4C)~ Rear ~ ~ _Depth _-I' Height ~ Iq' Number of Stories _[ Dimensions of same structure with alterations or additions: Front %-~--~O' Rear Depth '~ ~' He ght_ I o~ Number of Stories ( 8. Dimensions of entire new construction: Front Rear _Depth Height Number of Stories 9. Size oflot: Front 21~,~6'-- Rear 2 ~'47-1~ 'el'~ ' Depth ~'7. 7~ 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated ~OePO,.I :[~:vO~ ~:'~ E'~2>~ 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO ~ 13. Will lot be re-graded? YES NO ,~ Will excess fill be removed from premises? YES__ NO ~-- 14. Names of Owner ofpremises Address , Phone No. Name of Architect AOFt0$T 'H, ~U ifF' Xddress~Phone No ~['~ '7.~ -Z.~,~'7 Name of Contractor ~2oe:~x)t ~.a~ra2- (~,~¢a~Pd~ress IBa~y ?oe~ Iq ,q, Phone No. ~3 t '47z- zzT'z 15 a. Is this property within 100 feet of a tidal wetland or a ti'eshwater wetland? *YES * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO __ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO ,~ 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. 18. Are there any covenants and restrictions with respect to this property? * YES NO ~ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) X ~-'~tf_,t't~ ~ /-/~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the St' ~ ~ (Contractor, Agent~r~rate Offi_~, etc.) of said owner or owners, and is duly author/zed to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mariner set forth in the application filed therewith. Sworn to before me this /- /,,~ day of .~'~2 ¢ 20_/0 / Nota~ Pubhc ~o. 01PE6002103 Qualified in Suffolk Coun~ ~mmission Expires June 20, 'r~ Signature of Applicant / 4''''v4, ~ s ~ ~ ~ ~r~ TOWN OF SOUTHOLD PROPERTY RECORD C:ARO FORMER OWNER N S ~. , W TYPE OF BUILDING FA~ Acre Value Per Volue ' ' ' ~wamp~d FRONTAGE ON WA~R ~m~la~ FRONTAGE ON ROAD ~ ~K Bath nterJor Finish ~uc~f ! ~ ~ ~, LR. Heat ~/~ DR. Rooms Sst Flor Ext. Wails Fire Place ~e Roof TOWN OF SOUTHOLD PROPERT~ P~EC~ORD CARD N E S W FARM COMM. VILLAGE DIST. SUB. LOT ACIL TYPE OF BUILDING (~ MICS. Mkt. Value FROiqTAGE C~I WATER FRONTAGE ON ROAD DEPTH BULKHEAD TRIM M. Bk~g. Exter, elan Extension Breezeway Patio O.B. OWNI~R' TOWN 'OF SOUTHOLD PROPERTY RECORD CARD STRE~ ('.~ I O© JFARM TOTAL DATE FORMER OWNER ,~, ~/~ ..... R~mo tsp. ]VL ~ND IMP. VILLAGE E ~, DIST. SUB. LOT TYPE OF B~IJILDING / CB. MICS. Mkt. Value AGE NEW NORMAL FARM Acre T~llc~bte Woodland BUILDING CONDITION BELOW ABOVE Volue Per Value Acre FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD DOCK TOWN OF SOUTHOLD PROPERTY RECORD CARD ~ ~_. C~NER STREET ,~ j ~,~ VILLAGE DIST. SUB. lOT ' -- T~ BUlLDIN6 R~. S~. VL. ~ I I FARM CO~. CB. MI~. ' Mkt. Volu, ~N~ IMP. TOTAL DATE W~lo~ FRONTAGE ON ROAD COLOR Porch Breezeway Foundation jExt. Walls l Recreation Room [ Rooms 2nd Floor ~- [i -.- Driveway c/iO~j¢ , ,"'" R-40 ~ B / - , RESIDENTIAL ~ · / ~,~,o~, ~ I BUS'lESS SITE DATA .~d'~ "',',1 / / -~'~ ,, ,,. / A~~ 1935r )3-1,,4 ,~ 201O-Oe-Oe VOI~ PARCH At~A ~OLINP N~W L PO0~ WI'P'I (2) LA~R50P I" THICK 5[JP~R PII~f~M? L, KIfCPEN BXI51', WO/v~N5 fOILEr M~N5 fOILer RM, P.-XI~'I', COMtV¢~I~ Klfd~N / PAR:hq,N- FLOOR PLM',I r, eale: ¼" ~ I"0' ~P POOR WIfH 51YFL PPJv~F IN ~XI51'INI~ O?~NINd 5¢D/INd g×lSf, CLO~f L ~XlSf, WAIflN~ ALL CONSTRUOTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK ST ATE. I~XlFf, WAhlN~ LE~NP ~ ~×IST1N~ W~b5 ~ PR©PO~P PINI~Hi~5 COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF SOUTHOLD TOWfl Z~ SOUTHOLD TOWN PL~NNII~ I~RD $OUTHOLD TOWN TRUSTEES N.Y,S. DEC itEOUIRED IlEfOtlE OPENING OCCUPANCYOR USEI$ UNLAWFUL WITHOUTCERTIF ATE OFOCCUPANCY APPROVED ~ NOTED FEE'~BY~ NOTIFY BUILDING DEPAR'~NT AT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: I FOUNDATION- TWO REQUIRED FOR POURED CONCRETE 2. ROUGH- FRAMING, PLUMBING. STRAPPING, ELECTRICAL & CAULKING 3~ INSULATION 4 FINAL-CONSTRUCTION&ELECTRICAL MUST BE COMPLETE FOR CD ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS.