HomeMy WebLinkAbout32869-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32283 Date: 04/10/07
THIS CERTIFIES that the building HOOD SYSTEM
Location of Property: 730 MAIN BAYVIEW RD SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 70 Block 7 Lot 15
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 30, 2007 pursuant to which
Building Permit No.. 32869-Z dated MARCH 30, 2007
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 INSTALLATION OF A NEW HOOD SYSTEM IN EXISTING BAR/RESTAURANT AS
APPLIED FOR.
The certificate is issued to JANINA BIENIAS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
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. 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 fiom 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 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 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 S15.00
Date. 0
New Construction: Old or Pre-existing Building: (check one)
Location of Property: Ajy Vale�F UIf 7/
House No. Street Ifamlet l
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section �O' _Block Lot
Subdivision Filed
—
Map. Lot: -~
Permit No. Date of Permit. —O Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: �— (check one)
Fee Submitted: $
Applicant Signature
C0�3��5�
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. 32869 Z Date MARCH 30 , 2007
Permission is hereby granted to :
JANINA BIENIAS
730 BAYVIEW RD
SOUTHOLD,NY 11971
for
INSTALLATION OF A NEW HOOD SYSTEM AS APPLIED FOR. THIS PERMIT
REPLACES 30464 .
at premises located at 730 MAIN BAYVIEW RD SOUTHOLD
County Tax Map No. 473889 Section 070 Block 0007 Lot No. 015
pursuant to application dated MARCH 30, 2007 and approved by the
Building Inspector to expire on SEPTEMBER 30, 2008 .
Fee $ 200 . 00
Authorized Signature
ORIGINAL
Rev. 5/8/02
OF SO(/jyo�
� # '�
Ol�Yco�y'�c�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [FINAL
[ ] FIREPLACE A CHIMNEY [" ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
C
r
DATE INSPECTOR
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION(1ST)
---------------
------------------- Y
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FOUNDATION(2ND)
• z
4
ROUGH FRAMING&
PLUMBING
INSULATION PER N.Y. L
STATE ENERGY CODE
_ w
FINAL
V
ADDITIONAL COMMENTS
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WILLOWMERE INN, LTD.
730 MAIN BAYVIEW ROAD
SOUTHOLD, NEW YORK
JANINA BIENIAS, being duly sworn, deposes and says:
1) That she resides at 730 Main Bayview Road, Southold,New York, 11968.
2) That she is the daughter of Zofia Furmankdewicz who died on August 12,
2003.
3) That at the time of her death, Zofia Furmankiewicz was the sole proprietor of
the Willowmere Inn, a bar and restaurant business that she and her late husband, Florian
Furmankiewicz had operated at 730 Main Bayview Road, Southold,New York, since':1965; and
that your deponent had assisted in the operation of that business since 1965.
4) That upon the death of Zofia Furmankiewicz your deponent became the owner
of the real property known as 730 Main Bayview Road, Southold,New York, as evidenced by an
Executor's Deed dated September 29, 2003 and recorded in the Office of the Clerk of the County
of Suffolk on October 2, 2003 at Liber 12275,page 573, as well as the assets of the bar and
restaurant business previously owned by her mother.
5) That upon the death of Zofia Furmankiewicz your deponent created a new
corporation, Willowmere Inn, Ltd., of which she is the sole stockholder and officer, and that she
then transferred the New York State Liquor Authority license for the premises at 730 Main
Bayview Road, Southold,New York, and the'assets of her mother's business to said corporation.
6) That upon the personal knowledge of your deponent,the bar and restaurant
business formerly known as the Willowmere Inn was in continuous operation from 1965 up to
the day of Zofia Furmankiewicz's death on August 12, 2003; that the premises was open for
business on an occasional basis during the extensive physical renovations which began following
Zofia Furmankiewicz's death and which continued through the Spring of 2004; and that the
premises fully reopened for business in May, 2004.
Dated: June 3, 2004cg�
Janina Bienias
State of New York,County of Suffolk).:
On the 3rd day of June,in the year 2004,before me,the undersigned,personally appeared Janina Bienias,
personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s)whose name(s)
is(are)subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their capaci , and that by his/her their signature(s)on the instrument,the individual(s),or the person upon
behalf of whic e individual(s)acted, executed the instrument.
— ED'WARD JOHN BOYD 5th
——————
notary
Notary Public, State of New York 02BPublic State of New York
2B0037n625 Suffolk County
Commission Expires April 30, 2001
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TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET Q VILLAGE DIST. SUB. LOT
FORMER WNER f:.,r = E ACR.
�T
,Yor Gzv� t rrMahki '0j,1eZ S W I TYPE OF BUILDING
RES. SEAS. VL. FARM COMM CB. MICS. Mkt. Value
LAND. IMP. TOTAL DATE REMARKS
/W 3 7
Z�dO p 6r0 v
Roe � t
—L -275
AGE BUILDING CONDITION ..
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value
Acre
Tillable FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD db S
Meadowland DEPTH .ate.
House Plot BULKHEAD
Total ,.o "° DOCK
TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or ce.ed the fellowing,,befog applying?
TOWN HALL Board of Health
SOUTHOLD,NY 11971 4 aeis of Building
TELL(631)765-1802 Planning Board approval
FAX:(631)7b.5-9502 swvL —vnvw,northfork.net/Southold/` PEP.MIT NO. Check _
Septic Form
N.Y.S.D.E.C.
Examined _ 20___ Contact;
Approved ,214 Mail to:—
Disapproved a/o —
Phone:
Esxpiration � ,2 � —��
Building
MAY 2 8 M4 APPLICATION FOR BUILDING PERMIT
Date� )-
o
I_DG. D P7. INSTRUCTIONS
a, s ppiication 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 acid of buildings on premises,relationship to adjoining premises or public sheets or
areas,and watmvays,
c.The work covered by this application may not be c=meneed 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.
(-.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 bas not been completed within 18 months from such datE If,no zoning amendments or other regulations affecting the
property have been enacted in tfie interim,the Building Inspector may auih6rize,in vmt!ng,the extension of the permit for an
addition six months,Thereafter,a new permit shall be required.
APPLICATION IS HEREBY N1ADE to the Building Department.for the issuance of a Building Pon-at pursuant to the
Building Zone Ordinmtca of the Town of Southold,SuffolkCounty,New York,{tnd 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 far nwessary inspections. P)
(Signature icant or name,if a lation)
(Meiling address of applic )
State whether applicant is owner,lessee,agent,architect,engineer,ppeneral contractor,electrician,plumber or builder
Name of owner of premises
As on the tax roll or latest deed)
If tplic t is a co rati m,si tare of duly authori ed offic
wia
(Na and title W0,51orate fficer)
Builders License No._ _
Plumbers License No.
Electricians License No.
Other'Trade's License No.
l, Location of land on which proposed work will be done:
M �J
1 Jv A,J �A't J1FKf K o^b— �17..TTHGI.I?
House:Number Street � Hamlet
County Tsui Map No.1000 Section_010,00 _ Block O l.00 Lot G%<.000
Subdivision Filed Map No, Lot -
LZ:83 t70, 8Z 8da Tod 6T0 13S3 GALE r Q M(13 61?659;9LT£9
2, State existing use and occupancy of premises and intended use and occupancy of proposed construction.:
a. Existing use and occupancy
b• Intended use and occupancy • :S1, J*a
3. Nature of work(check which applicable):New.Building. _ _Addition _ Altenntion X
Repair Ttemoval Dernolition�-- Other works &fe
escription) �vaaC
4. Estimated Cost Fee_ a'z�•00
(To be paid on filing this application)
S. If dwelling,number of dwelling units \ 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 structures,if any:Front_ Rear____ Depth M_
Height Number of Stories 7.
Dimensions of same structure with alterations or additions:Front Rsar
Depth— ____--_—Height Number of Stories 'I-
S. Dimensiops of entire new construction; _Depth,
Height_ a(A Number of Stories �1
9. Size of lot:Front "Z,cs _Rear Depth i-\n-
10.Date of Purchase_ %\Ll)�03 Name of Former Owner
11.Gone or use district in which premises are situated I.
12.Does proposed construction violate any zoning law,ordinance or regulation?YES—NO Y,
13•Will Iot be re-graded?YES__NO X Wili excess fill be removed from premises?YES NO
14.Narnes of Owner of Address"OU0 Z Phone No. A-aL's
Name of Architect Address Phone No _.
Name of Contractor _ _ Address _ ___Phone No. �- - ----_
15 a.1s this property within 100 feet of a tidal wetland or a freshwater wetland?*YES__ _ NO X
*IF TES,SOUTHOLD TOWN TRUSTEES&D.B.C.PERMITS MAY BE REQUIRED.
b.Is this property vrithin 300 feet of a tidal wetland?*YES—NO X
*IF YES;D,E.C.PERMITS MAY BE REQUIRED.
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 OFF
t being°uly sworn,deposes and says that(s)he is the applicant
(Name o ' dividual sigr9d contract)above named,
(S)Ho is the K
(Contractor,Agent,Corporate Officer,etc.)
of said owner or owners,and is duly authorized to Mlorm or have performed the said work and to snake and file this application;
that all statemmts contained in ilds application are true to the best of his knowledge and belief;and that the work will br..
performed in the manner set forth,in the application filed therewith.
Sw to before me this
day-of 20 ba-
° Si ure of Applicant
_ M
y Public,State Qf wear�r t2F
N'o.41 47510°)8
r Co taete Flied In Buff&C•Wloj
Commission Expires 10131105
LC:80 t1o. eZ ddu Zod 6TO OS3 GAr f L16UMO 696999LT£9
ANSUL - R102 3 15
2i0in0 Material: Black_ Iron Max length` Max Rise � -
3uppty Pipe Sizes;3/8 Branch Pipe Size: 3/8 - .
3as Valve type =A
y►n ee t� S�ze t (4 Manufacturer v I
)etector Temperature rating 3�eN: 3
food Size: � � Duct 'Size: Ia- 141
to
-
n
Hood Size: .Duct Size:
EQUIPMENT �IANTITY SURFACB NOZZLE
TYF£ T.
'X.1V TIP# FIGHTS I:OCATIDNS . -
:e" .� 'c _ - - .. : - ` .• .. _ �.ZV
.i -
OCCUPANCY OR
� 245 o _ ., .. , ::F. I F USE I� UNLAWFUL RANGE 290 ` u-2o 1�ItIME�mt WITHOUT CERTIFICATE
GRIDDLE I "X air 1N ; — 35-40 - `
w 1N•_ 35-45 - PF OCCUPANCY S
UPRIGHT 1/2 N _ =
CHAIN BR IN
GAS/ELECRAD IN 26-40 - FIREJNSPECTION.
REQUIRED BEFORE
LAVAROM IX 18- II OPENING
18-40
NATURAL CHARCOAL/MES
3 14-40 �1 r�� Q� w ::.�r. c
MER r��( 1 3t ' xa " i F -3 xo-�t8 V� -
OTHM %bit
X Fryers to have High Limit Control to shut off fuel at 425 deg.` 1 1J = t{Ig%1, '11T1- +
X Detectors shall be located over every piece of equipment. h13
X The System instal led as per -manufacturers specs and the AHJ. 2 W = 4lot L4 6 :`�1v= 14t¢j�Q
X The System has been .instatted.as per UL300. " 23O yvg34O A UNDERWRITERSCEhTIFI(,ATE ALL CONSTRUCTION..SHALL
X The following functions too rate system discharge: - `�1t� I
upon y MEET THE REQUIREMENTS OF THE
• * supply air damper closes * Gas fuel shuts off in kitchen _ 2q O ` �18'SS3 l F=L{1q REQUIRED
Exhaust-fan remains on Electric fuel shut off under hood 3Ghl..Cylinder 429862 fAPPROVEDA NOTED }
CODES OF NEW YORK STATE.
* All 'systems to .activate simultaneously in same hazard area. AnsW Auh man 424��j3 DATE:' B.P.
* Fire Atarm shall activate if one is installed in building-. TankEadosure 429870 b L --
X Manual Pull is located 10-35 ft from hood and 3-5 ft from floor. FEE: BY:
Swivel Adaptor 423572 NOTi Y BUILDING DEPARTMENT AT ,.
X All fuel sources are GAS unless otherwise noted. [03tem a] r
Blow Off Cap . 77695 765-1802 8 AM TO 4 PM FOR THE
• - Scies Detector- 417369 FOLLOWING INSPECTIONS: /! �G-
CONTRACTOR. J�1C, EC'�(�o �.3v' p tp'��-g� ,L}$G'i ,� 41 $ 1. FOUNDATION .- TWO REQUIRED `
At3T DESIGN & FIRE P.iFROTECTIO Co�pui FOR POURED CCPJCRETE
ey- �42325'1
3�8» 2. ROUGH - FRAMING & PLUMBING O *u
t 49 hA o ntm u k .H i a hvvm 1r SCSI 172" 3. INSULATION STRUCTION MUST �h a
4. FINAL - CON. .
Pull Station 4835 BE COMPLETE FOR C-0.
Cantor .Moridhes NY - y 934'
M�,k_Valve1'4 Ansel =ALL CONSTRUCTION SHALL MEET_THE
REQUIREMENTS *OF THE CODES OF NEW.LOCATION: !l D Y= 2 o CO2 .t-fR 1-44(
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS. s
-7 c7 � E12�c z-c3aq t 3
- ----------------
All Views to the following scale [ Dimensions
KITCHEN CONSTRUCTION[c] �New Kitchen _Existing Kitchen ✓"' "• �p
NON Combustable[Masonry) _Limited Combustable-[S/Rock-metal stud] 11 Combustible[SJRock-wood studs]
FIRE RATED WALLS.-2 firs _Existing-1 fir ok NING _Special Sprinkler Installation-1 hr ok
OR [`RO C IV 1 h fir- Set(closing,sel latcning,fire ratee door assembly)_Special Sprinkler Installation-%hr oK_OK WITHOUT Opening Protectives if ALL of the following comply:
Draft Curtain 24"ht[NC/LC) Hds/Aes Special Sprinkler Installation
Exit t Grade ar-S rinkler heads within 24 inches of draft curtain 60 Inches a art.kitchen side
Cooking Equipment in the Kittchen _Cooking Equipment at the front counter Cooking Equipment in the dining room
Cooking Equipment in a Mobile unit Idj_Cooking Equipment in a Concession stand.ld)_Pizza Oven[d)
HOOD
Exhaust cfm-Medium Du tv[d] Exhaust cfm g-Heavy Dutv[d] —Exhaust cfm-Extra Heavy Duty d � �i' '(hot top,griddle,fryers,pizza,rotisseries) (ran e,wok, asletec broilers t [ ) vr•`• ""'�
1 ISokdfuelcharbroilers[Wall-LinearFt x 300],(S-island LinearFt x 500] IV1/all-LinearFt x 400j,(5•Island LinearFt x 6uu j
Liquid tight external weld 1 (Wall-LinearFt x 550],[S-Island LinearFt x 7001
q g 12 ft max hood length per exhaust riser]d] 18 ga steel or 20 ga Stainless
Supply Air 50/50 approx replacemnt[di_ Supply Air 10 deg difference except A/C IdJ _Supply air hood damper (286 deg max)
Clearance-3"to Combustibles. including 1 inch mineral wool,[insulate the combustible not the hood)
Clearance-3"to Limited Combustible[dL_Clearance-0"to Non Combustible Id1 _ i � t 4 CHARBROILERS -4' min to hood _Solid fuel to have spark arrestors[d Insulation-max Flame Spread Rating 251x j �
J _Solid fuel-under separate hood --�
FRYER-16 inch space to Flame producin pliance or 16 inch high steel baffle GrG'GSC'T ---------------
OP
FILTERS to heat source 18"minimum TO flue baffles 6 inch minimum (uprights,roticeeees,ovens,etc) ,(
6 inch overhang all sides 7 ft maximum off floor 24 Inch minimum height all sides (�•`�,} `4)2l:
LISTED HOOD installed in accordance with terms of its listing Elec.wue in conduit or EMT
Mode]Manufacturer _Exhaust cfm Clearance(Hood bottom to appi top) �.
_Supply cfm Maximum cooking surface temp
DUCTS
AIRFLOW 1500 Nminute minimum'
Dimensions(LxWxH) 16 ga steel or 18 ga Stainless
Du Field welds to be Bell or Telescoping[d]
d exits bldg directly as possible Id] Horizontal duct travel less than 75' d - 11
Liquid tight external weld [1 Duct connections to have flush bottoms IdJ
q g Shall
exhaust dampers used Duct pitched back hood to collect grease
Ducts not shared by other systems _ Shall not pass inch
fine Its _ Not insulated until inspected �/ 3 CLEARANCE-3"minimum to combustibles,including 1 inch mineral wool(insulate the combustible not the duct) b 1
Clearance-3"to Limited Combustibleld]_ Clearance-0"to Non Combustible(dJ
ACCESS PANELS-unobstructed Within 3 It each side of an infine fan Signs-'Access Panel-Do Not Obstruct'
20 feet Horizontally(d] At every floor Vertical)
Access door at vertical nser base Duct secured to bldg y At every Direction change
E EXTERIOR-Weatherproofed Fi�Sfi :
_ ENCLOSURES-In buildin gs more than 1 floor, from ceiling above hood or through any concealed spaces ducts shall be enclosed f Penetrate floors&ceilings 6 inches duct to enclosure[a] Vented in curb at roof i
Through Penetration Fire Stop System as alternative to Enclosures with 6 inch airspace
shall have a minimum 3 inch inclusive airspace,depending on mfg (dj ` e y]• �e1 ���
TERMINATES-at building exterior up and away from roof 40 inches from roof -
Fan hinges away from duct. with hold open retainer&flexible waterproof cable i'j�l
P Grease drains back to trap at fan Minimum 10'to au intakes,property fines,windows doors or 3'vertical Safe access area for servicing
_ -n_ --------N C side wall fan termination ok,no openings 10'horiz,verticle down.32'verticle up,except char-broilers not permitted ld)
'
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