HomeMy WebLinkAbout44252-Z ofFol
l'pGy Town of Southold 4/10/2023
M P.O.Box 1179
o _ 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 40841 Date: 11/7/2019
THIS CERTIFIES that the building COMMERCIAL ALTERATION
Location of Property: 61600 Route 25, Southold
SCTM#: 473889 Sec/Block/Lot: 56.-6-3.4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/18/2019 pursuant to which Building Permit No. 44252 dated 10/3/2019
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:
modification to an existing a nsel system as applied for.
The certificate is issued to 61600 Main Rd LLC
of the aforesaid building.
i
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED (/
A h reed Signature
TOWN OF SOUTHOLD
011 BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 44252 Date: 10/3/2019
Permission is hereby granted to:
61600 Main Rd LLC
c/o Johnny Donadic
45-25 39th St
Long Island City, NY 11104
To: modification to an existing ansel system as applied for.
At premises located at:
61600 Route 25, Southold
SCTM #473889
Sec/Block/Lot# 56.-6-3.4
Pursuant to application dated 9/18/2019 and approved by the Building Inspector.
To expire on 4/3/2021.
Fees:
CO -COMMERCIAL $50.00
AS BUILT -COMMERCIAL ADDITIONS/ALTERATIONS $250.00
Total: $300.00
Building Inspector
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY OCT 1 5 2019
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 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 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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00,
Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,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. I0 ?)
New Construction: IOld or Pre-existing Building: (check one)
Location of Property: VJ DO �0(e "�' !sC)U4" "
House No. Street Hamlet
Owner or Owners of Property: b I�, �-y�OO 1 ► �a I' ,Q n '`�d I—LC
Suffolk County Tax Map No 1000, Section 40 Block Lot
Subdivision �1Filed Map. Lot:
Permit No. 5 1 Date of Permit. ,O—N�i—Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate. (check one)
Fee Submitted: $
Applicant Signature
of souryo S6 - ( - 3.Lf � Su rr65
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# # TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATIOWCAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY f FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS: o`
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DATE D 3/ 020! `J' INSPECTOR
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION (1ST) 3l
-------------------------------------
FOUNDATION (2ND) cr
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ROUGH FRAMING&
PLUMBING
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INSULATION PER N.Y. y
STATE ENERGY CODE
FINAL
ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL:(631)765-1802 Planning Board approval
FAX:(631)765-9502 e `� �� Survey
Southoldtownny.gov PERMIT NO. Check
Septic Form
N Y.S.D.E.C.
Trustees
C.O Application
Flood Permit
Examined 20 Single&Separate
Truss Identification Form
Storm-Water Assessment Form
Contact:
Approved _20 Mail to.
Disapproved a/c
Phone:
Expiration ,20 caz,,_�I
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date C1 20 1
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
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.
( ignature of applicant or name,if a corporation)
0,4e-LL fide- (3d%140R4_ Mi II�o6
(Mailing address of applicant)
State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder
Name of owner of premises tp00 140L N Q1) LL G
(As on the tax roll or latest deed)
If applicant is a corporation,signature of duly authorized officer
PAyL Ty RR0 FQRCr,%AQ
(Name and title of corporate officer)
Builders License No
Plumbers License No
Electricians License No.
Other Trade's License No J 3
1 Location of land on which proposed work will be done.
6160o MK C\ Rt Sc",A\oLZ�
House Number Street Hamlet
County Tax Map No 1000 Section S6 Block u 6 -Lot-'3
Subdivision Filed Map No. Lot
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
3 Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost Fee
(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
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
Height Number of Stories
Dimensions of same structure with alterations or additions. Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction.Front Rear Depth
Height Number of Stories
9. Size of lot:Front Rear Depth
10.Date of Purchase Name of Former Owner
11.Zone or use district in which premises are situated
12.Does proposed construction violate any zoning law,ordinance or regulation?YES_NO
13. Will lot be re-graded?YES_NO Will excess till be removed from premises"YES NO
14.Names of Owner of premises Address Phone No.
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a.Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES NO
* 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.
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 )
�>AyL being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the eoc�%(_ AC-Te>P,
(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 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 tgbefore me tis w ` JOANNE MICALIZZI
(o day oL/ el f-(' 20� NOTARY PUBLIC STATE OF NEW YORK
SUFFOLK COUNTY
MI 289000
Notary Public Sign ture
SUFFOLK COUNTY
DEPARTMENT OF FIRE, RESCUE AND EMERGENCY SERVICES
PORTABLE FIRE EXTINGUISHER AND AUTOMATIC FIRE EXTINGUISHING SYSTEMS LICENSING
BOARD
CERTIFICATE OF REGISTRATION
REGISTRATION #: 113
EFFECTIVE DATE: 1/17/19 EXPIRATION DATE: 1/31/21
ISSUED TO: NAME: Suffolk Fire Inc.dba Anderson Fire Equipment
ADDRESS: 9 O'Neil Avenue
Bay Shore, NY 11706
ENDORSEMENTS: Portable Fire Extinguishers
High Pressure Hydrostatic Testing
DryNVet Chemical Extinguishing Systems
This Certificate of Registration Does Not Exclusively Recommend the Bearer
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COMMISSIONER CHIEF FIRE MARSHAL
Certificate ofAchievement
This certifies that
PATRICK TURRO
of
Anderson Fire Equipment
has successfully completed training for Applications, Installation, Maintenance and
Service of ProTex H and Applications, Maintenance and Service of ProTex 2000
and is certified as an authorized Distributor for Wet Chemical Restaurant Fire
Suppression Systems.
Congratulations on a job Well Done.
'I'racey J.Fuller Vice President-General Manager Kevin R.Mussack Vice President-'technical Services
TexII Training Completed 4/25/2019•Valid Through 4/30/2022
b7AUMNT Heiser BHC,LLC.•35 North Street,Suite 50•Canandaigua,New York 14424 �O
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PROTEX II L3000 x Fryers to have High Limit Control to shut off fuel at 425° aw o0 oZ Z=Zo
MAX FLOW POINTS = 10 (10 USED) x Detectors shall be located over every piece of equipment zmo� 0o W�J�
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Piping Material BLACK SCH 40 Max Rise 10' MAX PIPE VOLUME = 1910 x The System installed as per manufacturers specs and the AHJwwzg ~Qa Jo
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Supply Pipe Sze 3 8" Branch Pipe Size 3 8" Drops 3 8" MAX VOLUME BETWEEN FIRST AND LAST NOZZLE 1 125 y P aoaw� Z
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Hood Size 10'10' (EXIST.) Duct Size 12"x12" M815 MOUNTING BRACKET * All systems to activate simultaneously in same hazard area. =aeras « o<oo
MBP2 MOUNTING BRACKET * Fire Alarm shall activate
EQUIPMENT SURFACE NOZZLE MCH2 MECH CONTROL HEAD x Manual Pull Station shall be located a minimum of 10 ft. from o
TYPE QTY AREA TIP#/QTY HEIGHTS LOCATIONS NL2D NOZZLE hood & a maximum of 20 ft from hood and 4 ft from floor Q� (0 �
NL1H NOZZLE x All fuel sources are GAS unless otherwise noted �,,,� � a
DUCT 1 12"X12" NL2D 1 0"-6' 0"-6' IN OPENING NL2H NOZZLE °'
PLENUM 1 10' NL1H 1 0"-6" FROM END OF PLENUM NLiL NOZZLE } rT ,
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FLAT GRIDDLE 1 24"X24" NL1 H 1 24"-48" ABOVE ANY CORNER 3234 FUSIBLE LINK 360° C ' "• ''L`r WITH ALL CODES 0E= 6 0 U
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CHEESE MELTER 1 20"x20" NL1L 1 - FRONT EDGE ABOVE GRATE
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A FIRE EXTINGUISHER WITH A MINIMUM RATING
OF CLASS K MUST BE INSTALLED WITHIN THE
VICINITY OF THE COOKING AREA. a