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Home My WebLink About10595-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT OFfice of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.Z 16018 Date August 5, 1987 THIS CERTIFIES that the building .. ~ .r p.r.e~..a.n.d., ]..u.n.c.t? .e 9.n.e.r..t .e .................... Location of Ptoperty 5/4500--56560 Hain Street So. utho.[..d ........... h3 s'o3io; ...................... 'S'da3i.............. Hamlet County Tax Map No. 1000 Section 6 I . .Block 4 . .Lot 25 Subdivision ............................... Filed Map No ........ Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated bier. 26, 1980 pursuant to which Building Permit No. I 1206z dated.....June .......... 25, 1981......... ... was~ssued, and ¢onforms to all of the requirements of the applicable provimons of the law. The occupancy for which this certificate is issued is ......... Add kitchen, alter existing food market and .luncheonette. The certificate ~s issued toJOltN MALINOWSKI (MAIN STREET MARKET) ..................... io ,;o'r,x x x ................ of the aforesaid building. Suffolk County Department of Itealth Approval .... S. q4..6..8./..2 .5./.8.0. ........................ UNDERWRITERS CERTIFICATE NO. bl 7 I 7905 11 / 18 / 85 PLUMBERS Planning C.O. also C.O. also CERTIFICATION Board approval includes DATED: N/A 1987 B.P. #9488z 10/6/77 Underwriters N393852 May 11, includes B.P. #10595Z 3/24/80 to Coffee Shop Annex Underwriters N487116 Building Inspector Unloading shed with to Alter existing store to Main Street Marker. 7/25/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERFRIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 10595 Z pursuant to apphcat,on datedz.~/~.zq~Z.~......~..r~.-. .................... 1~..., and appro d y. Buildmg Inspector. .... FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ma==,=,~- to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Finn approval of Hea~th Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$t0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 '~ \~'kQ-%~f~ 5.Updated C.C. $ 50.00 Date .......................... NewConstruction ...... Old or Pre-existing Building ....... Vacant Land , . Location of Property .. House No. Street Ham/et Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section .. Subdivision ................................. Filed Map No ........... Lot No .............. mit No \b~ '~- Per ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ~ ~z;3 Construction on above described building and permit meets all applicable codes and regulations. THE NEW YORK BOARD QF FiRE UNDERWRITERS ~-- 85 JOHN STREET, NI~W YORK, NEW ~ORK 10038 THIS CERTIFIES THAT only the electrical equipment ~ described below and i~troduc~ b~ t~ a lic nt na o in the following location; [] Basemettt ~ /st FI. was cxa,.i.ed o. July 17, 1980 FIXTURE OUTLETS 26 IECEPTACLES SWITCHES FIXTURES NCANOE$CENT FLUORESCENT 19 18 8 DRYERS [] 2nd Fl. Section Block and found to be in co,npliar~ce with the r¢quirements of ~this Board. Lot EXHAUST FANS SYSTEMS NO OF FEET E OTHER APPARATUS: S E R V I C NO OF CC COND PER Pr AWe NO OF HI LEG j AWO NO AWG OF CC COND OF HI-LEG OF NEUTRALS I ~t:~t~k, ~, ~ 11952 ~0,242 ~ 11 This certificate must not be aJtered in any ~anner; return to the office of thw Board if Iocor~ect Ins ector{ ma be dentfed I~~~Z~ ~ P , y , by the,r credentials coP~ ~o. ,,,~.,.o .,.~.~,.,...,. co.~ o~ ~,,~, ~.o, B~.~,,,.. ,. ~~2 FOUNDATION FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N.Y. STATE ENERGY COpE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Application No. Disapproved a/c ..... ~..~.: ......................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS -/ a. This application must be completely filled in by Wpewriter or in ink and submitted in triplicate 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 giwng a detailed descriphon 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 issue 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 m whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 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, ]>+lilding code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessa spect' ns (Signatute of applicant, or name, if a corporation) · .... ........ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · rcuc .. .\ , ....................................................... Name of owner of premises , . ."~. C~. ~ ~N....[~/~ I~ I~.'[ .kO.O..~O....~..\% .~. ....................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and htle of c.orporate officer) Builder's License No..~.. l C>.~---~P/O .............. Plumber's License No ...................... Electrician's License No.. [ ...~..t~. ......... Other Trade's License No ...................... Location of land on which proposed work will be done. ~ ......................................... · ............. £Z ................. ................... House Number Street Hamlet County Tax Map No, 1000 Section .~..G..4 ............ Block~...~. ~. ............ Lot .~..~.0..-~.. .......... Subdivision .................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .~,7~.../'/...~..7~..,~..~..'~. .............................................. b. Intended use and occupancy . .~.~ . . .~./~.O.~.. ........................................... 3. Nature of work (check which app!icable): 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 u.nits ............... Number of dwelling units on each floor .... .~..' .......... If garage, number of cars ...... i .................................................................. 6. If business, commercial or mixedioccupancy, specify nature and extent of each type of use ~,~ .~.~..o.~ 7. D~ensions of existing stmctureg, if any: Front ............... Rear .............. Depth ............... Height Number of Stories Dimensions of same structure wi~h alterations or additions: Front ................. Rear .................. Depth .................... ~. HeiSt ...................... Number of Stories ...................... 8. D~ensions of entire new const~ctiqn: Front ...... . .~ ........ Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...........~ .......... Rear ...................... Depth ...................... 10. Date of Purchase ........... ; ................ ~m of Fo~er Owner ............................. 11. Zone or use district in w~ch prehises are situated .......... ~ ~ ....................................... 12. Does proposed construction wol8te any zoning law, ordinance or repletion: ................................ 13. Will lot be regraded ...... ~. [ .................. Will excess fill b~ re~ovo~xf~m premises: Yes No 14. Nam~ of Owner of premises a.. ~.~. Address ~.e ~ ~..~ ~'. Phone No ................ Name of Architect ~... ~ [.. J ................. Address .................. Phone No. N~e of Contractor ~.~ ~.~)9.~ ........... Address ~ .~ ~ ~.. Phone No. ~ ~4~ ~ 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 humber or description according to deed, and show street names and indicate whether interior or corner lot. (Name of individual signing contract) above named. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d~ly authorized to perform or have performed the said work and to make and file this application; that ali 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 to before me this i -- ~ [L ZAB~T. ^~ ~VlLL~ ~ (Signature of applicant) NOTARY PUBLIC, State of New YOM No. 52-8[25850, S~fto~ke~Nmt¥ Term E~p]res Nlarc~l // t/ t~;~TIIqCr 4~tAICH~IE 77E ...... ~:~/z~ ~.~. ~ ' - __~QDES. NOT RESPONSIBLE FOR DESIGN OR CO~ }4" ~LX,