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HomeMy WebLinkAbout16381-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy No. Z-16864 Date May 13, 1988 THIS CERTIFIES that the building ...E.L..E y.E?...8 .T.0. R. E...8?. O. P..P 7~q..C.~.~. r. ~..~ ............ Location of Property ....4.6.5. 2. 9..Qq u..n .ry...Rp.a.d.. ~! .4 .8 ........ 8. 9 .u.t.h.q .1 .d.,..N.: .Y.. ........... House No. Street Hamlet County Tax Map No. 1000 Section . . Q .5.5 ....... Block . . . Q .5 .......... Lot . . . .0.7 ............ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated April 8, I987 pursuant to which Building Permit No. 16381 z dated...................August 25, 1987 .......... 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 ......... GENERAL CONSTRUCTION OF ELEVEN STORE SHOPPING CENTER AS APPLIED FOR. The certificate is issued to .... .A.N.D.R.E. ~..~.! C. ,It.A.E.L...P.R.O.P.E..R?.!E' 8..,..L.T.D.: .................. (owner, YeT~if~-z~ 7,f~r,~fX X of the aforesaid building. Suffolk County Department of Health Approval ....... .C .1.0. q 8..77.0.0. 8....A.p.r..~ .1.. [ 8..,.. 1. 9. .8 .8 .... UNDERWRITERS CERTIFICATE NO I'I853672 - February 17, 1988 PLUMBERS CERTIFICATIOlq DATED: March 24, 1988-MILLER PLACE HEAT RITE Building Inspector Rev. 1/81 ~u~T TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. E~$~ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby orante~lo: t K ,e , ~ ~ ..~....~./.~...~.~..:.~~ ~. .....C~..~...~....~.~..~ ............................ ~ ........... ..~.....~.. ..~...~.~~.,~.:.~.:...t.l.2.~LI ......... at premises located at ...~..~...~.. ................ ~ ........ ,L~...~.. ...... .~.~ ............... pursuant to application dated ._~v~,_~e~:~......~ ...................... , 19.~..'~., and approved by the Building Inspector. Fee $....~...~.. ~..~.:....../~. Rev. 6/30/80 Andrew Michael Properties, Ltd "Reap Estate Developers" ~ Route 347 - Suite ~09 Hauppauge, New York '1~788 (516) 366-0500 March 22, 1988 Mr. Victor Lessard Building Administrator Town of Southold Main Road Southold, N. Y. 11971 Re: Southold Square Dear Mr. Lessard: This is to confim our advise with reference to the buildings constructed at the southeast corner of Route 48 and Youngs Avenue, Southold, that each storeowner will provide liability insurance for at least $500,000.00 in connection with any action or injury occurring at said premises. The stores have fixed side panels adjoining the doors. Each door panel has tempere~ glass and each side panel is not less then twenty-four (24") inches above the floor level. It is our understanding that this conforms to the State Building Code requirements. However, to assuage your concern as to safety glazing, by this letter, it is agreed that the undersigned owner shall hold harm- less and indemnnnify the Town of Southold and its officials as to any claims for damage or any loss sustained as a consequence of an accidental injury resulting from the breaking of the glass in said fixed side panels. Very truly yours, Andrew Michael Proper~T~s, Ltd. FORM NO. 6 TOWN OF SOUTHOLD Building.Department Town Hall Southold, N.Y. 11971 765 - ].802 "BLDQ, DE . APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m Im. mam~ 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. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval o[ electricar 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 property showing all property lines, streets, buildings and unusual natural or topographic featuros. 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. C. Fees: Additions $25.00 POOLS $25.00 1. Ce~tificate of occupancy New Dwelling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 =1 5.Updated C.O. $ 50.00 Date ..... ~,.~.~.- ......... New C OhS truc t; i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ...... .~...~..'~. /<t~v' /-/'"~ ._(,~,'7'7e-o~--/~ ?. .o ,~.T./ .?. Z,. (...~ House No, Street Ham/et Owner or Owners of Property .. County Tax Map No. 1000 Section ~"~ .,. Block ....... ~ ....... .~. ............ Lot .............. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ~b'~(~.~..'~. Date of Permit ~/.z~../~. ?.Applicant .,~C .¥.~.~.~?.. Health Dept. Approva~ ~-l.~. .-.~'..7.-':/.O?. ~.'. ....... Labor Dept. Approval ...................... Underwriters Approval, ~ ¢, .~.'3. b.7..z-. ......... Planning Board Approval .. J.A-~../~., ] ~ .~., Request for Temporary Certificate ..................... Final Certificate .... ,~/.~-. ~./,~'~ ........ Fee Submitted Construction on above describod building and permit ~eets al ~(~icable codes and recjulations. ................................ Rev. 10.10-78 MAYOR GEORGE W. HUBBARD TRUSTEES STEPHEN L. CLARKE JEANNE M. COOPER DAVID S. CORWIN GAlL F. HORTON SUPT. OF UTIL~IES JAMES1. MONSELL Ms. Valerie Scopac Town Planner Town of Southold Main Road Southold, New York Dear Valerie: 236 THIRD STREET P.O. BOX Alt GREENPORT, SUFFOLK COUNTY NEW YORK 11944 11971 OTILITYOFFICETEL. (S16)477.1748 POWER PLANT TEL. (516) 477-0172 WN OF DOUTHOLD TOWN 0~- March 28, 1988 Enclosed is a copy of the Water Supply Agreement between a minor subdivision called Southold Square Shoppes and the Village of Greenport. The Village Board oof Trustees approved the contract at their regular meeting of February 18, 1988 and it was.signed by Mayor George Hubbard. If I can be of further service, please call. Very truly yours, · Monsell Superintendent of Public Utilities JIM:hr Enc. cc: George Hubbard, Mayor All Village Trustees Utility Committee Victor Lessard, Building Department 100 Years of Community Service Mr. Bennett Orlowski Planning Board Main Road Southold, New York Dear Mr. Orlowski: I represent Andrew Mi previous corresponden referenced to in your 80 OISD COT3/qTRY Ro~ (~TE. ~8) i~IV~HF~AD, NY 11901 May 3rd, 1988 Jr. 1971 chael Properties, Ltd. Supplementing my ce, this is to advise that all of the items letter of April 26, 1988, have been completed. Please confirm that you have advised the building department that.the o~ner has complied with the requirements and that the certlf~cate bf occupancy may now be issued. ! If you h~ve any questions concerning this.ma~ter or there is to be a delay in your commuDicating with the building department beyond this week, please telephone me so that we may confer. Thank you for your CRC:cz J cc: Victor Lessard a~ icipated courtesy and cooperation. Very truly yours, Charles R. Cuddy S?ATE OF NEW YORK COUNTY OF SUFFOLK SS. (To be executed by Plumber) AFFIDAVIT WHEREAS, Section 905.5 of the New York State Building Construction Code requires that the lead content in solder used for soldering copper tube soldered joints shall be limited to .2% when it has been determined by the Town that a higher lead content constitutes a health hazard and WHEREAS, the Town of Brookhaven on January 17th, 1984, adopted a resolution declaring that the use of solder containifig more than 2/10's of 1% lead content in interior plumbing, is hereby declared to be a health hazard and WHEREAS, the undersigned is the plumber responsible for soldering the copper soldered joints or directly supervised the soldering of the join.ts within the job listed below, IN CONSIDERATION for the Building Inspector of the Town of Brookhaven issuing a Certificate of Occupancy for the premises, the undersigned hereby deposes and states that used in the interior plumbing of the below listed job contains no more than 2/10's of 1% lead content. Swomn to before me this ~ day o~ ~M~H ,  otary Public , Bldg. Permit No Job No. Job Name dUNE SCHMIDT ~allfled ~n Suff~ Commission Expires Mm*oh 198~ subject the solder MIELER PLACE HEAT R TE 669 ROUTE 25A ROCKY POINT, N. Y. ~77~ FIELD~INS?ECTION COMMENTS FOUNDATION (1st FOUNDATION (2nd ROUGH FRAME & 4BING INSULATION PER N. Y. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: OUTL£NE SPECIFICATIONS FOR: SOUTHOLD SQUARE SHOPPES NORTH ROAD, SOUTHOLD N.Y. OWNER: ANDREW MICHAEL PROPERTIES, LTD. 111 ROUTE 347 HAUPPAUGE N.Y. 11788 ARCHITECTS: MILLER ASSOCIATES/Architects, Planners 931 HALLOCK AVENUE PORT JEFFERSON STATION, N.Y. 11776 A. General OUTLINE SPECIFICATIONS FOR: SOUTHOLD SQUARE SHOPPES NORTH ROAD, SOUTHOLD, N~Y. page 1 of 4 1. These specifications are to be used in conjunction with the General Notes provided on sheet A-2. 2. All work shall conform to the New York State Building Code and the requirements of the Town of Southold. B. Site 1. All excavation shall be done to the dimensions and levels shown on the drawings. 2. Soil bearing capacity assumed 2 tons. C. Concrete Work 1. All concrete shall reach a compressive strength of 2500 pounds per square inch in 28 days. 2. The footings under all walls, columns, and piers are to be of concret~ with steel re-bars where shown. Ail footings to be of full dimension shown on plans. 3. All concrete floors to have steel troweled finish. D. Brick Work 1. Where shown on drawings, exterior walls and chimney's shall be finished with "Penfield" Brick, as manufactured by Glen Gary Brick Company. E. Block 1. Block mansonry shall be laid up with load-bearing blocks of standard sizes and shapes including necessary closures and fitters, Grade A conforming to the standard specifications of the A.S.T.M. F. Mortar Ail masonry.work shall be laid in mortar composed of one part portland cement, one part hydraCed lime, and five parts sand. Work plumb, level and true to line. Brick veneer shall be anchored with non-¢orrasive metal not more than 15" o.c. vertically and 32" o.c. horizontally. G. Lumber OUTLINE SPECIFICATIONS FOR: SOUTHOLD SQUARE SHOPPES NORTH ROAD, SOUTHOLD, N.Y. page 2 of 4 Ail lumber to be hem fir 75% construction grade, 25% standard grade 1200 P.S.I., sizes indicated on plans. Contractor shall furnish shop drawings for all roof trusses to Architect. H. Drywall 1. All interior walls shall be finished with 1/2" gypsum wall board unless otherwise noted. Spackle 3 coats. 2. Ail ceilings (underside of roof trusses or ceiling joists), shall be 5/8" fire proof gypsum wall board type "x". I. Steel 1. As per plan A.S.T.M. A. 36 Furnish and erect all steel and iron work such as columns, beams, girders% bearing plates, bracing, lintels, catch basin covers, and manhole covers as required by drawings and specifications or necessary to complete the work. 3. Furnish bearing plates as per plans for beams resting on walls. 4. Furnish necessary door frame anchors, anchor bolts, etc. J. Ceramic Tile 1. Tile floors shall be provided in each bathroom. Ail tiles shall be 4x4 of Standard Grade in colors selected by Architect. K. Interior Doors 1. As per plan, unrated doors to be masonite. L. Exterior Doors 1. Entrance doors: extruded aluminum "Duronic Brown" frames from manufacturer with. 5/8" insulating glass. 2. Rear Doors: As per plan, to be raised six panel steel door as manufactured by Stanley. page 3 o~ 4 OUTLINE SPECIFICATIONS FOR: SOUTHOLD SQUARE SHOPPES NORTH ROAD, SOUTHOLD, N.Y. M. Glazing 1. As per plan with "Duronic Brown" aluminum frames from manufacturer, 5/8" insulated glass. Provide wood grills as indicated on plans. N. ~xterior Millwork (continued) 3. All millwork shall be free of tool marks or ot~er objectionable defects. Set nails, seal with putty after prime coat of paint has been applied. O. Finish Hardware 1. Doors kwiket, brass or equal. Privacy lock at bathrooms, key lock and panic hardware at rear exit doors. P. Electric l. Provide hook up for all heating and air conditioning units. 2. Provide 100 amps circuit breaker at each store. 3. All eledtri¢ to meet or exceed the requirements of U.L. Lab, State, and local codes. Q. Exterior Finishes 1. As per elevation vinyl siding to be restoration series as manufactured by Wolverine products, Color: Almond. 2. Brick: Where shown on drawings, brick shall be "Penfield" brick as manufactured by Glen Gary Brick Company. 3. Ail millwork to be given 3 coats of oil base paint. All exterior doors to receive one coat of rust inhibitive metalic paint and finish coat of exterior metal paint. Color by: Architect. R. Heating and Air Conditioning 1. Provide single package heat pump (roof top installation) Lenox CHP 1~ withRMF15 roof mounting frame and RDE15 duct enclosure. 2. Provide main supply duct and return duct. S. Plumbing 1. OUTLINE SPECIFICATIONS FOR: SOUTHOLD SQUARE SHOPPES NORTH ROAD, SOUTHOLD, N.Y. page 4 of 4 Ail plumbing fixtures and diverters to be American Standard white. 2. Roughing: a. All waste lines cast iron b. All water supply lines copper T. Roof 1. "Timberline Brand" Asplhalt roof shingles as manufactured by GAF. Color by Architect. NOTE: 1. Substitutions of equal or better materials are permitted with notice to the Architect. 2. Guarantees for plumbing, heating, and roofing, will be furnished to owner upon completion. SQUARE FOOTAGE TABULATIONS: Exterior house wall area (Aw) Area of windows (Ag) Area of doors (Ad) 5~040 Sq. Ft. 820 ~q. Ft. 432 ~q. Gross exterior wall area (Ao) 13,200 Sq. Ft. Heating Calculationsl Ao = 13,200 SF Uw = 0.043 Aw = 5,040 SF Ug = 0.58 U~d = 820 SF = 0.40 Ad = 432 SF Uo = .07 Calc. Cooling Calculations~ A = 13~200 SF Uw = .043 Aw = 5,040 SF Ug = 0.58 Ag = 820 SF TDEQ = 23 SC = 0.83 SC t = (72° - 10°) SF = 130 OTTV = 9,3 calc. TEMPERATURE DIFFERENCES (TDEQ) FOR USE WITH EQUATION 4-2 WLS · Weight of ~o~structlon~ lbs/sq, ft. TDEQ FACTOR 99 23 765-J.802 BUILDING DEPT. INSPEC N [ ] FOUNDATION 1ST [,~ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~/~-~'~ ~/~ *~ ~ INSPECTOR ~'~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ~ROuGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS: .000:L74 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ,F~]0.r,%lEI~.,y 17s ~HN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT Ave., in the followlng Iocation~ ~ Basement ~lst FI. ~ 2~d FI. Section Bilk Lot ~s exatnlned orr ~b~ ~)~ ~ ~9~ attdfound to be in co. pliattce u' th the requirements qf this Board. FIXTURES RANGES OVENS EXHAUST FANS FIXTURE SgfllCHES FLUORE$Ci~NT MULTI.OUTLET SYSTEMS NO. OF F~ET omj~a~7~P%, 1-7cir. ~ 125amps., 7-70watt B~PS.,25-250watt MPS 7-Pole lites with 21-250watt HPS Fix( I C E No OF HI-LEG EECO Elec. Corp~ 325 Willow Point Road~ Southold, NY 11971 Lic%2816E This certificate must not be altered in any manner; return to the office c~f the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTh~ENT. THIS COPY, OF CERTIFICATE MUST NOT BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORMNO. 1 SURVEY .......... TOWN OF SOUTHOLD CHECK .......... ~UIhD~NGDEPARTMENT SE?TIC FORM ............. : TOWN HALL $OUTHOLD, N.Y. 11971 TEL.:765-1802 CALL ................ MAIL TO: atnined ................. 19 ... ~proved .................. 19... Permit No ............ sapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT July 14, 1987 Date .................. , 19... INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 s 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 areas, and giving a detailed description of layout of property must be drawn on the diagram which is part o£ this appli- ion. 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 issued a Building Permit to the applicant. Such permit 11 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 whatever until a Certificate of Occupancy 11 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 ,Ming Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or , ~ations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. z ~pplicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ntt authorized inspectors on premises and in building for necessary inspections. Andrew Michael Prooerties Ltd. (Signature of applicant, or name, if a corporation) 111 Rte.347 Suite 109, HanD., NY (M ailing address of applicant) 11788 ~te whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner Andrew Michael Proper%ies Ltd. mc o£ owner of premises .......................................................................... (as on the tax roll or latest deed) q)plica~t is a corpora/t-ion, signature of duly authorized officer. tLL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder'S License No ......... .42.0.4~HiI ......... Plumber's License No ....... 483-P Electrician's Licegse No ...... 2B.16. E .......... Other Trade's License No ...................... C.R. 48 North Road Location of]~nd on which proposed work will be done .................................................. East. O.f .Yo~gs./%v.e, . Hamlet..of. So~%ho~d,. Town. o.f..$©u.thold ............... ; ............. tlouse Nmnber Street Hamlet County Tax Map No. 1000 Section .... 55 ............ Block .... 5 ............. Lot .... 7. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and in tended use and occupancy of proposed construction: a. Existing use and occupancy ........ B.~sine~s--. R~tail..Skorga .................................. h. Intended use and occupancy ....... O~e. £t.ory. S.t~ip. Center; ................................. 3. Nature of work (check which ~pplicable): New Building .......... Addition .......... Alteration .......... Repair ............ Rer~oval .............. Demolition ............. Other Work ............... (Description) 4. Estimated Cost ..~.2,5.9.Q~.~ .......................... 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 ... [ .... 777'.-5': ................ ~ ';' '~ ' '/' ~;'- ..... ;~s' ' ' ' ~%'ff6' U'~ri~&]: ..... 6. If business, commercial or mi~ed occupancy, specify_nature and xtent oIean type or e ..................... 7. Dimenmons of exmtmg strUctures, ff any Front ............... Rear .............. Depth ............... ' o f Stories -- Height ........... . Number .................................................... l)imensions'of same structure W~th alterations or additions: Front ............ Rear .................. Depth .................. .... Height ...................... Number of Stories ...................... 8. Dimensions of entire new con~tructmn: Front ............... Rear ............... Depth ............... Height ............... Nmnber of Stories ........................................................ 9 Sizeoflot: Front 50,0 F.e.e.g .......... Rear ... 489,9.5 .......... Depth .a20,-.1.40 ........... 10. Date of Purchase .. $ 2/.~fi. ) .................... Name or I~'ormer Owner B.q~rn. ~qc.d, .t~:L~L~i .............. I 1. Zone or use district m whmh premises are mtuated ........ 13 t 2. Does proposed construction violate any zoning law, ordinance or regulation: .. . ixJ. o ......... - ...... ~ . Yes . · . ' ............ x 1~. Will lot be regraded ....... ., ........ , .......... Will excessfill be removed from re'cruises: ~ No 14 N,m. ofOwnerof,,r~,,isesAg~.r~.w. Micnael Pro~13~q~Rte347,Hau~.NY 11~/~X1~(516)~'6-6~-0500 iName oI Arcnitecl; .1'. ..... *- ·.. ^aoress_.... .. --. l'none iNo, ~ .~ ~. ·...~.~ .... ._,.~ . ~ eroS/ ~kh'es ........... wa~'iriQ' ~'i'~)~',' 'NY ~. .. Name o[ contractor ....... ' ................... Address .... i .............. rnone ~o ................ 15. Is this property locate~ within 300 feet of a tidal wetland? *Yes ..... NoX. X.... · If yes, Southold Town Trustees Permit maybe required. ... i PLOT DIAGRAM Locate clearly and distinctly b. ll buildings, whether existing or proposed, and. indicate all s~t-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. sroRx/ l Ul l-P,ll Sq.F t .---: COUNTY ROAD 48(NORTH ]iNTERIOR LOT iROAD)- EAST OF YOUNGS AVE. ;TATE OF NEW YORK, 'OUNTY OF S.S ..... ........... .~p. ~/.. t./'~q/]./~./~. .............. being duly sworn, deposes and says that he is the applicant (Name of individual si' ~ning contract) ~bove named. .) ff said owner or owners, and is uly authorized to perform or have performed the said work and to make and file this pplication; that all statements ce atained ht this application are true to the best of his knowledge and belief; and that the york will be performed in the m~ner set forth in the application filed therewith. ;worn to before me this : ~o. ~1719 ~ ~/ (S~gnature of applicant~ ~u~hfied . Commi~m~ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 e~ TEL.: 765-1803 Examin /,~ra~../~.5, 19 .~..-{ Approve~~.VY...~ .'~., 19 .~.'/. Permit No. ). {o. ~ .~ J..'.'.~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH .- 3 SETS OF PLANS ~ SURVg .... ' ." CHECK ...... CALL ............... MAIL TO: Bi. DG. [>t/PT. TOWN OF SOUT,*,~OLD Date ................... 19 INSTRUCTIONS a. This application 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 and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description 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 issued 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 in 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) ... T¢./.. (Mailing address of applicant) State whether applicant is_owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ................................................................................. Name of owner of premises ... jd.~c.6(..../~¢:4~.x..{- .... f.~j~$.~5 ..................................... (as on the tax roi1 or latest deed If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) - ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License N6; U.. ~ ..... -~..'.'/. ......... ~- Plumber's License No ......................... Electrician's License No ....................... 1. Location of land on which proposed work will be done ............................... House Number Street Hamlet County Tax Map No. I000 Section d~ ~-~ Block ~Y Lot 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 ...... .[/e.~.'O.~ ......................................................... use and occupancy ....... >.~:oDP. r.?d..(~. 6kff-- ....¢:~.~.Z.. ................................... Intended b. 3. Nature of work (check which applicable): New Building . .//..' .... '. Addition .......... Alteration ......... Repa/r .............. Removal ...... ..,..... Demolition .......... ....~ Other Work ............... i ~ (Description) 4 Estimated Cost ~ .~'.~.~/ c~oo Fee ~ (to be p~id 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 typelof use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ........ I ..... Depth ............... Height ............... Number of Stories ............................. ! .......................... Dimensions of same structure with alterations or additions: Front ............. ~... Rear ................... Depth ...................... Height ................ ~ ...... Number of Siories ...................... 8. Dimensions of entire new construction: Front, , ~q.' 2Z-o Rear . .'Z...~.o.... Height Number of Stories · .'.e?.m.~. 9. Size of lot: Front ...... : ~'e~.. .......... Rear ..................... D~pth ... :~..o ............... l0 Date of Purchase Name of Former Owner ! 1 .- Zone~oguse-distriet4n4vhi¢Ivprem~se~are~situated .... ..t~ ....... ~.; ......... I; ......................... 12. Does proposed construction violate any zoning law, ordinahceor,regulation: ...1D0 ................... - ....... ! 3. Will lot be regraded .... )/~'5 ..................... Will ex~ess fill be removed from premises: ~ No -. Name of Architect .~: I.l?r..~..~.m:~..A .......... Address .?.l .[~t eqSfiYt' £,.~. Phone No..~.~!-; .~.55.. ~. ...... Name of Contractor .......................... Address .... : ........... i · · Phone No ................ 25. Is this property located within 300 feet of a tidal wetland? *YesI ..... No M-~... · If yes, Southold Town Trustees Permit may_ be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. ~nd~eate all set-back dimensions from _~roperty lines. Give street and block number or description according to deed, and show Street names and indicate whether _nterior or corner lot. gTAT,E~OF NEW YORK, 2OUNaY OF...~.. v'g.~.~.k~. ....... S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) . . ~bove named. ' '~ -Ie is the (Contractor, agent, corporite officer, etc) . )f said owner or owners, m~d is duly authorized to perform or have performed the sai~ work and to make and file tiffs ~pplication; that all statements .contained. in this application .are'. true to the best of his knowledge and belie.f; and that the york will be performed' in the manner set forth in the application filed therewith. ~worn to before me this~' ': . ~ ~ .. ................ .~. .....day of ..... ~ ........ ,19 ?Z qotary Public, .......... ': .......... Count.~ ~ It£L£N K. DE VOE (Signature of applicant) NOTARY PUBL C, State of New York No. 4707878, Suffolk County~-~ Term Expires Msrch 30, ',S gCT'l O Ll C I OCCUPANCY OR USE IS UN~WFUL ~'-IIHOUT CERTIFICATE OF OCCUPANCY PLUMBER CERTIFICA ON ~AD CONTE~ BEFORE AIIB CERTIFICATE OF OCCUPANCy .SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of 1% LEAD. 4,7. 0 SCAL-~: BO'= ~= f~ 0 M ~ ~,&~oMT MON 0,5'W M~DOL-F--' ROAD ¢~pHALT_ .' pAVEN1ENT · '~ - c MON S 750 AREA L98acres N/O/F LA MORTE CERTIFE D TO, FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK SOUTHOLD SAVINGS BANK SURVEY FOR ANDREW MICHAEL PROPERTIES, LTD AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. 1000-55-05-07 Scale I' = $0~ July .~1,1987 ,JAN, '4, 1988 (FINAL) SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICE~ Approval of Constructed Works N,O. Ref. No,_~LdJ_.~.~_=~j~.~ The sewaEe dlsl~sal and water supply facihties at ~is Iocatio~ DATE ~ CHIEF OF GENERA[ EN~INEEEING SERVICES  'N.Y.S. LIC. NO. 49668 87-587B TYPICAL /4 ~qEA OF SiTE - LI~,'~AC~T ~Sq. Ft. k~k ~ R~N l" ~TUR~ STATE ' ~q. Ft. ESTI~TE OF DN-SITE ~(~ CUU 1~,6~ C.F. APPROVED BY PLANNING BOARD ToWN OF sOUTHOLD e DATE RECE~% :D BY S.1 sheet D of B' ARCHITECTS PLANNERS 5MITHTOWN (516) ~24-?191 I PO~T JEFFERSON STA (5] 5) 33]-8555 dateI I,/Z, ~7 '*~ - "- L" C Afl p~EI-LSVl bl.¢." ~,P,A N b ? F'I~OI~,% ¢,L~VATI ON '"w/ J ~"'U~L J"'"~T ~4~ 4¢-o" LJ I OCCUPANCY or USE IS UNLAWFUL _ WITHOUT CERTIFICATE OF OCCUPANCY If ~Oll~lr tubing II uaed for ~mter distributing ~t~ piping ihall ~ NOT~FY ~ILDING DEPARTM~T AT soLDER uSED IN wATER 765-1802 ~ am TO ~ ~ ~R THE SUPPLY SYSTEM ~NNOT EXCEED 2/10 of I~ ~AD. Fou~qO~'no~ ~o .mumm PLUMBER cERTIFICATION ~. ~N~r .,~s~m~c~ou ~u~ ON LEAD co~E~ BEFORE ALL CO;~P~ ~, [ T~O~ SHALL ~E~ CERTIFI~TE OF OCCUPANCY Tm a~ou,nv-~em u o~ rm ~.Y A,1 sheet.l of ~, ARCHITECTS PLANNERS ~ RETAIL #2. F'LOO1R IDT~. C HO*KC, U.-4 r-~q PLAIN t .0; &, LL- 3 IZ sheet; of~ cheer ~of ~ At CHITECTS PLANNERS LIGHTING FIXTWRE I1AP, K MANLIE OAT.~ PEsr~lON LAMP OUAN~ <~Z} ._ _%~cq .... v_e 15. HADCo P'lq8 16' LAHP ~b.c,6. MO~lltfe~ KEE'NE 5A14-oq3