HomeMy WebLinkAbout16515-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z19754
Date FEB. 25, 1991
THIS CERTIFIES that the building
Location of Propert~ 31525 MAIN ROAD
House No.
County Tax Map No. 1000 Section 097
EQUIPMENT BUILDING
CUTCHOGUE
Street
Block D5 Lot
Hamlet
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCT. 6, 1987 ~ursuant to which
Building Permit No. 16515Z dated OCT. tl, 1987
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
EQUIPMENT BUILDING TO EXISTING COMMERCIAL BUILDING
issued is KING KULLEN PLAZA STORE #9.
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
NATHAN L. SEROTA (S & E REALTY CO.)
Rev. 1/81
FOR~ NO. ·
TOWH OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, H. Y.
BUILDING PERMIT
Cf HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission is hereby granted to:
..~.~.~....~...~..~ ....................
..... ~.~:....,0..~....~.......~ .................
.~~~.....~.:..~:.....~.~..~.~....~ ......
.~....,.. _~.: ................. ~ .~...~ ....... ~ .....................................
at premises at .............................. ....... .................. ...........-y ................................
County Tox Map No. 1000 Section ....... .~...~.,~. ...... Block ...... ..~...,~,. ....... Lot No .....J.....~z.. ............
pursuant to oppIication doted ........ .C:)...~.,.~....~ ................... 19..~...~.., and approved by the
Building Inspector.
Building Inspector
Rev, 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERT%FICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: 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.~
Bo 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 a 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, Additiohs 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 - $5.00 over 5 years - $10.00
4.Updated Certificate of Occupancy - $50.00
5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
, Date ........
~ew Construction ........... Old Or Pre-existing Building ....
Location of Property..~.~.~. .............. ~ .............. ~..~.. .....
~nwer or Owners of Property ................ t ......
County Tax Map No 1000, Section .............. Block ......... Lot.
Subdivision
....................... Fmled Map Lot
Permit No ~'~' !.~.~!.~..~.Date Of P 7~ I
........... ermit ........... Applicant .........................
Health Dept. Approval ......................... · Underwriters Approval .... ~ .....................
Planning Board Approval ........................
Request for: Temporary Certificate .......... Final Certicate.
Fee Submitted:
×,r./drc -, .S ..........
DESIGN ENGINEERS
85 Newman Street · RO. Box 848
Hackensack, NJ 07602
(201) 489-7995
February 21, 1991
Town of Southold
Building Dept
Town Hall
Southold, N.Y. 11971
Subject: CO
Dear Sirs,
Attached please find an application for certificate of
occupancy.
This is for the shed we attached to the King Kullen Center
Cutchogue.
Please issue the certificate directly to King Kullen.
Sincerely,
FE825
FIELD
FOUNDATION
(1st)
FOUNDATION (2nd)
ROUGH FRAME &
FLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
Memorandum from ....
BUILDING INSPECTORS OFFICE
TOWN OF $OUTHOLD
Tow~q ~IALL, ROUTI~OLD, ]~. Y. 11971
765-1802
October 6, 1987
Design Engineers
85 Newman Street P.O. Box 848
Hackensack, N.J. 07602
Dear Mr, Kingzett:
Pursuant to our telephone conversation of today
I return herewith your building permit application to
be notarized.
Thank you,
SOUTHOLD TOWN BUIKLDING DEPT.
Georgia Rudder, Secretary
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
'rQWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1802
I) sapproved a/c .......................................
(BuUding Inspector) ~WN OF
APPLICATION FOR BUILDING PERMIT
....
BOARD Ob HEALTH ......
3 SETS OF PLANS .......
SURVEY ..........
CHECK ..........
SEPTIC FORM ............. :
NOTIFY
CALL ................
MAIL TO:
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, wit.
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 stre
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this ap!
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 per~
shall be kept on the premises available for inspection thronghont the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupm
'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 t
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and
admit authorized inspectors on premises and in buildh~g for necessary inspections.
· p .................
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant) o ~fo 0 h
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build
. ...%..
Name of owner of preulises .5: ~ .~".....~..'~.'0, .L77'..~. · ..~..Q ..............................................
(as on the tax roil or latest deed)
If applicant is a corporatio_n, signature of duly authorized officer.
(NOme and title of co/ffadrate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No ..........................
Pluml, er's License No......~..t-/.~..p. ...........
Electrician's License No .......................
Other rfrade's License No ......................
Location of land on which proposed work will be done. J%...L~ .... ~..~ ..........
.............. .............. ..................
County Tax Map No. 1000 Section .... ff."] ........... Block .... ~ ............ 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 .... . .,~..AL...~ ........................................
I~ II
b. Intended use and occtlparlcy ..................................................................
$, unDo .................................. mlqnd. £mlON
' ' ' 6I ' ..................... jo ~ep ........................
· 1oI 2ou.~oo ~o
roqlo[Im oluo!pu.~ puc som*u l~*~ls ~gqs pu~ 'poop o1 ~u}p~oopu uo}ld}aasop ~o ~oqmnu ~aolq ptm loo~ls *AID 'sou~I Xlaodoxd
t~oJj suo!s~o~p ~o~q-los llU oluo[p~}'pu~ 'posodoxd ~o ~u[1s}xo Jo~l~q~ 's~u[pHnq I~ Allou}ls}P pue XlXUOlo
.poain~ox oq Aum ~Tmao8 so~snxa, u~o,L pIoq~nos 's~X
..... oN ..... sOX~ gpu~T~' T~PT~ ~ go ~g OOg uS~I~ po~oo'[ K~xodoxd syq~ sI
'/~o -~ .... 2 ~% ON ouoqd ~ ............ , ~~ ssaappv ~f~.~ ~ ~, ~ ~olomluoo jo ottmN
............. oN ouoqd · ·; .... . ' ssoappV ..... ~ ................ lool[tIaaV jo oumN
· .. L ......~ ,fi'oN ouoq8 'X'~~X ssoappV ...... ~ '~sosm~o~d jo aou~o 3o Omen 'VI
,s ~ox ,o~s O~o=o~ oq .~ .......................... pop==o~ =q ~o~ t~ .g~
........................... 0~ ~ :~o~,~.so. ~o o.~.~[p,o ,~ =~o~ xu~ ~,~o~ ,~o~m:~uoo po~ooo~ ~ooc~ -rt
.......................... palunlts olg sos[utold llolq~ tt~ lolJlstp osn ~o m lo7 'I !
~0 'o a~*N· ·" ..........................
........................... ~ ,xau $o~o~j osuqaandJO algol 'Ol
..................... qldo~ ...................... lgo~ ...................... luold :loI JO ozts, '6
........................... · ~ ........................... so[aols jo aoqmnN ...............
............... qldofl ....... t ....... lua~ ............... luold :uo~lonilsuoo gou o~luo jo suo[suotu[O '8
...................... souols ~o aoqumN ...................... lq$[oH ...................... qldao
.................. auo~" .... ~ ........... luo~d :suo~l[pp~ ao suo~lu~olle ~l[~ oanla~ls ames jo suo.suotu[G
......................... ~ ........................... souols, jo aoqtunN ............... l~t~oI-I .
............... llldo~ ....... [ ...... I~o~ ............... }uold :~uuj[ 'saanlo~ls ~u[ls[xojo suo~suotu~(I 'L
..................... osn jo o{ Xl qouo jo luolxo pu~ oanluu XJ!oods 'Xouudnaoo poxl~ ~o [eD~ammoo 'ssoupnq JI '9
............................ ............................................ sago jo ~oqtunu 'oBmuB JI
................ aooN qono uo sl un ~UllIOmp jo aoqmnN ............... sl[un ~u. IIo~p 3o aoqtunu '~u~[loaxp JI 'g
(uo[3uo!Idd~ s[ttl ~u[I[t uo p~ed oq ol)
..................................... ood ............................ ~"[ '~' lso3 polmu[ls~ 'p
............... ~aohk joql~~ · uo[1Homa(l .............. lUaOmaH ........ .......
Examined ................. 19...
BOARD OF HEALTH ......
3 SETS OF PLANS .......
'FORM NO. 1 SURVEY ..........
TOWN OF $OUTHOLD CHECK ..........
BUILDING DEPARTMENT SEPTIC FORM ............. :
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1802 CALL ................
MAIL TO:
Approved ................. 19... Permit No ............
Dmapproved' a/c
................................................. k_kC
.............................. I. BLDG. DE. PT.
I TOWN OF SOUTHOLD
(B, lilding
Inspector)
APPLICATION FOR BUILDING PERMIT
Date .~. ~.. l ...... 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 cq.v.~red by this application may not be commenced before issuance of Building Permit.
d. Upon approval of-this.~app!ication, 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)
(Mailing address of applicant) t~ 76 O 'U
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ..O~..~..~"....g~,0.k.'~. ? C O .........................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
)
(NOme and title of coftd(~ate officer) -
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No ..........................
Plumber's License No.....~..~7..{~..e ...........
Electrician's License No .......................
Other Trade's License No ......................
House Num bet Street liI;~nq~i
County Tax Map No. 1000 Section .... q.) ........... Block .... ~. ............ Lot...I.~ .............
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name) ·
State existing [,se and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .... . .~4~..~. .
b. lntended use and occupancy ....................................................................
i .
3. Nature of work (check which applicable): New Building ............
Repair .............. Removal .............. Demolition ..
10.
12.
13.
'14.
Alteration .., ........
Work
j~ ~ (Description)
4. Estimated Cost , O'~ ..... Fee ......................................
! ' (to be paid on filing this application)
5. If dwelimg number of dwelhng umt ............... 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 w~th alterations or additions: Front ................. Rear ..................
Depth ' . ..... Height Number of Stories
DimenSions oi; entire new construction: Front .......... ' ..... Rear ............... Depth ...............
Height ............... Number of Stories ........................................................
Size of lot: Front .......... i Rear ................... Depth ...........
[)ate Df Purchase ........... : .................. Name of ~'ormer Owner . .......................
£oi~c or use d~stmct in Which pr~mises are mtuated ..............................
Does proposed construction rio!ate any zoning law, ordinance or regulation'., i~.~[ [ i iii i i ii i [i i i [ i i i ........
Will lot be regraded ......... i ................... Will excess, fill be~moved from premises:z- , Yes No
Name of Owner of premises~ ~-. ~ ...... Address .~...~......~--L-~.~. Phone No. '~'/9 ...........
Name of Architect ......... ~ ......... 0. ....... Address ...... ~ ............. Phone No ................
Name of Contractor
15. ]is this property located lwithin 300 feet of a tidal cwetland? *Yes ..... No ..... *Iff yes, Southold Town TrUstees Permit maybe required.
i 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 number or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW YORK, ,
COUNTY OF. ! S.S
.......................................... being duly sworn, deposes and says that he is the applicant'
(Name of individual sig9ing contract)
above named.
He is the .......... ............................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, arid is dt~ly authorized t0 perform or have perfo~ed the said work and to m~e and file this
application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the
work will be perfo~ed in the m~npr set forth ~ the application filed therewith. :
Sworn to before me this
/
Nota~ Public ......... ~~...~.. ~ounty
' ~ / ~' / ~ ..........
, ANN M. KOHL' ............. ~ ~'"~&"~t'
gnature ofapphc )
~ OF ~EW JERSEY U j
MY ~O~]MISSION EXPIRES FEB, 26, 1989
Memorandum from ....
BUILDING 1NSPEfYI'ORS OFFICE
TOWN OF ~OUTHOLD
Tows H^L~., SOUTItOLD, N. Y. 11971
765~1802
October 6, 1987
Design Engineers
85 Newman Street P.O. Box 848
Hackensack, N.J. 07602
Dear Mr. K~ngzett:
Pursuant to our telephone conversation of today
I return herewitb your building permit application to
be notarized.
Thank you,
SOUTHOLD TO~~DEPT.
Georgia Rudder, Secretary
THE 2" WATER LINE WILL BE RUN OUT THROUGH A SLEEVE INTO THE SHED,
CONNECTED TO THE FILTERS AND RUN BACK INSIDE THE MAIN BUILDING TO
THE DISTRIBUTION SYSTEM.
THE FILTER INSTALLATIONS ARE MADE ACCORDING TO CODE, INCLUDING
APPROVED PLUMBING MATERIALS, AN AIR GAP AT THE DRAIN AND A CHECK
VALVE TO PREVENT BACKFLOW FROM THE BUILDING.
HEAT WILL BE PROVIDED BY OIL-FILLED ELECTRIC BASEBOARD,
THERMOSTATICALLY CONTROLLED.
THE SIZE AND LOCATION OF THE SHED IS SUCH THAT IT DOES NOT INTRUDE
INTO THE PARKING LOT, NOR DOES tT IMPINGE INTO THE TRANSFORMER
AREA.
THE SHED HAS NO WINDOWS, HAS A SMALL SCREENED VENT AND A LOCKABLE
DOOR FOR SECURITY.
WE WOULD APPRECIATE IT IF YOU COULD CONSIDER OUR APPLICATION AS
SOON A-S POSSIBLE. IF YOU NEED FURTHER INFORMATION PL'EASE LET US
KNOW.
THANK YOU.
SINCERELY,
GARY W. K~G
CO
0
DESIGN ENGINEERS
85 Newman Street * P.O, Box 848
Hackensack, NJ 07602
(201) 489-7995
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
OCTOBER 2, 1987
SUBJECT: PROPOSED ALTERATION AT KING KULLEN PLAZA, CUTCHOGUE
GENTLEMEN,
WE ARE THE CONTRACTOR FOR RHONE PAULENC, FORMERLY UNION CARBIDE,
IN THEIR PROGRAM TO REMOVE ALDICARB FROM POTABLE WATER IN SUFFOLK
COUNTY. THE EQUIPMENT NECESSARY TO DO THIS IS ACTIVATED CARBON
FILTRATION. WITHIN THE PARAMETERS OF UNION CARBIDE'S AGREEMENT
WITH SUFFOLK COUNTY, THE ALDICARB REMOVAL SYSTEMS ARE CONSIDERED
"TEMPORARY" IN THE SENSE THAT THEY AREN'T NECESSARY AFTER THE
ALDICARB DISAPPEARS.
THERE' IS CURRENTLY INSTALLED AT KING KULLEN A TWIN MANUALLY
OPERATED ALDICARB REMOVAL FILTER SYSTEM. BECAUSE IT IS NEARLY
INACCESSIBLE, ALL PARTIES CONCERNED WOULD LIKE THE SYSTEM
RELOCATED TO A HANDIER LOCATION.
THE ATTACHED LETTER PROPOSAL DETAILS THE MAJOR POINTS.
THIS ADDITIONAL INFORMATION MIGHT BE USEFUL TO YOU.
1. THE ENCLOSURE IS A SUBSTANTIAL WOOD SHED, FURNISHED PREFINISHED
INCLUDING INSULATION, MOUNTED ON TREATED 4 X 4 WOODEN SLEEPERS.
THE SHED WILL BE SET ON GRADE. THE PROPOSED LOCATION IS LEVEL, WELL
DRAINED AND FIRM. NO SITE WORK IS CONTEMPLATED.
THE EXISTING EQUIPMENT WILL BE MOVED FROM ITS LOCATION IN THE
MANHOLE, REBEDDED AND REINSTALLED IN THE SHED.
INSTEAD OF FILTERING THE WATER GOING FROM THE PUMP TO THE PRESSURE
TANK, WE PLAN TO INSTALL THE FILTERS IN THE LINE FROM THE PRESSURE
TANK, TO THE DISTRIBUTION SYSTEM IN THE BUILDING.