HomeMy WebLinkAbout14815-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Zt9753 Date FEB. 25, 1991
THIS CERTIFIES that the building.
BUSINESS ALTERATION
Location of Property 31525 MAIN ROAD CUTCHOGUE
House No. Street Hamlet
097 Block 05 Lot 012
County Tax Map No. 1000 Section
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 1, 1986 pursuant to which
Building Permit No. 14815Z dated APRIL 29, 1986
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
ALTER EXISTING STORE INTO TWO STORES
issued is AND STORAGE AREA. STORES #3 & #4.
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N750481 MAY 21, 1986
PLUMBERS CERTIFICATION DATED N/A
NATHAN L. SEROTA (S & E REALTY CO.)
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
CQMPLETION OF THE WORK AUTHORIZED)
Permission is herebt granted to:
........ ..............
....z..o.. Z.... ~:5~,~,. ~....~Z~. ,~ ...........
..... .U.,~.~.~........)zTc-~........~.~...../../~-,~
,o ....... /. ~....~...~.~(.~ ...... ~ ........ z.~.....~......~.~&~.~ ....
I
.g...~~.~..~..~2.~~~....~.,~ ~ ~ ~ x~ ..................... F''':'
pursuon, to application dated ...~...~.~. ....... ~ ...................... , 1~.., and approved by the
Building Inspector.
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN ~ALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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.'
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 ...... ~ ........
House No. Street ..... '~a';~g~ .........
Onwer Owners of Pro ertv..~~ ~ .~.~ ~ ~ ~.~ .... ~) .....
or p ~ ........ % ............
.... ...... ....... f ...... ....... ...........
Subdivision .................................... Filed Map ............ Lot ......................
~ermit No./~1~ ~ ~ ~--g .~.~
............... Date Of Permit ................ Applicant ............. ~ .......
Health Dept. Approval .......................... Underwriters Approval..., .....................
Planning Board Approval ........................
Request for: Temporary Certificate ........ Final Certicate.
Fee Submitted: $.~.'.~ .....................
FIELD IN~SFEC~ION COMMENTS
FOUNDATION (1st
FOUNDATION (2nd
2.
ROUGH FRAME &
INSULATION FER N. Y.
STATE ENERGY
FINAL
ADDITIONAL COMMENTS:
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
', TEL,: 765-1803
Examined . · .~.~..~. ......... 1 .~..
.... .....
Disapproved a/c .....................................
(Buildb~g Inspector)
APPLICATION FOR BUILDING PERMIT
Date April 1st 19.8.6.
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
'~ets 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, bulldog co e~ousing~jte~nand regulations, and to
admit authorized inspectors on premises and in building for necessary insI~//~/...z..~....~....~
7.9 .~.....S.u.nr..i.s.e..U.wy..,..v.a.~.~.ey..s.t.rg.m.,..~,%..~.~.5.8.z.
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
owner
Name or owner of premises ..... S. '..&..E..R..e.a.l.t.y...C.o... ..................................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ............... ~ ........
Plumber s License No.. ~.t~..>. .~..~.../~.
Electrician's Licens~No ..... ~ ..........
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
·, ..................... .................. .c? ................ :
House Number Street Hamlet
County Tax Map No. 1000 Section .... .0.9.7. .......... Block .... .0.5. ........... Lot .... 9.1.2 ............
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
vacant
a. Existing use and occupancy .....................................................................
b. Intended use and occupancy Florist & vacant store
3. Nature of work (check which applicable): New Building ' Addition .. i ........ Alteration X.
Repair .............. Removal .............. Demolition ........... i .. Other Work ...............
. .~..~...~.0. ~.~ ....... (Description)
4. Estimated Cost .... .~. 5. . .0 .0 .0. .. -: ........................ Fee ...........................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling uniis on each floor ....... ' ..
If garage, number of cars ............................................ i .............. ~ .............
6. If business, commercial or mixed occupancy, specffy nat~ure and extent of each t¥~e of use ..F.l.orzst
7. Dimensions of existing structures, if any: Front...2.8.Q ......... Rear . .2. 8..0..~ ....... D;pth'~.0.' ~i'I i~.i ~'.5.2.' ;.
2
Height .... .1 .......... Number of Stories ....i ................ . ...........
Dimensions of same structure with alterations or additions: Front ' '2 ~0"' '.... ! ..... Rear . ' '~ ~(~'' ...........
Depth ....19.0.'.&...]..5.2. [ ....... Height ..... .2.1.' .............. Number oflStories....1 ..................
8 Dim sic of ti struction F Rea ~ Depth
. en ns en re new con : rent ............... r ........ , ................... ,...
Height .......... bet of Stories
9. Size oflot: Front .. Rear'"374'6:~-5" ........... ., 650.89I
......................................... ~aep~n ..................
10 Date of Purchase Name of Former Owner
I 1. Zone or use district in which premises are situated ......................... ! ............................
12. Does proposed construction violate any zoning law, ordinance or regulation: .. Na ...........................
13. Will lot be regraded ...... RQ ............ ' ....... Will excess fill be removed from premises: Yes No
14. Name of Owner ofRremises .S..&...E..R.~0.1.ty..gp..Address 70. E,Soor.i.s~ .H.wy . Phone No.(~§)~rg~OO...
Name ar A-~h~+~+ m,.,rton J. Seeli~ ''- . ?0 l~.gunl)l~e'~' Phone No.(.5.1.6.).
~ --~,-[*~[ · ' .............. q, ...... Address ............... ,...
Name of Contractor .................. Address ............ ; Phone No .... X' ' ': ........
15. Is this property located within 300 feet of a tidal wetland?''*'~g~'. .... No .....
· If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions t¥om
property lines. Give street and block number or description according to deed, and sho~
interior or corner lot.
~ street names and indicate whether
STATE OF NEW ~)cl?~,
COUNTY OF... ~7.99. 99.u ........ S.S
........ ' ............. ~.tbgn .b.. $.e.r. QCa ..., ....... '
....... ' being duly sworn, dep?es and says that he is thei applicant
(Name of individual signing contiact) . .
above named.
owner
He is the ..................... ........................................ ~ ...........................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the s~id work and to make and file this
application; that all statements contained in this application are true to the best of hisi 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
., / d'~'- day of A, t~2
, .... .................... :/. ..........
~tary Public ............ f.. .................... County
Qualified in Nassau County
THE NEW YORK BOARD OF FIRE UNDERWRITERS
1000460
BUREAU OF ELECTRICITY
~ 85 JOHN STREET, NEW YORK, NEW YORK 10038
Gate May 21,1986 Jpp"e""on~/o.o. yae400~6S/86 N 750481
THIS CERTIFIES THAT
only the elec;trical equipment as described below artd introduced by the applicant named on the abo~e application number in the premises of
~ ~ E Realty',. Hain Rd~ ~ Cutcho~ue, N.Y.
in the following location; [] Basement [] 1st FI. [] 2nd FI. Section Block Lot
.,~,s e~a.,ined on ~ay 1 S, 1986
FIXTURE
OUTLETS RECEPTACLE! SWITCHES
DRYERS
and found to be in compliance with the require.,ents of this Board.
FIXTURES RANGES OVENS DISH WASHERS EXHAUST
, FLUORESCENT
2
MULTI-OUTLET
SYSTEMS
NO. OF FEET
OTHER APPARATUS:
1 F, mg. Lite
E R V I C
OF CC. COND.
AWG.
NO, OF HI.LEO OF HI-LEG
NO OF NEUTRALS
OF NEUTRAL
6880 Nassau Point Rd.
Cutchoguo, N~Y. , 1~.955 ~-, x GENERAL ~A AGE.
:~ Th's certificate must not be atered in any manner-retur ....
u~U 6UILDINGDEPARTMENT. THIS COPY OF CERTIFICA E STN TBEA~EREDINANYMANN
tIoT CS
if copper lubing is u~ed
far water distributing
~ys~m; piping shall be
of types K or L only
_PLUMBER OERTIFICATION'
ON LEAD CONTENT BEFORE'
~.ERTZFICATE OF OCCUPANCY
SOLDER USED IN WATER
..~UPPL Y SYSTEM ~
.EJ~iC. EED 21.~0 o.f .~% LEAD.
NOTIFY BUILDING DE~ARTME~t'AT
765-1802 9 AM TO 4 PM FOR TH~
FOLLOWING INSPECTIONS:
1. FOUNDATION - ~O ~EqUIRED
FOR POURED CONCRETE
~. ROUGH - FRAMING & PLUMBING
3. INSULATION
4, FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C. O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
~FqlGN OR CONSTRUCTION ERRORS.
q
NOTIFY BUILDING DEPARTMENT AT
765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
',1. FOUNOATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C, O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
~ATE CONSTR~TION & ENERGY
CODES NOT RESPO~LE FOR
DES G~ OR CONST~UCTIO~ ERRORS
'%
II-
*AP~G~TD AS NOTED ~_~.'
.,NO~l~Y ~U~ING DEPA~T ~T
J; FOUNDATION - TWO REQUIRED
~: FOR POURED CONCRETE
~. ROUGH - FRAMING & PLUMBI~
~. INSULATION
4; FINAL - CONSTRUCTION MUST/;
'** BE COMPLET~ FOR C:O.,
ALL CONSTRU~ ON SHAEL
T~-:REQUIREMENTS df THE
~A~ CONS~RUCTION &
C~DES, NQT
~IGN