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Home My WebLink About15661-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No....Z.1.6.2..3.0 ........ Date ...qc..t 9.b.e.r...1 .... ].9.8.7 ............ THIS CERTIFIES that the building .... .R.e.t..a .~.1..s.t. 9.r.e. ............................. Location of Property . .1.0.3. .0 .5..R.t. :..2.5.. &...F.a.c.t..o.r.y..A..v.e......H.a.t.t. ~ .t .u.c.k. ................ House IVo. ~treet Hamlet County Tax Map No. ]000 Section .... 1.4. .2 ..... Block ...0.! ........... Lot ....2.6. ........... Subdivision..S .~.o.~.e.. ?.I.9. ................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated 5 a n. 2 9, 1 9 8 7 pursuant to which Building Permit No. 1 5 6 6 1 z dated ...F.. e..b....3. ,...1.9.8. 7. ........... 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 ......... RETAIL DRUG STORE--GENOVESE DRUGS, INC. The certificate is issued to GENOVESE DRUG STORES, INC. ~ifYe~ ~e~ ~,X~Y~ tenant) of the aforesaid building. A. CARDINALE-owner Suffolk County Department of Health Approval ...... ~/..A ................................. UNDERWRITERS CERTIFICATE NO .............. ~. 7..9.~.q9. 6...~.a.r.c..~..l?. ,...1.97. 7. .......... PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 TO~VN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15661 Z Permission is hereby granted to: ............ .................. i';~'~:;~"~'"'"~: .......... '~' ...... '~"'"; ........... ~ .............. ~ ....... ~ ..... ; .................. at premises located at ..~.......~'..~....'~.....~....~..~.~..: ......... ~...o~,,~~ ................ County Tax Map No. 1000 Section ...... ./.....~....,'~m'....... Block ....... .~....I ......... Lot No......~...~ ............. pursuant to application dated ............ ...~~ ..~..~ .......... , 19..~..-L, and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m ~ to the Building I nspec- 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 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. Bo 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 features. 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. Co Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 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 5.Updated C.O. $ 50.00 Date .......................... NewCons truction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property.. ~.~ .~...~..%.~.~....c~. ?.'...~.~..c;~.o..~/...~..o.%~.~. .... ..~..~...~.. fl .q{..", ?.k ....... House No. Street Ham/et Owner or Owners of Property ...,.,. ft.. y1. 1. ~ [~.},.~ ................................... County Tax Map No..1000 Section ............... Block ............... Lot ................ Subdivision ~.~ · '~. J. ·/..~./ ...... Filed Map No ........... LotNo .............. Permit No.. ~.~. ~.~"....~Date of Permit . .~-./.~ .~.~..Applicant.. ~'~C Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...C-~... ................ Fee Submitted $ ........................... Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS 1004~ BUREAU OF ELECTRICITY .o,e ...,i¢.,,o.~'o.o./,,e N 798096 THIS CERTIFIES THAT the premises Genove~%~ DruFJB? Rotlt~ 20 Main ~[oa~], orang Avenue ~ ~JU~ ~ ........... , ...... in the foliotclng locatlon: ~ Basement ~ Ist FI. was examined on ~'[D3?(.LI~ 3, 1997 FIXTURE OUTLETS RECEPTACLES SWITCHES FIXTURES 3;30 DRYERS FURNACE MOTORS SERVIC~ DISCONNECT OTHER APPARATUS: [] 2nd FI. Section Block and found to be in compliance u'ith the require.tents ~f this Board. ,jA.O. t' ct .o?T SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS M~LET AMT ~P. ~T. A~PS. TRANS. A~T H P NO. OF ~ET S E R V NO.O COND. OF CC. COND. 3/~ 5.->}ner,~ojency Exit Lites 6--~e~g~ncy., Pac Lit£~ 7-55 Wstt Ii~S, 5-150 Watt NO. OF HI-LEG Lot EXHAUST FANS DIMMERS C E A.W.O. NO, OF NEUTRALS A.W. G, OF HI,LEa OF NEUTRAL imtton Electrica/ Contracting Corp. 1~ Lake Avenue South Suite 16 Nesoonset, N.Y. 11767 GENERAL MANAGER Per ' /e 'als This certificate must not be attered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their c, COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. OU~DATION (1st) OUNDATION (2nd) OUGH FRAME & ?LUMBING ~NSULATION FER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: "' ":'~ '" TOWN OF BROOKHAVEN Department of Public Safety Division of Fire Prevention WATER SPRINKLER SYSTEMS REPORT OF INSPECTION · / .... ~ ................. ._. .............................................................................. ..................... · ': .............. r ...... :' ....... ~.~ ................................................................... ........ ]1 ...... ' .................................. ~,a,~ , - /..? ....... 1. GENERAL NA NO a. Is the building occupied? ............................. b. Is occupancy same as-previous inspection? .. ' .................................. · · * · c. Are all systems in service? .............. · * · ................................................ ®.· d. Are all fire protection systems same as last inspection? .. '" e. Is building completely sprinklered? ................................... f. Are all new additions and building changes properly protected~ · · · ...... g. Is all stock or storage properly below sprinkler piping~ h. In areas protected by wet system, does the building appear to be properly heated in all areas, including blind attics, perimeter areas and are all exterior openings protected against entrance of cold air? . 2. CONTROL VALVES (See Section 13) a. Are all sprinkler system main control valves open~ b. Are all other valves in proper position? ............................... c. Are all control valves in good condition and sealed or supervised? ..................... : · · 3. WATER SUPPLIES (See Section 14) a. Was the water flow test made and results satisfactory? ...~.. 4. TANKS, PUMPS, FIRE DEPT. CONNECTIONS ......... a. Are fire pumps, gravity tanks, reservoirs and pressure tanks in good condition and maintained? b. Are fire dept. connections in satisfactory condition, couplings free, caps in place and painted green and check valves tight? . ..-(. ................................................... 5. WET SYSTEMS (Instal]ed? Yes ~"~q':~ If no, delete this section) a. Are cold weather valves opened or ~losed as necessary? .....g,~.. b. Have anti-freeze systems been tested and left in satisfactory condition? .... ~..~. ~ .~.' .' .~.':: c. Are alarm valves, water flow indicators and retards in satisfactory condition? ............. ' .................. 6. DRY SYSTEMS (Installed? Yes No ~//If no, delete this section) a. Is dry valve in good condition? b. Is air pressure and priming water level normal? . c. Is air compressor in good condition? .......... d. Were low points drained during fall and winter inspections? .............................. e. Are Quick Opening Devices in service? .................. f. Has piping been checked for stoppage within past 10 years? '"' g. Has piping been checked for proper pitch with/n past 5 years? ............................ h. Have dry valves been trip tested satisfactorily~ as required? /. ............................ i. Are dry valves adequately protected from freezing? j. Valve house and heater condition satisfactory? i' ' 7. SPECIAL SYSTEMS (Installed? Yes No //// If Yes, Type If No, delete) a. Were valves tested as required? ........................ b. Were all heat responsive systems tested and results satisfa~'t~'~' .... ....................... I ......... ..................... c. Weresupervisoryfeaturestestedandresultssatisfactery? ...... ============================================J 8. ALARMS a. Water motor and gong test satisfactory? . . .... b. Electric alarm test satisfactory? ........ ~' ..... '~,~'t;ff~ ........ ,' ' ....................... · . : ...................................... ... y.~.~ · ..: .... c. Supervusory alarm serwce test satmfactory? Af~/V/~ .......... 9. SPRINKLERS - PIPING a. Are all sprinklers in good condition not obstructed, and free of corrosion or loadingv b. Are all sprinklers less than 50 years old? .................... '. i:i:. i c. Are extra sprinklers and w~ench readily available? ...................................... d. Is condition of piping, drain valves, check valves, hangers, pressure gauges, open sprinklers strainers satisfactory? ................................................................... YES e. Are all sprinklers of proper temperature rating? ........................................... ~ .... · · · 10. Date Dry System Piping last checked for stoppage ........ ~ .............................. , .................................. 11. Date Dry System Piping last checked for proper pitch ........... __]~' .~/~ 12. Date Dry Pipe Valve last trip tested ................................. ~ 13. CONTROL VALVES No? Type (Indicate OS & Y, -' PIV, Etc.) - City Connection Control Valve .......................................... Tank Control Valves .................................................... Pump Control Valves ..................................................... Sectional Control Valves .................... ~.dZ~.~___ ................ System Control Valves ................................................... 14. WATER FLOW TEST Water Pressure? ~( City PSI Tank ~ PSI Water Flow Test? Signs Condition ]. ............ ........... ............ Fire Pump /O O PSI (If none made, ~fhy?) ..................................................................... Test Pipe Located~~/j~/~_(~ Size Pressure Flow Pressure Test Pipe Before Pressure After 15. Are electrically operated bells installed within the protected premises? If so, were these bells inspected for operation? Were batteries for same inspected/replaced as needed? Yes No Yes No Yes No 16. Recent changes in building occupancy or fire protection equipment. 17. Adjustments or corrections made. 18. Were all noted deficiencies corrected? /~ If "no", why not? ................................................................. 19. Desireable improvements. Inspector: Company Affiliation: ,-~ ~ ~ ~ Company Address: .~7,~/ /f ~ ~/~-~'"-~.. ~ ~ Company Phone #: ~ ~? '-'~'- I certify that ~ his inspection has been properly conducted and all of the above statements are true and correct to the best of my knowledge. Signature of Inspector Sworn To Before Me This Day Of ,19 This Form Must Be Notarized FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL EOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examine~ .3.., 19~..~. .xoZ~..a~-~.. _~ '~.., 19~.~. Permit No. J..~.~..b./..~... Approved Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT FEB 2 ' 19fir Received ........... ,19... Date .................. I ~ · . , . 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 approgal 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 in~o, ections. ..... .............. (Signature of applicant, or nbtne, if a corporation) .... ..................................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pmmoer or builder. (as on the tax roll or latest deed) If ..... applica~~~is rp io at re .... of duly~..~. ~.: I~.: .auth°rized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No. t~/~2 /3 Electrician's License No. ~ 2.- q/3~ Other Trade's License No ...................... Location of land on which proposed work will be done .................... ~ .............................. House Number Street County Tax Map No. 1000 Section .................. 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 ....................................... : : . :. ::," ' .'~ '? ' ~ ......... b. Intended use and occupancy .............. · ...... 3. Nature of work.(check which applicable): New Building ..... i .... dition .......... Alteration ~ Repair ....... .~.. i~,I. . Removal .............. Demolition .............. Other Work .............. ~. ~)O ) ~)O~) (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 ........................... 1 I. Zone or use district in which premises are situated ................................................... 1.2. Does proposed construction violate any zoning law, ordinance or regulation: ............................... 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes IX 14. Name of Owner of premises .................... Address ~ '~'io',-'~'~' '~'. · Phone No ............... Name of Architect .~1.~. ~ .~_,~1...I'.. ~...~..?.1 .~.... Address t~. ~ ~,,~,~.. u~'~. Phone No.l~.~'?J...~?..'~. Name of Contractor .......................... Address ................... Phone No ............... 15. Is this property located withlnl.00 feet of a t±daJ, wetland? * Yes ..... No ..... · If yes, Southold Town Trustees Perm~.t may be requ±red. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions fro property lines. Give street and block number or description according to deed, and show street names and indicate wheth, interior or corner lot. STATE OF NEW YORK, S.S COUNTY O~F ................. ......... .~..~. ,.-.U...D?'.[.o. ! !6. ........................ being duly sworn, deposes and says that he is the applicm (Name of individual signing contract) above named. He is the ....... .~.. t.~ ~. ~~-~ O ~;C '~1'~ (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 tk application; that all statements contained in this application are true to the best of his knowledge and belief; and that tt work will be performed in the manner set forth in the application filed therewith. Sworn to before me this Notary~P~b~lic~: .;~¢~.,; ...... ~.:..~County _ c. . ............... ~,~,d ~ ~u~o~ C~untv (Signature of applican Lo,~,I?_ ~L. Alxl ,,& PLUMBER CER~'IFICA 2'10111 ON I. EAD CON] ENT BEFOR£ C£RTIFI~II'E OF OCCUP,41VCY uSED IN wATER ?YSTEM cANNOT :,,'i0 of I% LEAD. occj , 0F. NCY[ APf~O]VED A~ NOTED NOTI~ BUILDING DEPARTMENT AT FOLLOWIN~ INSP~C~ONS: F~NDA~rlON ~O R~RED ~OR ~OUR~O CONCRETE ROUGH F~AMING & PLUMBING LINTEL $CH~I)UH- o~.ll~Gs J U~"TO~:0" ro 7'0" , I~"WA~ 34x3~iH~. J I-SxII/2iS/I6AN~. ALL OTHER LINTELS NOTED. ALL LINTELS ~O HAVE BRICK