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Home My WebLink About27187-zFORM NO. 4 TOWN OF SOUTNOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27741 Date: 06/11/01 THIS CERTIFIES that the building Location of Property: . 10095 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 142 subdivision Filed Map No. __ ALTERATION MATTITUCK (STREET) (HAMLET) Block 1 Lot 26 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 8, 2000 pursuant to which Building Permit No. 27187-Z dated MARCH 28, 2001 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 ALTERATION OF EXISTING RADIO SHACK TO VIDEO STORE AS APPLIED FOR. The certificate is issued to ALAN A CARDINALE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENTOFHEALTHAPPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N 552745 N/A 03/08/01 Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES LrNTIL COMPLETION OF THE WORK AUTHORIZED) FULL PERMIT NO. 27187 Z Date MARCH 28, 2001 Permission is hereby granted to: ALAN A CARDINALE PO BOX 77 MATTITUCK,NY 11952 for : ALTERATION OF EXISTING RADIO SCHACK STORE TO A VIDEO STORE AS APPLIED FOR. at premises located at 10095 MAIN RD County Taxx Map No. 473889 Section 142 pursuant to application dated DECEMBER Building Inspector. MATTITUCK Block 0001 Lot No. 026 8, 2000 and approved by the Fee $ 572.00 Aut hori z e~I~ S ignat ure Rev. 2/19/98 ORIGINAL BUILDING PERMIT REVIEW CHECK LIST APPLICANT NAME: DATE REVIEWED:~ DATE SUBMITTED:/~/~ /fid SCTM#--- DISTRICT: 1,000 SECTION: lC,2 BLOCK: / LOT: PROJECT LOCATION STREET: I O ocL.~- ~ ARCHITECT / ENGINEER: SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES (~p..~NOTES: ZONING: PERMIT ESTIMATE AMOUNT:_$ /dB ./~ ~.00 ZONING DISTRICT: R40, R80, AC, SUBDIV. NAME: FAST TRACK: YES o~'~ CONFORMING: YES o~u NO REQUIRED LOT SIZE: _SQF WHE~-b-I~QT SIZE.-F~ROM?gT~XP, D A~TU~IS~'~EOT-SLZEh SQt ~REQUIRED~ REQUIRED REQUIRED .... ~,~ Ft(ONT: 'PROPOSED: ' SIDE YD: '/ ' PROPOSED: '/ ' REAR:__ 'PROPOSED: ' k.....LO_~_TcovERAGE: ALLO;WED: % ExisTING: sf % NE~: sf % TOTAL:____,..~_~s_f~) CORNER? YES o~ WAT ER FRONT? YES o~(~..~) ,t~ESCRIFTION: LOTS 40,000SF --100-24. Lot recognition. (CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25. Merger. (A nonconforming at any time after July 1, 1983.) PROJECT DESCRIPTION: ADD.~ACC OR N/D: AGENCY PERMITS REQUIRED FOR REV1EW TOWN SPETIC PERMIT: YES ort~ SUFFOLK COUNTY HEALTH DEPT: YES orklSlY, (BED #):__ NEW YORK STATE DEC: ~'~-l)~C 9/~/75 YES o~r~ SOUTHOLD TOWN TRUSTEES: YES TOWN ZONING BOARD APPROVAL: YES c[r NO ] TOWN PLAN. BOARD APPROVAL: YES oNN_~ FLOOD COMPLIANCE ZONE: ~mz-vmM 3/~8/80 PANEL ii: NYS ENERGY: YES OP~(~¢: __ EGRESS:__ VENT:__ NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR : ~ ~9-~ SF ~ o4~".,. ~'/~"'~ IT'~IN SECOND FLR : 8F TOTAL: 7 & ~ SF FEE DTE: / / PERMIT #:RI0- OTHER TOTAL FEE FEE FLOOD ZONE: LIGHT: TOT( Y-~S-~; SF)- (/9otb SF)= /doe'~ SF X $ ,.2_.~ =$ a~..~.. _+$ /t..~) .....+$ = $ ..~)~2 ~- '~'-:~] Form Nd. 6 ',[TOWN OF SOUTNOLD TO!~ ~LL 765-1802 ~PLICATION 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-diJposal(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 Complianoe 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 Vpre-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. 1. Certificate of Occupancy - New dwelling $25.00, Additions 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 Buildin~ - $100.00 3. Copy of Certificate of Oc'~pancy - ~ .~ 4. Updated Certificate of OcCupancy - $50.00 5. ~Temporary Certificate of Occupancy - Residential $175.00, Commercial $15.00 Bt ......... .... New Construction Old Or Pre-existing Building ~. Location of Property .................................... House No. Street Hamlet of Property * County Tax Map No, 1000, Section..l.~ ...... Block .......... (~/. ..... Lot....~..~.~ ............ Health Dept. Approval ........................ Underwriters.Approval.~.~. .. 1. t~ Planning Board Approval .................... ii.~ Request for: Temporary Certificate ...... ,. Sub itted: .............. . APPLICANT oeee5 THE NE W YORK BOARD OF F!RE:'Ui DERWRiTERs,, z '~ ~ BUREAU OF ELECTRICITY, ", ~ MARCH O8,2~O1 40 FULTON STREET NEW YORK~ ~Y~1~038 '" Date Applica~on No. on file THIS CERTIFIES THAT only the ~lectrical equipment as d~c~bed below and ~n~oduced by the applicant named on the above a~l~a~on number is ~n the premi~ of ~ C~DIN~E, RT.25 1-~IN RO~, ~TT~TUCK, w~ examined on and found to be in compl~nc~ with the Na~nat Electrical Code, FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS FIXTURE OUTLETS RECEPTACLES FLUORESCENT OTHER FUTURE APPLIANCE FEEDERS ~PECIALREC'PT. TIMECLOCKS 6 8 DRYERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: PADDLE FA~S-5 ~ME, RGENCY PACKS-4 EXIT T,IGHTS-.3 S E - R V I C NORTH ELECTRIC CO. 50C ROCKY POINT RD. ROCKY POINT, ~Y~ 11778 Per llGENERAL MANAGER ~ be oltered In ony monner; return to the office of the Boord il Incorrect. Inspectors moy be identified by their credenfiols. DING DEPARTMENT, THIS COPY OF CERTIFtCATE MUST NOT BE ALTERED IN ANY MANNER. ~IELD INSPECTION REPORT ..... ~ COI. I~NTS FOUNDATION (IST) FOUNDATION (2ND) ROUGll FP, AI~ & PLUItlIING INSULATION PER N. Y. STATE ENER~'~f CODE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGHPLBG. [ ] IN~ATION [ ~INAL [ ] FIREp/I,A~E & CHIMNEY REMARKS:~ ~~,~ ~ ~ jDATE INSPECTOR FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TONN HALL SOUTHOLD, N.Y. 1197 'I~L: 765- 1802 Disapproved ale ................................ .. · [ !, ~ (Building Inspector) APPLICATION FOR BUILDING PERMIT ,. 8 2000 BOARD OF HEALTH ............... '3 SETS OF PLANS ......... ' ...... SURVEY ........................ CHECK ......................... SEPTIC FORM ................... DEC ........................... TRUSTEES .............. NOTIFY: CALL MAIL TO: .................... Date r 'L ""'** t INSTRUCTIONS a. This applicfitxon mmt--I~ completely fill~ in by ~iter or in i~ ~ ~itt~ to ~e ~filding Ins~ctor w 3 ~ts of pl~, ~ate plot pl~ to ~ale. F~ ~co~i~ to ~le. b. Plot plm ~ lmtim of lot ~ of ~ildi~s m ~s, ~lation~ip to Mjoini~ pr~s or ~llc struts or ~e~, ~ givi~ a ~tail~ ~riptlm of l~t of pm~ ~t ~ dr~ on the diem ~i~ is ~rt of this a~li~tim. e. ~ ~ ~ ~ ~is a~li~tim my mt ~ ~ ~fore isle of ~ildi~ Pemit. d. ~ ~1 of ~is ~liarim, t~ ~ildi~ In~cror will i~ a ~ilding Pemir to the applic~t. ~t ~11 ~ ~pt m ~ ~s ~ail~le for in--tim th~mt the ~rk. e. ~ ~ildi~ ~11 ~ ~i~ or ~ in ~le or in ~rt for ~ ~ ~at~er mril a ~rtificate of ~ ~all ~ ~n ~ ~ ~ ~ildi~ I~tor. ~I~ I8 ~ ~ to t~ ~ildi~ ~nt for ~e isle of a ~ilding Pe~t ~rs~t to the ~ildi~ ~ ~im of ~ T~ of ~ld, ~ffolk ~ ~ Yo~, ~ other a~li~le ~s, ~di~es or ~lati~, for ~ ~t~tim of ~ildi~s, ~itims or alterations, or for r~al or ~liri~, ~ ~rein ~ri~. ~ a~li~t ~s m ~ly ~ all ~li~le 1~, ordi~es, ~ilding e~, ~ing ~lati~s, a to ~it m~ri~ i~tors ~ ~ms ~ in ~ildi~ for ~s~ ins~tia~s. I ............. (S~e of~a~li~,.or ~, if a co.ration) (~ili~ ~ress of ~Ifc~t) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plur~ber or lmilde ............................................................................................... of ..................................................... [ \ ' (as on the tax roll or latest deed) .{f~ica~at'is a corporat~ian, sil~at'~t~ of duly authorized officer. / __ /. (Nam and title of corporate officer) Builders License No .......................... Plmbers Lieen~ }lo .......... Electricians License No ...................... Other. Trade s License No ........................ I,,~(30~r'~vq/qfllllllll/lJIIK(l~ ,o .... ~OF~J~c~ · I. Iz~ation of land on ~hich proposed x~ork will be done....t?...tf..~....z..~./../Y!!~...~..~.(Z/.'~l~...,\...~.6, a.~.~...~.. .............. -' ............. House Nu~er. Street .. I Itanlet Sulxlivision ...................................... riled Map No ................ Loc ............... (Nam) 2. Scare exiaring use and occupancy of premise§ and intended use ~3d, c~Cupancy of propo~se~d~ construc.tion: a Existing use and occupancy ....... .~.TD~..~ ..... .~.. .~.~.. b. Inteeded use ~ ocanp~ ...... .', ............ 'i. .............. ~tt~re o ii ~cnccX ~uch apptic~l)le): Nc~v lklll<lln{~ .......... Addition ..~ .... Alteration ..... Esthmt~l ~s ................. f~ .............................................. 1 ts ............ if ~r~ge, ~r of cars ........ ' ............................. If I~i~ss, ~rcial or mi~ ~ ~, s~ci~ ~ture Di~nsi~s of ~isCi~ strip.res, if a~: ~C ................ ~ar ............... ~pth ................. I~i~t ......................... ~r of Stories Di~nsi~ of ~m st~re ~th tlCerati~s o~ ~iClons: ~out ............... ~ar ............... ~pth .................... ~i~t ................... Di.~nsi~ of entire ~ ~sC~C ~: ~C ................ ~ar ............... ~p~ .............. I~iO~t ......................... ~r of Stories ..................... Si~ of lot: ~C ................... ~ar .................... ~pch ............... lhte of ~rdm~ .................... ~ of Four ~mr ........................................ 7~ or u~ dlstricC in d~i~ pr~ i~s a~ si~t~ .............................................................. ~s pro~] c~t~ti~ violate any ~i~ 1~. o~i~e or re.latin: LOT D{AGRAH bucate clearly and distinctly all l~ildings, ~heLImr existing or p~o~, ~ i~i~te all ~t-~ d~nsions ~ p~r~ li~s. Oi~ st~t ~ bl~ ~r or ~scripti~ ~co~mg to ~. ~ ~ strut ~s ~ i~ieate t~tl~r interior or co~r lot. ..................... ~ ...... ~. ...................... I~ing duly ~m, ',~ of i~ivia[ si~ning c~tract) ~ is Lhe I (~Cractor, agent, eorIurate of~ieer, etc.) >f ~id ~r or ~rs, a~ is ~ly ~Cl}orlz~ Co ~rfo~m or h~e ~rfo~ tim ~id ~ m~ to ~ ~ file this {[~licati~; that all star--nfs c~ta[~ in this a~llcati~, are tn~ to chat the ~rk viii I~ ~rfo~l in t{~ ~m~r ~t forth in ~e a~l. icati~ fil~ ~. ~m Lo ~[~e ~ this [ ....... ......... ....... ....... ~' ~' UNDERWRITERS C~RTIFICkI~ _. - ' REQUIRED APPROVED AS NOTEB [:,ATE:B.P# NOTIFY BUILDING DEPARTMENT[ AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: I FOUNDATION - TWO REQU ~ED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION r 4. FINAL - CONSTRUCTION M{~JSI' BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE I~.y STATE CONSTRUCTION & ENERGY CODES NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS