HomeMy WebLinkAbout26622-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27361 Date: 10/23/00
THIS CERTIFIES that the building ALTERATION
Location of Property: 46455 CR 48 SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 55 Block 2 Lot 20
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 30, 2000 pursuant to which
Building Permit No_ 26622-Z dated JUNE 30, 2000
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 INTERIOR ALTERATION TO AN EXISTING COMMERCIAL BUILDING AS APPLIED FOR.
The certificate is issued to ANTHONY PIRERRA
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 27370 08/07/00
ELECTRICAL CERTIFICATE NO. 1324 08/09/00
PLUMBERS CERTIFICATION DATED 08/25/00 JACK GISMONDI
Authorized Sign re
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 UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 26622 Z Date JUNE 30, 2000
Permission is hereby granted to:
PIRRERA (L'HOMMEDIEU)
239C EAST MAIN STREET
PATCHOGUE,NY 11772
for
INTERIOR ALTERATION TO AN EXISTING COMMERCIAL BUILDING AS APPLIED
FOR.
at premises located at 46455 CR 48 SOUTHOLD
County Tax Map No. 473889 Section 055 Block 0002 Lot No. 020
pursuant to application dated MAY 30 , 2000 and approved by the
Building Inspector.
Fee $ 150. 00
C
Authori ed Si nature
ORIGINAL
Rev. 2/19/98
Form No. 6
TOWN OF SOUTHOLD
!f OCT 1 9 BUILDING DEPARTMENT
TOWN HALL
765-1802
- APPLICATION FOR CERTIFICATE 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 ofFire 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.
B. 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, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool sory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing - 0
3. Copy of Certificate of Occupancy - •251p
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date J.Q1?Aog... . . .. . .. .... . .. . . .. .. . .. . . . ..
New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . .
�
Location of Property. . . . .. R.Np 5. . . . . . . . . . . . .:�w�Ct ���C` . . . . . . . . . . . . . . . . . . . . . . . . . .
House No. Street Hamlet
Onwer or Owners of Property. ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. . . . .5 5. . . . .Block. . . .Zs. . . . . . . . . .Lot. . .ZA . . . . . . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
I2 (/ .
Permit No. . °.a . . . .Date Of Permit. �:QL ..iQ�Cf.\'). . . .Applicant nS V'. . U: ��eu. . . . . . . . .
Health Dept. Approval. . , .. . . . . . . . . . . . . . . . . . . . .Underwriters Approval. .. / . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. .,//. . . . . . . . . . . . . . . . . . . . /
Request for: Temporary Cert-ificate. . . . . . . . . . . Final Certicate. .�! . . . . . . .
Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . .
�b�35
Ct -&oZ 73 G4 APPLICANT
�Q�gpFF01K�o
G ,x
Town Hall, 53095 Main Road y x Fax (516)765.1823
P. O. Box 1179 0 _ '� Telephone(516) 765-1802 %
Southold, New York 11971 4,
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD z
C E R T I F I C A T I O N
DATE
a•
`i
Building Permit No. J
Owner: oMai r01tCJ
(please print)
Plumber:
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
.sX
( umbers Signature)
.i.
y
Sworn to before me this
1— day ofU -w—�200(�
Notary Public, County Nftrr� Y0* ~s
Nassau Suffolk Electrical Inspections, Inc.
5A Canal Street • Center Moriches, New York 11934 • Tel: 031-878-3500 • Fax: 631-878-3764
Application No: 1324 Date:8/9/2000
Issued to: Ice Cream Cove Inc.
Address: 46455 North Rd
Village: Southold Zip: 11971 ToNknship:Southold
Introduced by: Lademann electric Inc. License #: 4141-E
was examined and found to be in compliance with the National Electrical Code
AMC 1st FloorO Residential Pod Det.C>sr
Baserrent❑x 2nd floor C.amlercial El Hot Tub rW Dereds
Switches Receptacles Fixtures G-F.I. Healers Air Conditioners
4 3 6
Fens Dishwasher Washer/Amps Dryer/Amps Oven Carbon
Range/Amps Monoxide
Furnace Oil Gas Circulators Smoke Bell
Detectors Transformers
Other Equipment Meter Amps Phase Motors
1 200A OH 3
5-30A 3 Phase Outlets
11-20A Dedicated Outlets
1-125-25OVolt 20A Outlet
1-Exhaust Bath
Out Comm
This certificate must not be altered
in any manner
Building Permit No.
Section: Bloch: Lot:
O��gDFFO(,(-c
O
o� Gym
Town Hall,53095 Main Road W T Fax(516)765-1823
P.O.Box 1179 • � Telephone(516)765-1802
Southold, New York 11971
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
October 6, 2000
Russ L'Hommedieu
985 Carrington Rd.
Cutchogue, NY 11935
RE: 46455 CR 48, Southold, Ice Cream Parlor.
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
XX An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
XX The check is (not on file. ) $50.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984) .
BUILDING PERMIT # 26622-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
STATE OF NEW YORK )
) ss:
COUNTY OF SUFFOLK )
WARREN A . SAMSACH SR . p
, t;ing duly sworn.. deposes and says:
That deponent is over the age of 18 years and resides at
7675 Cox Lane Cutchogue NY. 11939
That on the 29 day of Mj_V , 2000 deponent ggiRWj;ac:Vengineer,
licensed by the State of New York, hereby states that z/he accepts full
responsibility for the accompanying plans compliance with the New York State
Fire Prevention and Building Code (9 NYCRR); said plans pertain to property
located at SCTM# 1000- 055-02-Plot 21 & 22
street address '16455 County Road 48 Southold NY 11971 ��//
1 �s ,
Architect/Engineer
SW to before me this
6' day of '12000.
Notary Public
HELENE D.HORNE
Notary Public,State of New York
No.495t364
Qualified in Suffolk County C� C
cc: Aion rica,i f
PP Icanr
STATE OF NEW YORK )
ss:
COUNTY OF SUFFOLK )
WARREN A. SAMBACH SR. P142tng duly sworn, deposes and says:
That deponent is over the age of 18 years and resides at
7675 Cox Lane Cutchogue NY 11939
That on the ,2 , day of MAY , 2000 deponent :Wengineer,
licensed by the State of New York, hereby states that s/he accepts full
responsibility for the accompanying plans compliance with the New York State
Fire Prevention and Building Code (9 NYCRR); said plans pertain to property
located at SCTM# 1000- 055-02-Plot 21 & 22
street address 46455 County Road 48 Southold NY 11971
�64'tlj 24
uc�altrQ � ,
Architect/Engineer
Sw�cn to before me this
(Lo' -day of 2000.
G
Notary Public
HELENE 0.HORNE
Notary Public,State of New York
No.4961384
Qualified in Suffolk County CJ
CCnnmisgion expire$May 22,oGOf) J
pp ICan
70-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ } FOUNDATION 2ND [ ] INSULATION
[ } FRAMING [ } FINAL
[ ] FIREPLACE &yCH�IIMNEY
REMA KS:, a l �!d 444e4G,?
;DATE 16 INSPECTOR
65-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ) FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING ( ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: 4, - g !-e �
- 1r�
DATE_= /� �°'` INSPECTOR `
,ems..
z2
765-11102
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]] INION
[ j FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS.
DATE �� U�° INSPECTO
M-1802
BUILDING DEPT.
IINSPECT!
[ ] FOUNDATION 1ST j [ ]PROuGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE& CHIMNEY
REMARKS:
DATE INSPECT
6;7
765-1802
BUILDING DEPT.
INSPECTI®
[ ] FOUNDATION 1ST ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
.'^
DATE 2 INSPECTO
FIELD INSPECTION REPORT DATE ------- ------ _-COMMENTS______
IjC------II - --- -- - .0 -"
( H r
FOUNDATION 1ST) H
i---
_if_ \
II 11
Ip-----I'--------------- --------------- ------ ---- -
FOUNDATION OND) _
-- ------------ -------------------- ---------
-------__________________ -
I
II �_
ROUGH FRAME & II—_--
ir
PLUMBINGir;
if
II
I
a
II jj y
INSULATION PER N. Y. Iif HI
----�� H
STATE ENERGY
CODE if
if
I
II II H �
FINAL if
ADDITIONAL COMMENTS:
Of
4e �g li -Of
Dd a l
100. ot
got �
�A�s/AJ � � w
H ri
O
z —
a
ro
- H
��GiS � GC�
BOARD OF HEALTH . .
MAY 3 02000 '., FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . —
TavPr. :i;� SOIJTWCLO TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
-'-- SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
CALL . . . . . . . . . . . . . . . . . .
Examined.. .............. 20.... MAIL TO: . . . . . . . . . . . . . . . . . . .
Approved.6.1............. .... Permit No. (o a;L... ............ ................
Disapproved a/c .. .
.................................. ............. ...... ............
......................................... . .........
(Building Inspect
APPLICATION FOR BUILDING PERMIT
Date. . . . . . . . . . . . . . . . . 20. . . .
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Tnspector t;
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 application.
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 issue 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 arty purpose whatever until a Certificate of
Oec,Ranhcy shall have been granted by the Building Inspector.
APPLICATICN IS HEREBY MAW to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Tam of Southold, Suffolk County, New York, and other applicable La s, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demnlition, 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 neces ary inspections.
...........
ngnature applicant, or name, if a corporation)
i up.�6...g35_
(Mailing address of applicant)
State wlrether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumtrer or build,
1- s ............................... ................................................................. .......
Name of owner of premises ..j.\h.Cl .!..1.{r�}..�
(a; orhs tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.........................................................
(Nam and title of corporate officer)
Builders License No. ......................... 734. P >7 S f c1 N:c uto{$ems
Plumbers License No. 39!3.--R............ 765 - 361c, H e N t y 5 N,k
Electricians License No. ..................... 73`i' ✓2 70 i"c M r2o51a K
Other Trade's License No. ..................
1. Inca ion.of laDd on which proposed work will be done.. ro l CI...VOP6'......... . .... .........
............................."1 .c. ... ...... ......
House Number Street Hamlet
County Tax Map No. 1000 Section ...J............ Block ... ......... Lot
Subdivision ...................................... Filed Map No. ............... Lot ........ .......
(Name)
2. State existing use and occupancy of premises and rnt�epded� /yuse jind occupancy of proposed construction:
a. Existing use and occupancy .. I�nV �^� ...n145Nk�V !(`ni.,.................................... ........
b. Intended use and occupancy
k". t • tt .«
V
? Kuture of work (check wlridm applicable): New Building .......... Addition .......... Alteration ..........
Repair . ....... .... Ree l ............. Demolition ............ Other Work ..................................
(Description)
4. Lstinrrted cost .. ..I.�.4.V ........ fee ..............................................
(to be paid on filing this application)
5.M^ IC .ening, mnber of dwelling units ............ Number of dwelling units on each floor ................
NfAIf rage, mnicr of cars ......................................
G. If business, commercial or mixed occupancy, specify mature and extent of each type of use..6 txs :.N eSS
�foirv-
7. Dimensions of existing structures, if any: Front...�.7L�........ Rear .... Depth
r
Ikigirt .. ._AX............... Number of Stories .....J................
Dimensions of sale structure with alterations or additions: Front ............... Rear ...............
Depth ........ ............ tleigtut .................... Number of Stories ...............
8.WtADir�rs of entire new construction: Front ................. Rear ............... Depth ..............
/"IR tleigjm[ ......................... prober of Stories .....N!ft.........
9. Size of lot: Front .......... Rear ....I�Q.......... Depth WeSr 18.x.. 9 C ST 150
10. [kite of Rnrchase . .................... Name of Former Owner ........................................
11. Zone or use district in which premises are situated ..............................................................
12. Des proposed construction violate any zoning law, ordinance or regulation: ....... �'
...............
13. Will lot be regraded ...N, n�........... Will excess fill be removed from premises: I�rnYES N3 G,3
14. dams of Owner of premises .?:i7;?R�mJN� ` ` C 5�-Address ..`�.9. .. � '�v"rNo.
1?tore ....
C- .. `{�RtGJno�e •••••• 5S1
Name of Architect W �'. ..'�.-...-X#N�-�J.f}`�.�}.,..... Address Ph?mJ.Q3"3:. A:/.r14one No. ..7iil•-7!
Name of Contractor
I5. is this property ................................... Address ................ .. ...Phone No. ...........
within 300 feet of a tidal wetland? * YES .......... NO .... . ..
*IF YIDS, S(IMUI) 'IOId7 '[RJ=-, PEMIT MY BE RWFM.
PI.0'r DIAGRAM
locate clearly acrd distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions
fmm property lines. Give street and block number or description according to deed, and show street nares and indicate
whether interior or corner lot. {O� `7 (0✓.! eN 0
SI'A'Iti (H' NSd ww'
SS
............... ............................ ...............being, duly sworn, deposes and says that he is Che applicant
(Name of individual signing contract)
above named,
Deis tile ... . ... . . ........ ..................................................................................
(Contractor, agent, corporate officer, etc.)
of said manner or c ioi s, and is dilly au[horized to perform or have performed the said work and to make and file this
applica(irnr; that. all statements amtainel in this application are true to the best of his knowledge and belief; and
that, the work will he perfonred in the rrnnrer set forth in Llle application filed therewith.
Sk,"m to before urn this ��/-�
J b day of .. ..y..... 20.0 G�
Notary Rub �.
. .... .. :. . .
LIZABETHASTATHIS ignature Applicant)
NOTARY PUBLIC.State of NewYotk
No.Ot ST600817'3,Suffolk County
Term Expires June 8.20_°d
_
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