HomeMy WebLinkAbout25567-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Scuthold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-26419
Date: 95/03/99
THIS CERTIFIES that the building
Location of Property: 12150 MAIN RD
(HOUSE NO.}
County Tax Map No. 473889 Section 114
Subdivision Filed Map No. __
ALTERATION
MATTITUCK
(STREET}
Block 12 Lot 2
Lot NO.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 26, 1999 pursuant to which
Building Permit No. 25567-Z dated FEBRUARY 26, 1999
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 COF~4ERCIAL BUILDING (DRY CLEANER)
AS APPLIED FOR.
The certificate is issued to JIM GRAY & PETER GRAY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N-484547 04/02/99
PLUMBERS CERTIFICATION DATED 04/14/99
ATLANTIC PLUMB.& HEATING
//B~ding Inspector
Rev. 1/81
FOR~ 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. 25567 Z
Date FEBRUARY 26r 1999
Permission is hereby granted to:
12150 MAIN RD
MATTITUCKtNY 11952
for :
INTERIOR ALTERATION TO AN EXISTING COMMERCIAL BUILDING (DRY
CLRANER) AS APPLIED FOR.
at premises located at 12150
County Tax Map No. 473889 Section 114
pursuant to application dated JANUARY
Building Inspector.
MAIN RD
Block
26 1999
MATTITUCK
0012 Lot No. 002
and approved by the
Fee $ 150.00
Authortzed~Signatur~
ORIGINAL
Rev. 2/19/98
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
APPLICATION FOR CEKTIFICATE OF OCCUPANCY
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% Iead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificat~ of Code Compliance from architect or engineer
responsible for the building.
Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
Ppre-existing" land uses:
1. Accurate survey of property showing ail 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.
Fees
I. 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 Buildinm - $100.00
3. Copy of Certificate of Occupancy - ~ .25~.~
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction Old Or Pre-existing Building/.
Location of Property '
House No. Street Hamlet
Onwer Owners of -
County Tax Map No 1000. Section...~.~.~. ........ Block...i..~'. .......... Lot...~- ..................
Subdivision Filed Map Lot ....
Permit No.~.~. ~%..~...Date Of Permit. 17.~..~. :] .~,~ .... Applicant ~%~.~ ~.~..~.~%¢~./.%.t{ 7. · .~. ~..~-
Health Dept Approval Underwriters Approval · -
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted:
ATLANTIC Plumbing & Heating, Inc.
101 Radio Ave. · Miller Place, N.Y. 11764 · (516) 744-2292
April 14,1999
To Whom It May Concern:
Asperjob# ~,~'-6"3c at I~%-2~ Ce.~,~ ~. Mattituck, NY,
all plumbing alteration work that was added to the existing store was
soldered with lead free solder on all hot and cold copper water pipes.
Sincerely,~/~ ) ¢'7'~
Atlantic Pluthbing and Heating Inc.
Robert Hlinko, President
Lie. # 1890P
No~ory Public, Store of New York
Ouolified in Suffolk County
No. 01 HA503857C
Commission Expires Jan. 30~-.,/
NDATION (2nd)
FRAME &
.PLUMBING
SULATION PEN N. Y.
STATE ENERGY
CODE
'FINAL
New York Sta{e'Department of Environmental Conservation
Air Facility' Reg!stration
DEGiD
I-I I I I I-I I I
....... Owner/Firm Taxpayer I ' ,
Slteet Address I~ JS'O H q,~ ~ -- ~' O, ~ /0~'~
I s~.~e or, Province I Cgunl~ ' i Zip~de "'
Facility
Name N)C~.),\~L..'~-:b~k~'~j b,~_.[u,~ (L(~-,,,<~r-~
Lo~tlonAddress /~15'l? ~h~ ~0, F,/),~
'~ Facilitylnformation
' ~ 113 Cap by Rule
Tolal Number of Er~ission ~3~ints: ~13'g'~-~' ] ,
,, Descriptiog ~
Standard Industrial Classification Codes
I I I
.HAP CAS Numbers
· "Il . Applicable Federal and NewY,.ork State Requirements (Part No.s)
~'5 5~ ,B~,'~I't'~'--''{' ~.ol P~ ~sg,l ,,
~t'~,:~- ~Ol P~
Cedification ,,,
I certl~ that this facility wilt be operated In conformance with all provisions of existing reguloflone..
....o..,b,. o,,,?,., lao,4),~ I). tS~.vu/:(.~.~J~ I'"" t~~
NEW YORK'STATE ,*
REGISTRATION ,APPLICATION INSTRUCTIONS
Stationary sources subject to the requirements set forth in 6 NYCRR Part 20l-4 will be required to register
w th the Department of Envi.ronmental Conservation. Instruct oas for completing the New York State rog stration
application are provided betow.
OWNER/FIRM: Enter tile name of the owner of the facd ty for which th~s apphcation ~s be ng prepared. For
individual owners, hst the fuill name (last m~ddle mit:al, first). For multiple ownership, where no legal btlsiness
partnership exists provide th~ name and mailing address, if different, of each individual owner using it backslash
(/) to separate data for each owner. For corporations, include division or subsidiary name, If any. Enter the
~ of tile owher. Include the COUNTRY if foreign owned (otherwise.leave blank) and the
appropriate ZIP/MAIL CODE (zip code + extension may also be entered). Enter the business TAXPAYER ID
number (no personal Social Security #, should be listed).
oWNER/FIRM CONTACT: List.the name .and telephone number of the owner/firm representative responsible
foranswertng any air perm~,t inquiries regarding this source.
FACILITY: Enter the nam~ and the.correct phvslcai focatioq of the facility (e.g. Acme Rd. or Building 3, XYZ
Industrial Park). Check tb~appropnate box and enter the name of the CITY, TOWN, or VILLAOE, and ZIP
.C. ODE for th.e. primary ju. risdiction of the facillty. For!ns?aces where a facility is located in multiplejurisdlctlons
0.e., across c~ty, town, wllage or county lines) list all jurisdictions using a back, slash (/) to separate data for each
location, with the primary jprisdictlon listed tint.
FACILITY INFORMATION
TOTAL NUMBER OF EMISSION POINTS: Enter the total number ofemlsslon poin. ts located at this facility.
D_o_Eo. kJIIglU~ any emissio~ points which vent emissions exclusively from exempt or trivial activities as defined
in 6 NYCRR Part 201-3.
CAP BY RULE: Check this box if the potential to emit for the facility is
NYCKR Part 201-7.3.
DESCRIPTION: Providelan overview description of tha facility referred to in this application in terms of its
.p. rimary function and/or buslin,e?s activity, principal industrial or manufacturing processes including the primary
item(s) being manufacture~ 0f applicable), and any other Infurmatlan supporting the SIC codes that are listed
below. Mention .any speclfi~ regulations (!.e., NSPS or New Source Performance Standards, MACT rules)that
apply to the fucthty and provide the rule cltattoa to the subpart level (Lo,, Subpert De - small boiler IflSPS).
STANDARD.INDUSTRIA..L CLASSIFICATION (SIC) CODES: Enter all SIC codes that apply tO
with the principle SIC code hsted first.
HAP CAS NUMBERS: SI ecify the Chemical Abstract Series or CAS numbers for any HAP's emitted from the
facility (up to a'maximum o' 12) in order of emission quantity. HAP's refer to hs*?~nJous air pollutant,t~ns defined
I~t 6 NYCRR Part 200.1(al~.
APPLICABLE FEDERAl ~ and NEW YORK STATE REQUIREMENTS (Part No.s): List the rUle dtationa
of all applicable federal am New York state regulations as they pertain to this facility. The rule cttatlofi should
be listed to the "Part" level (i.e., Part 201, 21.2:60 (for federal NSPS rules)) only. If a regulation Is fllrthet
identified by a subpart cital on, the subpart citahon and rule title should be listed in the facility description,
CERTIFICATION: Ente~ the name, offic, ial tltl.e., signature and date of signature of the ~
accountable for the comph~nce of this facdi!y w~th the applicable regulations. Certification is req~tt~ by a
representative of the firm or applicant responsible for demonstrating the truth, accuracy and completefle~ of the,
Information contained in thi$ appl cation. The responsible official should be aware that significant pcoaltles could
result in slthmlttlng false information, including the possibility of fines and imprisonment for knowin$ violations.
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
April 28, 1999
Noelle Buckle¥-Amato
6 Zebra Rd.
Rocky Point, NY 11778
RE: 12150 Main Rd., Mattituck,
1000-114-12-2.
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
The check is (not on file.)$50.00
XX No Health Department Approval on file.
No final inspection has been made.
XX No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 25567-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
THE NEW YO'RK BOARD OF FIRE UNDERWRITERS PAGE2
.UREAU OF ELECT.,C,TY
~- 40 FULTON STREET, NEW YORK, NY 10038
Date APRIL O2,1999 Ap~,licaao, No. on file 17933799/99 N 484547
THIS CERTIFIES THAT PERHIT NO. 25567
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premise* of
N & D DELUX CLEANERS, 12150 MAIN ROAD, SOUTH SIDE, ~LATTITUCK, NY
in the following location; [] Basement [] 1st Fl. [] 2nd Fl. SecHon Block Lot
was examined on ~ARCH 29,1999 and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES
OUTLETS
FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
SWITCHES
FLUORESCEN! OTHER
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
NO. OF FEET
SERVICE DISCONNECT S E R .... _V_ I C
NO, OF CC COND A.W,~ A W,G, A, W, G.
PER 0 OF CC. COND NO. OF HI-LEG OF HI-LEG NO, OF NEUTRALS OF NEUTRAL
OTHER APPARATUS:
OBER ELECTRIC
35 WYOMING STREET
CO~ACK, NY, 11725-4518
LIC,#E-222
GENERAL MANAGER
11
Per.
This certificate must not be altered in any manner; return to tho office of the Board If incorrect. Inspectors may be Identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE 'ALTERED IN ANY MANNER.
" THE NEW YORK BOARD OF FIRE UNDERWRITERS rAGE 1
1~{D6~5 BUREAU OF ELECTRICITY
~' 40 FULTON STREET, NEW YORK, NY 10038
Date APRIL O2,1999 Application No. on file 17933799/99 N 484547
THIS CERTIFIES THAT PEPJ.{IT NO. 25567
only the electrical equipment as described below and introduced by the applicant named on the above application numbe~ i$ in the premises of
N & D DELUX CLEANERS, 12150
in the following location; [] Basement
was examined on ~ARCH 29,1999
MAIN ROAD, SOUTH SIDE, MATTITUCK, NY
[] 1st FI. [] 2nd FI. Section Block
and found to be in compliance with the National Electrical Cpde.
Lot
FIXTURE
OUTLETS
DRYERS
FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
FLUORESCENT OTHER
FURNACE MOTORS ! APPLIANCE FEEDERS ~PECIAL REC'PT. TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
NO. OF FEET
SERVICE DISCONNECT S E R V I C
OTHER APPARATUS:
STEAM GENERATOR 2OA-1
CONVEYER-4
6OA DISCONNECT CLEANING MACHINE-1
3~A DISCONNECT COMPRESSOR-i
2OA DISCONNECT PUMPS-2
HOTORS:2-2 H.P.,i-5 H.P.
PANELBOARDS:l-11 CIR. 1~
Continued on Page 2 >>>
OF CC, COND,
NO OF HI-LEG
AWG
OF HI-LEG
NO. OF NEUTRALS
A. WG
OF NEUTRAL
GENERAL MAN~ER
Per-
This certificate must not be altered In any manner; return to the office of the Board If Incor!ect. Inspectors may be Identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUS;T NOT BE ALTERED IN ANY MANNER.
FORM NO. I
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TILL: 765-1802
Disapproved a/c ......
(Building Ias~tor) ~
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. 'Ibis application mst be 'canpletely filled in by typewriter or in ink and tmhnltted to the Building I~tor wi
3 sets of plans, accurate plot plan to seale. 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 deseription of layout of property mast be drawn on the diagram Oaich is part of
this application,
c. 'lhe work covered by this application my not be cameaced before issuance of Building Pemit.
' d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. ~och
pemit shall be kept on the premlaes available for inspection throughout the work.
e. NO building aball be occupied or used in ~i~ole or in part for any purpose ~0hatever tmtil a Certificate of
O~cupancy mhall have been g~ted by tim l~ilding Inspector.
APPLICATI~ IS ltEREBY lz~[g to the Building De~nt for the isl~mr~z of a Building Pemnit paranast to the
Building Zoon Ordinance of the Town of ~outhold, Saffolk County, New York, and other applicalile Laws, Ordilumces or
Regulations, for the co~t~tiou of buildings, additioas or alterations, or for r~oval or ~n,~lition, as herein
described. The applicant agrees to co~ply with all applicable laws, ordinances, building code, housing code, and
regulations, and to ~tmlt authorized inspectors ~ premises and in building for necessary inspectioas.
c.
(Signature of ~plleast, or n,~e, if a corporation)
(Mmling ~a~se of appllc~t)
State ~tmther applicant is owner, lessee, agent, architect, engincer,' general contractor, electrician, pluaber or builde~
. .~.~. .......................
Name of o~ner of premises .....v,...w~..~!.~x~.F~.~~~' ~-.,--,,O ~ ¢.\. C-~49~ ..~r....~.~.~..M.,N~.: :.k. ...................................................
(AS m the tax roll or latest deed) "
If applicant is a onr~oration, signatare of duly a~.thorized officer.
(Nane ~ title of corporate offi~.er)
Builders License No .......
r~re Li~ ~o...I.'~.%~.E ...........
glect~iciaas Licaase No..~..~..~.. ..........
OCher Trade's License No ................. .. . .
·
I. location of land on x,t~ich proposed work w~11 be done ....... ~ ...................................
..... 1 ..... .................. --, ........ ' · .........................................
House NumberStreet l~ml et
co~ty T~m~ NO. ~m0 S~tio~ ...IL.R ....... m~ ....I.~ ......... x~t ..4 ............
Sulxlivislon ................. riled 14ap No.. Lot .....
2. State,existing use and occupancy,l~ ~ ,A.~.,°f presdae, s and intended uae--and occupeney of propasad construction:
a. ~,ing ~e ~a o~m~y ...~.:~..*:.~:.~ ..........................................................
I0.
12.
13.
14.
property lines. Cive etreet m~l[block
whefl~er ieterior or eomer lot.
P~ture o[ ~ork (check ~htch appl! cable): lt~ I~lldiu~ .......... Mdition .......... Alteration .......
~ir ............ ~1 .... ' ........ ~ltti~ ............ O~r ~ ............. , ....................
{~rip~i~)
Esti~t~ ~st ' ' ~ .......................................
: (to W ~id ~ lili~ this a~li~ti~)
If ~i~ss~ ~,emial ~ ~[ ~, ~i~ ~e ~ ~t~t of ea~ ~ of ~. .
Di~nsi~s o[ ~sti~ st~ if ~: ~t ................ ~ar ............... ~pCh .................
I~t~t ......................... ~ ~r o~ Stories ......................
Oi~nsi~ o[ ~ st~m dt~ alteratt~s or ~iti~s: ~c ............... ~ar ...............
~pth .................... ~t~:t ................. .. . ~r o[ ~tortes .......... .... .
Oi~si~ o~ ~tt~ ~ ~st~ti~: ~t ................ ~ar ............... ~p~ ..............
~i~t ......................... l~r of 8t~iea .............
Si~ o[ lot: ~t ............ ~ ........ ~ .................... ~P~ ....................
~Ce of ~ta~ i ~ of Four ~r
~s ~l'o~ ~tt~ violate ~ ~i~ 1~, o~i~e ~ ~lstt~; .~.~ ...................
............ , .................. . ....~ress .............................. ~ ~.
m PLOT DYAG~H
(~ of indivilal signing c~trect)
(Contractor, agent, ~o~rate O~flCer, etc.)
o[ ~d ~r ~ ~rs, ~ is ~ly ~t~rl~ 5o ~r[o~ or h~ ~r[~ Om ~ld w~ ag to rake a~ file this
01/26/1999 12:58 5167663230
HERCULES MACHINERY
PAGE Bi
HERCULES MACHINERY SALES, INC.
3188 Lawson Boulevard
Oceanslde, New York 11572
TEL: (516) 766.8400 · FAX: (516) 766-3230
TRADE NAME OWNER'S NAME ..,_~~
STORE^DO.ESS ./..~/._r'~ /~/,e~,,v'~'~J STORETEL.#' "/?~' '~'~ 7
. ,,",,, .~.4,,7J~.. HOMETEL.#i,-r/~ ) ~'0~'/'
Y- MAKE... DE$CRIPTION MODEL ~ LIST PRIC
Equlpmenl Cost
Miscellaneous Costs Disc~radelN (-)
,, , Net Prl~e Equipmenl
FretghtlRIgging
Window Removal $
Installation
Foundation
Electrl= Work $
Conveyor Installation $
Permits
TOTAL SALES PRICE $ Mls=ellaneous Costs
)OWN PAYMENT $
AMOUNT TO FINANCE $ Taxable S~Ie
% 5ales Tax
TOTAL SALES PRICE
Salesman:
.om.T.,.. P,o.o.,Da,o= ///¢/~'--'---' -- -
0
./
~OT~: i
· ~ ~'IYIONUMENT
SURVEY FOR
PETECO REALTY CORE ~
MATT ITUCK ~',,'-'~/~- vo"~-~,~'.~ ~,
TOWN OF $OUTHOLO /~*X~ :-"~.,~,.,~o' .~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATIONIST [ ] ROUGHPLBG.
[ ] FOUNDATION2ND [ ] INSULATION
[ ] FRAMING [~]'"~AL
[ ] FIREPLACE & CHIMNEY
REMARKS'. ~
DATE
INSPECTOR
76S-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ,~ROUGH PLBG.
[ ] FOUNDATION2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE~&CHIMNEY
INSPECT~~
~Olttt~O.
TO~I OF SOUT~0LD
BUILDING DEPARTHBNT
TONNHALL
SOUTHOLD, H.¥. Il9?!
TIIL: 765-1802
Di~t~pro~ed a/e ..........
SuRVF-¥ '. .......................
SBPTIC ~o~ ...................
CALL .....
·
HAIL TO: .........
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. 'mis applicatian mst be cc~letely filled in by v2pe~iter or in i~k and ~,h~i~ted ~o
3 sets of plans, accurate plot plan to scale. Fee acconli~ co
b. Ploc plen shying locatine of lot and of buildi~s o~ praises, relatio~hip ~o adjoining pr~ises or public
streets or areas, and §iving a detailed descripti~ of layout of property ~,,~ be dra~ aa the dingr~ ~hich is par~ of
~his applicat ian.
c. 'lhe ~ork covered by ~his applicatian my not be ccramneed before issuance of lkfildi~ Pemit.
d. Upen approval of this application, dae t~ilding Inspector ~ill issue a Buildi~
pen0it ~hall be.kept ~ dae premises a~ailable for iaspectien ~ht~nghant the ~ork.
e. Bo b~ilding daall be occupied or u~d ia ~hole or in part for any purpose ~aatever ~til a Certificate of
Occupancy ~hall have been grenced by flae Ihildi~ Imspector.
APPLICATI(lt IS 1~21¥ ~ ~o r~e lhilding Deparn~t for the issuance of a Building Pemit pursuant to the
lkfilding ?~r~ Ordinance of fl~e To~ of 8enthold, Suffolk CennCy, ~ Yo~k, a~d offer applical~le L~s, Ordirar~-s or
Be~ulatior~s, /or ~be c~tnictioa of buildinga, additioas or alteratioas, or for r~val or ~litine, as herein
&scribed. The aFplica~t a~ees to ~_~c~.ly ~rith dl applicable lass, ordi~neea, buildi~ code~ hensi~ code, a~d
regelations, a~d to ~,t~it enthorized inspectors on pre~i~es and in buildir~ for necos~ry inspectiw, s.
................. ................
(Sis~ature of applicant, or r,~, if a corporatim)
....
(F~ili~ ~.~areas of applicator)
State ~hether applicant is oun~r, lessee, agent, architect, engineer,' general contractor, electrician, plumber or builde~
.......... . .~N~.<. ........................................................................
of of ...................................................
(as ne ~he tax roll or latest deed) .
If applicant is a cor~or4tion~ sigaature of duly ag.thorlzed officer.
(l'lam and title of corporate o ico )
Builders License Bo .................... . ... ..
Pl~b~rs u~_~-~ ~o...J.~.~.&P. ........... "'
~lect~i¢ia~ Lice~e Bo..~..0;~.. ..........
Orl~er Ikade's License No .....................
I. ~ti~ of 1~ ~ ~i~ ~ ~ ~11 ~ ~... ~ ~ ~ ·
~ ~r S~t ~let
a~ ~u~ ~. la atim ....~}A ....... ~N ...j.~ ......... ~t .~ ............
~Disi~ ...................................... ~il~ ~ ~ ................ ~t ...............
(~)
2. State ~sti~ ~ ~ ~ o~ .~s ~ inte~ ~ ~ ~ of pro~ ~=ti~:
a. Nsti~ ~ -~ ~ ..~.!~..~ ............ '. ............................................
/ lel ..........
b. ~ ~ ~ ~ ......... r..[~ ............................. ~ ..... ,~ ...............
lki~t ......................... ] ~r of S~ories ......................
Di~nst~ of ~ st~ ~ alteratt~s or ~tCt~s: ~C ............... Mar ...............
~pth .................... ~t~ .................... ~r of 9~ories ...............
~i~c ......................... [ ~r o~ 8tortes .....................
..................... ~ of Four ~r ............................
i ~OT DIAG~H
~r iuteri~ or ~ lot.
~u,P/OF .......................
.....~.~.L~..~.~..~...~...~._~:. .~. ~ ~.. ~;.1~1.s ~ that ~ is tl~ a~li~nt
~ ~ fl~e ........................... ~ ..................................................................
a~llcati~; ~at sll statics
that ~ ~ will ~ ~r~
~ ~ ~~ ............. . .~ ,
JNDER~RIT[RS CERTiFIOATE
RE~U~RED
DATE:,
PLUMBING
'rESTING BEFORE COVERING -
FIRE INSPECTION //.~ /
REQUIRED BEFORE _ .~ ~ -~' ~/~"/'/9;
¢.
FEE: -
NOTIFY BUILDING
765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPEC~ONS:
1 FOUNDATION - I~NO REQUIRED
FOR FOURED CON~RE'~
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.
STATE CONSTRUCTION & ENERGY
COD~S. NOT flESPONSIBLE-FOR
DESIGN OR CONSTRUCTION ERRORS
/
~S UN~WFUL
WffHOUT CERTiFIC~Ti:E
OF OOOU?ANOY
ize and Spacing o[ Grab Bars
18~ 54 min 1
1065 305 42'mln
1065 36 max r
~:gn TOILET PAPER ~ 2'~m'n ' 'i2am'n ~L II CLEAR
48 rain
~ater Closet
~,~ ',L~ ~ ~t ~ ~/~'../~'~ ~ .... :' ~:- '
~ "rn~n TOE CLEARANCE
280
430 [ DEP1 H
Leg Clearances
' LAw.