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23227-z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24669 Date OCTOBER 1, 1996 THIS CERTIFIES that the building ALTERATIONS Location of Property 7555 MAIN ROAD LAUREL, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 122 Block 6 Lot 31 Subdivision_ Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 17, 1996 pursuant to which Building Permit No. 23227-Z dated JANUARY 25, 1996 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 ALTERATIONS FOR PROFESSIONAL OFFICE IN EXISTING OFFICE AND RETAIL COMPLEX BUILDING AS APPLIED FOR. The certificate is issued to PARVIS FARAHZAD (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL INSPECTION CERT. #3723 - NOVEMBER 18, 1993 PLUMBERS CERTIFICATION DATED MARCH 15, 1996- EJ'S PLUMBING & HEATING '4 1 � - B lding Inspector 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) Q/ Nc" 23227 Z Date ............... aS...................... ........ . 19..,,!,.x' Permission Is hereby grant to: °o.... .... .. ............................................. e�,�JTr ru �...........�i.�....r�9..s to.....0 e1✓J! z4t:............/T� 17 - ............ //�!47..... f!f/i`�J✓��0..^C��G...... ... hl i7. !!,—.......... !r, .........- !...... ....... .... !��EX........... ..,.......pi's...... °. �i�.........,.�.. ........... .7x`Cs.......1 � .-........... �........... ..... ! ..9r`'. `.......................................................................... ................................................�...s......................................../.................................................................. at premises located at................✓�... . .......lv.4.. . .....".... .......................................................... ................................ e .G.................................................................... ..... tet ,7 County Tax Map No. 1000 Section ...e914F./ ............ Block...... VI....... ... Lot No. r.. .js. .. pursuant to application dated .............. 7............................ 19..../..QQ.(..., and approved by the Building Inspector. / Fee$...�f.3.�:..--.. `. . .. ........................ wilding Inspector Rev. 6/30/80 /// FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOYdN HALL SOUTHOLD,N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) C Date ...../0/7......................................... 19..1..3. N° 21698 Z Permission Is hereby granted to: Q.. .. .. . �.. .... ... . ...................................................... . ;'. .........�/...f...7�................. ............. ez.... .. .. ......... . . ..... ..,. . . ............................................................................................................... ....................................................................................................................................I............................. .................................................................................................................................................................... ZVat premises located at..TJ .. �...... Q ..............................................................�.�...%�(.................................................................�............. County Tax Map No. 1000 Section ...../„a,,.rZ....... Block .........J�l............. Lot No. 3,/.....Q...3�1�� pursuant to application d d ....yyl Z"................................... 19.Jn. � ....... and approved by the Building Inspector. ASG ?/>V . d-o Fee$.. ,3h'e . ... ...... ... ................................ Building Inspector Rev. 6/30/80 " SUILD:NG DEP.ART:ENT TOWN .LL 755-180^ APPLICATION FOR CERT IFICAT`• OF OCCUPANCY A. T_.?is application must be L'_17ed in by C.Tpewr'-tar OR ink and submitted to the building laspector wiEh the following: Lor new building or :lew use: 1 . rival survey or 7roperty with accurate IocaCi0n of all buildings, prooer C'1 Lines, streets, and unusual natural or topographic Leatures. �. 7iildi ADprOVal from HealCn Dent. pL tvaCer sllDp ly and sewerage-disposal(S-9 _oral) . 3 . Approval of electrical installation From Board of Fire Under"riters . 4. Sworn statement From plumber certifying twat the solder used in system contains less than 2/lO of Lo lead. 5. Commercial building, industrial building, multiple residences and similar buildings and-installations, a certificate of Code Compliance from architect or engineer resaonsible for the building. o. Submit Planning Board Approval of completed site pian requirements. B. For existing buildings (prior to April 9, 1957) pan-conforming uses, or buildings and "pre-existing" land uses: 1 . Accurate survey of property snowing all ?roperty lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent [o inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector sha11 state the reasons therefor in writing to the applicant. C . Fees 1 . Certificate of Occupancy - New dwelli--lg 525-00, Additions to dweiling 525.00, .Alterations to dwelling 525.00, Swimming pool $25.00, Accessory building 525.00, Additions to accessory building 325.00. Businesses 550.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy or Carti ftcate of Occupancy - .25p. i . Updated Certificate of Occupancy - 550.00 5. Temporary Certificate of Occupancy - Residential S15.00, Commercial $15.00 Date : . QS.T. . 1611.ch� New Construction. . . . . . . . . . . Old Or Pre-exit�s,tirinng,..,B/uilding. .*l. . . . . . . . . . . . . . Location of Property. . SJ` . .✓ `�. V .,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House No. Street Hamlet Oawer or Owners of Property. . . . . o'7� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . n County Tax iiap No LOCO, Section. . . .G.a . . . .Block. . . . {. . . . . . . .Lot. . �.1 . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .riled Hap . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No.Ca' .,l.�Date Of Permit. . . .�.� �. !:C?pelican[. '1..C:�. 1 .(!`.r4�? s!�. - - • • 3ealth Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . ?tanning Board .Aporoval. . . . . . . . . . . . . . . . . . . . . . . . Request tor: T_emporar-; Cartificace. . . . . . . . . . . F":: l Carticata- . . . . . . . . . . Fee Submit:--ad : 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICA`TL LITTLE ROCK 7441922 P 2 c.i r, 1,111 OF SOUTHOLD Tctvn N li, SaC9H Id.„a flgald '`' !!• r;z Asx 01$) L S t.23 P 0. Flex 11; rs .rrl 7rleC.hQnn fS I ! i 7GS t2p2 Souln,ld, tdBw `(4ik t 1A7� I I 6F'FICE OF' THE OUILDING INSPECTOR TOWN 0F SQU'TH LTA I C E R T : F ICA T I p N I i /� J i DATE :. _���!is /` � I I �u'- .t.rj i!"ICJ ...'??rl7l�'t•, O• ��..�:--' -�L.� � �I , fI I { pl ase pZ,., rtc) J i tJl ll I!tl7Cr: _C\- ` �i1.,1yY�/ 1 ,.rT ( p�eas� prim ) I cerci y that 4ha Solder uaad in the water aupply rstem I Contains Les thl n 2/10 of 1% I ( P1t, nbf,r s5at4�) � I f t 5'aorrl to ;:�e1ire me t))ls ._L y d a y i of ��//I-s'w•_,�Y r_ 1 c. �// New Vory -.-5E- 1 j , uot:ary PUbli I S i tv �/� Craun y 177 . o��g11FF0(,�cD o� Gyp w x Town Hall, 53095 Main Road p • Fax (516)765-1823 Southold, New York 911971 y�O� ��0� Telephone (516)765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD January 3, 1995 Mr. Parviz Farahzad P.O. Box 532 44 Niagara Street Miller Place, NY 11764 Re: Building Permit #21698-Z Premises : 7555 Main Road, Laurel Suff. Co. Tax Map #1000-122-6-31 During a review of our files it was noted that the above building permit has expired, and a Certificate of Occupancy has never been issued. According to the Code of the Town of Southold, Article XXVIII 100-284, it is unlawful to occupy or use a structure until a Certificate of Occupancy has been issued. Please contact this office as soon as possible so that we may clear up this matter. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. 1E LD IGS:E :lUN 11DA7 E j 04fMGNT 7OUIDATION ( 1st ) v FOUNDATION ( 2nd ) m 2 . z 0 ROUGH FRAME & .PLUMBING ti 3 . z m m INSULATION PER 11 . Y . STATE ENERGY CODE 4 . —gym FINAL ADDITIONAL COMMENTS : x X ' x b H 9 . H H O m a • r� H d ' m ro H CA Town Hall, 53095 Main Road 0-0 �p Fax (516)765-1823 P. 0. Box 1179 A Telephone (516)765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD ORDER TO REMEDY VIOLATION Date: January 12, 1996 TO: Parviz Farahzad P.O. Box 532 44 Niagra St. Miller Place, N.Y. 11764 PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance -- CHAPT. 45 Other Applicable Laws, Ordinances or Regulations TITLE 19 NYCRR at premises hereinafter described in that: OCCUPYING A BUILDING WITHOUT FIRST OBTAINING A CERTIFICATE OF OCCUPANCY FOR EXPIRED BUILDING PERMIT #21698-Z . In violation of CHAPT. 45-15 B. ZONING CODE TOWN OF SOUTHOLD TITLE 19 NYCRR - PART. 442.3 (a) YOU ARE THEREFORE DIRECTED AND ORDERED TO comply with the law and remedy the conditions above mentioned IMMEDIATELY The premises to which this ORDER TO REMEDY VIOLATION refers are situated at: 7555 MAIN ROAD, LAUREL, N.Y. COUNTY OF SUFFOLK NEW YORK SUFFOLK COUNTY TAX MAP #1000-122-06-31 Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by fine or imprisonment or both. GAPX. TISH BUILDING INSPECTOR encl. (Cert. Mail) WILLIAM C. GOGGINS ATTORNEYAND COUNSELOR AT LAW P.O.Box 65 11775 Main Road Mattituck,New York 11952 Phone(516) 298.4200 Fax(516) 298-4214 WILLIAM C COCGIN3 AiwyW w Law January 16, 1996 DONNAM.PALMER Pma4d Southold Town Building Department 53095 Main Road Southold, New York 11971 Attn: Gary Fish � �^ Re: Parviz Farahzad; Building Permit Renewal `J4N / Premises: 7555 Main Road Laurel New York 11948 X15 SCTM # 1000-122-06-31 gni Dear Mr. Fish: In connection with the above referenced matter, enclosed please find an Application for Renewal of Building Permit No. 21698A along with a check made payable to the Southold Town Building Department in the amount of Four Hundred Thirty One ($431.00) Dollars. Also, enclosed please find a copy of the Underwriters Certificate for the subject premises. If you have any questions, please do not hesitate to contact the undersigned. 1 V Y/Yn7yy—�s, ,y J WILL C INS WCG/dmp enclosure cc: Parviz Farahzad Jan. 16x+96 15:19 G.A.STRANG, ARCHITECT FAX 516-765-5490 P. 2 Garrett A. Strang Architect P.O. Box 1412, Southold, NY 11971 (516) 765-5455 Fax (516) 765-5490 January 16, 1996 Ms. Anne Marie Quaranta Eastern Long island Hospital 201 Manor Place Greenport, New York 11944 Re: Quannacut Alcohol Rehabilitation Clinic 7555 Main Road, Mattituck, New York Dear Anne Marie;* I have made a visit to the above referenced project site on Friday, January 12th and found that the Primary entrance ramp is in violation of the New York State Building Code as well "ADA" requirements and was not constructed in conformance with the drawings prepared by my office and dated 8-31-93 . Specifically, the landing at the top of the ramp is inadequate in len1th and in excess of 1/2" below the top of the threshold which is the maximum allowed by law. In addition the ramp does not have the requisite curb, is not accessible to the adjacent parking area and is lacking the proper rail extensions. I also observed the following conditions and call them to your attention: 1. Secondary ramps to the North and South doors are in violation of the New York State Building Code, are poorly constructed and presents a tripping hazard. 2 . All of the exterior doors have not been Fitted with accessible hardware as called for on the drawings . SAN 6 . BLDG.DEPT. TnAIN OF SOUTHOW Jan. 16 ' 96 15:20 G.A.5TRANG, ARCHITECT FAX 516-765-5490 P. 3 Me . Anne Marie Quaranta • Page Two January 16, 199¢ 3 . All exterior doors must have illuminated exit signs As called for on the drawings. Existing exit signs depicted on the drawings which were removed must be reinstated and illuminated per code . 4 . The HVAC system should have been balanced upon completion of alterations to the system. This. apparently has not been done and should be completed as soon as possible. If you have questions, please do not hesitate to contact me, Very truly yours, Garrett A. Strang Architect GAS/g CC: Mr. Ray Bble Mr. Gary Fish, Building Inspector fes` i6 ,SAh £s TnWN OP fiOKHOt 15 FORBI NO. 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Date .............. .... .. ........................., 19.. TO . sf t/iZ.....f��✓th'T�� . .. .. .. . .. .. ............................ (owner or authorized agent of owner) pp 4'r 53,2 S<5�. .1�J ,A_....ST . ,��/e I�4 �y /iJ� ..............rc........ ... . .. . . ... / � (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance .y-�� �s Other Applicable Laws, Ordinances-or Regulations TM �.....� ... � e.. at premises hereinafter described in that ............................................................................................. (state character of violation) �C ' . . W�l.?��1...... 7z! .%`��(u�.✓ .P..... ...... . ..... ... . . .. . . . .. ............. A :2 �,✓. . . .r.......... . ... ...._..oma, - �, .... .............. ... .. ! HA p0T $< >` /S /3 : c c9N. ... wn7 D/ .. .. r(£ {/ c in violation of ........b..:......c.. ........................... . ....-..........................1. ......`_..............(.�..... pek (State section or paragraph of applicable law, ordinance or regulation) Oq�l YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the low and to remedy the conditions above mentioned IMMEDIATELY The premises to which this ORDER TO REMEDY VIOLATION refers are situated at PL7, �/i�ti C.......County of Suffolk, New York. SUFFOLK COUNTY TAX MAP 6 /O0o —/1, — O eo —j/ Failure to remedy the conditions aforesaid and to comply with the applicable provisions of low may constitute an offense punishable by fine or imprisonment or both. ilding Inspector APPRCVM BY PLANN:NG SOARD TOWN OF SOJTHOLD LATE lODCi - 1 '2 2 V Ona C— V-11 0 F V-110F BTtVE, K1rLJF4) E.�ZS ice' P• �v�G ?_�ta c'b Cm '���. � . FT. CTP` 4,-L. L .O C 104 2 4 - - $,TAT. t`"L1LF� T"'/E=iF.Ybf�.W�.t� �^M-C�T•.'M 4 +^�l,J 4R'..Y4�+•'�" MLL.Ip Rte' Y Yo,a+ ,.:T . Y47.)44C-.;r , 4..lG,F W ffi>i�Cs 1 #-ECS amu+ .*�fa.rtTta�'� a T Si¢ L� 2G. J"t wUL...fe:', TITLE 3TRANG r z..l.►.x �uru� r-, �: LOCATION - — ti trteu�..a,�k (N� .� ;�, t�e�.�r,x'E-ruc et,. , af.rL•+f �, SCALE u Ila, k Y - bRAYttIES-MI k sO +���,�►a �stM,Ewa... told N.Y. 11971 DATE ,_` s ,4 �J.alb� - 41p' '.k.- 'W i.6%y6�. 4 ' iJI'L, 4-1 4'- .M4+i ijp '*i.'ti a C'I�i 9y�C7�.JIC1�t��efll7,1te251 tAil;li'�Ii1yl4,�."b'i �y�'1'� ELECTRICAL_ ''^iii1 INSPECTION _SERV'ISCE0 .! C , "N `.3.": - N a 1322 MONTAUK HIGHWAY EAST PATCHOGUE, NEW YORK 11772- Date 17]2-Date 11-18-93 Application No. On File 3723 THIS CERTIFIES THAT Wading River Electric LIC_ *2j58–E orrthe elect rical-eQ pui rnent as described ow beland.in-troduced b thea lioant naed on the above lication number _ I Little Rock Construction, 7555pmMain. Road, Mattituak m'a — G N In the remises of Nev York 11952 > 0a 0 N iti Q N j. in the following location: Basement _� tst Ft. 2nd FI. Pool Hot Tub > was examined on 11-18-93 and found to be in compliance with the National Electrical Code. ) — FIXTURE CEILING WASHER RANGES OVENS )— OU ACLES- SWFTCHE-R-- AMT K.YII. I AMTF X.W. I AMT K.W. ( ) DRYERS DISHWASHERS EXHAUST FANG FURNACE MOTORS FUTURE APPLIANCE FEEDERS L' AMT K.W. AMT K.W. AMT K.W. OIL H.P. GAS H.P. ' AMT NO. AMT {,{Y U `D D tr W } J SPECIAL REC'T TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET SYSTEMS DIMMERS r ) AMT AMPS AMT AMPS TRANS. AMT H.P. NO. OF FEET AMT WATTS J ----SERVICEDISCONNECT --- - MD.OF METERS AMP TYPE 1 200 U.G. resident OTHER APPARATUS: � � > i Thle certHlute must not be Meted M any manner. J09Wbcn mey be Identified by their DnedeMbble i I v v v f 65-1802 UILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNN/EY REMARKS: {rzc DATE _INSPECTOR T=. .., BOARD OF HEALTH . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . ` SURVEY .:l�, TOWN OF SOUTHOLD • " " " ' • • " • • • " h - BUILDING DEPARTMENT CIIECK . . . . . . _ . _ . . . . . . . . . LEqL, 2 4 TOWN HALL SEPTIC FORA . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 1 rOjv rr TEL.: 7651802 1:Oi`<FY : a.e+� 1 ', 1 � CALL . . . . . . . . . . . . . . . . . Examine . . . . . . 19� -� (� MAIL TO : Approvedelo . . . . . . . . 19��...�'ermit No. . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c==-�. . . !.��'/.tit . • (Building pecto0, APPLICATION FOR BUILDING PERMIT Date „September 199,3 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 stiee or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app 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 perm 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 Occupant 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 ti Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances i Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building c housing cods, and regulations, and admit authorized inspectors on premises and in building for necessary insp� — (Signature of applicant, or name, if a corporation) Garrett A. Strang, Architect P ,O, Box , 14 '2 . 5pAthoJd,, .I ,Y,._ , J 1971 , , (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor,,electrician, plumber or builder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Arphi,tett. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . Pax%1tz:.. .F•aFP.hz9d::. . .: : :... . :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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. . . . .". " Electrician's License No. ". . '. . .. Other Trade's License No. .". . . . . . .1. . . . . . . .it . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 �J%. . . .�t3 • , Main RoadLaurel . . . . . . . . . . . . . /. . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . . . . . . . . . Block . . . .96. . . . . . . . .. . . . Lot . . . . 3.1 Subdivision . . . . . . . ... . . N/A . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) , 1 State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Vacant • _Former. . . . . . . . . . . . . .Parlor- Restaurant ) b. Intended use and occupancy . Profess,ionQl„Offz.ce . Usz . :. '. 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteration . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . : . . . . . . . . . Other Work . . . . . . . . . . . . . (Description) 4. Estimated Cost . . . . . .S. 2z.,,000,.00... . . . . . . . . . . . . . . . . . Fee431 . 00 . . . . .$. . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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 ofeach type of use Pro€:, Of f ice 21 7. Dimensions of existing structures, if any: Front . . . . .80.'. . . . . . . Rear . . . .80'. . . . . . . Depth . 34 . . . .�q ' Height . . .2I . . . . . . . . . . Number ofStories . . . . . . .one Dimensions of same structure with alterations or additions: Front . . . SAME . • • • Rear . SAME Depth .SAMF . . . . . . . . . . . . Height . . . . SAME . : . . . . . . . . : . . Number of Stories . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . : Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . .Height . . . . . . . . . . . . . . . Number of Stories . . . . ... . . . . . . . . . . . 9. Size of lot: Front . . . 184 Rear . . . . . . . . . 2 . I . . . . . . . . . . . Depth . . . . It, �. . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name ofFormerOwner . .5tvrL,r)g. I.dg9. ye.rltyrAs 11. Zone or use district in which premises are situated . . .General. Business, , , . . . . • • N 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . . : . . .No. . . . . . . . . . . . . . . Will excess fill be removed from premises: N//lyes N 14. Name of Owner of premises . Pgr.y3$. cls 4h?,9tl. Address Miller, ,PJ.PPA • • . Phone No. .7,4.4-•1•$49, ; • Name of Architect G.A... S t rang . . . . . . . . . . . . . . Address . .�o u ih.al.d. . . . . . . . Phone No. .7.65rd4- Name of Contractor . . AAQt . SAlected .Yet. . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . 15. Is this property within 300 feet of a tidal wetland? *yes. . . . . . . . No.. X . ... . *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 frou property lines. Give street and block number or description according to deed, and show street names and indicate whethe interior or corner lot. STATE OF NE, S.S COU OF . . �l. . . . . . . . . . ! C . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing cdxtract) above named. Heis the . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . :. . . . . . . . . (Contract , agent, rporate officer, etc.) of said owner or owners, and is duly authorized to per or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his 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 r.d .day o . . ' Notary Public . . .. . . . . . .\. . . . . County CLAIRE L GLEW Notary Public.State of Newyork 1 . . . . . . . No.4879505 (Signature of applicant) Qualified in Suffolk County Commission Expires December 8,18 L BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . .. . . . . . . . I, . . .. TOWN OF SOUTHOLD SURVEY . .. .. . . . .. .. .. . . .. ... . . . BUILDING DEPARTMENT CHECK . . . .. ... . .. ... . . ... . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CALL . . .. . . .. . .. .. . . .. . Examined......1 j .., 19.!./Y� MAIL TO: .. . . . .. . . Approved......../2.5..., 19 'P Permit No. .216_q87,..... .................................. ...................................................... ..... (Buildirng Inspector) JAN 17 1996 APPLICATION FOR BUILDING PERMITBLDG.DEPT. Tn,NN OF SOUTHOLD .: anua� (Building Permit Renewal) 'Date. . .. . . . . . . . . .. . .. 19. . .96 . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector w 3 sets of plans, anisate 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 any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS 1 REHY MALE to the Building Department for the issuance of a Building Permit pursuant to the Building 2a-ne Ordinance of the Ttwn of Southold, Suffolk County, New York, and other applicable Laws, Ordinances'.or Regulations, for the construction of buildings, additions or alteratiuds, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable leas/ordi code housing 'sod regulations, and to admit authorized inspectors on premises and u8' n rn ions. .. ...................... (Signa of icant or Wane, if a corporation) WILLIAM C. GOGGINS P_O....Box1.195Z. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plunber or buildei ATTORNEY ........................................................................................................................ Name of owner of premises .....PAR:dIZ..EA.RA11ZA D.................................................................. (as on the tax roll or latest deed) AP ROV D AS NOTED If applicant is a corporation, signature of duly authorized officer. DATE: / S B.P.$ FEI I """" ................................................. Y:c NOTIFY BUILDING DEPART ENT AT (Name and title of corporate officer) OCCUPANCY OR FOLLOWI766-1802 INM TOTIONSM FOR THE builders License No. ..11ut..Sala.rLQE IS UNLAWFUL l FOUNDATPOURDCONTWO EREOUIRED Plumbers Lite No.rr.....................WITHOUT CERTIFICATE 2. ROUGH - FRAMING & PLUMPING ,r Of OCCUPANCY 3. FIN INSULATION Electricians License Ib. .. 4. FINAL - CONf EPt!CFl;�t.f n"+ST Other Trades License No. 'r rr BE COI'; LU FO:+ C O •••••••.•••••.••••.• ALL COn:SCFUCTS; "; 1;4i^-.1,: !,.t iT cc�-r;;o-'r' ' - t. location of land on which proposed work will be done...........................THE '" tr Y. gfx, .7 y:,,i.••.. ••....•C ';Y 7555 (Bldg . #i ) Main Road , Ir L�Qnr`r#1 '<,:`• ".'.E . ::R ................................................................................... House Number Street TfE inlet �CG:;3 t, {,+(; -Vt3' Nr:il Canty Tax Map No. 1000 Section .. 122 ......... Block ..06........... pot ...........31 .. Subdivishou N A .......... tiled No. Int ...... .... ................ Map ............... ............... (Name) 2. State edsting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... (Former Pizza Parlor-Restaurant) ........ .................................................I................... b. Intended use and occupancy .....Prof e.s s i o.n a l..Off.. i.c e..U s e .... ..... .... . .. .. .......................................... W, 3. Nature of work (check wbidr applicable): New Building .......... Addition .......... Alteration ...X...... Repair ............ Removal ............. Demolition ............ Other Work .................................. (Description) 22 $ , 000 .00 $431 . 4. Estimated Cost ......................... fee ......... 00..................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............ Timber of dwelling units on eadr floor ................ Ifgarage, number of cars ...................................... 6. If business cramercial or mixed occupancy, s Prof . Office 212 , specify nature and extent of each type of use...................... 7. Dimensions of existingstructures if 4 21 . any: Front r One.... Rear ...$�......... Depth .36.5.....,t .. height Nmnber of Stories ...................... Dimensions of same structure with alterations or additions: Front , S A . Bear ...... Depth --S-t 2E............ Height ...S AME........... tirdner of Stories ............... a. Dimensions of entire new construction. Front ................ Rear ............,.. Depth .............. Height ......................... Number of Stories ..................... 9. size of lot: Front ...18A:........... Rear ...213!........... Depth .....4.1-5.1 ...:..... 10. Date of Purchase Name of Former Owner , Sterling Idea Ventures ..................... ................................. 11. Zone or use district in rhicfii premises are situated t..........GENER...... AL ......BUSINESS....................................... 12. Does proposed construction violate any zoning lar, ordinance or regulation: ....,,N 0 . 13. Will lot be regraded .... O............. Will excess fill be reeved from premises N/A YES ma 14. Names of Owner of premuses PARVIZ FARAUM gess Miller Place_,,,,,., Phone No, .7A4.—.I.Q Name of Architect „G;A : StrangSouthold ............................ Address .............................. ftnome No, .......... Name of Contractor .. Not Yet Selected ....._.. Address ...............................Phone No. ................................. 15. ,Is this property within 300 feet of a tidal wetland? * YES .......... NO ....X..... *IF YES, SDM D 1061 TRUSTEES PERHIT MY BE RFtPTRED. PLOT DIAGRAM Locate clearly and distinctly all buildings, rbether existing or proposed, and indicate all set-hack dimensions frau property lines. Give street and block number or description according to deed, and show street names and indicate whetber interior or corner lot. STATE OF NEW YORK, SS COUNTY OF . SUFFOLK . . . ......WILLIA.M. C;_,GOGGI�a............... being duly sworn, deposes and says that tie is the applicant (Nam of individual signing cootritct) above named. die is the ... Attorney„ fqr_ P,P.B). .aP.t..CAGF.NT.)......................................................... (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 this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to iib�e115%e me this ........1.7..: f ('......n.,... day of ......IanUar.y... .. 19, .96.. Notary Publi , SLLWIC)Lp ...... Canty �rI MELISSA ECKHARDT J Yut Q 1 CdA v l Notary Public, state of New Yak.. .. .......... .. .............. No.4995913-Suffolk Co (Signal e o applic WILLIAM C . GOGGINS Iarm Evp vs May 4, 19 - - - - (2) I.A%Fwl Gtr �,� h Ylt 'x' CWeWUP1 /3vArXP 6Ao -0-01m jap y.�,�I . 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Of OCCUPANCY AP RD ED AS MOND rQ�nLt ��P c lr pM- • -' �''�/' �� ►�-- - I! l� 1 4 /�j�,, y � ` FEE BY: WL/ nlonr-v 641DE'ART AT 7651802 9 AM I j FOLLOWING INSPECTIONS: q/ 4 PM FOR THE I FOR POURED CONCRETE SQUIRED ✓r�nl r� 4 0 - � 2 ROUGH - FRAMING & PLUMBING 3. VISULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. SEP 241993 ;Iq ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. �• _ - STATE CONSTRUCTION & ENERGY �' e -i - CODES. NOT RESPONSIBLE FOR TOyaN Jf OU'"i 1rI t) •� DESIGN OR CONSTRUCTION ERRORS ^ iirie; i�'.kar�'vANN 6 ,i i�AR"RTI A, S�'R'AIV � ` '' LOCATION �' f .FC./G' m!'`c h I t: P C t: �V��d iter SCALE AV �,,����g NEVI ,. :......O _ • ! :� "�'� l•Oi•T'3 1?140 lY1d;TU+LIIA'!' Main Road P.O. Box 1412 Southold N.Y. 11971 DATE fr AVS 015294 b �j4TE OF NEW ypP 516 - 765 - 64$5 oxAwx sr rJ�A � .� •� .x0.1EOT NO &-'Opel r . r4ov,/av %� F , ... mat � �rt�rr + carat E �ct�rtlrta I' x A' . Z �ANtP Fw o�rJt ]CI)Oulit-C 1'0 r"Ai 1. �x��filNra I'x4' 2 - I�AMf Fu.to�F�G�r11' ' Fixt�f� �'� A U grit MEtEfZa 1i .�_ �Nri' I�fINa 1' � 2�' - L6ir�r' Fwr ��.t� �i,cts�je ro Ems. M �� ANO r90,&ea AV 411A-OW- 1, - 4ourFAd- rae{ Mrlt�?. forrc� f NFa O o jaEl�O LlpA6� htQUNt INGANC .�cFcnl { FI {11j2x' F671 It & ( f lea Ale t WA , nc� -[ PLK � r-19 'AC%O eM. C.w1 E - qp �E �r.�.u� N. � � ^�-..�.._ � � t � � . , � � � � � � � - nrr � �>E�r�i`IN.G-r _G,c�1"� r-�IUN {'o ��r�1•;�rr�l � , h1Ew bc1..� "VI INS �U, o WI'1r1plIt- uJ, B , � 1 " 4 I@• :r �F1H � - �U U� +�'WIrlt�nkNt� 40%v;, ��woEd '�S'tfi�� Me /� / �e J �� . I%KI�tIntC� d✓MoKt� O�{-��o}e.. �'v Altai . �rvfilnt/a �JWG-( ,�I(L @3. t�tFF,.�a�� 1`0 �ihlrJ E N�•UJ �au(� � /�tlz �'IFr=ua !' fir 1N��'AU-fid Z+ Ztif EKiT \_ - � �' tPaj'11`�tL�' E �WjN6 . 1! cKOAUOo rAra r� p-lgMAIN �V^Mt-ICa 'f\I c uk�' �Arj �I.or.,��Er� A� �I-IowN ( _NTT WA l`� r1-10jD _ ?*4AIN r - . TITLE ,f GARRETT . A. STRAN6 T yA � .Sri s LOCATION M . architect SCALE REVISE. mWAVI NG N9L Main Road P.O. Box 1412 Southold N.Y. 11971 .ATE " r"� {{{ 0152" 516 - 765 - 5455 .SwNETOF "� d sibr Nc4� PROJECT NO J.YL iaG r.