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Home My WebLink About22545-zFORM NO. 4 TOWN OF SOUTEOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. C~RTIFICATE OF OOcumANOY No Z-23714 Date JUNE 19, 1995 THIS CERTIFIES that the building Location of Propert~ 10095 MAIN ROAD House No. County Tax Map No. 1000 Section 142 Subdivision ALTERATION MATTITUCK, NEW YoRK Street Hamlet Block i Lot 26 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 15, 1994 ~ursuant to which Building Permit No. 22545-Z dated JANUARY 5, 1995 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 STORE ~18 FOR DRY CLEANERS AS APPLIED FOR. The certificate is issued to ALAN CA~DINA?~ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/a N-348359 - APRIL 12, 1995 MARCH 23, 1995-WM. M. GRENT.~R Rev. 1/81 FORM NO,$ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWel HALL SOUTHOLD, N,Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Dote ....... ~.~.........:... .......................... N~ 22545 Z Permission Is hereby granted to: ..~/~ ....... ~.~.,~..~ .................... .... :~..~ ,~_,.,.,,~.~:~:L..,~,.,~ ................ ,, ..... ,n,:/m:/..~..~.~.,:, ........ .,:~. >/.. .,. .. ............ , ,~ to.... ~. ~ ~ ~... ~../-~.....' d,~' .~.,. ,~.:?.. ~ :... ~ ~:.... ~ ./.~.....~.~ /g.~. 1o.~.~ ./..~.~.~ ~./......~.~ ....... .d..l~.~.~ ~ ........ ~... ~. ................. ...... ......... ............................................................................................. ........................ ~ ..................... .~..>..~.../.. ~.~.. .............................................................. CounlyTaxMapNo. ,000 Section ........ /..~..~.. Block ........./. .............. Lot No. .....~.....~... ............... pursuant to application dated .......... ~...~...~..../.~ .................. 1 g...~...¢'... ,nd approved bythe Building Inspector. ~ee ~?~.~ ............. Rev. 6/30/80 Building Insp~ ' Form No. 6 TOWN OF SOUTIIOLD 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 of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contairs less than 2/10 of I% 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 sho~ing 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 $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00., Commercial $15.00' / Date ' New Construction ........... Old Or Pre-existing Buildin ..... House No. Street Hamlet Onwer or Owners ,.,f Property ........ County Tax Map No 1000, Section.../.~e ..... Block ...... Z ........ Lot .................. Subdivision ................................. Fi[ed Map ............ Lot ..... ................ Date Of Permit ......... Applicant. ~J. ~ .... Health Dept. Approval ......................... Underwriters Approval ...................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Town Hall, 53095 Main Road P. O. Box 1179 Southold. New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD CERTIFICATION DATE: ~/2'3/~~, Building Permit No. ~~~~ Owner: Plumber: (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Signa~cure ) Sworn ko before me this Notary Public, County OEBRA K.WOERNER Notary Public, State o! New York No. 01WO5018O69 Qusiifled in Sutlotk County Commission Expires Sept. 20,1995 30,350 11:14 Fill 518 ?~? 0180 Tabte of Contents, Speoifleafions and Table of ~Olttambe ,Spedfloattans, $CH~ING R~D [~001 Page S~lt~atler~, Usflnge... ............ 2 C~muk ~a~r ~e~, D;m~n~lQn~ 4 ~ff l~eker 1" pm~ Pole .......... Cr~ g~k~r H~d[e ~lor ~dm ... 5 ~u~ Bma~r Ra~ and Te~l~a~ .. MSI~ Beaker, ~ Phe~ Me~ Lu~ Single Pha~ ~ M~ ~m~ ~fle[ D~m~s and ~enaal Nau~ Panel ............. D[men~ a~ ~rlng Comm~[al Mnmr S~ek~ ........... O[mensIon~ a~ ~n~ll~Ion ....... Mal~ ~er and Main Lug Cla~ CTL {{~rent Twin Me,nil) provided ~h phalli ~ Duplex and ~adp[~ ~ake~ fled ~ a ~mleg numb~ prefix eD, gQ or ~C) am ~uipped ~ a UL [~ted raJ~an ~ea~. (Refer ~ ~rl~9 Diag~ma en ' pag~ 37-~J ~uplex a~ ~uad~lex bmakem e ~l=g numb~ profl~ ~r pe~ meet ~e ~ulmm~n~ ~ Federa( All ~lm afl~ 2~ 12~ ~lt ~11 .p=[e G~ ~ro~d F~it ~a~ with a~x ~ ere ~ed ~ the ~dlan ~nda~ ~so~ation, Guide No, I~-R~ Ciasa 1~1, ~le ~. When l~taff~ i~ l~o~dan~ ~7t a~ Ar~le 3~16 ~f~ha N~onal El~fi~l ~d~ Meter ao~ un~ em Its~d ~em ~e ~ply ~n~u~ ea~r the building. r~ a main ~r~uE br~kar or ~. MU~t Include a3nneoTnr f~r boneRng end g~ndlng ~T "~ndord for Pa~ar~' U~; Gui~ U~O: Guide No, ~ Al9 ~lle ~¢?~ ' ~tderln8 ~ug~, U~; I0,C File Volume W, S~ 17. AU gmun~ng ba~ manufa~ute~ ~mp[y ~h und~ Lebaramrl~ ~rds and am I~ un~ ~u[de No. DH JR, ~la E31~ V~um~ W, Se~o~ 10.2 ~a ~l~ a~ "Re~uT~m~ f=r ~re Canne~m a~ ~ld~dng U~6; Ou[~ ~. ~ ~C Pile ~0. ~l ~nghauae b~a~m where m~k~, are auka~m ~r ~O,~ ~.C. U,~ aeries ~n~ed ne~ InUe~ Ug~ng an~ a~ha~e b~h =[raqit over~ne~ de~ ~d 30 am~r~ ~er~r~nt ~1~ Ibmneh ~]t a m~i~m ~ ~ afly one ~blflm. Whew e~e~ily ~nn~d by Sub ~ ~ug ~m. C. Oeeaember 1119{I ]LATIO:I PER' STATE EHERGy CODE " gDDITIO~IA'L CO!.h~iEIiTS: 765-~802 BUILDINO DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ~ INSULATION FRAMING [ ~FI NAL DATE ~h~-, BUILDING DEPT. INSPECTION [ ] FOUNDATION ,IST [ ] ROUGH ,PLBG. THE NEW YORK BOARD OF FIRE UNDERWRITERS :t 1~(~{~854 BUREAU OF ELECTRICITY ~ ~ ~5 JOHN STREET, NEW YORK, NEW YORK 10038 Oat~ ~RIL 12,1995 ~ppti~.d.. No.o~fil~ THIS CE~TIFI~ THAT o~y the ~l~trical ~ulpment ~ ~scribed be~ a~ i~tr~uc~ by t~ ap~tca~t ~d on the a~ application number in the ~t~m~8 of ~TTITUCK DRY C~RS~ ROUT~ 25 ~IN RO~, ~2TI~CK, N.Y. in thefoflowing location; ~ Basemen~ ~ Ist FL ~ 2nd ~. Section Bilk Lot ~s examined on H~CH 31 t 1995 and found to be in compliance ~ith the Nafional Electdcal Code. RANGES IA~aT' K,W' 01[ H,P. GAS H,P. AA~T. NO, A,W.G PECIAL REC'PI EXHAUST FANS DIMMERS OTHER APPARATUS: EXIT ~IG}fl'S - 2 POWER PACIng- 1 MOTORS:l-5 H.P. ,1-2 H.P. ,4-F H%P. P~O~S, 5- CIR. 3~, 1- CIR~ 6~ NORTH ELECTRIC LIC. #890-E 12[ ACACIA ROAD ROCKY POINT, NY, 11778 ~NERAL MANAGER 11 Per_ ' "~'' This certificate must not be altered in any manner; return to the 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 N ANY MANNER FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 DLDG. DEPI~ E.~amincd m:._g~.....K .... , Approved · ·., 19e~it No ....... ...... ~ ' ~ (~ilding Inspector) INSTRUCTIONS BOARD OF HEALTH ........... 3 SETS OF PLANS ........... SURVEY .................... CtIECK NOTIFY ~. --~ ' I ~ MAIL TO: _a: This application must be completely filled in by typewriter or in ink ind submitted to the Building Inspector, ~'ith sets of plans, accurate plot plan to scale. Fee according to schedule· 78 b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public strew or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl ca,oR. c c. The work covered by this application may not be commenced before issuance of Buildin~ Permit. ' d. Upon approval of this application, the Building Inspector will issued a Building Permit to-the applicant. ' shall be kept on the premises available for inspection throughout the work. Such perm: e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanc 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 th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws. Ordinances o Regulations, for the constmctinn of buildings, additions or alterations, or for ~:emoval or demolition, as herein described The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t~ .~//~Sig~t~re of applicant, o; ~a'me', ]f'a'e'O~'l~o'r.-itlc~n') ' ........... (flailing ;fidress of appii~6 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................... c U~g S N r rp i ALAN ~ ~.~Nhu~ ' ameo ownero remses .., ......... . .. . < ..... axes>' '' · .................... as on the tax roll or latest ' ' If applicant is a corporation, signature of duly authorized officer. Builder's License No ....................... Plumber's License No ................... Electrician's License Other Trade's License No ................... 1. Location of land on which proposed work ~vill be don. e. ,~ ~. 'A. 71'l--I1-'U(.l( ."~..~".~.Z,~. ..... "' ........... ' ................ .................... ' · · ' ~.~ :.z--r:.~ .r.c,a~< ' House Number ' ' ; Street\ . , '. Hamlet 00.0-'lq:L ' County Tax Map No. I000 Section ..... l .......... 'Bi?ck ....... ~ ........ Lot .Z....~. Subdivision ..................................... FxJIed Map No ....... (Name) ¥ ........ Lot ............... State existing use and occupancy of premises and in tended use and occupancy of proposed constrnction: a. E.,isti,g use and occupancy..C.C~.T.H.IN.~....-...KL P.~ O.N. kY. b.I,,e,,~ed K~.,-oc,~ t d '~,~v .c...~ANe..e.,~. use and occupancy ~ ~...'-:. 3. ature ?fwork (ch, eck which ~pplicable): New Building ..... ' ..... Addition ..... Alteration Repair ............ :,. Removal ............. Demolition ........... i. i '6t'her Work ..... 4. Estimatc'd Cost 1,0. t. 0.QO. i (Description) $ Ifdx~elling number of dwell : (to be paid on filing this application) , ,ngumts ........ Ntmber fd filing nits ' Ifg mb f · · ..... a o w u on each floor · usmess, commerciai or mixled occunancv s~--:c.- - , ' ................................ 7 Di ions t xisti l' if '- "~";~"'ynatureanoextentofcachtypeofuse,PX¥..~.~.~?.~,~$. · mens o e ng structu es, any: Front · Hight N mb fStories ", ............ Rear ............ , Depth D mens s o same structure a era ohs or additions: Front ......... Rear ................ 8 D~pth io f ............. :...Height ..................... :iq'u'dll~;;o;Stories ............. st ti Front ...... · H mens nso entire ne~v con nlc on: " .............. Rear ............ e . eight . · · · Nuinber of Stories . . .. D pth .............. 10 DateofPu ha ............. ear .... Depth ...... · re se .......... , ............... Name off I1 Z edist i tin~ hi hpiemis aresitu .... ormerOwner ........... 12 Do sp d tie iqlate ................................................... · e repose construe n v any zoning law, ordinance or r dation: .................... egt 13. Will lot be regraded '", ..... ! ................... W l excess fill be m · Name of O~vqer of. premises ..~q.h..c.~gp~d.~l.~ -~, ot~ t~,,,,, .,.~re ove. d from prem,ses. Yes No ' Name of Architect I .......... ,'~uoress t.v: ?.'-'a. il, ..........P ~one No ,,~r~Zfl~.~ ...... , ................. Address ................... Pro ~e. No . ' ' Name of Contractor ... '. i ... i ....... ' ......... Address ... ' .............. ........ Phone No ........... IS.Ia this property located '~thinao0 .feet of ~a ';i~l~a'l.' wetland? *¥E$ .... NO.'.~...' '' ~lf yes, Southold TowB Trustees Permit may be required. PLOT DIAG ILAM Locate clearly and distinctly ali buildings, whether existing or proposed, and. indicate ail set-back dimensions frown property lines. Give street and blockmumber or description according to deed, and show street names and indicate whether interior or comer lot. STATE OF NEW YORK COUNTY OF s.s ......... .............. 3..... (Name of individual signiqg contract) ......... being duly sworn, deposes and says that he is the applicant above named. lie is tire ........ .~ ,' ;.. ' ' . .......... '., '~ ', ',' t ............... ~,. ..., .................. (Co t fficer ) ........................... c . i ntractor, agen , co orate o , etc. ~ rp of said owner or owners, and is duly ;author zed to perform o~ahave performed the said work and to make and file this application; that all statements contaiOed in this application are true to thc best of his knowledge and belief; and that the Work will be perforated in the manner set forth in the application,filed therewith; S~Vorn to before tale {his /qe,,, ........................ day or ,. ]O.t 9 r o Jarg< .., i9.9./ NOtary Public, i ......... County Notary Public,'S:~;~,,~ ' * ~ ..... County NY#O1F~L~ 7~7, ,. , . ~ .' ~ .......... Commission E!.~. 240-9 ~' ' (Signature of applicant) 6'0 ',4 -rI- 6'0