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' • FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23800 Date JULY 27, 1995
THIS CERTIFIES that the building REPAIR
Location of Property 6580 NEW SUFFOLK ROAD NEW SUFFOLK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 117 Block 4 Lot 33
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 29, 1994 pursuant to which
Building Permit No. 22226-9 dated AUGUST 15, 1994
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 REPAIR EXISTING COMMERCIAL BUILDING AS APPLIED FOR.
The certificate is issued to JAMES G. NEKERMAN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL INSPECTION CERT. #7288 DATED FEBRUARY 23, 1995
PLUMBERS CERTIFICATION DATED N/A
I I ze~
Bui ding 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) ,s
N ~r
Date ....................Pa 19. ~.7.`.:.
22266 Z
Permission Is hereby granted to;
James G. Nekerman
George Rd.
.
New Suffolk, N.Y. 11956
REPAIR AN EXISTING COMMERCIAL BUILDING AS APPLIED FOR.
to I...................
.
at premises located at 6550 NEW SUFFOLK ROAD NEW SUFFOLK, N.Y.
County Tax Map No. 1000 Section .......1 . Block ........4................ Lot No. ,,,,,33...................
pursuant to application dated .........JULY..... 29, 19......94....., and approved by the
.
Building Inspector.
Fee
_
Building Inspector
Rev. 6/30/80
- (nun Mo. G
'101m OF sool l1m,l)
tJUL Z6 4995 Buu.ulNC ucpnuulrPrr
'1'OIdPI NALL ,
7G5-1U0'L
-JOt;AAPPLICAT'lON foil ,Lp-j-jj-jCATlr OF OCCUPANCY
A. Phis application mast 1, filled iit by LypewrI.Ler OR ink and submitted to the boildiug
inspector with Una follow tug: for new building or new use:
I• final survey of properly with accurate
sLra location Of all buildings, properly lines,
eCS, and unw;"at natural or topogrttphi.c features.
2. final- Approval, from lleatth Oept. of water supply and sewerage-clisPosal(S-9 form).
3. Approval or electrical installation from Board of fire Underwriters.
4, Sworn stat:enieut from;'plutuber certifying that the solder used in system contains
less than 2/10 of 1% lead,
r 5. Connaercial buiidinp, industrial building
.rnd installations, multiple residencer and simi.l.ar
responsible for th bui.ldin);s
i e of. Code Compli-auce from architect or enl;iucer
le ea build-inn, ,
6. Submit Planning Board Approval Of compl.eLed site plan requirements.
13. for existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
„
pre-exisli.ngn land uses;
I. Accurate survey of property showing all property lines, streets, bui.ldinq and
unusual naLUral or topogtapltic features.
2. A properly completed application and It consent to .inspect, signed by the applicant.
If a Cet'LUjUl to of. Occupancy is deuied, Che Uuildi.ng Inspector shall stn Le Lhe
reasons therefor in writing to Lhe applicant:.
C. Pees
1. Certificate of Occupancy - New dwelling $25.00, Additions Lo dwel.li.n,r, $25.00,
Alterations to dwelling $25.00, Swi.nnning pool. $25.00, Accessory building $25.00,
Additions Lo 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 Certi.fical:e of. Occupancy - $50.00
5. 'temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Y Date ~qZ) I i.
New construction.... Old or Pre-existing
Building
location of Property..... ........4> S(~F•E~
(louse No.
Street Ila"let
Onwer or Owners of Property...
County Tax Hap No IU00, Section ...h 2
131ock ..............Lot..
Subdivision ....................................filed Plop.......... -Lot
Q...........
V. rIII i.t NO ........(06.......b`-tte Of Pe ruiit. Appl itant
. . ~-(,L. . ~(C....
~ y'.... ~j
'lu:11 h OepL. Approval....,,
..••••••••••••••••..Ilndcrwriters Approval..........
lannlnB Board Approval
Iegoest for: 'rcinporary Certificot:e........... I.n Cea ca
cc Gb
LF48 6~ F~
rrfl 38 .
u:t
JIZDATION `3 61
_~(1st)
11113ATIOTI (2nd)
04
1GH FRAME &
•PLUI•IBING = _tw
H
:UL:,TIOtt PER N. Y. - y
m
STATE ENERGY II 9$
CODE
y
FINAL
o
ADDITIONAL COMMENTS' x
H
9
' N VI
• O 1\.
• m
m
'r+'a`%'i-~.Y =:Jaa T.ah.:.:.cu. w. os.r r"S.iA`'...;.i , ~ .-7 ?..~t:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FO ATION 2ND [ ] INSULATION
[ FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
7Z)
DATE Y r INSPECTOR a4 -A
(0~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: ~Q
4,12
DATE Z INSPECTOR
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
)h )
c , (516) 286-6642 ELECTRICAL INSPECTION SERVICE INC. )
375 DUNTON AVENUE
< EAST PATCHOGUE, NEW YORK 11772 >
7288
APPLICATION NO. ON FILE )
ce DATE: 2-23-95 )
c < ADDRESS: 6070 New Suffolk Lane VILLAGE: New Suffolk TOWN: Southold )
ISSUED TO: James Nekerman > )
INTRODUCED BY: Brite Lite Electric LTC. NO. 483-E
ca >
c AREAS LISTED WERE INSPECTED ON: 2-23-95AND WERE FOUND TO BE IN COMPLIANCE WITH THE
NATIONAL ELECTRICAL CODE.
~o )
LOCATION: BASE XX 1ST 2ND _3RD -ATTIC ---POOL
OUTSIDE,COMM. -SMOKE DETECTOR ,DETACHED GARAGE
~ )
Service Change
ca )
SERVICE DISCONNECT
METERS AMPS PHASE )
1 200 OA
c THIS CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. GO S. SURDIS. SURDI )
99~~ INSPECTORS MAY BE IDENTIFIED BY THEIR CREDENTIALS. PRESIDENT
c3{^ )
0 0 0 0 0 0 0 0 0 o v v e e o 0 0 0 00 0 0 0
/ I
.Y
110ARD OF HEALTH
FORM NO. 1 3 SETS OF. PLA.;S - • • -
10 TOWN OFSOUTHOLD SURVEY
BUILDING DEPARTMENT CHECK - _ _ , • •
TOWN HALL SEPTIC FORK _ .
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 t:OT'<F'f
Examined ] CALL _ - _ .
~.....,9~.
- / !TAIL TO:
Approved t 1 ,,permit Nor`Z'f-222 (0
Disapproved a/c ( _ .
l)S a t3M0y c
f
(Building Inspector ~'t
P ICATION FOR BUILDING PERMIT
s' ~ U
Dat..........., 19.
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 stieet:
or areas, and giving a detailed description of layout of property must be drawn on the dia- yam which is part of this appli
cation.
c. The work covered by this application may not be commenced before issuance of B .
d. Upon approval of this application, the Building Inspector will issued a Building Perms, a pplicant. 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 HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances of
Regulations, for the construction of.buildings, additions or alterations, or for removal or demolition, 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 necessary, inspections.
_
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
,,~Q4J\~,,.. crQ?
Name of owner of premises N k ~G 2
(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. .....t4
Electrician's License No . .
Other Trade's License No. .
.
1. Location of land on which proposed work will be done. W L S, ,Q F_ ,N!.a S~JFF=pLt~
2 5 o2cc C ~2ot!a0 - N ~i~J 'sue FFO`s.G
[louse Number Street " " " "
Hamlet
County Tax Map No. 1000 Section Block ...4.........:
Subdivision Filed Nlap No. Lot .
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy 5'Ao)p
b. Intended use and occupancy ...................IMF=r
3. Pep it of work jcheck whicapplicable): New Fluilding , • • , , , Addition
Alteration,
Removal
R air , , , , , , , , , , , , , Demolition - .
, Other Work .
4. Estimated Cost ......~~'C~C10•~' (Description)
Fee....
5. If dwelling, number of dwelling (to be paid on filing this application)
p units . Number of dwelling units on each floor .
If garage, number of cars .
6. If business, commercial or mixed occupancy, specify nature and extent of.each•t of use , , , , , • • •
7. Dimensions of }sting structures, if any: Front - ~g M,
Height Rear, Depth ..1Q.........
• • • • • • • • Number of Stories
Dimensions of same structure with alterations or additions: Front , , ,
Depth i Z>1150.A Fr...... Rear . .
• Height Number of Stories . , • •
8• Dimensions ofentire new construction: Front . C , •
Height Rear Depth
Number of Stories .
9. Size of lot: Front i 1*.~.~. .
10. Date of Purchase 3, , , , • , , , , , , , ,Name me of of Former Owner ~ • • • • ' • ~ '
11. Zone or use district in which premises ' ' Rear , ormer , , , . Depth ..~4~t ,
Do
12. 3, DoWill es lot be ro osed regraded construction vio'lae an an are situated , , . , na E"' • H.~ ~ ' ' • • • • • • • • •
late y zoning law, ordinance or regulation: ....NQ
1
ices:
F • • • • • Will excess fill be removed from premises: Yes No
14. Name of Owner of premiserloq4~,(~IL:I,?•• • ".04 Address
Name ;c1~p
Name of Architects • • • • • • Phone No-
. Address ,P4 .00,>&gpU Phone No.
Name of Contractor . ;1VC1'l 1%ac~a... , Address . I'MV
' •
15. Is this property within ' 00 feet of a tidal wetland? o.... No
*If yes, Southold Town Trustees Permit may be required, No..
PLOT DIAGRAM
Locate clearly and distinctly alll buildings, whr• - r existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block number or de; ,i according to deed, and show street names and indicate whether
interior or corner lot.
APR .A.. O.AS NOTED
UNDERWRITERS CERTIFICATE DATE p;p # X2 2
REQUIRED FEE:
NOTIFY BUILL)ING 8Yp
766-9802 9 AM T4 4 T AT
FOIL-OWING INSPECTI S: FOR THE
1. 'FOUNDATION - TWO REOUIRC-D
FOR POURED CON 'RETt:
.2.'C.1:1f W - FR,SagINC; F?, r~t.UUR9ttC
? IN ut.s:TIoll
lit. (7ty/q~ (•r'ic;wid~iC-CIOhT
At.t t:C)11.;f}~'t7t.:7"fE'k~f St-'.~„l..d., hJtEi=T'
r
i~41 FlF'OUINIr 31cPd7t C)C 'i't-3F N X.
1F~rF" za)iv:rrt,i,It"r!('E,v tb t~t;fRGv
9_E2'.3£ fi i'Tt7, F'8t=;;P(;jfVillii.E< FOR
t;i ._ai'SR; c)y COCd5TFgllCili",)F,t L,RFTt~sf;
i
7AT
E OF NEW YQ~R
'OUNTY OF e J S
• , • , ~Y • • • • being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
bove named.
e is the
:.(Contractor, agent, corpbratc officer, ctc.)
said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
,plication; that all statements contamOd in this application are true to thQ best of his knowledge and belief; and that the
ork will be performed-in the manner set forth in'4hc application filed therewith.
vorn to before me this
..........24 a of. TU
Mary Public, Sv"S°l
County
ROBERT i' ,1R. , G
IMARY ?UI atO O R%
No.4725089, uffolkCou (Signature of applicant)
Term ExpirQS_May 31,19j.
OG~avt~C 7grtiE' C 'RArtiES t/Li-Zavz" I J
+ ~UU(LQ/k/G LtJC,a
/!c/G I-dCA,770 J
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'01 11iI f '^I1 OL CC°f`
Ir 65-1802 9 AM TO 4 FOR THE
acr' ~ II 4. 'LA a !!a L dl Y~ L 'FOLLOWING WSPECTIONS:
FOUNDATION - TkAM RFOUIREFi oet
_ _ _ :UFc S//Ci97F//~.-i:• ~ ~Yl+/bUt9 _
4~iTr Am Pw,aI- SMluct t3
i
F
UNDERWRITERS CERTIFICA]E _.~.0~
REQUIRED
/oi,.IF2K}~+~ /6X2$ ~
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1
V 7" lr3E QEPukcE~ WirN rL,
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- Q(.Cl~/E"YL- ~AMtS NElF1E2nAh/ 1F1E2nAn/ - ~~-450
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