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HomeMy WebLinkAbout20294-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town H~ll Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20503 Date JANUARY 27, 1992 THIS CERTIFIES that the buildinQ Location of Property 56340 MAIN ROAD House No. County Tax Map No. 1000 Section 62 Subdivision ALTERATION Street Block 3 Filed Map No. SOUTHOLD, N.Y. Hamlet Lot 22.1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 13, 1985 pursuant to which Building Permit No. 20294-Z dated NOVEMBER 25, 1991 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 CONVERT RETAIL STORE TO DRY CLEANERS ON SITE CLEANING WITH NON COMBUBTIBLES~ SOLVENTS. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ALBERT W. ALBERTSON & ANO. UNDERWRITERS CERTIFICATE NO. N-733637 - JANUARY 30~ 1986 PLUMBERS CERTIFICATION DATED N/A Building/In~'pector Rev. 1/81 FOBlld[ NO. II TOWN 01: $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne- 20294 Z Dote ...//..../.~....,~.... .............................. , 19.~./ Permission is hereby gronted to: -- ~. , /~/~' ~ ,, ~- .... ~.~....~ ........ ~;..~....~......a./ ..... ~ //~ ..~~~ ~'~": ~...~ ........... .~ _~ . ,o ~.~~.~.....~....~~....~..~.....~~ ~Z..~ ..... ~- ~' ~//~~ ~ '~ ~ , ~, ,,m,,, ,~.,,d ,, .~~.~.~ .................................................................... ................................... ~a.~.....~ .... ~ .......................... ......................................... ~~.L...L..~L..~ ...................... T~T[~T[[~[ Coun~ Tox Map No. ~000 Section ....... ~.~ ........ e~k ........ E.~ .... Lot No ..... ~.~Z. ..... ~u~.n, ,o .~,=,,o, a.,~ ......... ~ ................................... , ~ ~,~ o~p~ov~ by ~e Building Inspector. Rev. 6/30/80 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING FElt, MIT CI"HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NB 14315 Z Permission is hereby granted to: ~ , ......~....,,,x~.~.~....../.~'.~z....~...,,~....~ .......... ...... ~:.....~....~... ........ .~.~ ...................... _ .... __.. ............ ~ .......... =. ................. ~*-~* ~o ....... ~.~z~.~.~..~. ....... ~.~.....~.:..~ ....... ~...~.~~ ..... ~,~,,~,,e, ,=,~, ............ ~.~,.~..~......~~~ ............... ~ ....................... .................................................... ~~ ....... ~.~:...~:, ....... ~.~r~m.: ~ ~/ County Tax Map No. 1000 Section ..~...~....?... ....... 8lock .....~......~.. ....... Lot No.~.~ ./. ..... ~...~....~..~'~ pursuant to application dated ......... ~.~...~.. ........ ./...~.. ............... , 19..~...~.,%nd approvm:l by the Building Inspector. Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTUOLD BUILDING DEPARTMENT TOWN BALL 765-i802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This-application must be filled in by typewriter OH 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% 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. Fees 1. 4. 5. 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. Certificate of Occupancy on Pre-existing Building - $100.O0 .Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential $1~00, Commercial $15.00 ...... eqnest for: Temporary Certificate ........... Final Ccrticate ........... ce Sub i to : $ ...... !;a~ Construction ........... Old Or Pre-existing Building ........... . House No , . -- S~ ~ - '' "~':~ .... ~"' ~''~''~''' , ' ~_ ~ ~ree~ Hamlet Onwer or Owners of Property.~.~;~.[.~. ~.~.~.....~.~ .................................. .ounty Tax Map No 1000, Section..~ ....... Block .... ~.~ ........ Lot .... ~.~/. .......... ;ubd ivision ..... ......................... Filed hap ............ Lot ............... ....... 'ermit ' .Date Of Permit. ~~ '' ' ................... Underwriters Approval. . . ... I' O ard Approval TOWN OF SOUTHOLD Building Department Town Hall BLDG, DEPT. Southold, N.Y. 11971 TOWN OF $OUTHO,LD,, 765 - 1802 APPLICATION FOR CERTIFICATE OF OCcupANcY f~.).~ in st ructions ',,,~.~ ~4~,~ A. This application must be filled in typewriter OR ink, and submitted I ~ to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building, 5.Submit Planning Board approval of completed site plan requirements where applicable. J~. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 1. Certificate of occupancv New Dwelling $25,00~ Accessory ,$10,00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0-. 0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $I0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .............................. House No, / Street __ / Ham/et Owner or Owners of Property ................................... ..~.., ... : / County Tax Map No. 1000 Section ............... Block ............... Lot ......... '.. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ~,~.~, J5 ,~. Date of Permit ?~, .~.0, ~,,, .Applicant . ~'~, J).~J~/7,~....~). RAJ.Q ,~,~-.-~. Health Dept. Approval ........................ Labor D~pt;Approval ......................., Underwriters Approval ........................ Planning Board Approval ....................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Applicant ...................................................· Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS LI~L},L3 BUREAU OF ELECTRICITY THIS CERTIfiES THAT only tko ~lec trical equipment as described be~w a,d int~duced by t~ applicant ~med on the able appl~catlo, number in the premises of ~ea~ ~alurae, ~/wJ~ ~ & ~,tain ~ad, So~o~d~ NY in the followlng location; ~ Baset,e,t ~ Ist FI. ~ 2nd Fl. Section Block Lo~ was examined on and found to be in compliance w~h the require~nents of this Board. J~a&~ 27, 19~ FIXTURE OUTLETS L DRYERS ~ECEPTACLES SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS FLUORESCENT E R V I C A W,G. NO. OF HI-LEG A,W.G. A PER ~ OF CC. COND OF HI-LEG OF NEUTRAL 1 2/O J. ~rn~st H~ Pappas/d/b/a 50 C~dar ,~ch Road GENEI~AL MANAGER Per ~1 This certificate must not be altered m any manner;, return to the office of the Board ~f ~ncorrect, Inspectors may be Jdentdied by their credentials. ~P~ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FIgLD'~NSPECTION COMMENTS FOUNDATION (1st) F( JNDATION (2nd) 2°' ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE FINAL DDITI' COMMEN.TS' TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR · P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 January 17, 1986 TEL. 765-1802 Andrew ?oliovras Colonial Corners Southold, N.Y. 11971 Dear Mr. PolioYras: I am writing to you regarding your Building Permit #14315Z, which you turned in yesterday. When I pulled your road file I see there has been no insulation inspection nor a final in- spection. Please arrange for these inepections to be made. I am enclosing an application for the C.O. please fill this out and return it to our office along with a check for $5.00 eo we can complete your Certificate of Occupancy. Yours truly~ Building Dept. Sec . Memorandum from BUILDING INSPECTORS OFFICE TOW]'~OF SOUTHOLD TOWN F[ALL, BOX728, SOUTHOLD, N.Y. 11971 765-1802 ANDREAS PALIOURAS Paul's Lane ?econi¢, N.Y.11958 SOUTHOLD TOWN BUILDING DEPT. Main Street Southold,N.Y.11971 12 May 1987 RE: Gentlemen: We would greatly appreciate Building Permit No:14315Z your granting us a six months ex- tention of the captioned Permit for the purpose of constructing and adding one Boiler room with the following specifications: Total dime~tions: 9' x 9' to be added to the present structure. Concrete foundation for same. 8" x 16" Cement blocks to be used for the construction of the Wslls. 5/8" Fire Code Sheet Rock to be used for the extended roof. One Steel Door 36" x 80". Also, a cocrete Ramp will be constructed at the same time. Thanking you very kindly for your consideration, we remain, Yours Faithfully, Examined. 7/.~. ·° ........ ,19 ..~.~ Approved . .~/~.~. ........ , 19o~..~. Permit No. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-180;3 Received ........... ,19... Disapproved a/c . .:>~..~ .................. (Building Inspector) ~ - APPLICATION FOR BUILDING PERMIT Date.. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 appli- 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 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 pumuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or 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. f: ...... (Signature of applicant, or name, if a corporation) ...,.p.,..o..,..g. 9.~'..~. ~..¢q.. p...e~...~..,. ;.....~..Y.. (Mailing address of applicant) /I el State whether applicant is owner, ss , agent, architect, ~ngineer, general contractor, electrician, plumber or builder. ...................................... · ................. '>ali ;>'")¢;;)'); .... · .:..' ~.~d.z,..C '~ ~ Name of owner o f premises ~7t~ .. ~..~...~. ~. ~. ~i ............................................ (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.../.'~..0....~..~-.... Electrician's License No ....... ~ ............ Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ................................................................. ..4¢?./. p.zo.¢.C).-: .~. .' ........ House Number Street Hamlet County Tax Map No. 1000 Section . ..................... ¢.~.~..Z_.... .... Block <D J . . Lot_ .r:~..~. ~..~..O..Z,...'~..... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use andoccupancy of pr. emises and intended use and occupancy of proposed construction: a. Existing use and occupancy , . .~.~.~, .~.. (.~..~-~..~..~?.~Q~..~ [ b. Intended use and occupancy ..................... .,. ~,,.~ ..... , ~ .p .,, .......... 10. 11. 12. 13. 14. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Ren oval .............. Demolition .............. Other Work ............... ' (Description) Estimated Cost ..................... Fee 77 .......................... ~' (to be paid on filing this application) If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage number of cars ~ .... ': ............ - ' If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dimensions of existing structures if any: Front ' -" Rear Depth...~... ...... Height ............... Number of Stories .............................. - ......................... Dimensions of same structure with alterations or addmons: Front ................ Rear .................. Depth ................... ~,,. Height ...................... Number of Stories ...................... Dimensions of entire new conslruct~on: Front .... , ............ Rear ............... Depth ............... lq'elght Number of Rtnr~aS', ,x ~ ' ,: Size of lot: Front ' i Rear Depth Date of Purchase ' Name of Former Owner Zone or use district in which premises are situated ..................................................... Does proposed construction vi61ate any zoning law, ordinance or regulation: .............................. Will lot be regraded ....... f~...o ................. Will excess fill be removed from premises: ' Yes ' Name of Owner of premises ...~g.~.~..-CJ~.q ~.}. .... Address t~,l/~. ~e~P~ .5~c> Phone No. ~/~..~'0..~'~.. Name of Architect ~ Address /¢ ~.~ 1~ [ ~ ,~ Phone No Name of Contractor ~ Address Phone No PLOT DIAGRAM Locate clearly and distinctly ~1 buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. of said owner or owners, and is di application; that all statements con work will be performed in the mann Sworn to before me this STATE OF NEW YORK, S.S COUNTY OF ................. ..... ~'"' .......... .' '; ....... I'. .................... being duly sworn, deposes and says that he is the applicant . · (Name of individual signing contract) above named, i He is the ..................... I .................................................................... (Contractor, agent, corporate officer, etc.) ly authorized to perform or have performed the said work and to make and file this mined in this application are true to the best of his knowledge and belief; and that the ~r set forth in the application filed therewith. NATu P-..AL F:O0 D~ TOI.L~T '~t LO" x'SLO~ .? LO 0 ¥~-. 'PLAN ~' P-.O N'T ~--LEX/AX' I 0 N $0 u'T t~t © u.D ~, lxl.~ TOILET '~LL~ ...... t P[KT'E. FOR. C.O. '. CONSTR.,C F ON S & ENERGY