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Home My WebLink About19668-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No . Z=-1-9866 Date APRIL 25~ 1991 THIS CERTIFIES that the buildin~ Location of Property 445 PIKE STREET & House No. County Tax Map No. 1000 Section 140 ALTERATIONS 400 LOVE LANE Street MATTITUCK~ N.Y. Hamlet Block 2 Lot 19 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 13, 1991 pursuant to which Building Permit No. 19668-Z dated FEBRUARY 14, 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 ALTERATIONS FOR A RETAIL ~VIDEO) STORE INA N EXISTING BUILDING The certificate is issued to JOANRE SHIP (Owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED (ROBERT CININELLI, Lessee) PENDING - APRIL 19~ 1991 Rev. 1/81 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) Ne- 19668 Z Permission is hereby granted to: ~ ,~ ,o ~....~,,~....~./.~ ......... ~. ....... ,.~ ....... ~ ......................... ot ,,r,m,,,, ,o¢oted ,~ ..... ~/~..._. ..~...'-.~.....~ ........................................................................ pursuant to application dated ...... ..~Z~./?.~ ..................................... , 19...?./.~ and approved by the Building Inspector. il..~' I rLspe~'to r Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, ~ certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Upre-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. 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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $I0.00 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 Building... ~. Location of Property ~PO ~C_ ~-~C~ I ~?.~.. ~.. ~ House No. Street Hamlet Onwer Owners of Property .~Oa~ 5~ County Tax Map No 1000, Section...~.~ ...... Block ..... ??. ........ Lot..~. ................ Subdivision .................................... Filed Map ............ Lot ...................... Permit No..../. C~. ?.~.~.. Da t e ......................................... Of Permit .... Applicant Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... 5-0.0o o ,u , ?ee Submitted: $ ............................. OV~ \ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~OOi)g'/9 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date ~ppJication No, on THIS CERTIFIES THAT in the followlng loca~ioo; ~ a~,e~f,t ~ Ist Fl. ~ 2nd FI. OIP:P Section BIlk Lot FIXTURE ! FIXTURES OUTLETS SWITCHESfINCANDESCENT FLUORESCENT OTHEI~ DRYERS RANGES OVENS DISH WASHERS EXHAUST FANS OTHER APPARATUS: S E R C NO. OiF~E~C,~CONDA-W G NO OF HI-LEG A W.G NO, Gl: NEUTRAJS A,W G, OF CC. COh/D OF Hr-LEO OF NEUTRAL GENERAL MANAGER 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 IN ANY i',~NNER. FOUNDATION ( ls t) FOUNDATION (2nd) ROUGH FRAME & ~?LUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS'. FORM f40. SURVEY .................. !i~i FEBI31ffil. , · 3s~,s or PL.,,s ......... B J;(3. ',.~{,:~., . BUILDING DEPARTMENT SEPTIC FO~H .... ~./}; ....... TOWN Or qOiPi~,!?' TOWN HALL · ~OUTHQ~. ~_ ~7 ~ NOT ' F~: ......... .~.~/~ .~ ?.: ................ · ........ ...... ............ Disapproved a/c APJ~R0¥ED AS NOTED "'a~:'~~:~. ~-~. · ~ .... ~. ~ .~.~ 765-1802 9 AM ~ 4 PM FOR THE FO~LOWlNG INSPECT O~S: APPLICATION FOR BUILDING PERM T 1. FOUNDATION - ~O REQUIRED FOR POURED CONCRET~ 2. ROUGN - FRAMING & PLUM~ING 3. INSULATION UNDERWRITERS CERIIRCATE REQUIRED y filled in by typewriter or in ink had submitted to thi Building rump=star, ~tit! Fee =eeording to schedule. ~t and 9f buildings on premises, relationship to adjoining premises or publ/e sere: =n of layout of property must be drawn on the diagram which is part of tiffs ap.r- may not be commenced before issuance of Building Permit. the Building Inspector will issued a Building Permit to the appfieant. Such pen-r 9~mspeetion throu-_hout the work. .... ~)/ffHOUT CERTIFICATE Elcctr,cnn s L No ............... Olher Ttadc's License No. · .O/0CCU?ANC¥ ilou~e Number Street. ....................... Hamlet ' Subdlvhion ..................................... Eilcd Map No. (Name) .............. Lot ............... St2Ic exh~ing u~e and occupancy of premises and in leaded use and occup.nncy o~ proposed A. Ex~sting use and occupancy ........... ~. ............... *,,,.,,,,,,,., ................. B. Intended, use and qccupancy.;,., ~ ~ (Name and title of corp6rate officcr) Builder a License No Plumber's License No ......................... OCCU?ANC¥ OR USE iS UNLAWFUL c, 7~i~- lt~j~t~gA~at~b~ qul~Uil:lj~ ~sed in whole or ~n part for any purpose whatever until a Cc~ficate of Occupmn: = . L ' ion. as her.~ dezchbe: Thc a~ll~ ~ to comair with all appticaffle laws. ordinances, buQd~g code. housing code. ALL CONSTRUCTION SHALL ME~ TH~ REQUIREMENm OF THE 'N.~ '' '(~ig~at[;e STATE CONSTRU~ION & E~ERGY CODES. N~ RESPONSIBLE FOR State whether applicant is owner agent, ~cifftect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ................................................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duty authorized officer. 3. Nature ofxvork (check which applicableS. N "' .... ' -'- Re-air' . ,. ~ t. e,,v ,,unumg .......... Addition .......... A~[er~tton . .,.,~,,.. ............ al .,.It:li~C I fl;r ' ' ~0[ oe~sOry Building .......... Fence ....... Other "ork ........ 4. Estimated Cost ..... · ' {La ha oaid on filing thi~ avplication} 5. lfdwelhng, numberofdwelhng~mts ............... Numberofdwutlin nnits on each floor ...... ' Ir garage, number of ca~ g ........ 6. Irbusmess co ..... ' ...... ~- . ' ......................................... n. . · ~.,,,,~m~orn.xcuiuccupancy,specifynaturcandcxt~.t~r ..... c.~, ~, . ~ ....... Number of Stones .... I Dept~. . , ........ Rear ...... Dimelnsi!~l~ontir0 ne~yi~pnstniction: Front ' ' ' Hei=ht '~ .... ~ ' ~Um~erofSto~cx ............... Rear . . Dcpt~ ..... 9. Size of lot: F/oat ...................... ..... ........ lO. Date of Purchase ..l... Name of FO~er Owner . .~ ..... ' ....... 11. Zone or use district in which pre~ xes ar~ situated ........ .... 12. Does proposed Construction viola:re any zoning law, ordinance or ,,w,,, ....... ......... . o :regraded g I 'on: ..... ~ ... 14 N~ f O .......... ~ ............ - ...... Will fp oxc e removed from prmN~:e o . . :,~ N~o of Architect ......... i ............ Addro~ . . Phone No ............... ' Address Phone No N~o of Oon~rn:~or .................. , · .............. Address ................... Phon~No .... 1~.~ :kis property o ' - · ' ~ e~ted uzth~n lOO feet of a tidal wet,and? '-~S .... ttO.M. ~I~ yes, Southold Towni~rnztees Permit moy be required. ~ PLOT DIAG~M , Locate cle:ly ~d dist~ctly ~1 buffdNgs, ' · · whether ex~stmg or proposed, ~d. indicate ~1 set-back d~enslor.~ :': prope~y ~nes. Giw street ~d block n~umber or doscSption accord~g to deed, ~d show street nines and Ndieate integer or comer loc , gTATE OF NEW YORK, S.N ........ ...... ,, !q ..... ..... h ,n=d,,,yswo .de,oscs ~bove nam'ed5Name o£individual signing contract) IF 1/7,1 :md says that he is the appfic::. is lite ~ (COntrnctor i , agent, corporate officer, cie.) said Owner or owners, and s duly authorized to pe.rform or have performed the said wor.k and to make and file ti: Pplication: that all statements contained in this application are true to the best of his knowledge and belief; and that u: vork will be perforated in the m~ner s~t forth in the application filed therewith. ;worn lo bcforc mc this i ..................... day of..~ ?[ ............. , 19. .... ~ i ':---~ County fl£LEN lC DE VOE NOTARY PUBLIC, State of New Yolk . · ~erm Expires I~srGh 30, 19 (Signature of appllcan'