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Home My WebLink About19684-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19876 Date APRIL 26~ 1991 THIS CERTIFIES that the building_ Location of Property 53345 MAIN ROAD House No. County Tax Map No. 1000 Section 61 Subdivision ALTERATION SOUTBOLD~ N.Y. Street Hamlet Block 1 Lot 13.1 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 19, 1991 pursuant to which Building Permit No. 19684-Z dated FEBRUARY 28~ 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 ALTERATION WORK FOR BUSINESS ON BUILDING #10 AS APPLIED FOR The certificate is issued to PUDGE CORP. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HF~tLTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ~Juiiding Inspector Rev. 1/81 ~' NO. ~ TO~N 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_ 19684 Z ..... , . at premises located at ................................................. [ ................... .: ............. .~. .............. ;...v .......... ~-. ................................. ~.~....--.....~..~.~...~.~.... ....... ~~ .... .......................................... ..,~..........~_........: ...................................................................................... ~,.,~ T,..x Mo~ No. ,000 S,,:,~ ....... ~.../.. ...... 8,o~. .......... /. .......... I.o, No.../.....Z..../.. .... ,,u,,,.,nt ,o ,,,~,,~,,,,or, ,~ted ......... ~..-,-~......./...~ ...... , ".e....,<., ,,nd o,,,ro,*' ~ Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application mu~t 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. 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. For existing buildings (prior to April 9, 1957) non-conforMing uses, or buildings and Vpre-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 i. 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 - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15,00 Date .... ~...I.~. ~..I?. ~. I . . New Construction ........... Old Or Pre-existing Building ................ · Location of Pro err..~.~.~... ' ............ P Y ........... g~ ...... ~.~ .................. House No. Street Hamlet Onwer or Owners of Property ...... ~U b~ ~g~ . County Tax Map No i000, Section .... .~J ....... Block .... / ........... Lot...f~'.~ .............. Subdivision .................................... Filed Map ............ Lot ...................... Permit No... [~2 ........... .......................... Health Planning Board Approval ........................ Request for: Temporary Pea Submitted. $ ...... ~. ~ ~ ...... . TOWN OF $OUTHOI, D OFFICE OF BUILDING INSPECTOR P.O. BOX I 179 TOWN IIALL SOUTIIOI.D, N.Y. 11971 April 9, 1991 TEL. 765-1802 Pudge Corp. 50800 Main Road Southold, N.Y. 11971 To Whom This May Concern, Ple are unable r.o complete your Certificate of Occupancy because .of the following reasons. /_--// An application for Certificate of Occupancy is not on'file. (ENCLOSED) / .//'~o Underwriters Certificate on file. /._~q'~' '"'[he check .£:;(r~]~]gl~/not ou file.) $25.00 /~/ No Health Dept. Approval on file. /-~/ No final insF, ection has fbeen made. P]ca:;e contact ()ur office on this matter. Thank you for your cooperation. lh~lldir',g PermJ. t (~ 1 9 6 8 4 Z (Building /~10 Alteration) Building Dept. ***/]/ ~I(~ Plumber :3older Certificate on file. ( a!l permits involving plumbing being issucd after April 1,1984 FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING INSULATION ~ER N. STATE ENERGY CODE FINAL ADDITION[L COMMENTS: ink soot pnntmg & copylcenter Town of Southold Building Depar~nent Southold, N.Y.11971 March ~,1991 To whom it concerns, I wish to amend Building pelmlit$~ ! ~ ~q 1he changes shown on enclosed drawing are for two non-structual walls/partitions. DBA the ink spot (516) 765-3625 · 1235 youngs ave. · southold, n.y. 11971 Examined 19 ........ - Disapproved a/c ..................................... FOI .!'A NO, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N,Y. 11971, TEL.: 765-1802 NOTIFY CALL MAIL . ............... TO: APPLICATION FOR BUILDING PERI~/1 IT Dote ................... 19... INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter orin 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 tiffs appli- cation. e. 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 a,ny purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for rite issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordhaances 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 applica~e laws, ordinances, building code, housing code, aud regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ...... W.q.v. .. (Signature o£ applicant, or name, if a corporanon) (Mailin~ address of applicant) State whether applicant is owner, lessee, agent, architect, 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 duly authorized officer. a and title of corporate officer Builder's License No ........................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... llouse Number Street, Hamlet County Tax Map No. 1000 Section .................. Block ........... Lot ...... Subdivision ..................................... F. iled Map NB ............... Lot ............... (Name) State existing use and occupancy of premises and intemlcd use and Occupancy of proposed constrnction: a. Existing use and occupancy b. Intended Use and occupancy .... ~"~J~ ............... ~ ' ' 3 Nat f k (ch ck h'chiappli hie): N B ildi Alte~tio · ure o wot e w i ca ew u ng ..... ' ..... Addition .......... n '.~ ....... Repair R..!im°val Demolit oh Other Work 4 Etim ted Co {to be paid on filing this application) $ If dwelling numberofdwelli0gunits Number ' · ' ............... of dwelling units on each floor .............. If garao, e number of cars ' 6.' If business Commercial or mixed occupancy spec f hart, re and extent of each type of use · y mrens~ons of exmtmg structUres if any: Front Rear Depth'"i"~' ...... i ' ' ' He/ght Number of Stories ' '' .................................... Dimensions oF same structure[with alterations or additions: Front ' Rear Depth I Height .............................. ............................................ Number of Stories .................... 8. Dimensions o£ entire new con~tmction: Front Rear Height Number of Stories .............................. Depth .............. Front Rear Depth 10' Date of Purchase ......... i ....................................... ' ................ · Zone .......................... Name of Former Owner ........................... I 1 or use district in which premises are situated ' 12 Does proposed construction violate ................................................... zoning law · any ordinance or regulation: ' 13 Willlot be regraded ........ ~ ................... Will excess fill be removed from premises: Yes N 14 Name of Owner of premisesI " ' Address Phone No Name of Architect ........ ................... Address .................... Phone No ............... Name of Contractor . · ,. .......................... Address ................... Phone No ............... 15.Is this property lo~ated ~ithinaO0 geet of a tidal wetland? ~YES .... NO .... · If yes, Southold To~u Trustees Permit may be,required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions fror property lines. Give street and bloc! number or description according to deed, and'show street names and indicate whethe interior or comer lot. ............ ~ .......... ~ ............. being doly sworn, deposes and says that he is tile applican- . (Name of individual signing contract) above named. ~ . . He is the .................. /..{.~..~.( .~. .......................................................... . ~ (Contractor, agent, corporate officer, etc.) of said owner or o~ners, and is dully authorized to pe,rform or have performed tire said work and to make and file thi_- application; that all statements contained in this application are true to the best of his knowledge and belief; and that thc Work will be performed in the manner set forth in tile application filed therewith. Sworn to before me this i " ' · . ........ /2 ......... da or .... .......... , HELENK. DEVOE , , ,, , ~ ,, ~ ..,,,.._ NOTARY PUBLIC, State of ", · York ''"''''''~'" '~i~*~a't ~r;';f ;pplicant- Ne. 4707878, Suffolk Co Term Expires M~rch 30,1.9