HomeMy WebLinkAbout18794-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-18873 Date MARCH 12~ 1990
THIS CERTIFIES that the building.
Location of Property 53345 (2) MAIN ROAD House No.
County Tax Map No. 1000 Section 61 Block 1
Subdivision Filed Map No.
ALTERATION
SOUTHOLD~ N.Y.
Street Hamlet
Lot
Lot No.
13.1
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 8, 1990 pursuant to which
Building Permit No. i8794-Z dated FEBRUARY 15r 1990
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 GIFT SHOP - FEATHER HILL BUILDING #2
The certificate is issued to
(tenant)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO. N-083265 - 7/27/89
PLUMBERS CERTIFICATION DATED
MISTLETOE & HOLLY
Building Insp~tor
Rev. 1/81
FO~ NO. ·
TOWN OF SOUTHOLD
BUILDING DEPARTJHENT
TOWN HALL
SOUTHOLD, H. Y,
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
18794
Z
Permission is hereby granted to:
...~%.ZY.~~. ......... ..' ..............................
.... ~.~.....~.:.~.......I.~.~.~. ............
,o
~:t premises located ~, .,.~..,.~..~.~...~,'~........~..~...~, ........ 1~~ ...............................
County Tax Map No. I000 Section ....... .(~..~, .) ....... Block ....... .~..I ........ Lot No ..... L~.~..] .........
BuildingpUrsuant Inspector.t° application dated ............................ ~.~h~...~... , 19..~...~., and approvod by the
B'~ildlng Inspector
Rev. 6/30/80
il971
APPLICATION FOR CERTIFICATE OF ocCUi~NC~
Filed Hnp ........ Lot
~h~ ~....~,pp~i~a,~ ...................
lgh Depc Approval ' U d ri App I
Planning Board Approval ................
for Temporary Cor=i£1ca=e ....... Final :::ruiflcn[e ................
Fee Suhm£eted: $ ....................
rev' lO/ 14/SS
;EUPLICATION FOR CERTIFICATE OF OCCUPANCY INSTFUCTIONS
This application must be filed in typewriter OR ink and submit~:~d to the Build~mg
Imspe~tor with thm followin~; for new buildin~:~ or :,w
[.' Final $u~ey of property with ~ccurate ~ocatiom of ail bai!dln~s, property
~. Fimal approval of Health Dept. of water mupply mw~ ~.wermge-d~:~,
3. Approval of electrical iustallmtiom from Board t~f Fire
4. Swo~ =tatmmen~ from pl~ber certifying that molder used in ~y~tcm
them 2/10 of lZ lead.
~. Co~ercial buildings, industrial buildin;<~ ~,~ltlpla residences and z~milar.'
or Engineer responsible for the building.
For ex'sting buildings {Prior to April 9, ~957~ nom-comfo~ing u~em. or huildlng~
I. Accurate su~ey of propert~ showing all proper~ lines, streets, buildlng~ m~d
unusual nagural or topographic fea~ure~.
2, A properly completed application, a conacmg Co inspect mf);med by the applicant
· If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
3. Date of any housing code or safety inspection of bul~,llngs or premises, or other
pertinent information required to prepare a certificate.
For Vacant Land Certificat~ of Occupancy:
1. Au application for vacant land Certificate of Cacupancy shali be submitted,
and a certified abstract of title issued by a t~tle company showing single and
separate ou~aership of ,the entire l~t pr{or to April 9, 1957 shmll al!so ac~o~npnny
the application. Xf a Certificate of Occupancy is de{{icJ, thc Building Inspector
shall state thc reasons therefor in writing to tim applicant.
FEES:
I.
CERTIFICATE OF OCCUPANCY -- New 9welling ~75.00, Additiot,s to Dwelling $25.00,
Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00
Addition to Accessory buildings, $2~.00 - i, asinesses $50.00.
2. Certificate of Occupancy on pre-existing dwelling -- $100.00.
3. Copy of Certificate of Occupancy - $5.80 - over 5 years - $10.00
4. Vacant Land Certificate of Occupancy - $2{).00
~. Updated Certificate pf Occupancy - $50.00
6. Iemporary Certificate of Occupancy -$~5.00 Residential
C,~imqercial
/
FOUI~DAT!0:I ( ls t )
?0U~;Dr, TI0:i ( 2nd ]
2.
ROUGH FRAME &
.PLUMBING
iNSULATION PER.N. Y.
STATE ENERGY
CODE
FI;;AL
ADDITIO}~A'L CO!~MEIITS:
THE NEW YORK BOARD OF FIRE UNDERWRITERS
1001381 BUREAU OF ELECTRICITY
--- 8.15 JOHN STREET, NEW YORK, rqEW YORK 10038
Da,, JULY 27,1989 ~4ppllcalionNo. onfil~ 63363589/89 N 083265
THIS CERTIFIES THAT
ordy the electrical equipment as described below and introduced by the appllca~ t named on the above application number in the premises of
JAMES L. GRAY SR.,
in the followi.,g location: ~ B.s.,nent
was exarnined on JULY 10,1989
HAIN ROAD, FEATHER HILL,
FIXTURE FIXTURES
OUTLETS SWITCHES FLUORESCENT
23 11
DRYERS
OTHER APPARATUS:
STORE 3, BUILDING A, 8OUTHOLD, N.Y.
RANGES OVENS DISH WASHERSI ~XHAU~T F~N~
S E R V I C
NO. OF FEET
40
DIMMERS
W G, NO OFHEUTRALS A W G,
HI.LEG OF NEUTRAL
3 TON A/C UNIT-1
FEEDERS:l-4 # 3 BASEMENT TO IST FLOOR
MOTORS:i-F M.P.
PANELBOARDS:i-21 CIR. 100
ELEC. WATER HEATERS::i-2 K.W.
TRACK LIGHTING:-190
JODY PUMILLO
PAT LANE
MATTITUCK, NY, 11952
LIC.~2300E
GENERA~ ~--------~GER
Per- 11 ~.~ /~..~
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.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTM£NT
TOWN HALL
~OUTHOLD, N.Y. 11971
TEL.: 765-1802
BOAPD OF HEALTH ...........
3 'SETS OF PLANS ...........
SURVEY ....................
CIiECK .....................
SEPTIC FORM ...............
NOTIFY CALL ....................
Approvud%~ .~...*~ fi..~.., 19~ ~)Pennit No..]. S.] .~.c~..~.
M
Disapproved a/c .....................................
MAIL TO: .......
(Building Inspector)
APPLICATION FOR BUILDING PERNIlT
BLDG, DEPT.
:TOWN ,OF SOOTHOLD,
INSTRUCTIONS
a. Tkis application must be completely filled in by Wpewriter 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 ~o adjoining premises or public stree
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app!
cation.
¢. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of tlils application, the Building Inspector will issued a Building Permit to the applicant. Such perm
shall be kept on the premises available for inspection throughout the work.
¢. 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 tl
Building Zone Ordinance of the Town of Southold, Suffolk Cou. nty~ New~ York;~and other applicable Laws, Ordinances,
Reeulations, for the construction of buildings, ad~ditions or alterations, or for removal or demolition, as herein describe,
Th~ applicant agrees to comply with all applicable laws, ordinances, building Code, housing code, and regulations, and t
admit authorizeddnspectors on premises and in building for necessary inspections.
,' ' - '. :;:, 't ...........
' (Si~ahatur~ o~ applicant, or n,qme, ~fa corporanc]n)
........ (Mailing .~ddress of aeplican/) .........
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buildux
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
........ (Name anti ti'ti/; officer)
Builder's License No ...........................
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
ill '
Location of land on wlilch proposed work w be done ....................................
/&,.,. ..........
[louse Number Street, Hamlet
County Tax Map No. I 000 Section ..... ~-.~./~'~' .....
Subdivision ....................................
(Name)
............. ¢'? ",.9,~.--
Block ~-~QO ..... Lot ..... ~ ............
F, ilcd Map No ............... Lot ...............
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy. ...... ....-.--..-...-..- .-. ................ ... ,:,"~ ..z.,.-:~,;;,~,:,. .. ~, , ,. ,;$....
b. Intended use and occupancy .................................................... · '' '' ' ·
3. Nature of ,, o[k (check which applicable): New Building ,. Addition .......... Alteration ....
Repair ............. R~:moval .............. Demolitioh .............. Other Work .........
~ -' ~ (Dcscfipt
4. Estimate'd Cost .............................
(to be paid on filing this application
5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ...........
If garaee number of cars .........
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ...............
7. Dimensions of existing structures, if any: Front ............... Rear ............... Depth .........
Height Number of Stories ; ...........
Dimensions of same ~ructure with alterations or additions: Front ................ Rear .........
Depth ...................... Height ...................... Number of Stories .............. ..
8. Dimensions of entire new construction: Front ............... Rear ............... Depth .........
Height Number of Stories '
9 Size of lot: Front ' Rear Depth
10 Date of Purchase · · · Name of Former Owner
11. Zone or use district in which premises are situated ...............................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ............. ..........
13. Will lot be regraded ............................ Will excess fill be removed from premises: . Yes
14 Name of Owner of premises ' Address Phone No
Name of Architect .... Address .. . Phone No
Name of Contractor Address Phone No
15.Is this property located within~00 feet of a tidal wetland? mYgS .... NO..
· If yes, Soathold Town Trustees Permit mmy be required.
PLOT DIAG I~AM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions
property lines. Give street and blockjmmber or description according to deed, and she .v street names and indicate wl
interior or comer lot.
' OCCUPiI~iCY OR
USE IS UNLAWFUL
WITHOUT' CERTIFICATE
OF OCCUPANCY
&~PRO~EO AS NOTED
N~iFY BUILDING OEPARTUE~T
?654802 9 AM TO ~ PM fO~ THE
FOLLO%~ING INSPECTIONS.
~, mU~OAnON ~O .mUmEO
FOR POURED CONCR~E
2, ROUGH - FRAnkING & PLUMBING
3, INSU~TION
4. FINAL . cONS~UCTION MUST
BE COMPLET~ FOR
ALL CONSTRUCTION SHALL
THE REQUIREMENTS OF TH~
STATE CONS~U~ON & ENERGY
cODES. N~ RESPONSlB~ FOR
DESIGN OR CONS~UC~ION ERRORS
STATE OF NEW YO,~K, ~
COUNTY OF ..... ~ .Q ........ S.S
............................. being duly swam, depascs and says that he is the app
(Natne of individual signing con tract)
above named.
,,e ,, the ..................... .C.. .......................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, ~d is duly authorized to pe.rform or have perfo~ed the said work and to m~e and fil
application; that all statements contained in this application are true to the best of his knowledge and belief; and th;
Work wflI be perforated in the m~ner set forth in the application filed therewith.
Swam to before mc tt~is
........ .......... 8~ ...... day of ..... ~e.¢t V ¢ ....... ~9 ~
Nota~ P~bli~, ..... , ........................... County .
- '" ........