HomeMy WebLinkAbout17786-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING BEPARTMENT
Office of the Building Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 219054 Date MAY 17, 1990
THIS CERTIFIES that the building BUSINESS ALTERATIONS
Location of Property 40200 MAIN ROAD ORIENT
House No. Street Hamlet
County Tax Map No. 1000 Section 15 Block 09 Lot 08
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DEC. 27, 1988 pursuant to which
Building Permit No. 0177862 dated JAN. 27, 1989
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 TO EXISTING BUSINESS BUILDING.
The certificate is issued to MGH ENTERPRISES INC.
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N070685 MAY 9, 1989
PLUMBERS CERTIFICATION DATED KING PLUMBING & HEATING MAY 10, 1990
T r r i1 rr-c. ~..e~~ a..c p`~,
Building Inspector
Rev. 1/81
Fosas xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON TFiE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°_ 017786 Z Dote ....../.~l...f:.~ 19..x!!
Permission is hereby granted to: ' ~
Q
........~-3 3
e ~...~i.:. .r.......1~~51.,1.....
to .~`°"""'Y. 'fi`r "~~",,"/~~'2~j~. .G~ Ze:.......~.E jN""", "4J1.,~....'.~ ...y
~:......G~~~~G(......~ .0../~...D.o
.
ct premises located at ..........~':•.........~....~.......1~,~/.....~~!
County Tax Map No. 1000 Section ~5...... Block Lot No....Q..................
pursuant to application doted Z~ .~.~iF.'f 19........, and approved by the
Building Inspector. ~
Fee $...~Q..t7...~ D .
wilding for
Rev. 6/30/80
,3.3'~ Form No. 6 - ~
O I'''~ TOWN OF SOUTHOLD u " ' ~ ,
BUILDTOWNDHALLTMENT MAY ~ Q ~~~Q
765-1802
7~4~11V OE :a5! i
APPLICATION FOR CERTIFICATE OF OCCUPAN '
A. 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, 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.
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 - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $//15.00, Commercial $15.00
Date .....7~~ /~Q .
New Construction........... Old Or Pre-existin,Jg Building..
Location of Property...y0 2bC7..... ~~!t~..l?~ ................®.~4~!'t~.~................
House No.~p ,J, Street Harriet
Onwer or Owners of Property...!'.r:C?~~:~.:~.~W1.•..~Y~C,....9
County Tax Map No 1000, Section....~:`~.......Block.....!..........Lot.. ~
Subdivision ....................................Filed Map............Lot......................
Permit No..~.l.~. g Yi.....Date ^Of Permit...~~2~~gq.....Applicant
Health Dept. Approval......^N//n!7
................Underwriters Approval......................... -
Planning Board Approval...(YJT ,
Request for: Temporary Crertifircate........... Final Certicate...".......
Fee Submitted:
3 ~s~6 s- ~ .
Co. 2 /9O S/ APPLICANT
TEL. 765-1802
pSVFF~L!(CpG TOWN OF 50UTHOLD . •f~ i_.°,:
Z ~ OFFICE OF BUILDING INSPECTOR ~~r~~~~ ~C-+~~~ U~ ~~`'I i t
z P.O. BOX 728 i ~~.Y~.~ - ; ~ It:
s° yr TOWN HALL ~ ~ ~
~ 1
~O~y~® ~~`e- SOUTHOLD, N.Y. 11971 ~ ~ MAY' ~ 4 ~'i~ "
sl.eo. oersr, s
C E R T I F I C A T I O N
Date 5-10-g0
Building Permit No. 17786-Z
Owner M.G.H. Ent. Inc.
(please print)
Plumber_King PlumbinE & Heating Inc.
iplease print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1~ lead.
(plumber's signature)
Sworn to before me this
~0 _day Of ~•_r r ~ ~l
?L~
19~. N ary Public
Notary Public, .County
~L ~MARILYN p. NORKEIYN
Notary PubRC, State of New Yak
T Ntr.52.4609555
Qualified in Suffolk County o~ffff
mission E><pirea March 30, 191L...
TEL. 7G5-1 F01.
~~~F~
O/~ ~l;r~ T'O~C'N (.1I' SOIITIIO~,~
~l OPNICii Ol' iIIJiLll1NG 11JSP[•:CTQR
,r a
nrt ' rs 1'.O. 1JOX 7~8
~:1'1>~J' TOPJTJ II,1LL
I~'~~y ~'s~'`.c~ ~ SO(JIItOt.U N.`:. 11971
'~""r~~ May ~i , 1990
MGH ENT.ERPRISES,'INC.
BOX 333
ORIENT, N.Y. 11957
To whom This P4ay Concern,
toe arc unable r_o complete your Certificate
• of Occupanoy becau:>e ,of the following masons.
An application for Certificnte of Occupancy
is not nn file. (ENCLOSED)
7~~" `IO !Jnder:•~riters Certificate on file.
/r// The check .is (d4~%IC&$Il;~i/not on file.) $50.00 (RESTAURANT)
i:o Health Dept. Approval on file.
I:o final in:;pect:ion hay been made.
P]ea~,e contact: our office on this matter.
Thank you for your cooperation.
Duildinry Pexmit 1{ 1 7 7 8 6 2
Duilr~l~i/r.q UcpL-.
~ k"/?/ IIn I'l~~mber Solder Cert•.ificate on file.
( all permit:; involving plumbing being '
issued afL-er April 2,19II4 )
` MAY I Q 19~ : ~ ;
BLOB, CSEPT.
'~,,.~L~~
1'C7~'!V 0~ 804l7f~'(7iwi1
F
t
THE NEW YORK'BOARD OF FIRE UNDERWRITERS DACE 1` '
1D00773 irtt''~iit` BUREAU OF ELECTRICITY
83 JOHN STREET. NEW YORK, NEW YORK 70038
Date - MAY 09, 1989 .,;'gpplirotian No. on fife 61374589/89 ~ N 070685
THIS CERTIFIES THAT ~ ~
only the electr&al equipment as described below and introduced by the applicant named on the above application number in the premises of
.1j: f-r-~.
RIENT'BY THE SEA MARINA, MAIN ROAD, ORIENT, N.Y.
in thefolfaecing location: ? Basement 0 lat FL ? 2nd F!. Sertiun ~ Blcek Lot "
erns examined on APRIL 24,1989 ondfound to be in coneplianee with [he requirements of this Board. -
fIXTURE ECEPTACLEE SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS INCANDESCENT fIUORESCENT OTHER AMi K W. AMT K.W. MAT. NW. AMi K.W. AMT. H.P.
7• 6 5 2
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT NEA7ER5 MULTLOUTIET DIMMERS
' AMT. K. W. Oll H, P. GAS N. P. AMT. NO. A W. G. AMT AMP. AMT. PMPS. TRANS. MIT H. P. SYSTEMS AMT. WATTS
NO.OF FEET
SERVICE DISCONNECT No. of " ~ - . 5' E R ~ . V .I, , C 'E ~
MIT. AMP.' TYPE EQUIP. I q [w l a 0W 3 $ SW 3,a' Aw NO.OPER BCOND Of CC. COND NO. Of HI-LEG Of ~N ~lfG NO Oi ttUIRA15 ~ Oj NEViRAt !
OTHER APPARA7U5: - .
SMOKE DETECTOR:-1
-
L.~e4~~%eC.li+-~ ii . .
~~%'C
ARTHUR A. RUROEDE LIC.~2234E
..:'.MAIN ROAD ~ ~ ~ r~;x.-,,~-
" ORIENT, NY, 11957 GENE7M4 A AO[R ,
' = 54 qq
i 1 ',I'~l i i p,~.
Per
This certificate must not be altered in any manner; return to The office of the Board if incorrect. lnspettors1 Inny be identified by their credentials.
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TOWN OF SOUTFIOLD
BUILDING DEPARTMENT
SOUTFIOLD, NEW YORK
STOP WORK ORDER
TO: MGH ENTRPRISES, INC.
Owner, Owner's Agent or Person Performing Work
46 Garfield Avenue
Glen Head, NY 11545
Address of above-named person
YOU ARE HEREBY NOTIFIED TO. SUSPEND ALL WORK AT:
40200 Main Road, OYient, NY
Address where work is to be stopped
TAX MAP NUMBER 1000- 1 5-9-8
Pursuant to section 100- 14 I of the Code of the Town of Southold, New York you
are notified to immediately suspend all work and building activities until this order has been
rescinded.
BASIS OF STOP WORK ORDER• A building permit is needed for any renovation
work involving structural work.
CONDITIONS UNDER WHICH WORK MRY BE RESUMED: When a building permit
has been issues by the Building Inspector.
Failure to remedy the ctinditions aforesaid and to comply with the applicable provisions of
!aw may constitute an offense punishable by fine or imprisonment or both.
DATED: 12/22/88 ~ ~ ~~Gt:~
BUILDING INSPECTOR /COD E~N4~FJ~OdCCRCE~bIENT OFFICER
Vincent R. Wieczorek,, ,
,
~f - 1
T85-1802
BUILDING DEPT.
INSPECTIC'N
' [ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[y'F'RAMING [ ]FINAL
' REMARKS: %~~FC _O' -~I
DATE ~ lD (J ~ INSPECTOR G
~
~ Y ~ l
Eft 5~t~
~ ~
~ ~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDA ON 1ST [ l ROUG LBG.
[ ] FO DATION 2ND [ ] 1 CATION
[ RAMING ~ FINAL
REMARKS: ~ ~ l~ 1 C'~0 l~-(.mil ~f 1~,~
U1 L~1 ?,-t-~ ~t~~-lam ~~T
DATE l Z ~.,o ~fT INSPECTOR U~~lZ~r
Uri.-~~
~ o r3 N ~ ~-s
'ss-iso2
BUILDING DEPT.
INSPECTION
[ ] F ND ION 1ST [ ] OUG PLBG.
[ ] FOU ATION 2ND [ ~ IN CATION
[ ] F MIN [ ] F NAL
REMARKS: ~F l.( d~1,' ~i' 1 l R.C Cn ~ ~ c.l•t ~~~-f
~~~i~c•l~ t~ ~o d~-
tiCc S ~ t i
DATE ~ 8 INSPECTOR l~e~re
t~~~,~y~, ,
cT a . _ _
BOA D OF HEALTH
3 SETS OF PLANS
FORM NO. 1 SURVEY ,
TOWN OF SOUTHOLD CHECK w. ~ . .
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL
vDUTHOLD, N.Y. 11971 NOTIFY ~ ~ Q~
TEL.: 765.1802 CALL y
Examined ..l/.~7......., 19? f. MAIL T0:
~ s
p~ /
Approved ...~..?'.7 4i ~77~tp ~ 1~~~-` l~ij , r~_-.~ ...,3~
19 Permit No............ ! ,
q - .<< i.•
Disapproved a/c i~ t
f aac z 7 is$s ~ .
t i
BLDG. Di:Pi,
70WN OF uOtJ7HpLD +
( uil b nspector)
` APPLICATION FOR BUILDING PERMIT
Date ...................15...
INSTRUCTIONS
a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
' s,^ts 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 pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other appiicable 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.
- -
(Signature of"applicant, or name, if a corporation)
o~c 3 3 3
' (Mailin~ address"of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises s. ~-:...~N.: !~G<. .
(as on the tax roll or latest deed]
' If applicant ' corporation, s tur o duly authorized officer.
y:
j~.......
(Nam and title of corporate officer)
Builder's License No. ¢•K?.~vcY?• • • „ • . , , ,
Plumber's License No . .
Electrician's License No . .
Other Trade's License No . .
1. Location of land on which~pao~
~ work will be done. ~L-~S ~~~2dl,?r!7`; , d}; ~ . , d ?2i L~u-/ j~~ ~-y~-
House Number Stree ~ ~ ~ • ~ ~ • ' " " " "
/Hatnle
County Tax Map No. 1000 Section BI'pck , , • Lot
Subdivision ................(Name) F~yled Alap No. Lot .
State existing use and occupancy of//premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....`,~L 5;~.• . • • • • • . • , , ,
b. Intended use and occupancy . • •4~.~~~+• • • • • G~~~n-;
T _
5' 3. Nature of wor heck whiRemoi licable :New Buildin , , , , ~
P ) g Addition Alteration , , , , ,
Repair val Demolition Other 1Vork .
d ~ (Description)
p 4,, Estimated Cost ....~U.~X"~ Fee , .
(to be paid on Cling this application)
5. If dwelling, number of dwelling µnits . , , , , , . Number of dwelling units on each floor , , , , , , , ,
If gars^e, number of cars , , : . .
6. Tf business, commercial or mixed occupancy, specify na~urc and extent of each tyrpe of use ~e5-Fa .
7. Dimensions of existing structure , if any: Front ~ `.F , ; ~
~ , .Rear ...7. `f......... Depth hfd-~k, , , , , .
Height , . Number of Stories . .
Dimensions of same structure with alterations or additions: Front ~ Rear . ,7. ~
De th ~ . Ilei t . i
p .i. gh fl . Number of Stories .
8. Diinensi`an o e tare new const
rµction: Front Rear Depth , , , , , , , ,
Height , , , Number of Stories . .
9. Size of lot: Front . Rear ,^.../:4-P..r......... Depth , C.SZ?. ~ .
101. Zone or usecdistrict in wh~h re ' ' ' ' ' ' • • • • Nam of Former Owner . .
E 12. lloes ro osed construction P limises are situated ~ : ( . . . . . . . . . . . . .
j P P ate any zoning ]aw, ordinance or regulation: , ~D . .
13. Will lot be regraded . , .
` 14. Name of Owner of premises ~ ~ ' ' ' ' ' ' ' ' • • • Will excess fill be removed from premises: Yes
li ~=`!rT. 1f~--~-. Address !"JH:if'! . 12A . CJ,I2i~:^~ ~~~tone No. ,a ,
Name of Architect i , , , , , , , .Address ...................Phone No... .
' Name of Contractor .c,-- , , , , , , , ,Address .Phone No.......
,
15.Is this property located within 300 feet of a tidal wetland? *YES....NO.S/.'
*If yes, Southold Town' Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all I, buildings, whether existing or proposed, and, indicate all set-back dimensions from
' property lines. Give street and block jtumber or description according to deed, and show street names and indicate whether
interior or corner lot.
I
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IS
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STATE OF NE~V YORK, S.S
CO[JNTY OF , . ,N9,4S.S4'~-~ ~ _
. ,G-•L~ ~G-C-.. • /C. • `f~S ~ , , , , , , , being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named. I
He is the...... P~-~,~ ~I
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements contdined in this application are true to the best of Itis knowledge and belief; and that the
work will be perfomted in the manner set forth in the application filed therewith,
Sworn to before me this
\ - _ -
b . .....day of!,.. Q~C~:~-~T~A , 19
Note Public, ~?C`-S~~ti~c'4............ County ~ ,
PnTRICiA a. ia[EnWA (Signature of~applicant)
Notary Public, State of New York !
No. 4242992
Qualified in Suffolt< County '
pq
Commission Expires December 31, 19..p., ( '
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as
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IT UT CE T1F6CTE
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Ut~~~CY' NOTIFY gU1401NQ~~pER~~~MRNT ! "
SOLI?E~q? USED IN'WAl~R Fo~LO`w~iNC N~
~ S" ~0R ~ ~ ~ '
u ~ ~ SUPPLYSYST$Arl CA~ltN(7~T ~ ~ FouNnaT~ON ~
' E.XCEFD,~/jp 4f'fq$i FOR PQURED'coNCRETEp~O
LEAD: ~
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1 s: INSU<Anoro
AnatN~ a ~ ~ `v~~^,
4. FINgL ',Ct3M$TRUCTK)MpNU$T ~
BE COMPLETE FOR C.O.
~Li,' CONSTRUCTION 3NAL1: MEET
' ~ THE ~ RffgUiREMENT3 OF' 1fIE N.V. ~
~qq ~ If Ico~per tubtn STATE CONSTRUCTION- 8 ~NERpY !
j , w sibr water dtst~butTn g~~ " ~onl:3.' NOT RESPONSIBLE I~O~t ;
Y~teirg, n~S~l"sN OR CONSTRUCTION ERROR8 `
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