Loading...
HomeMy WebLinkAbout17855-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22364 Date MAY 27, 1993 THIS CERTIFIES that the building ALTERATION Location of Property 10095 MAIN ROAD MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 142 Block 1 Lot 26 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 14, 1989 pursuant to which Building Permit No. 17855-Z dated FEBRUARY 17, 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 STORE #20 FOR CLOTHING STORE. The certificate is issued to ALAN A. CARDINALS (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N-073790 - MAY 26 1989 PLUMBERS CERTIFICATION DATED N/A ' Building Inspecto~~ Rev. 1/81 rows xo. s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON TFiE PREMISES UN71L FULL COMPLETION OF THE WORK AUTHORIZED) N°_ 017855 Z Date ....`~:.~-~....1..7 ~9.~~. Permission is hereby granted t j ......~~....~:~......C~:~..~~ . 4?. ? ~ . ~ . ~ . . . . . . . . ~ ..fir.....-.-.. ~ ~Q~t l ..~.x:...~:.~:!~ .:,.......C...!.s.:~........................ y~ ~p ~y-.., ct premises located of .l a a.~.w~.......' I.J.G~V.+:n..":::~'............~.°.4r,S~!~^.!^.~:-Pr..K r' e n ~:...~.:...~:....l~nax,~,,. Caunty Tox Map No. 1000 Sectiony.....t!..7.~........ Blo''c//k ....Q.~...........gqLot No...a.~ pursuant to application dated ~..Z 19~..J..., and approved by the Building Inspector. Fee ' Bu ng Inspector Rev. 6/30/80 • ~ Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL - 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 17 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~pl-an 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 - Resident/i~ayl/$15.00, Commercial/$15.00 Date ..t/.(,/.~A..~.~~./.1..~~.~....... New Construction...l!...... Ol`d Or P /e,-existing Building.... Location of Property..~~~r~.J~,,,~p,SO~,,,,~i~'7,~,7,~,,,,,,,,,~...t~l~... ~ House No. Street Hamlet ~ . Onwer o~ 0 ~e"i~~ of Property.......~!~/ i~,,,,,~,1„ County Tax Map No 1000, Section...[..~.f....B1ock....0..~.......Lot..... Subdivision ....................................Filed Map............Lot.. Permit No.4l.~.~LI..L.J .-Date Of Permit4.``~~ 1~~~Applicant... ~!'rti.!lrX,t , , 30 / S'y Health Dept. Approval ..........................Underwriters Approval~/© ~ 9'~~..,,.,,,, Planning Board Approval Request for: Temporary Certificate........... Final Certicate...!/...... Fee Submitted: $~d,P.O' C ~ ~ ad 3 AFPLZCANT r . 1 d" S N STO anGE S d ~ C~7 Tt . r 6` f IS ~z 9 r I WR~L o°Fai 6f iT 3~ v°{~°~E^ itd'z 0,. 1 `o~r~=- ~ 3~, SncE ~ StnRE z 8' Q ^'-~j Htce55 II 1)ssu JI To TAPS ~N_ om \ • :J ~ 3' Rmrro Pnw~cL. ' \ ARt w 9 ~NRnP „Rea OCCUPANCY OR _ SfPeenle vcnN , _°T USE i5 O~II.A~IFUL ~7 . - z\~ SNuE~ pl. ~sny y~R~~UUT CERTIFICATE IJ ~,~R o~_ cuR:<<ES OF QCCUPANCY alb r~\ \ ~ ~ q y - Dl vi ~~ea Ap fR£C STANOIrJG FINTIf <fs ~ FEE . - 13Y a.~ 1 NOTIFY BUII~dINtY DEFnH7MFNT A7 -I-- 6 - " 134i1.i :N WAtI F:XT4Att ~65.18U2 k3 AM 1'C) ~t Plan. FCJR 7HE ,J./~~ FOLi.,(}W1NCs tN5PEC7IJAiS,' _ - _ 7. FOUNDATION TWO RE(1UtREd - C v e...e r FOR POURED CONCRETE ~ 2. ROUGH • FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST ? BE COMPLETE FOR C.Q. ~ REFlR 17K~w6 f ~ XMRCS ALL CONSTRUCTION SHALL MEET (1 ~ ~ ~ c!~„R ~~~TH THE REOUtREMENTS OF THE N.Y. 11 JI STATE CONSTRUCTION & ENERGY ~ .!`4`?. 1 ca~~*cR se~cwwre Ptn:+r CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS - DReSS~Nt QM bowRS ~ jo~~ Inn'r[11 G'N nP "`SY A~ c'lELD ili~:~C:iU;+ ~~U,;.E I~ ~OaYMfrNT~ , - ,b J 1 . ~ cb H h - - - - H t~ FOUNDATION (1st) (fin ~ FOUNDATTOt•1 (2nd} ~ cep ~a 2. z o O a P,OUGH FRAh1E & h PLUMBING H 3. ~ . r~ m IIJSULATION PER N. Y. • • STATE ENERGY r CODE . y FZiJAL ADDITIOPIAL COMMENT'S: x ` ~p S - `.y. . ' x vJ H b H J O ..Q 2 d [TJ I ~ a .C~s„r _ H i+ O, m ro H 1 5 S THE NEW YORK BOARD OF FIRE UNDERWRITERS l~~"~Y~ LI..aGiCtt>~ BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 'LWi~A+ ?#~,~9gq ~f)Tl92~7S~1Si3 ~t it'?;7~t? Date Application No. on file THIS CERTIFIES THAT only the electrical equipment as described 6elou+and introduced 6y the applicant named on the above application number in the premuea of f?E~'dFII`" N.~S?ll<))$;., I2T, ~~lil`d11--rIP1)t6f, id~Y. in thefollouinq loca(jgnj ~ 0_I Qgxement IJ /st Fl. ? 2nd F'l. .Serlion Block Lot was exornined on @ Y ii and found to 6r in conrplianre with the requirements u(this Roard. FIXTURE gCEPTACIE$ SWITCHES FIXTURES RANGES COOKING DECRS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCPNDESCENL FLUORESCENT OTHER AMi K W. AMi K. W. AMT NW. AMT K.W AMT. H P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS gEll UNIT HEATERS MULTI.OUTLET DIMMERS AMT. K. W. Oll H. P. GAS H. P. AMi. NO. A. W G AMT. AMP. AMT. AMPS TRANS, pMT. H. P SYSTEMS AMi. WATTS S NO.OF FEET ~ f~k) SERVICE DISCONNECT NO.OF 5 E R Y 1 C E AMT AMP TYPE METER I 4W 1 ~ 3W ~.a' 3W 3R' 4W NO OF CC. COND A W. G. NO. OF HbLEG A' G' NO OF NEUTRALS A W C' EQUIP. PER % OF CC COND, Of HbLEG OF NEUTRAL 7. 20~ t;~ I ~ ) ~I~ ~ ~z/fi OTNER APPARATUS: rr~h~:~sra~ar7;~:~.-37 c:re_ o~i~fa T'R.'taL'Si 11TC;~`I'SNTi: ~ 11)C7 I,A'SC[r f;:i1Fa+"4'kT.t` 3,3fi.#~S~SI±; $ (U~-F:. 3d~, .I. ! 9h l GENERAL MANAGER ~5.1 Per 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 MANNER. , ~ FORM NO. 7 ~ ~ 2 n [111 f2 TOWN OF SOUTHOLD D 15 ~l 15 BUILDING DEPARTMENT TOWN BALL ~ t-kB ~ Q SOUTHOLD, N.Y. 11971 TEL.: 765.1802 6LDG. t:r P'L n , TOWN OF SOUTkfOLD Examined ~~.'.a~u~!*.~.. ~ 19 e c e i v e d , 1 9 . Approved~:~~!M+:oN.~.1.1., 19~`~. Permit No. I 8 Sa.",~, ~ „n_ Disapproved a/c V ~ ~ ~ 7g ..tiy~'cw . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date a. ~ . ! 0....., 19 8`). 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 pazt for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depaztment for the issuance of a Building Permit pursuant 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. ~~C.'-~.-~ . (Signa ure of applicant, or name, if a corporation) ..1.°.P..4~ox...7.~.,.MAf .tv~.K.,.N.Y..I.l95z... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...aY,s?:~1 Nazne of owner of premises G Et"fZ,D I.IJ.QLE . . . . . . . . . . . . . . . . . (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 . . Electrician's License No . . v~um au c'a i.iwt~ac ,vv . . 1. Location of land on which proposed work will be done. . ~A.'Sf.t,'~,UGK R -h'P GEtd"~E'~ [OD95...1~1a!nI.'~'?...:MR(rl,fuc.i<.~..^~; 1195~•.........5~-.~~e,~ ~z~ House Number Street Hamlet County Tax Map No. ] 000 Section y'Z Block Lot Z~ . Subdivision Filed Map No. Lot . (Name) 2. State existing use and occupancy of p-rpemises and intended use and occupancy of proposed construction: a. Existing use and occupancy r~,h.T~aL..~V0.~?-clj"~ . p \ b. Intended use and occupancy ....R ~"rAll,....~.I~~e2~§) 3. Nature of work (check whiah~)?Jic ple): New Building Addition , Alteration ..w . Repair .Re'rnd'Sa1~ Demolition Other Work . (Description) 4. Estimated Cost . ~QQ , : Fee . (to be paid on filing this application) 5. If ~welglin , number of dwellin u g , , . , . g g If era e number of cars , , #~its Number of dwellin units on each floor . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . Hei ht ...............Numb if any: Front Rear Depth . 7. Di ~ensions of existing structures,er of Stories . Dimensions'of same structure with alterations or additions: Front Rear . De th 8. Dimensions of entire new constru • Height Number of Stories . ption: Front • • ' .Rear VAl;I E5........ Depth „1.~4......... . Hei ht er of Stories . 9. Size of lot: Front ~ AAA , , . , , , . Rear Depth . 10. Date of Purchase . .....Name of Former Owner . 11. Zone or use district in which prerr~ises 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 i>~ 14. Name of Owner of premises F\4-AH.A ~'~QI~AI,ir , ,Address . ................Phone No, >'e~9-`FL?'~..... . Name of Architect ...............Address ...................Phone No............... . Name of Contractor .............Address , ......Phone No........ , , . 15. Is this property located within 300 feetyyof a tggiuudal wetland? *Yes No *If yes, Southold Town Trus~ees PermitPLOT DIAGKAMed. Locate clearly and distinctly all 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 intei~or or corner lot. i Ii ' it 1TATE O~ N)~ YO~~I i S•,S ~OUNT/T/y OF 4.~,,~7~7~f//.-.. `/(Y,~-,C,e,. <l/ / • • • • • • • • • ti • • ~ • • • ~ ~~".`p• being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) :hove named. Ieisthe (Contractor, agent, corporate officer, etc.) ~f said owner or owners, and is duly (authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the pork will be performed in the manner s,et forth in the application filed therewith. 'worn to before me this 0 Iotary Publ' ~ } ~ ' County • CAROLQUYTpN' (Signature of applicant) Na1'ARY PU8U4 St6U of ~Isw York No. 82.4812668 - 8 CommiealonEq~keir