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Home My WebLink About21287-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22226 Date MARCH 26, 1993 THIS CERTIFIES that the building. Location of Property 10095 (2E) MAIN ROAD House No. ALTERATION MATTITUCK~ N.Y. 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 MARCH 9, 1993 pursuant to which Building Permit No. 21287-Z dated MARCH 25, 1993 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 #2E FOR TANNING SALON "AS BUILT" The certificate is issued to ALAN CARDINBL~ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N-581485 - NOV. 11, 1982 Rev. 1/81 IIP~ORM NO. B TOVv'N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~N°. 2128TZ Permission is hereby granted to: ................................... ................................. County Tox Map No. 1000 Section .... /...~..~. .... Block ..../_ ................ Lot No .....,~..~.. ........ pursuant to application doted ................. ..~...,~. ...... .~... ...... , I9.~'~.., and approved by the Building 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 inspect6r 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-exist~ng" 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. 2. 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... e~-~'.'.~.~.. ~.~...fZ,/. ~.~.~. ............. .ew Construction ........... O1~ Or Pre-ex~ting Bu~ding ..... ''~'''''~-o..- ,oca~ion of Property..~..~.~....~.'.~.]~..~.../~.:..~..~.'./.~ · House No. ~ Street , H~t ...... nwer or Owners of Prop rty .... 4.. .; ................ ounty Tax Map No 1000, Section..~ ....... Block ........ Lot. ubdivision .................................... Filed Map ............ Lot ..................... ermit No~..~7 .... Date Of Permit ealth Dept. Approval ..................... ....Underwriters Approval? ..... ~..~..~.~.~.~] lanning Board Approval ........................ equest for: Temporary Certificate ......... · Final Certicate ......... ee Submitted: ~_ooo3~5 THE NEW YORK~ BOARD OF,~i:.FI ['-~]_,1,[ "' 85 JOHN STREET; NEW YORi~,~ NEWr ~O~K 10038 THIS CE~IFIES THAT FIXTURE OUTLETS SWITCHES DRYERS FURNACE MOTORS IKJ?URE API'%IANCE FEEDERS' MULTI-OUTLET DIMMERS SYSTEMS ,Ho. OF PEET' SERVICE DISCONNECT OTHER APPARATUS: ~ : !! !U ~ ~t ~ iq ~it [[ ~is ceffificale must not be alfered ih any manner;, FoRM NO.'I" TOWN OF SOUTHOLD .'BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ................ ,19... Approved ~/~j~t~t,..~.4~..., 19~. ,~.. Permit No..~../. ~..~..7 Disapproved a/c ' ' HEALTH ' BOARD OF ......... 3 SETS OF PLANS SURVEY ................... ClIECK .................... SEPTIC FORH CALL ................... HAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by WPewriter 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 tot 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. ¢. 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 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. - (Signature of applicant, or name, if a corporation) .' (Mailing address of applicant) . State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder} ''&~ · (as ~n ~roll or latest deed) Name of owner of premises .~~..~{..~~'. .......... 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.~TZT~~. .~...~..~....&. Other Trade's License No ...................... 1. Lo_cation of land on which proposed work will be'done. : . .. '"House Number ............ . Street ~ Hamlet .............. County Tax MapNo. 1000Section .../~ ......... Block ...... l ........... Lot...~.6 ............ Subdivision ..................................... Filed Map No. Lot (Name) ............................. 2. State existing use and occupancy ofp~ses an~ intended use and occupancy of proposed construction: a. Existing use and occupancy , ~~ use ............................ -3. Nature of work (check which applicable): New Building. ' ..... Addition Alteration .......... Repair .............. Removal .............. Demolition .... '.'. · ·; .....Other Work ............... 4. Estimated Cost .~-.../. fi-/..~ ~ ' '" ,¢...-_- (Description) 5. If dwelling, number of dwelIin,, uni' ~/ /L (to be paid on filing this application) . If garaoe, number of cars ber of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature 7. D,mensmns of existing structures if a-- '- and extent of each type of use ~. ~ ............... c~umoer of St,,,-;oo ..................... L~epm ... l~mlensions of same structure with alterat?o';'i~r' JJJi}i'o'n'sl Front .; ............. Rear ''' · Depth ..... ' ................. Height ............ · ......... '.. Number of Stories ............ ' 8. Dimensions of entire new construction: Front ............. Rear De th 9 oHeIght..'; '- ........... Number of Stories , - ' ' ' .............. P ........ ' ...... · raze otiot: l~ront .............. ~ .....'.. Rear ................... Depth ~ ' ..... I0. Date of Purchase .......... ' .......... . ........ Name of Former 2,ner .. I 1. Zone or use district in which premises are '~ situated ~ 2 ................... !,~. Does proposed construct;~-.: ...... '~ ~'¢ ~ '~.?~..',2~...-:. ~. ,.~.~-.~.'~. ' .... s,.,sa wu~ate any zoning law ordina -- 13. Will lot be regraded · , nce or regulfition: ....... ' ...... ~4. Name Willexgqs. s filj, be.removed from premises: p~ame of Contractor ................ j ......... ~,rl,~r~:: .................. ;hh~nn; ~,/o° ............ ;... 15.' Is th±$ property within 300 feet ;'f' ~' 't~t~'l'-~; .... '0 ............... · *If yes, Southold Town T ......... tland. *Yes ........ u~ ' ............. '' ~uo~ues ~'ermlr may be required. ' ~'~ ......... .... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all ~et-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or coruer lot. .. STATE OF NEW YORK, ~ ~ :OUNTy o~ . . ..5.. q g Foc_l~ ~.~ ........ (Name of individual signing contracti .......... ~bove named. being duly sworn, deposes and says that he is the applicant leis the .., ' ' ontractor, agent, corporate o ' ' (C ~cer, etc.) ................... ~f said owner or owners, and is duly authorized to perform or have performed tile 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 /ork will be performed in the manner set forth in the application filed therewith. worn to before me this /.0. ..................... day of../)q...O, rca ................ , 19 · . '' ''x ..... '. County ~,,'// . //~ County, NY #01 FA4§g177.7, .. C0mm ssion Exp. 2-10-97 (Signature of applicant)