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Home My WebLink About20877-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20923 Date AUGUST 7~ 1992 THIS CERTIFIES that the building Location of Property 10095 MAIN ROAD House No. County Tax Map No. 1000 Section 142 Subdivision ALTERATION MATTITUCKr N.Y. Street Hamlet Block 1 Filed Map No. Lot 26 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 6r 1992 pursuant to which Building Permit No. 20877-Z dated AUGUST 6~ 1992 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 STORE #11 TO BANK OFFICE AS APPLIED FOR The certificate is issued to ALAN A. CARDIN~LN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 246652 AUGUST 1992 Building Inspector Rev. 1/81 FORM NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJ~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO-N.o 20877Z Permission is hereby granted to: ..~..~.~.k..~~.....,J.~..~.~ ....... .~xL.~.......~t...: ................................................ ...~~.....~..:.~:......~.~..~.~ ................. ~o...~....~....t....~.~ ...... ~.....~......~.~-....~~ ........ ~ .......... ...... ....................... ...... ....... ..... County Tax Map No. 1000 Section ..... ./.~....'~.. .......... Block ...... ..~....( ......... Lot No .......'~....~. ........... pursuant to application dated ...... ..~..~,~..~......~R ............. , 19.~...~T'., and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FORCERTIFICATE 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 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 an~'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 ..... '~'~"'~i~'''/'~'~'~' ................ · ';ew Construction ........... Ol'd Or Pre-existing Building. Location of Property~ ..................................................... ~.- ....... - .......... ~. House No. Street Hamlet 9nwer or Owners of Property ...... ~....~'...~.A~['~4~.~ .............................. ?oonty Tax Map No 1000, Section ..... /.~.! .... Block ..... 1 .......... L°t..~ ~nbdivision ...................... ' ..... ~ ........ Filed Map ............ Lot ..... ~ ............... ~ermit No ................ Date Of Permit.. ~. .Applicant ........... lealth Dept. Approval ........... .~l~. .......... Underwriters Approval ......................... · Jv.. 'lanning Board Approval ............ ",equest for: Temporary C~rtificate ........... Final Certicate~ ....... THE NEW YORK BOARD OF FIRE UNDERWRITERS p^c.~. ~ ~.~.~ SUREAU OF ~_ECT.,C,TY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date A]~yU~T 1~ [~ ~pplication No. onfil~ ~34B2792/'9~ ~ 246652 THIS CERTIFIES THAT o~ly the el~tric~ ~ulpment ~ ~scri~ be~w and intr~uc~ by the applicant ~med on the a~ve application number in the premhes of BRI~EI~TON NATION.~3~, 11 ~.~IN ~., A~& P. SH~PPING CE~ER, f~I~3C~, N.Y. ~s examined on AOGUST 10,1992 and found to be in compliance wltb the require,tents {~f thi.x Board. F XTURE [ L I FIXTURES RANGES C~K NG DECKS OVENS DISH WASHERS EXHAUST FANS AMT. K, W. OIL H.P. GAS H. P ~T NO. A.W.G. AMT ~P. j ~T. AMPS. TRANS. AMT H P. NO. OF ~ET AMT. WATTS ITHER APPARATUS: BATTERY PAC~3 JODY PUt{, PAT LANE MATTITUCK, N'Y', 11952 LIC. #27~O-E GENrd~AL MANAGER 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. ?OUNDA'TION (1st) ~OUNDATIO|! ( 2nd ) :OUGH FRAME & -PLUMBING _ ti ~NSULATION PER N. Y. STATE ENERGY CODE FI~;AL It ADDITIONA'L COMMENTS: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 cd~ TEL.: 765-1802 xamin · Approve~{J. ~F- 7_ .,, 19~.~ Permit No .c~...O.?.~..~..'~.. Disapproved a/c ..................................... ................................ ....... _ .. (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEAL'I'll ......... 3 SETS OF' PLANS .......... SURVEY ................... CHECK .................... SEPTIC FORH NAIL TO: INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 -'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 r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. ¢. 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 hall be'kept on the premises available for inspection throughout the wbrk. e. No building shall be occupied or. used in whole or in part for any purpose whatever until a Certificate of Occupancy tall 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 uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. he applicant agrees to comply with all applicable laws, ordinances, building code~ housin code and re-ul ' Jmzt authorized inspectors on premzses and m building for necessary inspections.f/] gt ' ~atmns, and to .... , · . .... ..... -- : (Si~,nature of applicantyol n]~n'e] if a co'/~(}ia~i'o'n') .... (Mailing address of applicant) tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. :amc of owner of premises ... ~.. ~.~.~. t~. A:..~...~..l:0..~-. yt~. ........................................... (as on the tax roll or latest deed) 'applicant is a corporation, signature of duly authoriz'ed officer. (Name and title of corporate officer) Builder's License No ........... ~ .............. Plumber's License No ......................... Electrician's License Nb ....................... Other Trade's License No ...................... Location ofland on which proposed work wili be'done .... ..~.¢~jtq(y fl~._]~[,2/O~ 0t~l'~. ~. ti ..... ' .................. ..... h.'/?.il iiiiiiiiiiiiiii ii ii iiiii llouse Number Street ......... Ha~flet ' ' ' Cot,nty Tax Map No. 1000 Section ..... I .1~..~. ........ Block ...t .............. Lot..~.g. .............. Subdivision ~ ................ (~'a~fi~) ................ Filed Map No ...... 7 ....~.... Lot - State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........... :¢~,~-~.a~.~. .... ,~.~ ................................. b. Intended use and occupancy '(~..k 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration(~...' .... Repair .............. Removal .............. Demolition ............. Other Work ............... 4. Estimated Cost .... .~/j.~ '"--- (Description) ......................... Fee 5. If dwelhng, number Of Jwelling units ----- , .... (to be paid on filing this application) · · .............. c~umoer of dw,) ' · oor · If garage, number of cars ..... elhng units on each fl ................ 6. If business, commercial or mixed occupancy, specify nature grid extent 0'f'e'a~it~;~'of't~s'e' '/_' .~'~'.'a.' '~. ....... 7. Dimensions of existi~g structures, ifany. Front .,, ...... Rea ..//... i~¢~TM °f sam~..cturNeUw~tb~°:i~:?onne; or a..d~itions: ~ro~[ .... ~' 'l' ......... ~: ;~): .......... 8. Dimensions of entire new construction: Front Height ............... Number of Stories ......... ' ..... Rear ............... Depth ....-~.~. ......... 9. Size of lot: Front ............................................. i .......... I0. Date of Purchase ...................... Rear ...................... Depth · . '-. ............ -::.7... ......... ' ..................... 11. one or use &.strict in which premises are situated .... .N.a.m. ~ 75.F.°..nn..e.r.?7.n.es. ii ~ ."~.' i i: ~ i i .................. 12. DZoes proposea construction violate~ny zoning law, ordinance or regulation: .............................. 13. 14. ~ila~l la° to ~) ~; doefdp r ~ ~n'i~ ~s .... ~k] .~. ............. ~'d~ill excess fill be rem°red fr°m premises: ~ Yes ~'~ ..................... ress ................... Phone No. ~.fO?:~.y.~.e/...~.. Name of Architect ................. t .... Address . · ''. .' ...~.i~i i ................. Phone No. ..... ~Yf yes, Southold To~n Trustees Perm±t may be required. .... PLOT DIAGRAM 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 interior or comer lot. 0I: OCCtl?~C~ APPROVED AS NOTED , DAlE. ~"1 I & · ~E:~ w,,: fi, ~. NOTIFY 8U)LD)NG DEPARTMENT AT ~ 7654802 9 AM. TO 4 PM FOR FOL. LO'¢~NG ~NSP~CTtOf4S: 1. FOU~ DAT.ON ~,VO REQUIRED' ~/ . ~ ' [ 3 iNSULATiON S%~TE OF NEW YO~ ~ S ' ----"~' ' ' / ~' S S ~ ~ -- - 8E CO~?L.E'rS FOa C,O. COU~y OF _~ ~ ~ · // ~ ~ ALL CONSTRUCTION SMALL .... ' ............ ;"~ be' ~ · e E N.~ (Na~t) ~~ ~' ~ ~ '~g ~SP 1 hcant ....... · ........ m duly s~ r~ s~t ~ T~ I ' · ,bore named ~--- ' - ......................... ............ ( ~ractor, agent, corporate officer, etc.) .... said owner or owners, ~d is duly authorized to perform or have performed tlie said work and to m~e and file this :pplication; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the york will be perfo~ed in the manner set forth in the application filed therewith. ;worn to before me this ......... ..... o-:.'.¢av* .... ~ '/F ~2 ' ~' *~' .....* ...... '.~.. :~....County ~/J - . ...... .... . ....... ~ 47~9, ~ ~'. ~ 'gnature of applicant)