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Home My WebLink About17780-Z - FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22221 Date MARCH 26, 1993 THIS CERTIFIES that the building ALTERATION Location of Property 10095 (18) MAIN ROAD MATTITUCR, 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 JANUARY 23, 1989 pursuant to which Building Permit No. 17780-Z dated JANUARY 26, 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 #18 FOA CHILDRENS CLOTHING STORE The certificate is issued to ALAN A. CARDINALE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROPAL N/A UNDERWRITERS CERTIFICATE NO. N-643587 - MAY 10, 1984 PLUMBERS CERTIFICATION DATID N/A ~11~( G~1~~y1~• o Building Inspector Rev. 1/81 f'OBa! NO. f TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 017 7 8 0 Z DateG/~Z~:,......~ ~ 9..~y. Permission is hereby granted to: ~i7 .......G!~~..~.~J!-.........t~7.j....MS,..e .......~.~.~,,,7.~......1......1 G~~.... ..................:1.~...................................................................... ct premises located at .......~.Q..Q....~.J~. ..........G~~,.~%.Y,1.. . Caunty Tox Map No. 1000 Section ...~..~..,y~.... Block .........1............ Lot No...~...:4~.......... pursuant to application dated ........C~~~~j.L(Y.~............~..~......, 19.~~ and approved by the Building Inspector. ~J , Fee $....~.ll~',~.~/...~ .7~...~. y~.Y~--- Bu (ding Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD , BUILDING DEPARTMENT TOWN HALL 765-1802 ' . ~ 0~~;-~ APPLICATION FOR CERTIFICATE OF OCCUPANCY; t.... 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 - $50.00 5. Temporary Certificate of Occupancy - Residential ,$/'1y5-.~0,0, C~,oommerpcial $15.00 Date .....:./.:1~~.~:=N.~1~.~9~3... New Construction......~..n... cO.l~d- O~r Pref~existing B?u~i,,,l~ding..../~ Location of Property:l.~/G~r~C~t-lyc;~°~,1,~~,.4~7/!c~ , C.~, , ~"~-,?~~7 , : l.~l.G.~~..`~[K~, , , House No/~~.. Street Hamlet Onwer or Owners of Property...(;,~d:4~~:~:..~:..C..Q~~~ County Tax Map No 1000, Section. lT..'2 ......Block.......~........Lot.....°~~ Subdivision ....................................Filed Map............//Lot...................... Permit No.~.7 .,Date Of Permit ................Applicant...,L~~ O.. Health Dept. Approval....... ...................Underwriters Approval...~Q,7.•,F/,.(,1..~ „ Planning Board Approval Request for: Temporary Certificate........... Final Certicate.~...... Fee Submitted: $ ~.Q<Qd t e0 ~~~~r APPLICANT FIXTURE SWITCHES OUTLETS DRYERS FURNACE MOTORS AI~AN~ I~EEDER$ SERVICE DISCONNECT! OTHER AF~'AIATUS '~' i l;' . I ,l I I :: I !~1 ~ ! :i :! ~i !q ~il.:!iI:!!t :1t1:: ill t!l..ll : ~i :I., '~ I! II! !l' Ii:.Itl -Iii :tit:Ill ; ~, i, : III/:PI:HII~ III ~;i - :~ ii: {!! _ H Ii il !l{:lt :P ! I!l ii~ :Il' ;t Th s certificate must not be a tered n any manner) t:' ilks II:~L' .,:-I I 5~IIIL I{! Ili!:bi {~i UNIT HEATtES MULTI-OUTI~! DIMMERS }Ii EYETIM$ NO. OIl }lit II :Ill ~ f: ~i }l':llt Ill sLIl~ Ill Il Il I: II ::dll:: Lzlll iii; I!l::lll .::llt.::~ll 11:~:lil~lll:7 !II-:Ill: liE: IIl::~ltl:~<tll :: Ill:iIiIzPl (-!l,.~lll}!Ilt: IIZlll LIP&II{ c'lELD I;:S: ~O:lu:I ~~Ui.i ~UiKMENT~ -o 1 . . H O. _ - - - HC FOUtIDATION (1st) -1` FOUtIDATION (2nd) 2 . z o , C P,OUGH FRAME & o ~ U PLUMBING . '3 x_ N Z H 3 . m mb . H IIISULATIOPI PER N. Y. v STATE ENERGY ~ f CODE ' x ' a , 4. c FIi1AL ~ - I O ~ ADDITIONAL COMMEII x a S 7 . [+7 X 'b ~ H R ~ c H ~ H ~ O C r • x m a r H - _ d m -o H BOARD OF HEALTH . FORM NO. 1 3 SETS OF PLANS , , - SURVEY _ _ _ _ " TOWN OF SOUTHOLD CHECK ~ • _ ~ ~ ~ ' ' ' • BUILDING DEPARTMENT SEPTIC FOR:I - TOWNHALL~ • SOUTHOLD, N.Y. 11~J71 NOTIFY ~t+OJ TEL.:7G5-1802 CALL E~aminc~/~~Yt.h~(v...., 19!~e!./ ~ PIAIL T0 : Approve/~ l 194.~crmit No.O l~~. ~r~~~~ . Disapproved a/c - (Building Inspector) y/~`^ T/J APPLICATION FOR BUILDING PERMIT q - Date .....I.`Z~........, I5~1 INSTRUCTIONS . a. Tltis application must be completely filled in by tgpewriter 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 to 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. e. The work covered by this application may not be commenced before issuance of Building d. Upon approval of this application, the Building ~ Permit. o Inspector will issued a Building Permit to the applicant. Such perm 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 Occupanc shall have been granted by the Building Inspector. APPLICATION IS HEREBY b1ADE to the Building Department for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Re__^_ulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describec The applicant agrees to comply with all applicablle laws, ordinances, building code, housing code, and regulations, and t; admit authorized inspectors on premises and in building For necessary inspe ti ns. 7 . .(Si;nature of applicant, or name, if a corporation) ~ ~ • ~ 30 ~ _ . .x..7:7..Y!'1.~~ N y it 9 5 (Mailing address of applicant State whether applicant is owner lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of otivner of premises A ~-,A. ~ A ..~.~.R I? .f. N A (mot- . (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. ~~~f~~~' f'........... Electrician's License No. Other Trade's License No. . 3. 1~'ature of work (check which applicable): New Building Addition Alteration . Repair Removal Demolition Other Work~,r.L~Ly4~, , . . 4 i~yyy'ZLJL(, ~~~j. ( (D:acription) 4. Estimated Cost ../~j ~ Fee . ~l.~ ~fl/..,0'.~ . (to be paid on films this application) 5. If d~vciling, nurnbcr of dwellins units Number of dwelling units on each (loot . If Sara.c, nurnbcr of cars ~ ~ ~ ~ ' ' 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use • 7. Dimensions of cxistins structures, if any: Front . •Rcar Depth . Height Number of Stories _ ~ ~ ~ ~ • Dimensions of same structure with alterations or additions: Front Rcar . Depth IIcight . .Number of Stories . 8. Dimensions of entire new construction: Front Rear .Depth Heigltt Number of Stories . . 9. Size of lot: Front Rcar ......................Depth . ]0. Date of Purchase .....................Name of Former Owner ~ • 11. one or use district in ~vhicli premises are situated . 12. oes proposed construction violate any zoning law, ordinance or regulation : . 13. \Vill lot be regraded " " • " " " • • • • • • • • • • • • • • • 1Vi11 excess fill be removed from premises: Yes Nq/ 14. Name of Owner of premises ....................Address P}ronc No........ . Name of Architect ...........................Address .Phone No. Name of Contractor . .Address .Phone No. lS.Is this property located with in 300 -feet of a tidal .wetland? =YES....NO. *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAb1 Locate clearly and distinctly all buildinss, 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 corner lot. . STATE OF \E~V YORh, COUtiTl' OF S.S ~r~~ ' f.L' ' being duly sworn, deposes and says that he is the applicant ('\an:c of individual signing contract) 7bovc named.