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Home My WebLink About17009-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17096 Date JULY 19~ 1988 THIS CERTIFIES that the buildin~ ALTERATION Location of Propert~ 10305 MAIN ROAD A & P SHOPPING CENTER MATTITUCK 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 MAY 3, 1988 pursuant to which Building Permit No. 17009Z dated MAY 18, 1988 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 STORE 12B TOTALT~ TONED, ALTERATIONS IN EXISTING BUILDING The certificate is issued to ALAN A. CARDINAL~ (owner, X~) of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. PENDING 7/18/88 PLUMBERS CERTIFICATE NO. N/A Building ~Inspector Rev. 1/81 FORM' NO. 0 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) No_ 0!7009 Z Dote ..~.. ........................................ ;~.~....~ Permission is hej'e, by granted to: ,o.~~~~....~~.,.~....~~ .......... ~ ............. ......................................................................................... ~, ~re,,,e, ,~,,~ ~, ~ ~.....~.~~~.....~ ................... ........................................... ~.~..~ ...... ~::.....~ ............ ". .................... - .................... ............................................... ~~~~.L..~.~ .................................................. p~,~o,t ~o op~ti~tSon dot~ .......... ~/.~ .............................. 19~., o~d oppro,~ by t~e Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted I~ to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5.Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occQpancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory '$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 .~..~ 5.Updated C.O. $ 50.00 Date ..... &.~.i.~'.~ ........ New Cons truc tion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ~/-f [-~)di' ' /'J '' Z ~ ~c_ . ' House No. Street '' ~l[i~iet Owner or Owners of Property ....~..~. J ..~..~.... ~ ....(~ .1~ ~-.~..~.~ :~.~.~..~. [..--(~.~ .................... County Tax Map No. 1000 Section ...~ q ~ Block .(~). J Lot ..... 2 ~ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. (~.).'~.~.0.~.. Date of Permit .5.IL '/.¢' ..App,icant ~',_~'/O.~Z ~...~.~J.c/~.~.~¢~ .... Health Dept. Approval , ....................... Labor Dept. Approval .... ,~.L/,..~". ............. Underwriters Approval ........................ Planning Board Approval ....~././~?~ ............. Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building~:~oer, mLi;~.e~t.s all applicable F..pdes and regulations. ~OUNDATION (1st) ~OUNDATION (2nd) tOUGH FRAME & .PLUMBING iNSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORM ................ NOTIFY CALL 20.' .......... TEL.: 765-1802 ~,~/~ a¢:~!~ MAIL TO: 4amined ?.l./.' ............ 19 ~pro eu .~., ................... ¢' . !iLJ)i ...... !111 .... ..... td : ..... .......................... ~...~'"~ ~ ~ /~ | F, LDG. DE:, "r .... / iidingInspector .... ....... APPLICATION FOR BUILDING PERMIT Date ................... 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 Is 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 areas, and giving a detailed description of laYout of property must be drawn on the diagram which is part of this appli- tion. 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 ail 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 all 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 ailding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or zgulations, for the construction of buildings, additions or alterations, or for ~emoval or demolition, as herein described. '.m applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to Imit authorized inspectors on premises and in building for necessary inspections. · .~5o.q.e:-.q ~..4~..r.~.. ef...m.,.~.:~.cA.. ~.T.~... (Signature of applicant, or name, if a corporauon) (Mailing address of applicant) tate whether applicant is owne~ agent, architect, engineer, general contractor, electrician, plumber or builder. :ame of owner of premises .../~ .~. · ./L//.../i~ ...... C/~..~. ~Z~/~J..~ ~ ............................ (as on the tax roll or latest deed) ~ apl~licant 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 ....................... Other Trade's License No ...................... Location ofland on which proposed work will be done. · ,,Q~t_~ J2: ~ ..~.~cp ..~..~.Vfl(~.~.C&, ................................................. House Number Street Hamlet County Tax Map NO. 1000 Section ..... /..C/. ~ ........ Block ....(_.9../. .......... Lot ..... .2....~. ...... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy....~.../~'t..~...~.//..~.~ ........................................... b. Intended use and occupancy ~ /~¢'V~ ~' ' ' ~ '~ ' ~4~'r ' ~ .......... 3. Nature of work (check which applicable): New Building ' Addition .......... Alteration . ,A~.:. Repair ,, ............. Removal .............. Demolition .............. Other Work ............... /2 .~, ~ (Description) 4. Estimate'd Cost .................................. Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner ............................. 11. Zone or use district in which premises 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 No 14. Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ........................... Address ............... .'... Phone No ................ Name of Contractor .......................... Address ................... Phone No ............ :. ~. ... PLOT DIAGRAM ~i 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 corner lot. STATE OF NEW YORK, COUNTY OF ................. S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the (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 contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ........ .~. .... day of ..... .~..'~. .......... 19 d Notary Public ..... ~.-:~ff....'~:.. './0.et...~/.¢~..~ ..... County . NOTARY PUBLIC, State of NO~ Y~ (Signature of applicant) No. 47078'/8. Suffolk Term Expire~ M~rch 30, la r ? fco~per tubing is used for water distributing system; piping shall be of types K__or L only OCCUPANCY OR USE IS UNLAWFUL ~,~~ -~,',.u~ CERTIFICATE PLUMBING ALL PI.UMBING t'M~E & WATER UhE~ NEED TESTING BEFORE COVERING PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY .~OLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of I% LEAD. APPROVED AS NOTED , DATE~'"~---~ Bm P # ~L..~,~ 765-1~2 9 AM ~ 4 PM FOR THE FO~O~NG INSPECTIONS: 1. F~ND~ . ~R~RED 4. RN~ - ~~NM~ ~ ~~ ~R C.O. ~. ~~ ~