HomeMy WebLinkAbout28403-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30489 Date: 10/08/04
THIS CERTIFIES that the building ANSEL SYSTEM
Location of Property: 7850 MAIN RD EAST MARION
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 31 Block 6 Lot 17.2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 17, 2002 pursuant to which
Building Permit No. 28403-Z dated MAY 20, 2002
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 INSTALL AN ANSEL SYSTEM AS APPLIED FOR.
The certificate is issued to BRUCE GARRITANO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 04-5111 07/14/04
PLUMBERS CERTIFICATION DATED N/A
c
i
Authorized SQ9nature
Rev. 1/81
FORM NO. 3
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)
PERMIT NO. 28403 Z Date MAY 20, 2002
Permission is hereby granted to:
BRUCE GARRITANO
15 WEST END AVE
EAST QUOGUE,NY 11942
for
INSTALLATION OF AN ANSEL SYSTEM AS APPLIED FOR
at premises located at 7850 MAIN RD EAST MARION
County Tax Map No. 473889 Section 031 Block 0006 Lot No. 017 . 002
pursuant to application dated MAY 17, 2002 and approved by the
Building Inspector to expire on NOVEMBER 20, 2003 .
Fee $ 200 . 00
Authorized Si ature
ORIGINAL
Rev. 5/8/02
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
\, APPLICATION FOR CERTIFICATE OF OCCUPANCY
This applicatio mu e filled in by typewriter or ink and submitted to the Building Department with the following:
A. 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 I% 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 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- $100.00
3. Copy of Certificate of Occupancy-$.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00
Date. �w WJ C)1(1. I Fs, ZLO i l
New Construction: Old or Pre-existing Building: (check one)
a
Location of Property: �gbo -�(�kJ(L�
House No. /� Street Hamlet 'l a 3q
Owner or Owners of Property: ( a0i) X 1±,CLnn
Suffolk County Tax Map No 1000, Section �U Block 0(n .(1C Lot 0\-1 �(»�
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:�����X
Health Dept. Approval: Underwriters Approval:
Planning Board Approval: /
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
Applicant ure
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Electrical Inspectors, Inc. 04-5111
308 East Meadow Avenue Municipality: Southold.Town Of
Last Meadow,NY 11554
Office:(516)794-0400(631)396-7474 inspector: i 22
Fax:(516)7945854 issue Doe: 7/14/2004
Website:www.clectricalinspectors.com
Emil:infa@ekciricalinspcstots.com
Mail To. Property Addrebis:
East Counry Eketric,Inc.
William Oster/Bruce Oster Blue Dolphin Motet
PO Box 2620 7850 Main Road
Aqueboque,NY 11931 East Marion,NY 11939
Licetmo: 1005E
ELECTPICAL APPR 0VAL CER TI-I.7CATE
AREAS LISTED BELOW ARE APPROVED BY INSPECTION
AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
No visual defects wero found for dic elecuical inspection provided.No obvious unsatisfactory conditions were found in the areas
herein below only.
Commercial A-vactiort
I-EdmustFan,I-Motor.
^ Nat valid unless signed by an
0 sot 'zed Ell Agent
'lflig",- - - l
Richard M.BivOtIC Philip F.Goehring
YL—P I
Chief Electrical Inspector
President
Tooe ZST096COTS YVd 9t:tT 60/ST/LO
2 � yo3�
7ss-1e02 II
BUILDING DEPT. '
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]AN"TION
[ ] FRAMING [ FINAL �
[ ] FIREPLACE 8 CHIMNEY
REMARKS: � �� • ��'^'' --�
DATE INSPECTOR�/�*
4 Lue 'bot�')
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING ] FINAL
[ ] FlREPLACE & CHIMNEY FIRE SAFETY INSPECTION
REMARKS:
ba es
l W�I�S Id.�G ' OCJOZu��
mt�l �4-tiChc�S� ��•
DATE -712-d o INSPECTOR oi I
FIELD INSPECTION REPORT DATE COMMENTS
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FOUNDATION(1ST) -_--
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--- _ (113)
FOUNDATION (2ND) - -
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PLUMBING --- -- --- ---- ---- .. y
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INSULATION PER N.Y. -- - - - - - --- - - -- --_ y
STATE ENERGY CODE
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FINAL ---
ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying;
TOWN HALL Board of Health
SOUTHOLD,NY 11971 3 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 2 Survey
PERMIT NO C �/u C chec
Septic Form
_ N.Y.S.D.E.C.
Examined _ 20 20 2 Trustees
Contact:
Approved - 20 Z. Mail to:
Disapproved a/c
Phone:
Expiration 0
Building InsPR�
MAY IS !
-- APPLICATION FOR BUILDING PERIVIIT
BLDG.DEPT.
S QW LD
,
INSTRUCTIONS Date 20
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 waterways.
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 issue a Building permit to the applicant. Such a permit
shall be kept on the premises available for inspection throughoutthe work
e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate.of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the
property Have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an
addition six months. Thereafter,a new permit shall be required.
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$outhold, Suffolk County,New York,and-other applicable Laws, Ordinances or
Regulations, for the construction aof
ll
applicant agrees to comply with all buildings,additions,or alterations or for removal or demolition as herein described. The
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)
7g50
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder
c,�►J�r
Name of owner of premisesus�
(As on the tax roll'or latest deed)
If applic 4ac n, tune of duly authorized officer
(N �tit�leof corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
15�
House Number Strom
County Tax Map No. 1000 Section—.031,Q0 Block_(
Subdivision Filed Map No. Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy
T4s IeF- �
b. Intended use and occupancy ' o &1-41
3. Nature of wo k(check which appli le):New Building Addition Alteration
Repair Removal Demolition Other Work
oa (Description)
4. Estimated 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 fear
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 g'A7-O 1 Name of Former Owner 042leAU�;II 'ok;A
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO
13. Will lot be re-graded?YES NO Will excess fill be removed from premises?YES NO `
14. Names of Owner of premises Rroc•. s a Phone No. '177-0c07
Name of Architect (41.6yj6, Address S10__P 0 f0A Phone No—'7A6- l 6n
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO
* IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C.PERMITS MAY BE UIRED.
b. Is this property within 300 feet of a tidal wetland? *YES NO
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate fouridation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey.
STATE OF NEW YORK)
COUNTY OFIOA"
&uC& l rarr.\2-_00n _ M-5A>pIr being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)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 20 6
'NotIfy Public Si f Applicant
LYNDA M.BOHN
NOTARY PUBLIC,State of New York
No.01B06020932
ouaiified in Suffolk Cou
Term Expires March 8,20
Duct to extend 18"above roof.
Fan discharge to be 40"above 2000 CFM Upblast -
roof minimum. f Type Fan
Job- Blue Dolphin Motel
Wood Roof —Grease Catch 7850 Main Road
East Marion,NY 11939
System Make$Model
Pratex 2000 L400016"x 14"16 ga.gal Contractor: All Courdy Fire Protection,Inc.
P.O.Box 90 _
314"Mechanical
welded duct East Moriches NY 11940
.-
Gas Valve 1-631-874-3279 -
360 Dgeree Fusible Link
D D D — Located in hood
NL2D
NL1 H 6'x 36"x 24"18 gauge �!
—SIS welded hood wl
L2L NL2NL1H NL2H
S2a, ► L7�'
OCCUPANCY OR NOTIFT BULDW DEPARTMENT AT
Manus USE $ UNLAWFUL + "11.1N! • AM TO B PM FOR THE
14LL0111MIII M ECTIONS:
Pull nr-77171n WITHOUT
�CERTIFICATE � FOUNDATION • Two REQUIRED
Fryer Griddle Grill 2 Burner OF OCCUPMC iKIRPOUI�IED
Nates: CONMI
14"x14" 42"x24" 24"x24" 12"x 24" 1 ROUGINSH
TION ING A PLUMBING
1)These plans are typical and not to scale t FINAL • CONSTRUCTION MUST
2)All pipe is 318"flack 1119 ATE FOA C.O.
3)Hood Is to overhang appliances by W AIL CONSTRUCTION SHALL MEET
4)This system is designed to LL300 standards TME IIEQUIREMENTS OF THE N.Y.
5)Ail work is to be performed in accordance to STATE CONSTRUCTION A ENERGY
NFPA 17A and 96 CODES. NOT RESPONSIBLE FO
6)AN electrical work is to be performed in accordance 3„Air Gap Grease Cup
with NFPA 70 and all other codes OESIQN OR CONSTRUCTION ERR
7)AN outlets by hood to be GFCI protected Back Wall Is SIS on double 518" NE
Sheetrock on metal studs W
Appliance yet" fps D. R
T .
FIRE INSPECTION
REQUIRED BEFORE UNDERWRITERS CERTIRCATEF R ' o43g°'P���o
OPENING REQUIRED oFESSION
BKAiJL
STEPS
2ND STY �► $
m i OVHG. ca 6
4 g 11 O e U.P.
14•x. 24.7'
)T
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o ^iI &4MOMM Wr SWM MW UMJTY POLE LOGAnOM ARE NOT t fAUOMREEA
4. O 7W OMET DAADOWN SM W MEA'aw FROM W S7RlJCnms TO 7ME PRt7PER7Y LAVES
6 O
ARE FW SPECIFIC MAWOW AW US& IMMUi71RE ARE NOr WV$PM M MW 7N£
0 tq OWCWN OF n NCES RETAINWVG WALLS POOR$ PAWS PlAWW AREA%
x CONC- DRIVKWAY T AOOMM 77 R& W GS AND OMM COMSfl7tACnM 7NF GaSnDN" OF RIGM
106 OF VAM WMANDS
C.0 WOOD STEPS 1C 90 ARE NOT GXAARAw►1EFD ANDAOR FJISE7IfN1S OF RECORD. JF ANY NOT SHOW
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OD .- �j-�q��S dt� O@` �ANMu►++ovarz�n ALrFRA77aN OR AaomnN ro MIS SURVEY IS A wau7�oN of
ASPHALT PARlCDVG AREA WOOD 004t! �- W O SECTION 7208 OF 7W WW YORK STATE EDWA7K1N LAw to pxs OF TW SURVEY AMP
NOT BEA%W INE LAND SLNVFYOIRS S1GN17URF AND RED INK OR aeosSm SEAL SNALL
�I3.2a' Opp NOT SE CONS MI) A TRUE VALD COPY.
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0.4 b PAT TSECCAFIC
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Cg.41 . �. T. O P. L. S.
SUCCESSOR TO —
0
FR. 0' 'N CONC. D1IY.
�. o.1;N- S 4549'00 294.98 DONALD TASE, L.S.
1.2 - RICHARD WILHELM AND AssoclATEs
- PROFESSIONAL LAND SURVEYORS
0
N/F G. SOLD 328A Main Street 41 Centre St.
U.P. 0 Center Moriches, NY 119J4 Sayville, New York 11
(631) 878-0120 FAX:(631) 878-7190 (631) 567-4;
N. Y.S. LIC. N0. 049287
1 " = 30' DATE: 12128/2000 COPYRIGHT