The URL can be used to link to this page

Home My WebLink About30733-ZFORM N'O, 4 TOWN OF SOUTHOLD BUILDIMG DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30576 Date: 11/23/04 THIS CERTIFIES that the building ALTERATIONS Location of Property: 53345 ~AIN RO~ SOUTHOLD (HOUSE NO.I ~STREET) (HAMLET) Co~unty Tax Map No. 473889 Section 61 Block 1 I~)t 1~.1 Subdivision Filed Map No. __ Lot No. ___ conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 21, 2004 pursuit to which Building Pez~nlt No. 30733-Z dated OCTOBER 28, 2004 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 INTERIOR ALTERATIONS, CONVERSION OF REAL ESTATE OFFICE TO B~I~K IN BUILDI~IG ~11 AS APPLIED FOR. The certificate is issued to LLC FHV of the aforesaid building. SUFFOLK CO~TY DEPARTMENT OF HEALTH A~PROVAL N/A ELECTRICAL CERTIFICATE NO. 93707 10/28/04 PLL~4BERS CERTIFICATION D~rku3 10/28/04 PECONIC PL~dB. &HEATING 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. 30733 Z Date OCTOBER 28, 2004 Permission is hereby granted to: LLC FHV BOX 1295 CUTCHOGUE,NY 11935 fOE : INTERIOR ALTErcATIONS, CONVERSION OF REAL ESTATE OFFICE TO B.nJqK at premises located at%~;~~ 620 County Tax Map No. 473889 Section 061 pursuant to application dated OCTOBER Building Inspector to expire on APRIL Fee $ 200.00 TRAVELER ST SOUTHOLD Block 0001 Lot NO. 013.001 21, 2004 and approved by the 28, 2006. Au~h~f'L~a~ure__ ORIGINAL Rev. 5/S/02 TOX,~ OF SOUTHOLD BUll. DING DEPARTMENT TOWN IIALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application ~nust be f'dled in by typewriter or ink and submitted to the Building Department with the following: For' now bui[dhm or new J. I m,l ~dn ¢} Ol prope~D with accm'ate location of all buildings, property lines, streets, and unusual natural ot topograptfic 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 frmn plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Conunercial building, industrial building, multiple residences and similar buildings and installations, a cemficate of Code Compliance from architect or engineer responsible for the building. 6. Subnfit Plmming Board Approval of completed site plan requirements. 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 propeay lines, streets, building and unusual natural or topograplfic features. 2. A properly completed application and consent to inspect signed by the applicant. Ifa Certificate of Occupancy is detfied, the Building Inspector shall state the reasotzs therefor in writing to the applicant. I. Certificate of Occupancy - New dwelling $25.00, Additions to dweiling $25.00, Alterations to dwelhng $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 Occapf. acy - $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate ofGccupancy - Residential $15.00, Commercial $15.00 Date. //~ ~ '- 0 ff New Construction: Location of Property: ~o 2 0 House No. Owner or Owners of Property: [-. LC_.. Suffolk Count), Tax Map No 1000, Section Subdivision 'em it No:. 5 dU 55 Health Dept. Approval: Planning Board Approval: Old or Pm-existing Building: ~ Street (D (o/ Block C}OO Filed Map. ~ q Date of Permit. ecl- } % gooq Applicant: Underwriters Approval: Request for: Temporary Certificate Fee Submitted: $ ~-O ~ Final Certificate: (check one) Hamlet (check one) AppliOat'Signature 10/29/2004 Electrical Inspection Certificate Ele~trleM lupectlon ~[l'~eI Inc. Application Number 37S DuntQn Avenue 93707C East Patchogue, New York 11772 (d~31) ZaO-SM2 Issued To: FHV LLC - Building 11-1 Street: 53345 Main Roac~ Village: Southold Section: 61 Block: 1 Contractor:. G. J. S. Electric (L) (cc) Zip: 11971 Town: Southold Lot: 13.1 Lic.# 4839-E Wes examlM~ end fi~ufld to be I~ com~ance with the N~tlofl,ll Eleoldcal Code. IX l Cnmmerslel ~ NV Defects ~-~ P~)I ~] 1st moor [] Indoor [ ~ Basement [ ~Hot Tub i~ Resldnfltlal ~] DeC. Garage i~ A~IIo ~(J 2nd Floor ~l Outdone [-~ AcIdiflon (~ Survey Switches Receptacles Plxtures 8 DIshwasher Washer/Amps ~/Am~ Furnace Oil Cl~Mt~rs ~t~ A~ ~ U~ J~u~i / Bldg. Permit: Other Equipment ; /~ Heaters A/C Pans i Oven Range/Amps Microwaves I , · Television CO Detector I President Town Hall, 53095 Main Road P.O. Box 1170 Southold, New York 1197141959 Fax (631) 765-9502 Telephone (63 [~ 765-1802 BUILDING DEPARTMENT TOWN OF SOUTItOLD CERTIFICATION Building Permit No. Owner: ~1I1LV Plumber: (please print) lead. I certify that the solder used in the water supply system contains less than 2/10 of 1% Sworn to before me this day of , 20 Notary Public, COLUlty ~ ,,~Pl~abers ~a~ VICKI L. LOPER Notary Public, State of New York No. 01LOG070081 ~Jofified in Suffolk County Commission Expires 0 1 I cji D PROFESSIONAL ENGINEER 1725 HOBART ROAD / PO Box 616, SOUTHOLB. NEW YORK 11971 TEL631-765-2954. FAX63~-614-3516 · e-mail: joseph@fischetfi.com Date: Reference: October 28, 2004 Hudson City Savings Bank/Southold Branch Southold Building Department Main Road Southold, NY 11971 Dear Sir, In inspected the rough framing and rough plumbing at Hudson City Bank Branch in Feather Hill. I certify that the rough framing and rough plumbing meet New York State Building Codes. A final inspection of the completed work shows that all work meets New York State Building Codes. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL ] FIREPLACE & CHIMNEY ~FIRE SAFETY INSPECTION DATE INSPECTO~ FIELD INgPECTION REPORT ] DATE I COMMENTS FOUNDATION (IST) ROUG~ F~I~G & PLUNmmG ~S~ATION PER N. Y. STATE ENERGY CODE ~mo~ comeTS TOWN OF SOUTHOLD BUILDING DEPARTMENT T OXX,.%r HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 ,,,~'w. northfork.netJSouthold/ Examined '/-/~ ~'~ ,20 . &pproved /~9 /7:~- ~ ,20 ~/ Disapproved ac Exptrauon //,,,2-~tS/ ,20 -~ ,/ PERMIT NO. ' '[~ilding Inspector BUILDING PERMIT APPLICATI~3N CHECKLIST Do you have or need the following, beTore appl~nng~' Board of Health .- _ 4 sets of Building Plans ,/ planning Board approval Survey Septic Fo.rm N.Y.S.D.E.C. Tmstees Contact: APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,20 0¥ a This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 sweets or areas, and waterways. c. The work covered by this application may not be commenced befor~ 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 throughout the work. e. No building shag 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 reqiaired. A.PPLiCATION IS HEREBY MADE to the Building Department for the issuance of a Building pernnt pursuant tv 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 applic~.ble 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 corporadonj (M~Jlqg address of a~plicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 3q$ MP tocauon of land on which proposed work will be done: 533'/5 House Nmnber Street Hamlet County Tax Map No. 1000 Section Subdivtmon (Name) Block [ Filed Map No. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy '-¢oPH'~ ~ 3. Nature of work (check which applicable): New Building Removal Demolition 4. Repair Estimated Cost ~ Ot bOO If dwelling, number of dwelling units If garage, number of cars N~ Addition Alteration Other Work '"~XtTF~41~t- N.~4"'~EAttO(~ (Description) Fee (To be paid on filing th!s application) Number of dwelling units on each floor 7. Dimensions of existing structures, if any: Front ~ Ot Rear Height ~ '2~' Number of Stofles If business, commercial or mixed occupancy, specify nature and extent of each type of use. '"~ ~. ~ O' .Depth ~(~" ~ [/&~ Dimensions of same structure with alterations or additions: Front ,,~0 Depth ~jt~,. ~t[%, Height. g ¢~. Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories 9. Size oflot: Front ~t Rear 5H~' Rear .Depth 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? YES __ NO X 13. Will lot be re-graded? YES__ 14. Names of Owner of premises Name of Architect Name of Contractor ~',~u 15 a. Is this property within I00 feet of a tidal wetland or a ~eshwater wetland? *YES__ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO X * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO X Will excess fill be removed from premises? YES__ AddressCMl~h,~a~' *,if llql~Phone No. Address I~,~, L~,- ql I. Tr 5~Phone No Address ~ ~l~t~lltt[~Phone No. NO NO ~< X 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. l 7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ) %~ ~;:b, ~ I~L being duly sworn, deposes and says that (s)he is the applicant (Name of individual si~tming contract) above named, (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed thc said work and to make and file this application; that all statements contained in this application are true to thc best of his knowledge and belief; and that the work will be performed in the ~nner set forth in the application filed therewith. Sworn to before me tkis {\ BONNI£J. DOfiOSm Notary Pub#c, mate Of NewYld #o. 01D0S0OS,~.8, SelM~ Cout~ 2oo /~ )'~a~e of Applicant