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31270-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUP/LNCY No: Z-31124 Date: 08/19/05 THIS CERTIFIES that the building ALTERATIONS Location of Property: 43375 CR 48 SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map NO. 473889 Section 59 Block 3 Lot 29 Filed Map No. -- Lot NO. Subdivision conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 12, 2005 pursuant to which Building Permit No. 31270-Z dated JULY 12, 2005 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 "AS BUILT" ALTERATIONS TO AN EXISTING COMMERCIAL BUILDING AS APPLIED FOR CONSTRUCTION CERTIFIED BY WARREN A SAMBACH~ P.E. The certificate is issued to JOHN J & JOAN D CALLAHAN (OWNER) of the aforesaid building. SUFFOLK CO~ DEPARTT~ENT OF HEALTH APPROVAL ELEC-£KICAL CERTIFICATE NO. PLU~BI~RS CERTIFICATION DA'l~u3 N/A ~gnature 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 COMPLETION OF THE WORK AUTHORIZED) FULL PERMIT NO. 31270 Z Date JULY 12, 2005 Permission is hereby granted to: JOHN J & JOAN D CALLAH3kN 125 LIGHTHOUSE RD SOUTHOLD,NY 11971 for : AS BUILT ALTERATIONS TO AN EXISTING COMMERCIAL STRUCTURE AS APPLIED FOR. ADDITIONAL CERTIFICATION MAY BE REQUIRED. at premises located at 43375 CR 48 County Tax Map No. 473889 Section 059 pursuant to application dated JULY SOUTHOLD Block 0003 Lot No. 029 12, 2005 and approved by the Building Inspector to expire on JANUARY 12, 2007. Fee $ 400.00 ORIGINAL Rev. 5/8/02 Warren A. Sambach Consulting Engineers Planners 255 Dogwood Lane East Marion, NY 11939 August 16, 2005 Att: Mike Verity Southold Toxvn Building Department Main Road Southold, NY 11971 Dear Mr. Verity, RE: Callahan Property 1000-59-3-29 43375 County Route 48 Southold, NY 11971 Please be advised that I am familiar with the subject building. I have inspected the site and find that the work that is in place is consistent with my drawings dated 8/16/05. Opening between units shown on previous plan dated 6/21/05 have been closed with 1 hour fire rated construction to complete the I hour separation between tenancies. The existing septic system as installed is sufficient to handle the occupancies that presently exist. However, ifa new wet use is to be located at this site the system would have to be re-evaluated. I further certify that these improvements would have met all codes in place at the time of their construction to the best of my knowledge. Sincerely, Warren A. Sambach, Sr. BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG, [ ] FOUNDATION2ND [ ] INSULATION [ ] FRAMING .[ ] FINAL [ ] FIREPLACE & CHIMNEY~;~ ~ I~-~/S_~'~T¥ REMARKS: /1, ~t~ FIELD INSPECTION REPORT i DATE I COMMENTS FOUNDATION (1ST) FOUNDATION (2ND) ROUGH FRAMING & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOVqN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX:'(631) 765-9502 ~v. northfork.net/Southold/ Z~ ,20 % Examined Approved ~, 20 "x Disapproved a'c Expiration ,20 :3'",. PER3~IT NO. / BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying'? Board of Health 4 sets of Building Plans planmng Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: % ~9~..,C3 '- 'APPLICATION FOR BUILDING PERMIT .-~ \ Date /~Q/~ o[9 .~c ' - INSTRUCTIONS ' ,200 a. l~his~.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 streets or areas, and waterways. c. The work covered by this application may not be commenced befbre 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 shall be occupied or used in whole or hi 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 ora Building Permit pursuant to 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 applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature~f a~plicant or.e, ifa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name °f °w'ner °f premises ~(~C~~1 Or latest deed)ill i~ If applic~.3s a co~t~igna~[lqe o~ duly authorized officer corpo_ e officcr Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on whi~h~proposed work ~/ill be don~ House Number Street ,7 Hamlet Count)' Tax Map No. 1000 Subdivision (Name) Section Block '~ Filed Map No. Lot State existing use and occupancy ofprerr3jses and intended use and~ .~cfi. u~p~ancy of proposed construction: a. Existing use and occupancy ~ ~,~&/ d4'rt~ ~' F b' b. Intended use and occupancy ~('_7[d~ ~:/ 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost ~ © 5. If dwelling, number of dwelling units l~-/&. If garage, number of cars ~,'L/~4 ~ Addition Alteration Other Work ;~/749cO (Description) Fee (To be paid on filing this application) Number of dwelling units on each floor If business, commercial or mixed occupancy, specify nature and extent of each type of use. - tn f oimens'o s o existing structures, if any: Front Rear Depth Height Number of Stories / Dimensions of same structure with alterations or additions: Front ~ear 10. DateofPurchase l[-lb- q4 Name°fF°rmerOwner'~6~[l'v~ 11. Zone or use district in which premises are situated ~-~ ]~ 12. Does proposed construction violate any zoning law, ordinance or regulation? YES.__ 13. Will lot be re-graded? YES__ Depth_ Height. Number of Stories Dimensions of entire new construction: Front (~1~) Rear Depth Height Number of Stories Size of lot: Front i'-~ ' Rear 1{~51 Depth No NO t//Will excess fill be removed from premises? YES__ NO__ 14. Names of Owner of premises_ Name of Architect Name of Contractor Address Phone No. Address Phone No 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 REQUIRED. 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 foundation 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) SS: COUNTY OF ) '~f)14^f~,q I ~d"] C ~2 (/~-x ~v'~ being duly sworn, deposes and says that (s)he is the applicant (Na~e of-i,~lividufiI signing contract~bove 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 tree to the best of his knowledge and belief; and that the work will be performed in the manner set forth in thc application filed therewith. Sworn to before me this . ~mmissi0n ~pims May 24, 20 ~