HomeMy WebLinkAbout31250-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31140
Date: 08/29/05
TRIS CERTIFIES that the building ALTERATIONS
~ocatlon of Property: 28320 MAIN RD CUTCHOGUE
(ROUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 102 Block 6 Lot 15
subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 23, 2005 pursuant to which
Building Pez~tit No. 31250-Z dated JULY 5, 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 ALTERATIONS TO AN EXISTING COMMERCIAL BUILDING AS APPLIED FOR.
The certificate is issued to VICTOR CIERACR
of the aforesaid building.
( OWNER )
~JFFOLK COUNTY DEPARTMENT OF REALT~ APPROVAL N/A
ELECTRICAL c~TIFICATE NO. 2064604 08/16/05
PLUMBEP~ CERTIFICATION DA'r~u N/A
Authorized Signature
Rev. 1/81
Form No. 6
TO%~qN OF SOUTHOLD
BUILDING DEPARTMENT
TO~VN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application nmst be filled in by typewriter or ink and subnfitted 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 uuusual natural or
topographic features.
2. Fhml Approval from Health Dept. of water supply and sewerage-disposal (S-9 fom~).
3. Approval of electrical installation from Board of Fire Under~vriters.
4. Sworn slatement from plumber certifying that the solder used iu system contains less titan 2;10 of I% lead
5. Conm~ercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect ot engineer responsible for the building.
6. Submit Planning Board Approval of cotnpleted site plan requirements.
B. For existing buildings (pr[or to April 9, 1957) non-conforming uses, or buildings and "l)re-existing" land uses:
I. Acctuate sup:ey of property sbov¢ing all property lines, streets, buikling and unasual natural or topographic
2. A pxoperly cmnpleted application and consent to inspect signed by the applicant. Ifa Certificate of Occupan%' is
denied, the Building Inspector shall state the reasous therefor in writing to the applicant
C. Fees 1. Cemficalc ot 3ccupanc5 New dwelling $25.00, Additions to &veiling $25.00, Alteratious to dwelhng $25.00,
Swmmfing pool $25.00, A~esso~' building $25.00, Add ti )ns to accessoo' build~g $25 00 Bnsmesses $50 00
2. Ceniticate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Cemficate of Occupancy- $50.00
5. TemporaD' Certificate of Occupancy - Residential $15.00. Commercial $[ 5.00
Old or P~e-existing Building: ~ (cheek one)
Street Hamlet
New Constructiml:
Location ofProl!elty: o~ g~ o~ O House No.
Owne~ or Owners or'Property: ~,/ I C T O,~--_ ~q~[ ~ ,~/q'(2P7/
Suffolk Coanty Tax Map No 1000, Section [O ~ Block
Lot ~/~..~___
Subdivision
Pemfit No. ~ I o'15-0
Health Dept. Approval: ~1 /~
Plamung Board Xpproval: ~ [ .~
Request for: Temt)ora~T Ce~ificate
Fee Snbmiued: 5 ~ ~
Co %
Filed Map. Lot'
Underwritei s Appro~ al:
Final Certifica , :
( Applicant Signtre d
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. 31250 Z Date JULY 5, 2005
Permission is hereby granted to:
VICTOR CIERACH
JOCKEY CREEK DR
SOUTHOLD,NY 11971
for :
ALTERATIONS TO AN EXISTING COMMERCIAL BUILDING AS APPLIED FOR
at premises located at 28320 MAIN RD
County Tax Map No. 473889 Section 102 Block
pursuant to application dated JUNE 23, 2005
CUTCHOGUE
0006 Lot No. 015
and approved by the
Building Inspector to expire on JANUARY 5, 200~77.
FeeS 200.00 ~'"~'~'--'~~
ORIGINAL
Rev. 5/8/02
BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET ~ NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of
upon premises owned by
ROSLAK ELECTRIC
P.O. BOX 164
CUTCHOGUE, NY 11935-2453,
* CIERACH
28320 MAIN ROAD
CUTCHOGUE, NY 11935
Located at
28320 MAIN ROAD CUTCHOGUE, NY 11935
Application Number: 2064604
Certificate Number: 2064604
Section: Block: Lot: Building Permit: BDC: ns11
Described as a Commercial occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
First Floor, Outside,
A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed
herein, was conducted in accordance with the requirements of the applicable code and/or standard
promulgated by the State of New York, Department of State Code Enforcement and Administration, or other
authority having jurisdiction, and found to be in compliance therewith on the 16th Day of August, 2005.
Name QTY Rate Rating Circuit TYpe
Miscellaneous
minor renovation
Alarm and Emergency Equipment
Emergency Light
Exit Light
Wiring and Devices
Receptacle
Receptacle
Fixture
I 0
[ 0
8 0 General Purpose
I 0 GFC!
4 0 Incandescent
seal
I of 1
This ceAificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] INSULATION
[ ]FRAMING / STRAPPING ~FINAL
DATE ~-~/~-'~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [
[~FRAMING [
[ ] FIREPLACE & CHIMNEY [
] INSULATION
] FINAL
] FIRE SAFETY INSPECTION
REMARKS:
FIELD'INSI~CTIONI/-- REPORT i DATE COMMENTS
FO~DATION (2ND)
ROUG~ F~I~G &
PL~IB~G -
~S~ATION PER N.Y. -
STATE ENERGY CODE
.~D~ION~ COMMENTS
TO'%~ OF DOUTI~IOLD
BUILDING DEPARTMENT
TOX~Tq HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
~v. no rthfork,net/Southold/
PERMIT NO.
Examined ,20 x
Approved :~ ,20 3
Disapprox ed a c
Expiration
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
N Y.S.D.E.C.
Trustees
Contact:
Mailto: I'~r~O. rct_ ~b(~l veq
~( v \~\ APPLICATION FOR BUILDING PERMIT
~ ~ ~t~c~ I ~ INSTRUCTIONS -
~ T~s a~lisg~y~b~pletely filled in by typewriter or in ~ and submitted to the Bulldog Nspector with 4
sets of ~ xs,~ plot plan to scale. Fee according to schedule.
bkPlot ~showing location of lot and of buildings on premises, relationship to adjoining pre~ses or public streets or
areas, and watem'ays.
c. The work cox ered by this application Ina>' not be commeuced before issuance of Building Permit.
d. Upon approval of tiffs application, the Building Inspector ,,','ill issue a Building Permit to the applicant. Such a permit
shall be kept on the premises available for inspection tbxoughout the 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. Eveu~ 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 e~ension of the permit for an
addition six momhs. 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 Southold. Suffolk Count>', New York, and other applicable Laws. Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for removal or demolkion 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 tbr necessa~' inspections.
,/15
/ (Sibmamre ofapp~ant ar name, ifa c~rporation)
(Mailing address o{qa~plicam) d
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name o f owner o f premises V t~--~-o,l (__t o_o~ Agk
(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 Licen~,e No.
Electricians License No.
Other Trade s License
Location of land on which proposed work will be done:
House Number Street ') Hamlet
County Tax Map No. 1000 Section
Subdivision
(Name)
tOP mock 6
Filed Map No.
2. State existing use and occupancy of premises and intended use and occupancy of proposed constmctton:
a. Existing use and occupancy x/&ca4qT ,-%
b. Intended use and occupancy C~,n~,/ i6iffT
I
$. Nature of work (check which applicable): New Buildin~ Addition Alteration
Repair Removal Demolition Other Work
4. Estimated Cost oq~OO - Fee
)
5. If dwelling, number of dwelling units N I Pr
If garage, number of cars N IFt
(Description)
(To be paid on filing this application)
Number of dwelling units on each floor N [/q
/
6. If business, commercial or mixed occupancy, specie' nature and extent of each type of use. ~6j
7. Dimensions of existing structures, if any: Front Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front
Depth Height. Number of Stories
Rear
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear .Depth
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
l 2. Does proposed construction violate an5' zoning law, ordinance or regulation? YES NO ~
13. Will lot be re-gaded? YES NO ~h Will excess fill be removed fi'om 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__ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet ora tidal wetland? * YES__ NO
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
NO ~
16. Provide sum'ey, 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)
o 5. llcS)s:
'~0t~ ~)~tl'-~ ,~q~,l ~ being duly sworn, deposes and says that (s)he is the applicant
(Name of individ~l si~ng contract) above named.
(S)He is theWS[ ~55 D ~ ~ ~
(Contractor, Agent, Corporate Officer, etc.)
of said owner or owners, and is dui3' 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
perfomxed in the mariner set forth in the application filed therewith.
Sworn to before ~e th~s
da> of,JO
~)q'~otaO' Public
M~rtz K Schwartz, AIA -Architect, PLLC
P.O. Box 933
Cutchogue, New York 11935
Phone: (631) 734 -4185
Fax: (631) 734 - 2110
July 01, 2005
B's Treats
28320 Main Road
Cutchogue, New York
USE AND OCCUPANCY CLASSIFICATION:
CONSTRUCTION TYPE: V
BUILDING HEIGHT: 11'-0" +/-
TOTAL OCCUPANT LOAD: 15
M
FIRE AREA: EXISTING PROPOSED
Re, il Area 669 SF Retail Area
Storage Area
Office
Bathroom 35 SF Bathroom
Utility Room 10 SF Utility Room
Total Area 714 SF
370 SF '
195 SF
104SF
35SF
10SF
714 SF
INSTALL FIRE EXTINGUISHERS AS PER CODE
INSTALL SMOKE DEI'ECTORS/CO2 DETECTORS AS PER CODE
EXIT SIGNS TO COMPLY WITH SECTION 1003.2, NYS CODE
EXIT DOOR TO COMPLY WITH 1005.2.1, NYS CODE
FIRE INSPECTION
REQUIRED BEFORE
OPENING
OCCUPANCYOR
USEIS UNLAWFUL
WITHOUTCERTIFICATE
OFOCCUPANCY
COMPLY WITH ALL COD~'S OF
NEW YORK STATE & TOWN - ?'DES
AS REQUIRED AND CONDI't'~, :uS OF
_ ~. . ?¢1 PLANNI' ~
/ N.~.S. DSC
UND£R~NR~lERS CERTtRC~klE
REQU)RED
APPI~OV~ED AS NOTEO
765-1802 8AM T J, ~k'~ FOR THE
FOLLOWING INSPECT;ONS:
1. FOUNDATION - ~",','O REQUIRED
FOR POURED
2. ROUGH . FRAM,~ ~ PLUMBING
~. INSU~TION
-k FINAL - COK~'CTION MUST
ALL CONST~UCT'ON SHAL~_ MEET THE
REQUIREMEHTS OF THE CODES OF NEW
YORK STATE, NOT RESPONSIBLE FOR
~ OR CONSTRUCTION ERRORS.
ALL CONSTRUCTION SHALL
MEET THE REQUIREMENTS OF THE
CODES OF NEW YORK STATE.