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Home My WebLink About31526-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31508 Date: 04/03/06 THIS CERTIFIES that the building ALTER3~TION Location of Property: 56275 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 63 Subdivision Filed Map No. -- (STREET) Block 3 Lot 12 LOt No. SOUTHOLD (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 13, 2005 pursuant to which Building Permit No. 31526-Z dated OCTOBER 13, 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 ALTERATION TO ~! EXISTING STOOP ON AN EXISTING COMMERCIAL BUILDING AS APPLIED FOR. The certificate is issued to PILLES REALTY HOLDING LLC (OWNER) of the aforesaid building. SUFFOLK COU1TI~f DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION D~r~u N/A N/A N/A Authorized Signature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TO~VN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and suNmtted 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 1% 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. New Construction: Location of Property: Old or Pre-existing Building: _ (check one) _ Hamlet Block C"X~2>5 Filed Map. House No. Street Owner or Owners of Property: _~l/~ ~> Suffolk County 'Fax Map No 1000, Section Subdivision Permit No. ~l.¢~ Dam of Permit. Applicant: Lot: Health Dept. Approval: Plmming Board Approval: Underwriters Approval: __ Request for: Temporary Certificate Fee Submitted: $ Final Certificate: (check one) Applicant Signature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 31526 Z Date OCTOBER 13, 2005 Permission is hereby granted to: ESTHER M PILLES PO BOX 1309 SOUTHOLD,NY 11971 for : ALTERATION TO AN EXISTING STOOP ON AN EXISTING COMMERCIAL STRUCTURE AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 063 pursuant to application dated OCTOBER Building Inspector to expire on APRIL 56275 MAIN RD Block Fee $ 200.00 SOUTHOLD 0003 Lot No. 012 13, 2005 and approved by the 13, 2007. ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING / STRAPPING I'~ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE INSPECTOR ~7~- FIELD INSPECTION REPORT I DATE FOUNDATION (1ST) FOUNDATION (2ND) COMMENTS ROUGH FRAMING & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS TOWN OF SOUTHOLD BUILDING DEPARTMEI~I' TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ / Examined Approved / 0// Disapproved a/c Expiration ,20 ]PERMIT NO. 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 e'~/~C::~ ~' '~ Check Septic Form N.Y.S,D.E.C. Trustees ~ ~ Contact: . : Mail to: (~.. ~/ // Phone: T 2 ,l . B~lding Inspector ........ ~" ~ '~-' .'(' '~..~'~"'-~"~ APPLICATION FOR BUILDING PERMIT ·[, i(' , 0 .0 'L..,'· ~ INSTRUCTIONS -- t a. m .i ing sets o~ plantlike Olot' ~fi to scale. Fee according to sched~e. ~1~ showing location of lot and of buildings on pre~ses, relationsNp to adjoining pre~ses or public s~eets or ~eas, and wate~ays. c. The work cov~ by this application may not be co~enced before issu~ce of B~l~ng P~t. d. Upon approval oftNs application, the Building Nspector will issue a Building Pemt to ~e applic~t. Such a p~t shall be kept on the pre~ses available fi>r inspection t~ou~out the work. e. No building shall be occupied or used in whole or in p~ for ~y p~ose what so ever ~til the B~l~ng h~spector issues a Ce~ificate of Occupancy. f. Evew building pe~t shall expire if the work authorized has not co~enced witNn 12 months a~er the date of issu~ce or Ms not been completed within 18 monks from such date. If no zoNng amendments or other re~lations ~fecting the prope~y have been enacted in the interim, the Building Nspector may authorize, in writing, the extension of the p~t for ~ addition six months. Thereafter, a new pe~t shall be required. ~PLICATION IS HE,BY M~E to the Building Dep~ment for the issuance of a Building Pemt p~su~t to the Building Zone Ordin~ce of the Town of Southold, Suffolk Co~ty, New York, ~d other app~cable Laws, Ordin~ces or Re~lations, for the construction ofb~ldings, additions, or alterations or for removal or demolition as herein described. The applicant a~ees to comply with all applicable laws, ordinances, building code, housing code, ~d re~lmions, ~d to ad~t authorized inspectors on prenfises and in b~lding for necess~ inspections. ~ ~[~t~ ¢,[~e5 ~ (Signature of ~pli~or nam~ if a ~o~oration7 (Mail'hag address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises ~>,\L<¢ ~---o--/~-<] ~'~-sIg,~r~, i (-Q'"~ (As on the t. lJx roll or latest deed) If applie~iSt i_s~a'co~, .~'~mre of duly authorized officer [°Name ar~tit~of corpoh~ officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No, 1. Location of land on whch proposed work will be done: House Number Street County Tax Map No. 1000 Section Subdivision (Name) Hamlet Block O ~,, , Filed Ma ,my ,;', ~ 2. State existing use and occupancy~f premises an~ intended use and occupancy of proposed construction: a. Existing use and occupan,~y b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal f.M Demolition 4. Estimated Cost ~ %1()C :f~"~ 5. If dwelling, number of dwelling units If garage, number of cars Fee Addition Alteration Other Work [~v~ld ~,c k 5~f~.¢~; (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear Depth 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 ~xr'~.,~xl r.4' 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO :kS 13. Will lot be re-graded? YES NO ,X2 Will excess fill be removed from premises? YES NO__ 14. Names of Owner ofpremises~l~-s gee]K/~]~,ff-~dress f>~> ¢::C~ I~'~. Phone NameofArchitect ~7-c-~ C.~,-~..~,, ~f= "Address%r_,</~...rfl~,.~,pz.,~](PhoneNo(~-.g NameofContractorP-~-~o.m g,- l,, ~- ,(c,- r AddressPl,~t~c/1%_,_/~/( PhoneNo. G'>! 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 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 OF6uf(-O ~t ,~--J~c--\~ ~- 4'- ~-'T~ ~x\ It_ ~ being duly sworn, deposes and says ttmt (s)he is the applicant (Name of'individual signing contract) above named, (S)He is the (Contrac, tor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly author/zed 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 tc~before me thi~ /~ day of 0(I. Notary P.flbllc