HomeMy WebLinkAbout31978-ZFORM NO. 4
TOWN OF SOUTROLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31821 Date: 09/19/06
THIS CERTIFIES that the building ALTERATIONS
Location of Property: 8955 MAIN RD EAST MARION
(ROUSE NO.) (STREET) {HAMLET)
County Tax Map No. 473889 Section 31 Block 3 Lot 16
subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 8, 2006 pursuant to which
Building Permit No. 31978-Z dated MAY 9, 2006
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" INTERIOR ALTERATIONS TO AN EXISTING COMMERCIAL BUILDING
AS APPLIED FOR.
The certificate is issued to TRACEY BYRNES
of the aforesaid building.
(OWNER)
SUFFOLK COUNTY DEPARTMEIqT OF H]~ELTH APPROVAL
ELECTRICAL c~KTIFICATE NO.
PLUMBERS ta~KTIFICATION DA'~'~u 09/08/06
N/A
2072979 08/25/06
RBT.VANETTEN PLUMBING
//uth~ize~ Signature
Rev. 1/81
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Depa~ment 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
New Construction:
Location of Property:
House No.
Owner or Owners of Property:
Suffolk County T~ Map No 1000, Section
Subdivision
Old or Pre-existing Building:
mare
Street
i_
Permit No.
Health Dept. Approval:
Planning Board Approval:
Date of Permit.
(check one)
Hamlet
t e5
Block ODD '~ Lot O I/,~
Filed Map, Lot:
Applicant:
Underwriters Approval:
Request for: Temporary Certificate
Fee Submitted: $
Final Certificate: v,/ (check one)
~,,,_,.,- Appl'c~(~ign~tur~
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. 31978 Z Date MAY 9, 2006
Permission is hereby granted to:
TRACEY BYRNES
for :
AS BUILT INTERIOR ALTERATIONS TO AN EXISTING COMMERCIAL BUILDING
AS APPLIED FOR. ADDITIONAL CERTIFICATION MAY BE REQUIRED.
at premises located at 8955 MAIN RD
County Tax Map No. 473889 Section 031
pursuant to application dated MAY
Building Inspector to expire on NOVEMBER
Fee $ 400.00
EAST MARION
Block 0003 Lot NO. 016
8, 2006 and approved by the
9, 2007.
~d Signature
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
TUCKER ELECTRIC, INC
1800 HARBOR LN./BOX 1065
CUTCHOGUE, NY 11935,
TRACEY BYRNES
8955 MAIN RD.
EAST MARION, NY 11939
Located at 8955 MAIN RD. EAST MARION, NY 11939
Application Number: 2072979
Section: Block: Lot:
Certificate Number: 2072979
Building Permit: BDC:
ns11
Described as a Commcrcia[ 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 25th Day of August, 2006.
Name
Alarm and Emergency Equipment
Emergency Light
Exit Light
Appliances and Accessories
Air Conditioner
Refrigerator/Freezer walk in type
Wiring and Devices
Outlet
Fixture
Fixture
Outlet
Receptacle
Switch
Receptacle
Service
Service Disconnect:
Service Disconnect:
Meters: 2
QTY Rate Ratinl~ Circuit Type
2 0
2 0
I 0 36.000 B~
10
22 0
6 0
16 0
20 0
15 0
8 0
4 0
Fixture
Incandescent
Flourescent
General Purpose
General Purpose
General Purpose
GFCI
1 200 cb
I 100 cb
Continued on Next Page 1 of 2
seal
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
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
TUCKER ELECTRIC, lNG TRACEY BYRNES
1800 HARBOR LN./BOX 1065 8955 MAIN RD.
CUTCHOGUE, NY 11935, EAST MARION, NY 11939
Located at 8955 MAIN RD. EAST MARION, NY 11939
Application Number: 2072979 Certificate Number: 2072979
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 25th Day of August, 2006.
Name QTY Rate Ratin~ Circuit Type
seal
2 of 2
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Fax (631) 765-9502
Telephone (631) 765-1802
B~U'ILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Building Permit No. .-~ I q '7 ~2 7__
Owner:--/--V-r~c'.,oan /_ ~:~I/rVI~_~ - ,~J (Piease prifit)
Plumber: '~,,Db~ ~fJfl [~_~
(Please print)
Date:
I certify that the solder used in the water supply system contains less than 2/10 of 1%
lead.
Sworn to before me this ~-~
day of~~L~. ,20 t~ ~
Notary Publi~~ounty
. Suffolk 0
(Plumbers Signature)
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [/,~]~ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSU/LATION
] FRAMING / STRAPPING [/,,3]~INAL
[
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
FOUNDATION (1ST) ..~
FOUNDATION (2ND)
ROUGH FRA1VI~G &
PLUMBIIqG
INSULATION PER lq. Y.
STATE ENERGY CODE
Y~/~//~ ~ ?~d,t c_~
. ~D~ON~ CO~TS
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL '
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork.net/Southold/
/
Examined ~/c~] ,20
Approved F [~ ,20
Disapproved a/c
Expiration
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
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
Mail to:
~ Phone:
Inspector
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 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 throughout 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. 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 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 heroin 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. /~x
[,- - (Sig~m'ha'e~o/f applica~l~or name, if a corporation)
(Mailing address of applicant)
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.
Location of land on which proposed work will be don.e: ,
House Number Street
County Tax Map No. 1000 Section
Subdivision
(Name)
Block~
Filed M/t~-No. - Lot
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
3. Nature of work (check which applicable): New Building.
Repair Removal Demolition
4. Estimated Cost Fee
5. If dwelling, number of dwelling units
If garage, number of cars
Addition Alteration
Other Work
(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. Sizeoflot: Front Rear .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__
13. Will lot be re-graded? YES __ NO__Will excess fill be removed from premises? YES__
14. Names of Owner of premise ~Jdff~2~Address _,~.. 5'h-/ffdJ~/'/~/./~ Jr'. Phone No.
Name of Architect ~Address Phone No
Name of Contractor Address Phone No.
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 of a tidal wetland? * YES__ NO__
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
NO
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 x~H ~1/_.)
~rCtO'~'~ L C'~[~lrtq~ > being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing co~ract) above named,
(S)Heis the /e~D f'~ liN_ 1
(ContractOr, Agent,~orpomte 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 the application filed therewith.
Sworn ~ ~j~fore me this
d yof
Notary Pfiblic
650 Vanston Road
Cutchogue, New York 11935
Phone 631 -734-2794
EMAIL fickneileen~optonlin~.net
APP~IOV£D AS NOTED
DATE'q.~.~ B.P.
FEE:¢~ q/J/) By: ~7t:~O_fi~k
NOTiFTY BUILDING DEPARTMENT AT
78~-180a 8AM TO 4PM FO~ THE
FOkLOWIN~
~, FOUNDATION - ~O ~EQUIflEO
FOR POURED CONCfl~E
2. ROUGH - FRAMING & PLUMBING
3. INSU~TION
4. RNAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENT8 OF THE CODES OF NEW
YORK STATE. NOT RE8PONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS,
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
AS REQUIRED AND CONDITIONS OF
SOUT? JLD TOWN ZBA
SOUTr~OLD TOWN PLANNING BOARD
SOU]HOLD TOWN TRUSTEES
N.Y.S. DEC
ALL CONSTRUCTION 8HN.[
MEET THE REQUIREMENTS OF THE
~' 7'DES OF NEW YORK STATE.
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
PLUMBING
ALL PLUMBING WASTE
& WATER LINES NEED
TESTING BEFORE COVERING
PLUMBER CERTIFICATION
ON LEAD CON~ENT BEFORE
CERTIFICATE OF OCCUPANCY
SOL DER U,3ED IN WA TER
SUPPLY SYSTEM CANNOT
EXCEED 2/10 OF I% LEAD.
UNDERWRITERS CERTIFICATE'