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Home My WebLink About29767-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date, 10/14/05 NO, Z-31224 THIS CERTIFIES that the building ELECTRICAL Location of Property, 28080 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 102 (STREET) Block 6 CUTCHOGUE (HAMLET) Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 9, 2003 pursuant to which Building Permit No. 29767-Z dated SEPTEMBER 29, 2003 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 ELECTRICAL WORK TO AN EXISTING COMMERCIAL BUILDING AS APPLIED FOR. The certificate is issued to DAWN BLANGIARDO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1160663 05/09/04 PLUMBERS CERTIFICATION DATED ~ N/A ./) .. / .. j. .. .. . '. 1/ I ~/fJ6 Z{/1 (lCi) /f~l/~ I Author~zed Signatur~ Rev. 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 /' r /' . 1/32005 .J APPLICATION FOR CERTIFICATE OF OCCUP-ANCY ',. This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: I. 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 2/1 0 of I % 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 nses, or buildings and "pre-existing" land uses: I. 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 $~ Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesse~ 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 $15.00 New Construction: ."':::::::.:.:::-- ;l~ or Pre-existing BUildin;J Date. ~Pllo5 Location of Property: .-- (check one) /<..)'1 II q~'S , House No. Owner or Owners of Property: R.t::N~TT' /PJ ft1"lc., ,a..PIv'. Suffolk County Tax Map No 1000, Section In.:2 Hamlet :JM$O rY'a'n (21) Block (-) C:-) (, ,thosoG' Lot oOts Subdivision Filed Map. _~_ Lot: PermitNo...2gtb I Dateofpermit. $. ?q.q.n~Applicant: Health Dept. Approval: Planning Board Approval: --'~-, nderwriters Approval: ~ \..l~,:,,> --.--.-..:-:::::; . ':'.-". ...----.... (:lnal Certificat~~______ ,/ (check one) Request for: Temporary Certificate Fee Submitted: $ ';;-0- CD -2c '3 I;}.d. ~ ~c.. 109049 'iJ5~A ..~ ,~ Appl cant Signature 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. 29767 Z Date SEPTEMBER 29, 2003 Permission is hereby granted to: DAWN BLANGIARDO 905 PEQUASH AVENUE CUTCHOGUE,NY 11935 for : ELECTRICAL WORK TO AN EXISTING COMMERCIAL BUILDING AS APPLIED FOR at premises located at 28080 MAIN RD CUTCHOGUE County Tax Map No. 473889 Section 102 Block 0006 Lot No. 008 pursuant to application dated SEPTEMBER 9, 2003 and approved by the Building Inspector to expire on MARCH 29, 2005. Fee $ 200.00 ORIGINAL Rev. 5/8/02 r rn.rn I % ~C1 '113 BY THIS CERTIFICATE OF COMPLIANCE THE I ~ NEW YORK BOARD OF FIRE UNDERWRITERS ~ ~ BUREAU OF ELECTRICITY ~ ~ ' /1) 40 FULTON STREET _ NEW YORK, NY 1 0038 ~ ~ 0 ~ ~ / ,/ CERTIFIES THAT ~ ~ ~ ~ ~ Upon the application of upon premises owned by ~ ~ LUDEMANN ELECTRIC DAWN BENNETT ~ ~ 465 NORTH MAIN STREET 355 DEEP HOLE DRIVE ~ ~ FREEPORT, NY 11520-1252, MATTI TUCK, NY 11952 ~ ~ SIW CORNER OF MAIN RD NEW SUFFOLK AVE CUTCHOGUE, NY 11935 ~ ~ Located at ~ ~ Application Number: 1160663 Certificate Number: 1160663 ~ I Section: Block: Lo!: Building Permit: BDC: NS11 I ~ Described as a Commercial occupancy, wherein the premises electrical system consisting of ~ ~ electrical devices and wiring, described below, located in/on the premises at: ~ ~ 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 9th Day of March, 2004. ~ ~ Name OTY Rate Rating Circuit :D:M ~ ~ Service ~ ~ 3 Phase 4W Service Rating 600 Amperes ~ ~ Service Disconnect: 4 100 cb ~ ~ Service Disconnect: 2 200 cb ~ ~ Meters: 6 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ seal ~ ~ ~ ~ 1 of 1 ~ I This certificate may not be altered in any way and is validated only by the presence of a raised seal at the locaticn indicated. I rn~.rn -- ~ ft\ -? /(j~o- OWNER , TOWN OF SOUTHOLD PROPERTY RECORD CARD /' 0 _ __ / tJ ,;; .. 10 - ,I' _.-r ;'"" VILLAGE DIST. SUB. LOT , I. j I I(O-d(j' /1 -I I leNd C! '..!€. ~ J\ . L).Q .[ < )- ! O-e J N : I . /::jd I/o' [1 j /1. (, (.'1 ~j' E /\ . / y,.'.// W v f3lal1cya. rdo ~ u.)f . ;: .s:ko lye/on ~,y RES. Y ? I I SfAS. I VL. ',t ,...:-o:te ACR. 2 TYPE OF BUILDING r-- _"'1 '\...,i I L }r-o r/ ! v' -~-- S -i~' ~o' TOTAL ! /) ^ J ' /,..t.- (,./_,- ~i I FARM DATE I (fOMM) CB. MICS. Mkt. Value ,...'..,,- ,)." ""\ -) , LAND IMP. ..~. b 0 1,,]66 900 ~' .I -~ z..~' ~:J" C i..) v "00 3{,oo 'V \ / V rillable ! ~oodlond F~ONI^61: ON nATCR - d..- 1;:" ;- -..) - / 0 ~(} :+_~':: A, {"<:~ ;"',,, w\eQdowland iOU$Cl Pklt FRONTAGE ON ROAD DEPTH (lv-. BULKHEAD ,2o-f'-/. a).3 0 0' I fa S-' , ::; ::~ ,) {) "otol (' -'5 COLOR TRIM 'I I, II ,\' ,:'? / ~ 31 ;. i ( M. Bldg. '3>-1'n/~ 3'7<1 o Yf Extr.sion .., l./o"J.o~ iJ-'1~ d Extension ~.;I.o :2 f. '. :"'1 :""1) ,Extension ( ".:~ -;: -::- ! 1../0 (-'lIt! Ol) ::--- 3 t,/ J-f. Foundation , 3cjK21~ /O~ <j " 0 I. I (. , Basement Ext. Walls 4-& \' '7 , ) ~ ') f Fire Place Both Dinette Floors K. Interior Finish LR. Heat DR. Rooms 1st Floor BR. Rooms 2nd Floor FIN. B Poft:h ;: / S ~ YO ':.. u ( Breezeway, Ilorch r.- " ' If .~, ,f '_ " LJ 1.\ Garage I '{'3n-. :).() IY~i.. ),,,,, ,.{ .... ype Roof Recreation Room Dormer Patio O. B. TGfal , /;?t/t> ,-7570 . ,,,.do' ~. -So Jffp ~j ICe"'. --:>ob = '13fto ", ' ~'o ':i' . .~. '\ j',>,,_ . v-- -ru-- :>--.- .~. \J ~ ')471- 3f3 tfU16 met. &utVdctJ INC/ \.4('~"tl~_~S /lI'A-.c:.:.lc TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 , TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.netlSouthold/ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans Plarming Board approval Survey Check Septic Form N.Y.SD.E.C. Trustees Contact: PERMIT NO. Examined Approved Disapproved ale ,20_ ,20 Ylail to: Phone: Expiration ,20_ 9 ?nm QCCUPANeY!~ Building Inspector USE IS UNLAW~ APPLICATION FOR BUlLDlN~ CERd'~f~TE OF ~tY~~~ r7'/ b ~ r 9 , INSTRUCTIONS ,2OD'S_ a~Tfus application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location oflot 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 uutil 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 South old, 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. / %" ,. / ,'-- , ~), (~A' ~,na4t-''1' L (Signature of applicant or name, if a corporation) UNDERWRITERS CERTIFICATE REQUIRED to' 136'1 {;d.! ./{/el/J I )<.IH;/~ AlY //9Ct (Mailing address of applic t) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder .E lee-iff C/,4 V Nameofownerofpremises Jhwn ~nl1e tj- ~VEDASNOTED (As on the tax roll or latest de~h. B P , .act 16 9 If applicant is a corporation, signature of duly authorized officer DA~ ct '.'" . ~'9\L-- FE. 7,oc" BY: (Name and title of corporate officer) NOTIFY BUilDING DEPARTMENT AT 765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION. TWO REQUIRED FOR POURED CONCRETE 2. ROUGH . FRAMING & PLUMBING 3. INSUlATION 4. FINAL . CONSTRUCTION MUST ~lETE FOR C.O. ALL a~ALl MEET THE REmlffi.fMENTS cou~ of NEW YORK STATE. NOT RESPONSIBLE FOR Block t, DESIGN OR CO~6~UC~~"'~~ , 'Id ~~'(1,^", FI e Map No. ~" A;,./': _lJ:.,t<t.:' Builders License No. Plumbers License No. Electricians License No. J-/& L.,I. S - t=. Other Trade's License No. 1. Location ofIand on which proposed work will be done: House Number Street County Tax Map No. 1000 Section Subdivision I~' ^ .. (Name) -~".- 2. State existing use and occupancy of premises and intended use and occupancy of proposed constmction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Alteration Other Work .EleclncilJ (Description) 4. Estimated Cost , q , c:::I cJ d Fee , (To be paid on filing this application) 5. If dwelling, number of dwelling units 2 Number of dwelling units on each floor 2.. If garage, number of cars j)e./ i . . ..' (jfft:;;/T/f4" 6. Ifbusmess, comm~<Y~'fL~~l5' specIfy nature and extent of each type of use. Jt~fi:-nryn 7. DimensionsofJJU~~,Dl~q;mt Rear Depth Height ::11'. '.4J::\1~ .ITn' "J"' J"'..... ..I)IIo1{l1i:i.er.~ Stories ~)',)H'IW Dimensions of sa\fi14,A1ql!J~!Ilitl\ ~ations or additions: Front Depth ~~ht Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size oflot: 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_NO_ 14. Names of Owner ofpremises.11)('<J 11 f:IoYJ"'<L'vAddress Name of Architect Address NameofContractor'"\Mhn /rJr:!Pffl"zn/1 AddressCtl.~oY t:,,7../ )Je(..L> $'0 ffo//;' 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. Phone No.o1. "J S' - F<fG:3 Phone No PhoneNo.~q-- ou..,S~ 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~ (p"21:' ..... .~.'?~ICF;lNA. U c'h/7 '/.;;ctty7,.) n I? being duly sworn, deposes and says that (s)he is the applicant (Name oTIIiiliviOl.lanigniIlg c:ontract)-above nttmed, (S)He is the5i?"'Jn.yr--. li:Jy (Contractor,Aget1t; Corporate Officer, etc.) '. ",\",' ~ ,.:."..;' of said owner or o~, and is duly authorized.to perform or have performed the said work and to make and file this application' that all stat~ments. contained in this applri,Cation:.3l'e true to the best of his knowledge and belief; and that the work will be ' performed m the li\!mIler set forth'mtne application filed therewith. Swo ( 20~ , No BollNifi." '" Notary Public, Stili OII11lrM No.01006095328,SuftIIlCllldr Term Expires July 7. 2O.J:l.:l.. 't' Signature of Applicant 1,:/' ':.;;(j.~ ' '--