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Home My WebLink About33990-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-33159 Date: 07/18/08 THIS U~KTIFIRS t~at the bui]dl,g ALTER/HOOD/SUPP. SYSTEM I~c~ti~ of Property: 10095 MAIN RD (HOUSE NO.) (STREET) County Tax Map NO. 473889 Section 142 Block 1 subdivision Filed ~ No. -- Lot NO. __ MATTITUCK Lot 26 {HAMLET) conforms substantially to the Application for Building Permit heretofore filed i~ this office dated JUNE 5, 2008 purs,,~-t tow h ich Buildl,g Pexmit NO. 33990-Z dated J~JNE 18, 2008 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 & INSTALLATION OF HOOD & FIRE SUPPRESSION SYSTEM AS APPLIED FOR. The certificate is issued to MATTITUCK PLAZA STORE #15 (OWNER) of the aforesaid building. SuffOLK CO~TTY DEPARTMenT OF ~%LTH APPROVAL ~.~_-I'~ICAL u~KTIFICATE NO. PLiErS ~K'PIFICATION DA'£~u N/A 4005023 N/A ~ zed/~i~nature 07/02/08 Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 i APPLICATION FOR CERTIFICATE OF OCCUPANCY~-~ 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: 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 iustallation 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. Coramercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for tim building. 6. Submit Planniug Board Approval of completed site plan requirements. For existing bnildings (prior to April 9, 1957) non-conforming rises, or bnildings and "pre-existing" land rises: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and conseut to inspect signed by thc applicant. If a Ccrtiticate of Occupancy is denied, the Building Inspector shall state the reasons therefor iu writing to thc applicant. · C. Fees 1. Certificate of Occupancy -Ncw dwelling $25.00, Additions to dwelling $25.0t), Alterations to dwelling $25.00, 2. 3. 4. 5. Nesv Constructiou: ()Id or Pre-existing Building: Location of Property: }~-6tck' [QLt, atz,~c ~..~¥o~'e_ [ ~- ttouse No. Street Owner or Owners of Property: ,/'~/ /?/6/ ~(~,4 ~ /5,/.~ [ ~ Suffolk County Tax Map No 1000, Section /4 ~- Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Busioesses $50.00. Certificate of Occupancy on Fre-existing Building - $100.00 Copy of Cmlificate of Occupancy - $.25 Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential $15.00, Conmmrcial $15.00 Date. ¢6/~Oc~(- ~/ (check one) ltamlet Subdivision Permit No. ~ ~ c~ ~ ~) Health Dept. Approval: __ Planning Board Approval: Block [ Lot Filed Map. Lot: nateofPermit. [~/l~/Oe~ Applicant: ]x/l c..- ~____~lp,._--/-?.~ Underwriters Approval: ~//fffl~J"ddg?_.~ Request tbr: Temporary Certificate Fee Submitted: $ ...~'~,. 6,0 Final Certificate: (check one) A~t~licartt Signatur~'"- FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PEP~IT NO. 33990 Z Date JUNE 18, 2008 Permission is hereby granted to: MATTITUCK PLAZA STORE #15 PO BOX 77 MATTITUCK,NY 11952 for : ALTEP, ATION & INSTALLATION OF HOOD & FIRE SUPPRESSION SYSTEM at premises located at County Tax Map No. 473889 Section 142 pursuant to application dated JUNE Building Inspector to expire on DECEMBER 10095 MAIN RD MATTITUCK Block 0001 Lot No. 026 5, 2008 and approved by the 18, 2009. Fee $ 250.00 / Author i ~e~l~Signatur e ORIGINAL Rev. 5/8/02 FORM RO. I TOWN OF SOUTHOLD BUILDING D~PARTN~IqT TOWN HA~L SOUTHOLD, N.Y. 11971 T~L: 765-1802 (~ilding Inspector) APPLICATION FOR BUILDING PERMIT ~NSTRUCTIONS BOARD OF HEALTH ............... B SETS OF PLANS ............... spEvzv ........................ CHECK ......................... SEPTIC FORM ................... NOTIFY: MAIL TO:~ ............ ~,~ .... ...... ~/4.'....,:..?.£~.. ......... a, 'Ibis applicatiou ~tst be completely filled in by typewriter or in ink ~ud suhnitted to the lkdlding I~cor uit 3 sets of plm~, accurate plot plm to scale. Fee according to schedule. /2~ ~c~ ~-7', /-¢o~,~o,< .~' //'20,/ .... . ./7.E.~¥.. / :..~. ~.~.s .r..~..L~.....~.¢..~.< .~..~..77.~ .............................................................. ~ of ~ of p~, .../Ylm.~-.rir.'f..o..~..~ ...... P.Y~r~.~4 ........... .~..t,..~ ................................. , .....Z..~. .......... ~... ........ Builders License No .......................... . Plmtmrs License No .......................... ~lectriciams License Ro ...................... Other Trade's Lice~e No ..................... ,. ~=t~ o~ ~ ~.~ ~o~ ~o~ ~l~ ~ ~...../.~.../.z~..-~..?.s~..../..~.~.~.....o.~~ J% /Zya2-rwr~,c/< /Wy /lO'~.z. ................................................................. .... i~f/~'~,f.; ................ '/'"'i~', ........ .~ c~ T~ ~p ,o. ,~o ~u,~ ...l..q...~. ..... ~ ......I ......... t~ ..... ~{* ....... Sdadivisio~ ...................................... Filed Map No ................ lot ............... (mm) a. Existing use ~ occupancy ..... ff.~.?.~.~.~..~.q.~.4t.~..IT.. ................................................. b. ~t~ ~ ~d ~,=,,~y ...... ./.~.~.~q..~.C ................................................. l~ir ............ ~al ............. l~ht~ ............ Other ~ ~q~.,.~...~.. ~rlpti~) PLOT DIAGRAH Locate clearly and dlstinetly all buildings, ~hether existing or proposed, and indicate all act-back dimensions · NO. 0110L6171607 Commission Expms July 23, ,mil Town H~I, 53095 M~n Road P. O. Box 1179 ~outhold, NeWYo~ ~]971 Fax (516) 765-1823 Telel~o.e (518) 765-1 OFFICE OF THE BUILDING INSPECTOR TOWN OF 8OUTHOLD print) I certify that the solder used tn the water supply system contains less than 2/10 of 1% le~d. (Plumbers Signature) -- Sworn to before me tht~ ~C(;OGGiNS/ - 'If---' County ction NEW Estab. ID: -1027 Estab~ Class: 110 Estab. Name:~ BAHIA ctiv. Co'de(s): 12 Inspection Date: 7/16/2008 Tflne o£Inspection: 1:28:17 PM PART 2: BLUE MAINTENANCE ITEMS These items relate to maintenance of the food service operation and cleanliness, correct as scheduled. Other Notes - Per o,~er, hc is signed up for the J. Kings Suffolk County FMC class on Jul)' 23rd. Pre-operational Inspection 3 compartment sink -- (L x W x H) 18 x 18 x 14 as per plans Hot water heater AP Smith BTR-154 81 gallon, 154,000 BUT/Hr recovery rate. No Dishwasher RE: Conditions to approval 1. Adequate storage space provided. 2. Menu advisory was adequate. a. Advised owner that a link would be reqnimd, in additional to the disclosure, and reminder statements. 3. 26" sneeze guard that extends 24" back noted. ISSUE PERMIT / OK 1o operate. Questions please call 852.5999 Raymond Lam BAREHAND CONTACT WITH ANY READY TO EAT FOOD ITEMS, AS WELL AS FOOD OPENLY DISPLAYED IS SUBJECT TO IMMEDIATE FINES. Establishment constructed to the approved plans, with the exception o£the violations cited. Questions please call 852.5999 Raymond La~n For urgent matters, please ask to speak with a supervisor. 840.7371 Mobile 852.5871 Facsimile To sign up staff for the Food Manager's Class, please call 852.5997 Class given in English and Spanish, please specifiy language preference when calling. BAREHAND CONTACT WITH ANY READY TO EAT FOOD ITEMS, AS WIELL AS FOOD OPENLY DISPLAYED ARE SUBJECT TO IMMEDIATE FINES. Person Receiving Report: Sanitarian: 784 Lam Pa~e Page 2 of 2 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOOD ESTABLISHMENT INSPECTION SUMMARY REPORT Action:NEW Activ. Code(s): 12 Estab. ID: -1027 Estab. Class: 110 Estab. Name: BAHIA Estab. Address: 10095 RTE. 25 STORE #11 Ovmer: JAMES MCCARTHY, PRESlD Corp. Address: 675 WESTVIEW DR., PO BOX Corp. Zip: 11952 Estab. City: MATTTUCK Corp Name: MATTITUCK STORE Inspection Date: 7/16/2008 Time of Inspection: 1:28:17 PM PART 2: BLUE MAINTENANCE ITEMS perrmt Restr:S Z Mgr. Cert. #1: lnsp. Status(es): 06 Capacity: 16 SAFE: R/sk: 1 These items relate to maintenance of the food service operation and cleanliness, correct as scheduled. Code Section 760-1303.2 760-1304. l.b 760-1353.1.c 760-1353.2.d Description of Violation PERMITS, POSTINGS, PLAN REVIEW, APPLICATIONS, COMMISSIONER'S ORDERS PERMITS, POSTINGS, PLAN REVIEW, APPLICATIONS, COMMISSIONER'S ORDERS TOILET FACILITIES TOILET FACILITIES Correct By 7/30/2008 7/30/2008 7/30/2008 7/30/2008 Signature of Person Receiving Report: Print Name: Sanitarimr 784 Lam Joint Sanitarian: Page:Pagel ofl "The items noted above are violations of applicable laws, rules and regulations found during an inspection of the operation of the facilities in this establishment which must be corrected as indicated. Failure to comply may result in the initiation of legal action against this establishment as provided for in Articles 2 and 13 of the Suffolk County Sanitary Code including a hearing, possible suspension of your fo~d operation, and or the publication of the violation and fines." a, SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOOD INSPECTION NARRATIVE lA_etlon: NEW Estab. ID: -1027 Estab. Class: 110 Es[ab. Name:. BAHIA ]v~Code(s~ 12 Inspection Date: 7/16/2008 Time of Inspection: 1:28:17 PM PART 2: BLUE MAINTENANCE ITEMS These items relate to maintenance of the food service operation and cleanliness, correct as scheduled. Code Section 760-1303.2 To Wit: Description of Violation Any person desiring to operate a food establishment shall make written application for a permit on forms provided by the department. Such application shall include the applicant's full name and post office address and whether such applicant is an individual, firm or corporation, and if partnership, the names of the partners, together with their addresses; proof of the applicant's authority to collect sales tax in the State of New York; the location and the type of food establishment; and the signature of the applicant or applicants. If the application is for a temporary food establishment, it shall also include the inclusive dates of the proposed operation. The operator failed to submit a properly prepared application for a permit, in that: 760-1304A.b To Wit: - Proof of disability insurance was not submitted. - Proof of worker's compansation insumace was not submilled. All construction, remodeling, or alterations shall be done in accordance with the approved plans. Establishment was not bult according to proposed plans, in that: 760-1353.1.c To Wit: 760-1353.2.d To Wit: 1) Ice machine (25) was moved to the back storage area (9). 2) Wall refrigerator (27) was not installed per approved plans. 3) Storage rack was moved to an adjacent location (9). 4) Salamander grill noted aboe stove (17). Toilet rooms shall be completely enclosed and shall have tight fitting, self-closing doors. The toilet room door was not self-closing. A toilet room used by females shall be provided with a covered receptacle for sanitary napkins. A covered receptacle for the disposal of sanitary napkins was not provided in the EMPLOYEE/PATRON toilet room. Correct By 7/30/2008 7/30/2008 7/30/2008 7/30/2008 Person Receiving Report: Smntarian: 784 Lam Page Page 1 of 2 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING / STRAPPING [~ FINAL FIREPLACE & CHIMNEY [~/~RE SAFETY INSPECTION [ ] FIRE RESISTANT COflSTRUCTIOH [ ] FIRE RESISTANT PENETRATION REMARKS: FO~ATION (1ST) FO[~ATION (2ND) ROUG~ F~G & ~NS~ATION PER N. Y. STATE ENERGY CODE 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 CUSTOM LIGHTING OF SUFFOLK INC * CARDINALLE PO BOX 1698 ROUTE 25 MA'I-rlTUCK, NY 11952, MATTITUCK, NY 11952 Located at ROUTE 25 MATTITUCK, NY 11952 Application Number: 4005023 Certificate Number: 4005023 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: Floor, Outside, First 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 2nd Day of JulY, 2oes. Name OTY Rate Rati~a Circuits ~ AdditionalCharges install exhaust fans over grill Appliances and Accessories Exhaust Fan 2 0 F,H,p Wiring And Devices Fixture 5 0 Incandescent Switch 2 0 Gen, Purpose seal I of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES CERTIFICATE OF APPROVAL OF FOOD SERVICE ESTABLISHMENT FOR CONSTRUCTION, ALTERATION OR REMODELING Applicant Bahia Establishment Location 10095 Rte. 25 Mattituck, New York Approval is issued under the provisions of Article 13, Section 1304 of the Suffolk County Sanitary Code for: 1) New Structure 3) __ X__ Conversion 2). Remodeling 4)__ __ Other THE FOLLOWING CONDITIONS APPLY: 1) THAT THE PROPOSED CONSTRUCTION IS IN CONFORMITY WITH THE PLANS AND SPECIFICATIONS APPROVED BY THIS DEPARTMENT. 2) THAT THE APPLICANT CONTACT THE FOOD CONTROL OFFICE AT 631 852-5873 TO ARRANGE AN INSPECTION OF COMPLETED CONSTRUCTION PRIOR TO OPERATION. 3) THIS CERTIFICATE IS NOT A PERMIT TO OPERATE A FOOD SERVICE ESTABLISHMENT. OPERATION WITHOUT A SATISFACTORY PRE-OPERATIONAL INSPECTION AND/OR A PERMIT TO OPERATE WILL RESULT IN LEGAL ACTION. 4) THAT THE APPLICANT SHALL ASSURE CONFORMANCE WITH THE FOLLOWING AMENDMENTS TO PLANS AND SPECIFICATIONS: a) Provide adequate storage protection. b) Provide an adequate menu advisory. c) Provide adequate sneeze protection at the front counter. ISSUED~ 'AD~E~IZG~AT~c~SEI~TATI f~FOR THE COMMISSIONER OF HE/A~LT ,I,t,,~ ~~_A~ F TRAINING AND PLAN REVIEW UNIT 360 Yaphank Ave. Yaphank, N.¥ 11980 *~1 852-5873 STEVE LEVY County Executive DAVID G. GRAHAM, M.D., M.P.H. Acting Commissioner FOOD MANAGER'S CERTIFICATE May 23, 2007 Date This is to certify that ~.NRZQV~. o~.zvA has fulfilled the experience and training requirements specified in the Suffolk County Sanitary Code, for Food Manager. Certificate No. 70498 Expires 05/23/2010 Acting Commissioner BRoi~s - 4' ~ ~ ho~ -- Syd ~e{ ~ h~e ~pa~ ~e~o~ {~ ~ fao - under AeRate h~d Model -- SuppJy cfm' ABT DESIGN & FIRE PROTECTION 1724 CHURCH STREET HOLBROOK, NY 11741 631-878-4896 FAX: 631-878-5727 APPROVED AS NOTED DATE;_ ¢ -6S-~802 8A~J TO, :., FO:q THE ' -( - '~O 4. FINAL - C,L "!4UST. CO~v,~L: : .... :.,, ALL CONSTRUCTtON S~,'~L[. ~.,- M::T THE - ............. OFTH~ ~d~ OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ER~RS. REG..4RF,-? 2,:F%~R~,,-,,-._ ',,,~r uN ,Y %.. OPENING' uot: 15 UNLAW~, ,, · WITHOuT,~,--,. 2 7/ "'~' ' ' Q'OCCuPANCy .- . -~ ~ ~= THE Hp'in~ Mater[a[: Black Iron ;t~pply ?ipe Size: 5/8 :. ]as Val've type: /~-~' Size )erector ~ture rating : ~o~ SiZe: Branch Pipe S~ze: 3/8 D~t Size: /~ "'0~. D~t S~ze: . ' Fm/ers to have High Limit Control to shut off f..~l at (~2_5 deg. Detectors shall be lccat~ over e~ery piece ot~ equip~_fit. The System installed as per n~vdfacturers s~ and the AHJ. " The ~s~ has ~ i~talt~ =~ ~r U~O0. The follo~i~ f~ti~ ~o o~rate ~ sy~t~ discharge: * S~ly air d~r clos~ * ~as f~l'shuts 9ff in ki't6hen * ~a~t f~ r~i~ ~ *'Electric f~-t shut off ~r h~ *'All s~t~ to aFtivate si~lt~ty {n s~ haza~ aFea. * Fire Ala~ s~ab[ activate if ~'Ma~t ~tt iz t~t~ lO-Z5 ft ffm h~ ~ .3% ft fr~ ft~r. ~tt fm't s~ro~ ire ~s mt~ othe~ise ~t~.' CON!RACTOR': OCA~ION:- ABT DESIGN & FIRE PROTECTION 1724 CHURCH STREET HOLBROOK, NY 11741 631-878-4896 'FAX: 631-878-5727 .I T~ n~ ~nclosure 429870 · Swivel Aa~ 42~5T2 ~~ 41~9 Tcrmirml D~ 4lT36~ puli S_~nS'oa 4835 /~r 'Vatve-zlMxmI' ~7¢~/o ' SERVICE I KITCHEN PUBLIC H/C TOILETS 2"~ ~ ~ -~ -- ~ ~ ~ ~ I EL.D,^,, EL, I I ~ 2" 1 1/2' 2" 2" 1 1/2' 1" ~ I ~WASTE DIAGRAM I%--so:nm~ I SCALE: NT% C.I. MAIN < ~ PIZZA GREECE KITCHEN PUBLIC 3/4" HW 3/4' ~ ~ 1/; ~ 1/2"1/2 ~ ~/2" ICE -- ~/~' V2 ~/2' HW CW HW CW OW UW i PI EP HAh) SINK = ~II ~ DROP - IN DROP - IN / I ~ ~ ~ ~ -- WALK ,N COOER BOX HOT ~LLS COLD PANS KITCHEN FINISH MATERIAL SCHEDULE ~ Y ~ I J I ~"~ Y y ! FLOOr QUARRY TILE ~ S U P P L Y WALLS DYNA GLASS FRP RI %ER D I AGR AM SC*L~ : NTS ~u~*~s E O U I P M E N T S C H E D U L E NO 2TY EQUIPMENT CATEGORY REMARKS Sf~¢~ 1 1 DROP-IN, COLD PAN 5: : ~ ~ ~~ ~ :E~%~ -- ~ 5 1 DROP-IN, HOT WELLS ~ SINK ~l _ ~ H~¢~NK W/S~LA~ 7 1 SINK, MOP W/ MOP HOOK EXISTING ~__ sm ~T~AGE ~ 9 1 SHELVING UNIT, STARTER, M~AL, WIRE- DRY AND CAN GOOD _ ~ -- -- ~ .... 12 1 WORKTABLE I ~ ~I I ~ ~ _ ~ ~ ~ ~ ~ ~ / ~BELOW COUN~R PAPER I UND' RAISE[ i ~ ]~ - 0 ~ 0 ~E~E GUARD PRO~D~ AT SALSA CSUN~ ~ ~ 20 19 18 11 BROILER' GAS 1 HOOD' EXHAUST REFRIGERATOR, SHOR~ - - - -- rmm - " 1 GRIDDLE, GAS -- ~ ' ~ ~ 23 1 HAND SINK WITH SP~SH GUARD / 24 1 DISPENSER, NON--CARD ~ ~ %6 EMPLO~E L~KERS 25 1 DISPENSER, ICE/B~ERAGE ~FLOOR PLAN SCALE : 1/~" = 1'-0" EQUIPMENT SCHEDULE ITEM ' EQUIPMENT NO ~TY EQUIPMENT CATEGORY REMARKS 1 DROP-IN, COLD PAN 2 1 SNEEZE GUARD 3 1 DROP-IN, HOT WELLS 4 1 REFRIG DROP IN W/SNEEZE GUARD 5 1 SHELVING, WIRE 6 1 5x6 TAFCO WALK-IN 7 1 SINK, MOP W/ MOP HOOK EXISTING 8 i SPARE # g 1 SHELVING UNIT, STARTER, METAL, WIRE- 10 1 POT RACK 12 1 WORKTABLE 1Z 1 5-COMP SINK EXISTING 14 1 TUBULAR BRAIN SHELF 15 I HAND SINK W/SPLASH GUARDS EXISTING 16 1 TABLE W/FOOD PREP SINK 17 1 RANGE, GAS 18 1 HOOD, EXHAUST - 19 1 BROILER, GAS 20 1 REFRIGERATOR, SHORTY 21 1 GRIDDLE, OAS 22 2 FRYER, GAS W/SIDE GUARDS 25 1 HAND SINK WITH SPLASH GUARD 24 1 DISPENSER, NON--CARE3 25 1 DISPENSER, ICE/BEVERAGE 26 1 ICE MAKER 27 1 WALL MOUNT REFRIG -