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Home My WebLink About35427-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34379 Rte: 05/27/10 THIS CERTIFIES that the building FIRE SYSTEM Location of Property: 55765 MAIN RD SOUTROLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 63 Block 3 Lot 8 Subdivision Filed Map No. __ Lot Bo. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCR 29, 2010 pursuant to which Building ~r~t No. 35427-Z dated 5~RCH 31, 2010 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 ROOD AND FIRE SUPPRESSION SYSTEM FOR RESTAURANT INA N EXISTING C0~gfERCIAL BUILDING AS APPLIED FOR. (COUNTRY CORNER CAFE INC) The certificate is issued to STOCKEN DEVELOPMENT 1 LLC ( OWNER ) of the aforesaid building. ~uF~OLKCOI]I~YDEPART~NT OF BF~%LTHAPPRO%raL BI~E~-rKICAL C]~IITIFIC_A~]~ NO. CERTIFICATION DA-r~a3 N/A N/A N/A Authorized 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 ia 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. F/aal Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical iustallation from Board of F/re Underwriters. 4. Sworn statement from plumber ce/tifying that the solder used in system contains less than 2/10 of 1% lea& 5. Commercial btti]ding, industt/al building, multiple residences and Similar buildings and installations, a Certificate of Code Compliance from archiiect.or engineer responsible for the building. 6. Submit Planning Board Approval of coiapleted site plan requirements~ B. For existing buildings(prior to April 9, I957) non-conforming uses, or buildings and -pre.existing- hnd 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 $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, BusInesses $50.00. 2. Certificate of O~cupancy or~ 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: Loc/tion of Property: Date. Old or Pre-existing Building: ,~' House No. Street owner or Owners of Property: · Suffolk County Tax Map No 1000, Section Subdivision Filed Map. Permit No. 3~ L~ ~ ~ H~lth Dept. Approval: 'Planning Board Approval: Date of Permit. Applicant: (check One) 33 Underwriters Approval: Request for: Temporary Certificate Fee Submitted: $ ~--C C C Final Certificate: (check one) Applicant Signature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII/)ING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35427 Z Date MARCH 31, 2010 Permission is hereby granted to: ABT DESIGN FOR STOCKEN 1724 CHURCH ST HOLBROOK,NY 11741 for : INSTALLATION OF A FIRE PROTECTION SYSTEM AT CAFE BUILDING AS APPLIED FOR at premises located at 55765 MAIN RD SOUTHOLD County Tax Map No. 473889 Section 063 Block 0003 Lot No. 008 pursuant to application dated MARCH 29, 2010 and approved by the Building Inspector to expire on SEPTEMBER 31, 2011. Fee $ 250.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [~)~ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] RRE RESISTANT FENETRATION REMARKS: , DATE ~~~~__ INSPECTOR ~~ FO~A~ON (1S~ , ROUGH ~G & PL~G ~$~ON PER N. Y. STA~ E~R~ CODE FOP, It NO. I TOI~I OF SOUTItOLD BUILDING DRPARTI~ffiltT TOl~l HALL SOUTltOLD, lt.Y. 11971 TEL: 76§- 1802 INSTRUCTIONS BOARD OF HEALTH ............... 3 SETS OF PLANS ............... SURVEY ....................... CHECK ......................... SEPTIC FORH .... ................ Date ................ , ~ .... al 'Ibis application ra,,t be completely filled in by typeariter or in ink and suhnitted to the Building Iaspeetor ~t 3 se[s of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan sbu~ing locacio~ of lot and of I~ildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of la,~ut of property [mst be dr~ on the diagrm ~hich is part of this application. c. lhe ~ork covered by ~his application my not be camenced before is~m~ of Building Pemit. d. Upm apb, oval of this application, ~he Building h~pec~or ~ill issue a lhilding Pemit to the applicant. ~ch pemit shall be kept on fi~e ~,=,ises available for inspection thro~hon~ the ~. e. NO beilding shall be occupied or used in daole or in part for any ~ ~hacever mtil a Certificate of Occupar~ shall have been grm~ed by the lhilding Inspector. APPLICATI(lt IS ~l~.~i ~ ~o the lhildiag Depart-ut for the iasu~ce of a Building Pemit pursuant to the Building Zone (him of ~e To~ of Sonl~old described,lk~gulat ions, fo,r%,ulati.s, The. L~ C~:~~ MAR 29 2010 BI DG. DEPT· IOWN OF SOUTHO[O ~uffolk Count-y, Nea York, and other applicable l~s, Ordin~es or tditions or alterations, or for t~al or ~lition, as herein Il applicable 1~,'~, ordln~'~ces, building code, housing code, and a p~e~ises and in building'for necessary inspections. (Signature Off applic~t, or ra~, if a corporation) (Failing ~ddress of applicant) State ~t~ether applicant is c~ner, 3essee, agent, architect, engineer, general contractor, electrician, plunber or builder Nave of ~er of pr~dses ............................................................................................. (as on fl~e t~x roll or l~tast deed) If applicent is a corporation, signature of duly ~horized officer. (N,~e and title of corporate officer) Builders License No .......................... Plumbers License No .......................... Electricians License NO ................. .... . Other Trade's License No ..................... 1. Iocation of land on ~hich proposed ~rk vi11 be done .............................................................. House Number Street I-Troffer Ccunt-y Tax ~ NO. 1000 Section 0(° ~ Block 0 g I~t ~.~. (~) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. ~xisting use and occupancy . ~..~f..e ........................ b. Intended use and occupancy ...................................................... )o ~ture of ~ork (cl~-~.k ~ltid~ spplicable): ~ ~ildi~ .......... ~iti~ .......... Alterati~ .......... If ~r~e, ~r of ~rs ...................................... ~pth .................... ~i~ .................... ~r o~ Stories ............... ~ oE ~Er~or ................................... ~ress ............................... ~ ~ .............. PLOT DIAGRAM l~caCe clearly and distinctly all l~aildings, ~hether existing or proposed, and indicate al1 set-back dimensions r~ pt'oi~erty lioes. Give street and blc~k r,~her or descriptio~ accoxding to deed, and ~ steer nar~s and i~dicate ~ether interior or corner lot. FA'IE (36 ~!~ YO~K, ........ .~:0.[.'~.~0 ....... '...~ ................... I~i~ duly ~m, ~s a~ ~* ~ of i~ivi~l si~ing ~tract) ~ i, t~,~ ....... ~ 5~.~f~ 5~.4 ....... : ................................................................... (~traetor, agent, co.rate officer, etc.) f ~id ~r or ~rs, ~ is duly athori~ to ~rfom or h~ ~rEo~ am ~id w~ ag to m~ a~ file tills ~lieation; d~at ail stat~nts e~tat~ in ~is a~l. leati=~ are t~ to ~e ~st og his ~1~ ~ to ~[or~ m ~is ........ ~ ....... ~o~ .~~..~. ...... ....... ..................... ~ ... (si~ o~ A~tic~t) Jl NOTIFY BUILOl[,! ,FI ¢ /,T FIRE INSPECTION REQUIRED BEFORE OPENING OCCUPANCY OR UoE IS LINLAWFUL ALL CONSTF:',Tr' Ii,, ,,I SHALL M :E THE REQU,.~:I ,.., o OF TI (;ODES OF NEW/'OF,',( S rATE, ,'.' --. AJaT DESIGN& FIltE, PROTECTION' :[- 'i r ti:i" ' ' DATE; UNDERWRITEFIS CERTIFICATE