HomeMy WebLinkAbout36174-ZTown of Southold Annex
54375 Main Road
Southold, New York 11971
4/22/2011
CERTIFICATE OF OCCUPANCY
No: 34911 Date: 4/22/2011
THIS CERTIFIES that the building COMMERCIAL ALTERATION
Location of Property:
28350 Route 25, Cutchogue, NY 11935,
SCTM #: 473889 Sec/Block/Lot: 102.-6-18.1
Subdivision: Filed Map No.
conforms substantially to the Application for Building Permit heretofore
2/11/2011 pursuant to which Building Permit No.
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:
interior alteration of existing restaurant as applied for.
Lot No.
filed in this officed dated
36174 dated 2/11/2011
The certificate is issued to
OffFairway Inc
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED Thomas Azzaria
36174 4/22/11
Au/3/20/11...
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit #: 36174
Permission is hereby granted to:
Off Fairway Inc
Date: 2/11/2011
28350 Route 25
PO BOX 958
Cutchogue, NY 11935
To:
alter the interior of an existing restaurant as applied for
At premises located at:
28350 Route 25
SCTM # 473889
Sec/Block/Lot # 102.-6-18.1
Pursuant to application dated
To expire on 8/12/2012.
Fees:
2/11/2011
and approved by the Building Inspector.
NEW COMMERCIAL, ALTERATION OR ADDITIONS
CO - COMMERCIAL
Total:
$337.20
$50.00
$387.20
Building Inspector
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 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 state~nent from plumber certifying that the solder used in syste~n 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 l¥om architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
1. Accurate survey of property showing all property lines, streets, building anal 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
l. Certificate of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00,
Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00.
2. Certificate of Occupancy on Pm-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, Co~nmercial $15.00
New Construction:
Location of Property:
Old or Pre-existing Building:
Date.
(check one)
House No. Street
Owner or Owners of Property: 30}-~
Suffolk County Tax Map No 1000, Section ~.~ ~.
ltamlet
Block
Lot I. ~'. \
Subdivision
Permit No.
Health Dept. Approval:
Date of Permit.
Filed Map. Lot:
Applicant: ~T'l'~'vt,~ ~,,~'-~
Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fcc Submitted: $ ~.~4
Final Certificate:
(check one)
Applicant Signature
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631 ) 765-18(12
Fax (631) 765-9502
ro.qer.dchort~town southo d ny us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Touch of Venice
Address: 28350 Main Rd City: Cutchogue St: NY Zip: 11935
Building Permit #: 36174 Section: Block: Lot:
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Michaels Electric LicenseNo: 35472-me
SITE DETAILS
Office Use Only
Resiflential ~ Indoor ~ Basement ~ Service Only
Commedcal Outdoor 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Servicelph ~ Heat ~ DuplecRecpt ~ CeilingFixtures ~ HIDFixtures
Service 3 ph Hot Water GFCI Recpt Wall Fixtures ~.~ Smoke Detectors
Main Panel NC Condenser Single Recpt Recessed Fixtures ~.~ CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture ~.~ Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures[~ Time Clocks
Disconnect Switches Twist Lock Exit Fixtures L._.._J TVSS
Other Equipment: exhaust fan-1
Notes: partial up grade of electricle equipment
Inspector Signature:
Date: Ma)/2 2011
81-Cert Electrical Compliance Form
Town Hall Annex
54375 M~in Road
P.O. Box ! 179
Southold. New York 11971-0959
Telephone (631 ) 765-1802
Fnx ~631 ) 765-9502
BUILDING DEPARTMENT
TOWN OF SOUTHOLr~
CERTIFICATION
Building Permit No.
Owner:
Plumber:
Date:
(Please print)~- ~-' ' '
(Please print)
I certify that the solder used in the water supply system contains less than 2/I0 of 1%
lead.
Sworn to before me this
day o ,~ , 20
(Plumbers
CONNIE D. BUNCH
Notary Public, Sta~ of New York
No. 01BU6185060
Qualified in Suffolk County ~
Commission Expires Apfl114, 2~'
Notary Public, ~ County
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. 33829 Z Date APRIL 17, 2008
Permission is hereby granted to:
for :
FAIRWAY INC OFF
PO BOX 958
CUTCHOGUE,NY 11935
INSTALLATION OF A FIRE SUPRESSION SYSTEM AT AN EXISTING RESTAURANT
AS APPLIED FOR.REPLACES EXPIRED BP # 30144.
at premises located at 28350
County Tax ~4ap No. 473889 Section 102
pursuant to application dated APRIL
Building Inspector to expire on OCTOBER
Fee $ 200.00
MAIN RD CUTCHOGUE
Block 0006 ~ot No. 018.001
17, 2008 and approved by the
17, 2009.
'e
ORIGINAL
Rev. 5/8/02
FOR~ NO. I
TOI~i OF SOUTltOLD
BO [LDING DEPARTNENT
T011N IIAL[.
SOUTHOLD. N.Y. 11971
TEL= 765- IS02
(Building Inspector )
2004 APPLICATION FOR BUILDING PERNIT
BOARD OF III'.'^i.Tli ..............
3 SETS OF PLANS ...............
SURVEY ........................
CHECK .........................
SEPTIC FORH ...................
NOTIFY:
CALl. .................
NAIL TO: ....................
· Date ..........
INSTRUCTIONS
a. llais applieatim mast be em~.letely filled in by type~iter or in itl{ and
3 ~ts of pl~, ~ate pl~ pl~ to ~e. F~ ~i~ to ~le.
b. Plot pl~ ~ l~ti~ of lot ~ of ~ildi~ ~ ~s, mlati~ip to ~joini~ p~s or ~lic
st~ts or ~, ~ givi~ a ~tail~ ~ri~i~ of l~t of ~ ~t ~ dr~ ~ ~ di~ ~i~ is ~ of
~is ~liotim.
c. ~ ~ ~M ~ ~is ~lioti~ ~ mt ~ ~ ~fo~ i~ of hildi~
d. ~ ~al of ~is a~li~ti~, t~ ~ildi~ I~etor ~11 is~ a ~ildi~ ~t to
~t ~11 ~ ~ m ~ pi~s ~ail~le for i~ti~ ~t ~ ~.
e. ~ildi~ ~1 ~ ~i~ or ~ ingle or in ~rt for ~ ~t~r mtil a~ificateof
~ ~1 ~ ~ ~mt~ ~ ~ Mildi~ I~r.
~I~ IS ~ ~ ~ ~ ~iMi~ ~nt for ~ is~ of a ~ildi~ ~t ~mt to
~ildi~ ~ ~i~ of ~ ~ of ~ld, ~ffolk ~, ~ Yo~, ~ o~r ~li~le ~, ~i~s or
~lati~, br ~ mt~tim of ~ildi~, ~iti~ or alterati~, or for ~1 or ~liti~,
~ri~. ~ a~li~t ~s to ~ly ~th all a~li~le 1~, o~i~s, ~ildi~
r~ati~, ~ to ~it m~ri~ i~t~s m ~s ~ in ~ildi~ for ~ i~ti~.
............ ..................
(SiCn~ of ~lie~t, or ~, if a ~rati~)
State ~flmr ~ti~t ia ~r, lea~, ~t, ~it~t, e~i~r, ~ral ~tr~tor, et~triei~, pier or
~ of ~r of ~a .............................................
(~ m ~ t~ ~1~ or lateat ~)
..... ........ .....
~ ~ title%f ~ra~te
Builders License No ........................
Plm/~ers License No ..........................
Electricims Li~e No ......................
Location of land on ~hich propoaed ~ork ~ill be ...........
County Tax ~ no. I000 Section ................ Block ................ Lot ...... '. .........
Subdivisian .... :~ ...................... Filed Nap ~ ....... Lot ...~...
a. Existing use and o~?~cy ...............................................................
3. Pz~ture of ~ork (deck ~idd~ applicable): N~ l~dhling .......... 6dditlon ....... ... Al~:eration .....
Relmir ............ Ren~val ............. l}emol ition .. Other 14ark ..~'/~..~~
6. Estimated Cost ......................... fee ......... : ..................................
(to be paid on filing this application)
5. If ~eiling, raed~er of d~elling traits ............ ttml~er of d~elling ~mlts on each floor ................
If garage, nteber of tara ......................................
6. If Inmineas, cu,,,,:ccial or mi~nl oceepaney, apecify nature and extent of each type of use.~3.__..............
7. Dimenaicnm of exlating atructurea, if any: Froot ................ Rear ............... Depth .................
Ileight ....................... :~ ....................
8. Di~ '~om of entire ne~ c(mstructicn,: Frcmt ... ~..~. ....... Rear .~.~c.. Depth ..............
Ileigl~t ................... .~.~=~Hlinber of Storiea ~ ~ .
10. l}ate of~cr~clm.n~ .......... ::: ........ I~me of For~r O, ner ....... .~:2: .............................
a~ .n~ t~mtc~l ..................................
I I. cu~ d~-ri~t in ~ddd~ premlsea ' ~ · ...........................
12. l}eea?r~opoaed ec~mtroctiee violate any ~xn~ing 1~, ordln~ce or regulation: ........................
13. ~1~ lot be re~raded .................... ~lill e~eas fill be removed £rom pr~isea: ~ ND
I~lre_ O[~ ~.-.--r 0 , ' . ..................................... . , . .......
.' .......... ..............
15. Is this property w~thin 300 feet of a tidal ~etland? * YIL~; .......... NO .......... C/
· I.F YES, ~XITII3LD ~ 11~,.~fEES FEI~FF HAY HE
PI,OT DIAGRAH
I~cate clearly and distinctly all buildings, d~ether existing or proposed, and indicate all set-back dimensions
I~ron proFerl'y lines. Give street and block ra~ber or description according to deed, and sho~t street hanes and indicate
~d~etber interior or corner lot.
· '~F^'IE {1r ~l~
,:~,,, / /.. ~. ~s .
.... ...... ..........
(~ of ]~ivi~t slg, i~tract)
........... ................ ..........................................
(U~trsetor, ~nt, cor~rnte o{ficer, etc.)
of ~id ~er or ~ere, at~ is ~lly ~Ll~ri~l to ~rfom or h~ lerfo~ Lie ~id ~ m~l Lo rake a~ file this
n[~}llcntion; Lhal: al
that Oe ~rk will be ~rfon~l
~rn Lo I~[ore ~ this
....... .....
~a~ Retie . -'-- ------------~---.
(Sig~mt~of ApplJc, nt~
~N R HE~
NQ~ ~, State
~ NO. ~676
~s~J~5;~ /
duly .,r~rt), del~oses aT~l ..~ays that be is the nppl. icant
765-,80
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGHPLBG.
[ ] FOUNDATION 2ND [ ] I~ATION
[ ] FRAMING / STRAPPING [ ~ FINAL
[ ] FIREPLACE&CHIMNEY [ ] FIRESA~,=~'INSPECTION
DATE
/~/// INSPECTOR_~
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING / STRAPPING [ ] FINAL
FIREPLACE & CHIMNEY ~i;IRE SAFETY INSPECTION
[ ] fiRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
DATE ~ INSPECTOR
.~-~ jr
~/~ TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] RRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) '~ ELECTRICAL (FINAL)
REMARKS:
DATE __
~/'~ INSPECTOr-'
Mark D. Geiselman Architect, PC
20 April 2011
Town of Southold
Building Department
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
Re: Touch of Venice
28350 Main Road
Cutchogue, NY 11935
Permit # 36174
To Whom It May Concern:
Based on visual inspections and to the best of my knowledge, the new wall framing at
the above referenced project has been completed as per the approved plans and is in
compliance with all applicable cedes, rules and regulations of the Building Code of New
York State.
Should you have ay questions or require additional information, please feel free to
contact my office.
Mark D. Geiselman, AIA~~'A
NYS lic. # 020357
Post Office Box 871 · Long Beach, New York 11561 · TELffAX 516.432.0918 · www. MDGArchitectpc.com
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL ' ·
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
Examined ~f/'/ , 20 l !
Approved O~gl, 20 J[
Disapproved a/c
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_
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Storm-Water Assessment Form
Contact:
Mail to:
Phone: 7¢'
Expiration~ (//?/20 /t,~ ~
_ ,~ n nn r~-~ Building Inspector
~/ J~l ~ 2011 /~,j Date ~'~ ~AS4tlgl~ ',20_11_
2 t INSTRUCTIONS '
sets ( ' ' ' ' .... ' ' '
~ !Pelee};lcYorfidlne: :on ~[h;YffuelTnter or in ink and submitted to the Bmld,ng Inspector with4
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or
ajeas, and waterways.
· c. The work covered by this application may not be corrrmenced 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 until4he 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 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.
(Signature of applicant or name, if a corporation)
(Mailing ad.ess 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 o£duly authorize._d officer
(Name and ti!le of 9orporate officer)
Builders License:No:',..:
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which pro~o?ed work will be done:
House Number Street
County Tax Map No. 1000 Section
Subdivision
Hamlet
Block (a Lot 1~. I
Filed Map No. Lot
State existing use and occupancy of premises and intended use and occupancy of proposed constmcfio, n:
a. Existing use and occupancy ,lib, m- ~m~.~ .~.~..r/.~r,~t.I}~ff7'
b. Intended use and occupancy ,l~g~lga.¥
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost~ I ~'~', ~:'~
5. If dwelling, number of dwelling units
If garage, number of cars
Addition
Other Work
Fee
Alteration
(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.
Dimensions of existing structures, if any: Front *-. a,~,' Rear
Height_ · ¢---- Number of Stories
Dimensions of same structure with alterations or additions: Front u~'
Depth_ Height. Number of StOries
Depth
Dimensions of entire new construction: Front gl /,A Rear ' Depth
Height Number of Stories ~
9. Size oflot: Front ~.~fi.'~i Rear ~ 114
Depth t ~35~1~
10. Date of Purchase
Name of Former Owner
11. Zone or use district in which premises are situated 14 lj~
12. Does proposed construction violate any zoning law, ordinance or regulation? YES
NO
13. Will lot be re-graded? YES __ NO .X Will excess fill be removed from premises? YES__ NO ,X
14.
Names of Owner of premises Address Phone No.
Name of Architect Vl~.~.~r~l.t,.~ ,~I~-,#t1'8~ 'p.r~ ~.~. ~ ~,'u
Address - , Phone No ~Jt.~. ,~a3~-,~'11~
Name of Contractor Address Phone No.
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.
16.
17.
Provide survey, to scale, with accurate foundation plan and distances to property lines.
If elevation at any point on property ls at 10 feet or below, must provide topographical data on survey.
18. Are there any covenants and restrictions with respect to this property? * YES __
· IF YES, PROVIDE A COPY.
NO ,X
STATE OF NEW YORK)
SS:
COUNTY OF )
~-"'Fr~::%~o '~l~k[~...[,.) i,~ being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named, '
CONNIE D. BUNCH
Notary Public, 6'rate of New Yo~
(S)He is the b ~5.~ ~ ~ ~
(Contractor, Agent, Corporate Officer, etc:) Qua#fled In ~ 0otmiy
Oomml~lo~ Expires April 14,
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 tme 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 to before me this
Notary Public
Signature of Applicant
State existing use and occupancy of premises and intended use and occupancy of Proposed construe,tie, n:
a. Existing use and occupancy )~.m' ~nam~ A.~* ?...~a-,a,u~,~q'
b. Intended use and occupancy ~n8~.,¢ ~-.m,a~* A-'~ Iz~r4at~l-
3. Nature of work (check which applicable): New Building . Addition
Repair Removal Demolition Other Work
Estimated Cost~_. 1 ~'~'; ~,a:,~
If dwelling, number of dwelling units
If garage, number of cars
Fee
Alteration.
(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.
8. Dimensions of entire pew construction: Front ~i/A
Height Number of Stories
9. Size of lot: Front
Dimensions of existing structures, if any: Front ~' at,' Rear :Ir t~¢,' Depth
Height *- ¢--- Number of Stories
Dimensions of same structure with alterations or additions: Front ~av
Depth Height Number of S~o?ies
Rear
b
Rear ~ ti4 .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 /X
14. Names of Owner of premises Address Phone No.
Name of Architect t~o.~w,~t,,nan Al'u,~'l'~ ?.r~ Address - ~ Phone No
Name of COntractor Address Phone No.
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 REQUI,RED.
16. Provide survey,,to, scale,, with., accurate, foundation plan and distances to property lines.
17. If elevation at any poiAt on proPert5 'lS at'i0 feet or below, must provide topographical data on survey.
18. Are there any covenants and restrictions with respect to this property? * YES__
· IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF )
NO ,X
~"FI'~%~O "~I~A.IJI~¢C*[,,! 1,~ being duly sworn, deposes, and says that (s)he is the. applicant
(Name of individual signing contract) above named, - ' ;" '~ ~ ; '' ' '
CONNIE D. BUNCH
(S)Heis the [,~'~ NOlafy Pdffio, ~lltO of l~n~Yol~~ 0IRl1818~fl~O
(Contractor, Agent, Corporate Officer, etc:) Qualified In 8ulto~ Oounty ~, ~.
Comml~lon Explm~ AI~ 14, ~
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 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 to before me this
p~.'~ day of ~-~f',.-~XINkM 20
Not~y Public
Signature of Applicant
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HAIL '
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
Southo!dTown.NorthFork.net
Examined ~[! ,20 It
Approved O~g ,20 J[
Disapproved aJc
PERMIT NO. 3(~ ["2 t~
BUILDIN.G PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
' ~ ~4 sets of Building Plans
Planning Board approval
·" Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Flood P~ermit _
Storm~Water A~se~smen Form
Contact:
Mail to:
ExplratlOff,, .~- ff//~20 /~ *-~ Phone: ~,7~'~
---'-~ ~ n ~ ~ ' Building hspector
~ BUILDING PERMIT
PPLICATION
FOR
~JA~ ~ 2011 [~ "~' Date Z~ ~U,~ ..2011
~ INSTRUCTIONS ' ' --
~OG. OiPt.. _ --
a. This :~ ~ - -' completely filled in by t~e~fft~r'or in ink and submitted'to the Bulldog ~spector with 4
sets ~ ~. accurate plot plan to scale. Fee according to schedule,
b. Plot pla showing location of lot and of buildings on premises, relationship to adjoining premises or public streets ~r
aeeas, and wate~ays.
c. The work covered by this application may not be e&~h,enced before issu~ce of Building Pemit
d. Upon approval of this application, the Building Inspector will issue a Building Pemit to the applicant. Such a pemit
shall be kept on the p~mises available for inspection throughout the work.
e. No building shall be occupied or used in whole or m p~ for any pu¢ose what so ever unt~he Building Inspector
issues a Ceaificate of Occup~cy.
i Ev~U b~lding pemit shall expire if the work authorized has not commenced within 12 monks aaer the date of
~ssuance or has not be~ completed within 18 months ~om such date. If no zo~ng mendments or other re~lations affecting the
property have been enacted in the ~terim ,a%B~i~mg hspector may authorize, in writing, the extension of ~e pemit for an
addili~ff gix,months:'Therea~er, a new~pemt s~l,b~ ~ired. ' '"" ' ......... ' ....
~PLICATION IS ~BY M~E to the Building Depament for the issu~ce of a Building Pemit pursuit to the
Buil~ng Zone Ordin~ce of ~e Town of Sou~old, Suffolk County, New York. ~d o~er applicable Laws, Ordinates or
Regulations, for ao'~onsmction ofbuil~ngs, ad~tions, or alterations or for removal or demolition as here~ described. The
applic~t a~ees to comply with all applicable laws, ordinances, building code, housing code, and re~lations, and to admit
authorized inspectors on premises and in building for necess~ inspections.
(Signature of applicant or name, ifa corporanom
(Mailing address of apphcant)
State whether applicant% owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises
cAs on the tax roll or latest deed)
If applicant is a corporation, signature o~f duly authorized officer o~,-
(Namer~"~l{~orate~ officer)
PlumbersBUilders Lia~i:4O~eL~ c ~n ~%~q~5'~TMn`
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
House Number St/'eet Hamlet
County Tax Map No. 1000 Section I~'t.. Block ~ Lot
Subdivision Filed Map No. Lot
FORH NO. I
TOWN OF SOUTHOLD
BUILDING DEPARTHEiqT
TOWN HALL
SOUTHOLD, N.Y. ll971
TEL: 765-1802
BOARD OF HEALTH ...............
3 SETS OF pLANS ...............
SURVEY ........................
CHECK .........................
SEPTIC FORM ... ................
APPLICATION FOR BUILDING pERMIT ~/~././//
INSTRUCTIONS
a. 'Ibis application must be c~pletely filled in by typewriter or in ink and $t~nitted to the hfilding Inspector wit
3 ~ets of plmas, accurate plot plan to scale. Fee according to c~aedule.
b. Plot plan mhc~dng lc~ation of lot ~ad of buildings o~ praises, relatioe~hip to adjoining pr~dses or pabllc
BLDG. DEPL (Wiling ~klres~/of applicm~t)
..... ./.77. ~.../.~?. ~..c~,~ ,u ~.. ?.~.~.-~ r.~.~ ................................
~ o~ o,..,~.,- o~- g~, ................ ~ a.~e,o-r'-c . . ................
bailders License No ..........................
Pl~abers Licer~se No ..........................
ElecKrici~ License N~ ......................
O~ber Traders License NO .....................
I. location of land on which prol~sed work will be do~e ..............................................................
~ ~ ~. ~ ~ ..... ./.e.6 ..... Bi~ ....U. ........... ~t ..... d.~.~./....
S~divisic~ ...................................... Filed Fmp I/a ................ I~t ...............
a. Existing use aad cccupancy .. '/<~?/f~<d,'~,~7 ............
hpth .................... ~t .................... ~r of Stories ...............
~Ce of ~d~a~ ..................... ~ of Four ~r ........................................
PLOT DIACRAH
locate clearly a~l. distinctly all buildings, ff~ether existing or proposed, and indicate all set-back dhuensio~s
ptuperty liuas., ~i~ street and block xx~oer or description according to deed, and sho~ street rk'eaeS and indicate
berber interior or co~r lot.
........ ./.~.~.~f.~.'~....~.~..7',~.,~.¥ ....................... being duly s~u~, depuses and says that be is the applic~,t
~ of individual signing co~tract)
-~ is the ....... .~.. :~.~.q-.r~ ........... . .............
Town of Southold
Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM
PROPERTY LOCATION: $.C,T.M.~ THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A
I~! e~ I~! I STORM-WATEI~ GRADING, DRAII~I~AGE AND ER(~SION CONTROl. FLAN
e~mt Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK.
sCOPE OF WORK ~ PROPOSED CONSTRUCTION iTEM# / WORK ASSESSMENT ] Yes No
a. What Is the Total Ama of the Project Parcels?
(Inctude Total Ama of all Parcels k)catad wi~in. / '1 Will this Project Retain NI Storm-Water Run-Off
theScopeofWorkforpropesndConstmcitou)~l?-}~,q',,Fr./}.iA/4 ~' Generated by a Two (2") lnch Rainfall ou Site?
b. What IS the Total Area of Land Clemtng {S.F. I Ac,~) (This itam will Include all mn-off created by site
clearing and/or constmciton actMfies as well as all
and/or Ground Oisturbence for the proposed O Site Improvements and the permanent creaiton of
coustruction ac~ impervious surfaces.)
' (S.F.l,~res) 2 Does the Site Plan and/or Survey Show All Proposed
PROVidE B]~EF PROJ~,C-~ DF~CE[FT[ON (Pmv~ Peges,sN.d~ Drainage Structures Indica§ng Size & Location? This
Item shall ~nclude all Prolx~ed C-rede Changes and
["~lth,,l~i,'l,- I~.'IFEFv~:~. ,~l~'~'~vt~T'tc~l~ ~ Slopes Controlling Surfaco Water Ffow.
~x~5~-~ F.L=~I-4Lt~,,~F ~= 5/,!'~-~1 3 O°estheSitePlanandlorSurveYdesc~betheeroSion
. ' and sediment control practices that will be used to
control site erosion end storm water discharges. This
,~LTI~ TIOA,~ o ~'~, ~ item must be maintained throughout the Entire
Construction Period.
4 Will this Project Require any Land Filling, Grading or
Excavation where them is a change to the NofuraJ
Existing Grade Involv;ng more than 200 Cubic Yards
of Material within any Parcel?
5 Will this Application Require Land Disturbing Activities
Encompassing an A~ea in Excess of Five Thousand
(5,000 S.F.) Square Feet of Ground Surface?
6 Is there a Nalural Water Course Running through the
Site? Is this Project within the Tmstaes jurisdiction ~/,
General DEC ~NPPP Requirements: or within One Hundred (100') feet of a Weitand or --
Submission of a SWPPP is required for all Construction act~ties involving soil Beach?
disturbances of one (1) or more acres; including dbturbances of less than o*le ac~e that 7 Will there be ~Sita preparaitou on Existing Grade Slopes
am pad of a larger common plan that wli~ ult~llately disturb one or mo~e acres of land; which Exceed Fifteen (I 5) feet of Vertical Rise to r~
ind~lisg Cons~uc~on activales isvd~g soi~'dls~rbar~ of le~ than o~e (1) acre where One H. undred (100') of Horizontal Distance?I--I --
the DEC has determined thai a SPDES permit is required for Ston~ water dischanjes..
SWPPP's Shall meet the Minimum Requirements of the SPDES General Pemlit 8 Will Driveways, Parking Areas or other Impervious
for Storm Water Discharges from Construction actlvfiy o Permit No. GP~-I 0-001.) Surfaces be Sloped to Direct Sturm-Water Run-OffI~1
1. The SWPPP shall be pm~red pr~or fo the submittal of the NOI. ~e NOI she, be into and/or in the dir~on of a Town right-of-wey? --
2. 'l~e SWPPP shall desc~oe the em~io~ and sediment control practices and v/ne~ 9 Will this Project Require the Placement of Material,
~equimd. post-consth~t ion sto~m water management p~actioes that ~11 be used endfo~ Removal of Vegetation and/or the Construction of any
constructed fo reduce the pdJutants in storm water db4=hargss and to a~su~e Item Within the Town Right-of-Way or Road ShoctderL~J
com~ wllh the tur~s end conditions of this permit. In addilfon, the SWPPp shell
quatity of sfoml wa for discharge~. NOTE: If AnY Answer Io Questers One through Nine I~ Ar~wemd v.~th a Cbeek 14a~<
3. Att SWPPPs that requha the best-conslmcbert sfoml wafer management ixacflce In a Box and the con~tn/~ctfon sag disturbance I. betv~en 5,~0 $.F. & t A~re th area,
component shal be prepared by a quatifled coslgn Professional Licensed In New Yet}( a Stumt-Wafor, Gradfog, Drafoage & Erosion Conf~ol Plan II Reqntmd by tbe '~'ew11 of
S']'A'I'~ OF NEW' YeP, K, ~. . ~ Notary Public, Sta~ o~ New York
' COUgar OY .....~....q.~E~..~)..c.._.....~ ....... SS No. 0mUS~8SOS0
Qualified In Suffolk County
And that h~$he is the ..... ~.~ ~..~ ~..
Owner and/or represenh~live of the Owner or Owners, and is duly authorized to perform or have performed the ~aid work and to
make and file this application that all statemenbi contained in this application are t~ue to the best of his knowledge and belief; and
that the work will be performed in the manner set forth in the application filed herewith.
Sworn to before me this;
'~' ................. , :','~-' -'7"r ........ 71:';~ ,~ ...........
FORM - 06/10
ACTION HEALTH SERVICES
N~W ~1 DELT ~1 REPORT
FROZEN
DESSERT
INSPECTION TIME OF WATER SAMPLE ~O. DAY YR.
DATE INSP. DATE
ECONOMIC S~.F.£. ~ 2[~ 3[~ IREINSPEOTION
YES [~ NO [~ VIOLATION YES [~ NO [~ CLAS$1FICAT~3N DATE
PART 1: RED CRITICAL ITEMS
SUMMARY OF
VlO[ATIONS
DESCRIPTION OF VIOLATION DATE
THESE ITEMS RELATE DIRECTLY TO FACTORS WHICH LEAD TO FOODSORNE ILLNESS AND MUST RECEIVE tMMEDIATE ATTENTION CORRECTED
VIOLATIONS
PART 2:BLUE MAINTENANCE ITEMS
THESE ITEMS RELATE TO MAINTENANCE OF THE FOOD SERVICE OPERATION AND (
CORRECT
BY
THE MARKED ITEMS ABOVE ARE VIOLATIONS FOUND DURING AN INSPECTION OF THE OPERATION OF THE FACILITIES IN THIS
ESTABLISHMENT WHICH MUST BE CORRECTED ~S INDICATED. F~ILU~E TO COMPLY MAY ~ESULT IN THE INITIATION OF LEGAL ACTION
AGAINST THIS ESTABLISHMENT AS PROVIDED FOR IN A~TICLE8 2 ANDI8 OF THE ~UFFOLK COUNTY SANITARY CODE INCLUDING A
HEARING, POSSIBLE ~U~pENSlON OF YOU~ FOOD OPERATION, AND OR THE PUBLICA~OF TH[ V~O~TION AND FINES.
~PER~ ~ V ' ~ / / . ~" TITLE ~NITAR~N/# ,~ ~ ~ ISAN.~.~,~ ]INSPECTION~ /~
RED CRITICAL ITEMS - RELATE DIRECTLY TO FACTORS WHICH LEAD TO FOODBOREE ILLNESS -
M~ST RECEIVE IMMEDIATE ATTENTION
1 FOODS INCLUDING SHELLFISH WHOLESOME UNADULTERATED AND FROM AN
APPROVED SOURCE - PASTEURIZED M~LK AND MILK PRODUCTS USED FOOD OR
EQUIPMENT EMBARGOED REDUCED OXYGEN PACKAGING METHOD APPROVED FiSH
FOR SALE AS RAW FROZEN PRIOR TO SERVICE - NO OPENLY DISPLAYED FOODS
2 EGGS RECEIVED AT 41 DEGREES FAHRENHE[% NOT CRACKED AND LABELED WITH
SOURCE AND SAFE HANDLING INSTRUCTIONS
3 FOOD CONTAINER SHOWING EVIDENCE OF SWELLING RUST LEAK OR
OTHERWISE IN SUCH CONDITION AS MAY RENDER THE PRODUCT UNWHOLESOME NOT
FAHRENHEIT OR ABOVE 140 DEGREES FAHRENHEIT TEMPERATURE LOG MAINTAINED
EOF{ FOOD TRANSPORT
15 iNGREDIENTS USED TO MAKE POTENTIALLY HAZARDOUS FOODS WHICH ARE TO
BE SERVED WITHOUT FURTHER COOK~NG ARE PRECHILLED BEFORE MIXING
16 SUFFICIENT NUMBER OF REFRIGERATORS AND HOT FOOD STORAGE FACILI7
AVAILABLE FOR THE SERVICE STORAGE DISpLAy AND TRANSPORTATION
POTENTIALLY HAZARDOUS FOODS
17 UNWRAPPED OR POTENTIALLY HAZARDOUS FOOD NOT RESERVED
18 FOOD NOT SUBJECT TO FURTHER COOKINU PROTECTED AGAINS'
CQNTAMfNATION FROM FOOD REQUIRING WASHING OR COOKING
19 iOOD CONTACT SURFACES OF EQUIPMENT CLEANED AND SANITIZE. 8EFOR
EACH USE WITH DIFFERENT TypEs OF RAW ANIMAL FOOD AND EACH TIME THERE IS A
CHANGE FROM WORKING WITH RAW FOODS TO READY TO EAT FOODS OR BETWEEN
RAW ~RUITS AND VEGETABLES AND POTENTIAL[ y HAZAHL)OUU
20 FOOD NOT STORED UNDER WASTE OR DRAIN LINES OR
POSSIBLE CONTAM[NATION
BLUE MAINTENANCE ITEMS - CORRECT AS SCHEDULED
28 OPERATING WITH A VALID PERMIT AND IN ACCORDANCE WiTH THE CONDITIONS OF THE
PERMI'~ CONSTRUCTION AND REMODELING DONE IN ACCORDANCE WITH APPROVED
PLANS LAST RECORD OF INSPECTION AVAILABLE POSTINGS AND NOTIFICATIONS TO
THE PUBLIC PRESENT.
29 A PERSON IN CHARGE W~LL HOLD AND DISPLAY A VALID FOOD MANAG ER~S CERTIFICATE
AND DEMONSTRATE KNOWLEDGE OF FOODBORNE DISEASE PREVENTION EMPLOYEES
PROPERLY TRAINED IN FOOD SAFETY.
30 SMOKING I~W COMPLIED WITH
31 FOOD PROTECTED DURING STORAGE, PREPARATION, DISPLAY TRANSPORTATION AND
SERVICE FOOD PROPERLY COVERED I~BELED AND NOT STORED DIRECTLY ON FLOOR
WHOLE FISH KEPT ON ICE OR REFRIGERATED UNNECESSARY TRAFFIC THROUGH FOOD
PREPARATION AND UTENSIL WASHING AREAS PROHIBITED NO UNSUPERVISED
INDIVIDUALS FOOD OFFERED IN A WAY THAT DOES NOT MISLF~D THE CONSUMER
32 . IN USE FOOD DISPENSING UTENSILS PROPERLY STORED.
33 .. CLaN AND SANITIZED UTENSILS AND EQUIPMENT PROPERLY HANDLED. STORED AND
DISPENSED. CLEAN TABLEWARE USED BY CONSUMERS AT SELF-SERVICE DISPLAYS
34 SINGLE SERVICE ITEMS PROPERLY STORED, DISPENSED HANDLED AND NOT REUSED
35 HOT AND COLD STORAGE FACILITIES PROVIDED WITH ACCURATE THERMOMETERS.
36 .. PROPER THAWING pROCEDURES USED (UNDEB REFR~GE~¢~T~ON OR RUNNING WATER)
37 RAW FRUITS AND VEGETABLES WASHED BEFORE USE
38 .. PERSONAL CLEANLINESS ADEQUATE, CLEAN OUTER GARMENTS WORN, NO EXCESSIVE
JEWELRY WORN
39 .. SMOKING, USE OF TOBACCO, EATING OR DRINKING PROHIBITED iN FOOD PREPARATION
DIBHWASHING AND FOOD PREPARATION AREAS
40 PROPER HAiR RESTRAINTS USED
41 FACILITIES FOR THE STORAGE OF EMPLOYEES PERSONAL BELONGINGS PROVIDED AND
KEPT CLEAN
42 EQUIPMENT AND UTENSILS DESIGNED AND CONSTRUCTED AS TO BE SMOOTH, EASILY
CLEANABLE, DURABLE AND NONTOXIC AND KEPT IN GOOD REPAIR MOLLUSK AND
CRUSTAC EA SHELLS NOT USED MORE THAN ONCE
43 . . EQUIPMENT LOCATED AND INSTALLED SO AS TO BE EASILY CLEANABLE AND iN
CONFORMANCE WITH LOCAL REQUIREMENTS ADEQUATE WORKING SPACES PROVIDED
44 WASH AND RINSE WATER CLEAN AND AT PROPER TEMPERATURES
48 WIPING CLOTHS CLEAN AND STORED BETWEEN USES IN A SANITIZING SOLUTION
A SUITABLE SANITIZER TEST KIT AVAILABLE AND USED CLOTHS NOT USED FOR WIPING
ARE DIFFERENT COLOR.
49 FOOD CONTACT SURFACES CLEANED AND SANITIZED AFTER EACH USE AND FOLLOWING
ANY fNTERRUPTION OF OPERATIONS DURING WHICH CONTAMINATION IS LIKELY TO HAVE
OCCURRED UTENSILS USED ~N THE PREPARATION OF RAW SHELL EGGS CLEANED AND
SANITIZED HOURL'~
50 NON-FOOD CONTACT SURFACES OF EQUIPMENT CLEAN
51 POTABLE WATER SUPPLIES COMPLY WITH SUBPART 5-1 OF THE NY STATE SANITARY
CODE ADEQUATE AMOUNT OF HOT AND COLD RUNNING WATER UNDER ADEQUATE
PRESSURE PROVIDED HOT WATER AT THE THREE COMPARTMENT StNK MAINTAINED AT A
MINIMUM OF 140 DEGREES PAHRENHEIT HOT WATER SUPPLY DEDICATED ONLY TO THE
FOOD SERVICE AND UNDER CONTROL OF PERSON IN CHARGE
52. ALL SEWAGE AND LIQUID WASTE DFSPOSED OF IN A PUBLIC SEWER, OR IN THE ABSENCE
THEREOF, IN A MANNER SATISFACTORY TO THE BEPARTMEN%
53 PLUMBING PROPERLY SIZED INSTALLED AND MAIFFfAINED ALL REQUtRED INDIRECT
DRAINLINE CONNECTIONS PROVIDED
54 TOILET FACILITIES ADEQUATE CONVENIENTLY LOCATED. COMPLETELY ENCLOSED WITH
SELF-CLOSiNG DOORS, MECHANICALLY VENTILATED, KEPT CLEAN, IN GOOD REPAIR AND
EQUIPPED WITH HANDS~NKS. EMPLOYEE HANDWABHING SIGNS POSTED
55. ADEQUATE HAND WASHtNG FACILITIES PROVIDED, USED ONLY FOR HAND WASHING,
PROPERLy MAINTAINED AND SUPPLIED WITH HOT AND COLD RUNNING WATER SANITARY
TOWELS OR HAND DRYING DEVICE AND HAND CLEANSER
56 ADEQUATE, LEAKPROOF NON-ABSORBENT, VERMIN-PROOF, COVERED CONTAINERS
PROVIDED WHERE NEEDED ADEQUATE REFUSE CONTAINERS AVAILABLE FOR
CUSTOMER USE
57 OUTSIDE GARBAGE STORAGE AREAS ADEQUATE IN SIZE, CLEAN AND NOT CONSTITUTING
A NUISANCE CONTAINERS STORED ON A CONCRETE SLAB OR OTHER NON ABSORBENT
SURFACE
58 EFFECTIVE MEASURES TAKEN AGAINST THE ENTRANCE AND THE BREEDING OR
PRESENCE ON THE PREMISES OF INSECTS, RODENTS AND OTHER PESTS
59 INSECTICIDES APPLIED BY A NYSDEC CERTIFIED "COMMERCIAL APPLICATOR"
§0 FLOORS WALLS AND CEILINGS PROPERLY CONSTRUCTED, SMOOTH AND EASILY
CLEANABLE AND MAINTAINED CLEAN
61 ADEQUATE LIGHTING PROVIDED IN F6OD PREPARATION, FOOD STORAGE, UTENSIL
WASHING. HANDWASHING, DRESSING ROOM, TOILET ROOM AND GARBAGE STORAGE
AREAS LIGHT BULBS SHIELDED
45 SANITIZING RINSE AT PROPER TEMPERATURE, CHEMICAL CONCENTRATION ANDiEOR~FOR 62 ADEQUATE VENTILATION PROV)DED AREAS AND EQUIPMENT FROM WHICH AEROSOLS,
APPROPRIATE TIME ODORS OR NOXIOUS FUMES ORIGINATE, VENTED TO THE OUTSIDE
46 PROPER WASHING TECHNIQUE USED (WASH, RINSE, SANITIZE) THREE BAY SiNK ONLY ARTICLES NECESSARY TO THE OPERATION AND MAINTENANCE OF THE FOOD
PROVIDED DISHWASHER PROVIDED WHEN MULTI USE EATING AND DRINKING UTEN RATION PERMI~DED IN THE ESTABLISHMENT EXTERIOR WALKING AND DRIVING
ARE USED. ~FACES MAINTAINED CLEAN AND IN GOOD REPAIR
47 . . ACCURATE THERMOMETERS, CHEMICAL TEST KITS AND PRESSURE GAUGES AVAILA/!ING QUARTERS COMPLETELY SEPARATE FROM FOOD ESTABLISHMENT OPERATIONS
TO MONITOR DISHWASHING MACHINES DISHWASHING MACHINES MAINTAINED IN G
REPAIR VE ANIMALS EXCEPT SERVICE ANIMALS RESTRICTED FROM PREMISES,
LEANING EQUIPMENTAND LINENS PROPERLY STORED LAUNDRYAREAS PROPERLY
COATED
18~)490. 03/09kk
~~ Chronology of Events ~~ Document1
Touch of Venice
11-e2-e2 Started Plans review for alterations to building to be renamed Touch of
Venice
Bar 44, Lobby 28, Dining Room #1 40,Dining Room #2 22, Back Foyer 10, Party Rm
Sm 22, Party Rm Lg 43, Kitchen 4, Building Total Occupancy 210. Occupancy Loads
from plans, need to be site measured when ready to open.
Still the following
1. Hood plans and appliance layout.
2. Fire suppression system plans with cut sheets.
3. Fire alarm plans with cut sheets.
4. Fire extinguisher in service area in party rooms.
5. Occupancy classification.
6. Building classification.
L~F- rs~ 1 oo22_
~ Rise
8Far, ch Pipe Size ~,,~* / ~
/~" Hanufacturer
,_~,, Quantity: _.
Piping Hatertal
Supply Pipe Size
Gas Valve type: .9'~/¢ Size
Detector Temperature rating
Hood Size: /pCd"~ ~Z ~~z' Duct Size: ~z) /~Z /~
Hood Si~e: Duct Size:
NOZZLE
I/F # }%EIGHTS
ADP
ADP
L~ ~-2o
R ZO-~
LOCA270NS
~X Frye, rs to have High Limit Control to shut off fuel at 425 deg~
~X Detectors shall be Located over every piece of ~quipolent.
~ The System installed as per m~nufacturers spefs-and the AHJ.
~X The Sys[em has been installed as per
X The following functions to operate upon system discharge:
* Supply air damper closes * Gas fuel shuts off in kitchen
* Exhaust fan r~ma~r~s on * Electric fuel shut off under hood
* All systems to activate simultaneously in same hazard area.
* Fire ALarm shall activate if one Vs ~nstaLled in building.
~X Manual Pull is loc~tt~d 1~-35 ft from hood~and 3-5 ft-from floor
ABT DESIGN & FIRE PROTECTION
1724 CHURCH STREET
HOLBROOK, NY 11741
631-878-4896 FAX: 631-878-5727
Cylind~r:B12OOOQ A/zooof
Control Head:B120OlO
Pull S~ation:919746~
Link KLt:
Micro Switch:91972~8
Gan Valve:B1200~
Corn.r Pulley:B844648
V~nt p~ug:9~ 97430
gi~cha.cqc Adapt~r:844908
()
Feb 10 11 11:16a Mark D. Geiselman 516-432-0918 p.1
TOWN OF SOUTHO~D
~ /~ '
~,',
~ .. J ' t H~'--
· ., : ., , , , · ~ ~ HI'
;~j~ ,.. , .,,,,~,,;,, = ,
i ~"
~, T~m~ ~T~NT ~TION ~ 'L~"]~kD.
~*~' ~"~" TOUGH O~
2~D~ HAIN ~AD
ELEOTRICAL
I ALL ELEF~TRICAL MORN. 9HALL b~E IN~TALLEE~ IN
¢ONPORf"fAN¢B WITH ALL APPLIOAE~LE
HVAO
I ALL MECHANICAL WORK- 5HALL BE INSTALLEP
CON~EP-?ATION RULES ANI~
_REGULATION5
Z
.4:
PLOT PLAN
5~,ALE, I" =
',PLUMBING
ALL PLUMBING WASTE
&WATER LINES blEED
TESTING BEFG,' S C L,','L I] P
PL UMBER CERTIFICATION
QN LEAD CQN'EENT BEFORE
CERTIFICATE QF OCCUPANC¥
SOLDER USED IN WA TER
SUPPLY SYSTEM CANNOT
EXCEED2~10 OF 1% !.EAD.
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
APPROVED AS NOTED
NOTIF~F BUILDING DFr'- ~M' ,T
3 INSdL~ flON
4 Fff~AL -;ONSTRUCTION & ELECTRICAL
MUST BE COMPLETE FOR C 0
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE COBES OF NEW
YORK STATE, NOT RESPONSIBLE FOR
FIRE INSPECTION
REQUIRED BEFORE
OPENING
ELECTRICAL
INSPECTION REQUIRED
FEB ] 0
BLDG, DEPT.
TOWNOFSOUTHOL§
~P-,A~ I NC SO H ~U L
AJ ®ENEP,,AL NOTES, I~LOT PLAN
A.2 C, ONSTR, UCa ION / EPEMO PLAN, H C,. BATH DETAILS
A.5 FURNITURE / EQUIPMENT PLAN
A.4 ~EFLEC, TEB', GELLING PLAN
III
Zz
H.6. E~ATH ~TAILS
Z
,[] fl
II
II
I*l
HIN
CONSTRUCTION / O~dO PLAN
II
SC, ALE, I/4" =
DININg
]1
II II
II II
t=Ut~,NITU~E~ / E~L/IPI, d~NT PLAN
5~ALE, I/4" =
-4)-
+
I
+ + +
P.,EFLEC, TEO CEILIN~ PLAN PLAN
DOALE, I/4" -- I'-0"