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Home My WebLink About37196-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 7/9/2012 CERTIFICATE OF OCCUPANCY No: 35808 Date: 7/9/2012 THIS CERTIFIES that the building COMMERCIAL ALTERATION Location of Property: 10095 Route 25, Mattituck, SCTM #: 473889 Sec/Block/Lot: 142.-1-26 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore 5/1/2012 pursuant to which Building Permit No. 37196 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: Alterations to a Commercial Building: Bagel Store (Interior Only) Handicap Bathroom, Kitchen, as applied for. Lot No. filed in this officed dated dated 5/7/2012 The certificate is issued to Mattituck Plaza LLC (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 37196 7/3/12 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 #: 37196 Date: 5/7/2012 Permission is hereby granted to: Mattituck Plaza LLC PO BOX 77 Mattituck, NY 11952 To: Alterations to a Commercial Building; Bagel Store (Interior Only) Handicap Bathroom, Kitchen, as applied for. At premises located at: 10095 Route 25, Mattituck SCTM # 473889 Sec/Block/Lot # 142.-1-26 Pursuant to application dated To expire on 11/6/2013. Fees: 5/1/2012 and approved by the Building Inspector. CO - COMMERCIAL NEW COMMERCIAL, ALTERATION OR ADDITIONS Total: $50.00 $303.60 $353.60 Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631 ) 765-1802 Fax (63 I) 765-9502 ro.qer.richert~town.southold.ny.us BUILDING DEPARTMENT TOWN OF SOUTI-IOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION ssued To: North Fork Bagel Co ~,ddress: Center Mall Rt 25 City: Mattituck St: NY Zip: 11952 3uilding Permit #: 37196 Section: 142 Block: 1 Lot: 2( WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: North Electric Co License No: 890-e SITE DETAILS Office Use Only Residential ~ Indoor ~ Basement [~ Service Only ~ Commericel Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage Service 1 ph U Heat Service 3 ph ~ Hot Water Main Panel NC Condenser Sub Panel NC Blower Transformer Appliances Disconnect Switches Other Equipment: INVENTORY GFCl Recpt Single Recpt Range Recpt Dryer Recpt Twist Lock Ceiling Fixtures~~ ~ HID Fixtures Wall Fixtures I I Smoke Detectors Recessed Fixtures CO Detectors Fluorescent Fixtur(~ Pumps Emergency Fixture Time Clocks Exit Fixtures 131 TVSS 2-paddle fans, 1-exhaust fan, 2-walk in coolers Notes: Inspector Signature: Date: July 3 2012 81-Cert Electrical Compliance Form.xls TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING / STRAPPING [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [~] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ~ ELECTRICAL (FINAL) REMARKS: INSPECTOR~--~ DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [ ]FRAMING/STRAPPING [ ] FINAL FIREPLACE & CHIMNEY /~ FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: ~'-I~j- ~:~~-~ ~ DATE ~'~ ~' I~- INSPECTOR TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net ×am,ned _.Y"-'"'-3 ,:0 IL ^pp,'oved 7 .:0 / I AY - 1:0 2 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 C.O. Application Flood Permit Single & Separate Storm-Water Assessment Form Contact: Mail to: Phone: Building Inspector T0'.Lq.~ O! 50BIHOLD 'PL1CATION FOR BUILDING PERMIT Date INSTRUCTIONS 4--2-7 -20 I Z_ ,20 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 showiug location of lot and of buildings on premises, relationship to adjoining premises or public streets ot~ 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 pa~ for any purpose what so ever until the Building Inspector issues a Ceaificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months a~er the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the prope~ have beeo enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for m~ addition six months. Therea~er, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Depamnent for the issuance ora Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suflblk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additious, or alterations or for removal or demolition as herein described. The applicant agrees to comply with ali applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on promises and in building for necessary inspections. (Si~nat~ure oJ~pplicant or name, ifa corporation) (M~iling address of ~pplicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises LSog~Ykx ~-o9¥---(~'~f~3~}taxr~?~-'~?a?es%tr~d)~ m~ m.~t ~ If' applicant is a corporation, signature of duly attthor zed 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 xvhich proposed work will be done: House Number ! Hamlet County Tax Map No. 1000 Section \a~'7_~ Block ~ Lot Subdivision Filed Map No. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~c.,5 ¢ \ s ~-oC~ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost q5 "3000 -- Fee 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work (Description) (To be paid ou filing this application) Number of dwelling units on each floor 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. Size of lot: 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 of premises Name of Architect &-~,-~ go~'ro~'~q Name of Contractor Address Phone No. ~%r, ec~Address Phone No Address Phone No. -c':,,Y -? ) I b 15 a. Is this property ~vithin 100 feet of a tidal wetland or a freshwater wetland? * YES __ N O · 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. Provide survey, to scale, with accurate foundation plan aud distances to property lines. 17. If elevation at any poin[ on property is 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 STATE OF NEW YORK) SS: COUNTY OF ) ~ ~¢¥xv.O .~c.~x ~. being duly sworn, deposes and says~lONISIl~l}.i~l~plicant (Name of individual signing contract) above named, Notary Public, State of New York No. 01BU6185050 Qualified In Suffolk County .~., tS)He is tile ~X q_o ,-x'¥ Commll~eion E~,lree ,~. ril 14, ~ '~ (Contractor, Agent, Corporate 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 trne to the best of his knowledge and belieF, and that the work will be performed in the manner set forth in the applicatioa filed therewith. Notary Public Signature of Applicant FORM NO. TOWN OF $OUTHOLD BUILDING DEPARII4ENT TOWN HALL SOUTHOLD, N.Y. TEL: 765- }802 Exani ned ................. , 19 .... Appr~vc~J ................. , 19 .... Penu~t No ................. Disapprr~ed a/c .................................. BOARD OF HEALT~ ............... 3 SETS OF PLANS ............... SURVEY ........................ CHECK ......................... SEPTIC FORM ................... (P~ilding Ir~pector ) APPLICATION FOR BUILDING pERMIT INSTRUCTIONS (2 c~ tim t~x roll or latest deed) ......... .......... ........ I. Locatio~ of la~l o~ which proposed ~ork will be do~e .............................................................. House Number Street Hanlet C~m~ T~( Map No. I000 Sectitm ................ BI~ ................ l~t ................ ~ivisi~ ...................................... Film Map lqo ................ I~t ............... (~) a. Existing tree and occupm~cy ........ .</.~.'~J.4.~..~... ~.O~ ................................................ N~Cure o~ ~ck (d~ck ~dch applicable): ~ Building .......... ~kliric~ .......... AlCerarion .......... gepair ............ l~c,v~l ............. l~mli~io~ ............ O~her ~ork ~q.~.~.d.C.~.~.~...~)./~-.e~4~ .'fi~.~.xo~l¢ ...... ~..~.~..~....,~..~..~.~..7.~{<.~ ........................... being duly ~m, ~s a~ ~ys t~t ~ is tim a~li~t ~ i~ th~ ....... ~.¢~re.4 ........................................................................... ......~}'~ ........ ~ ~ ~ 0~, o~ ................. (~ ~ ¢(~ Town of Southold - Chapter 236 - Stormwater Management ~ SWPPP - Storm Water Pollution Prevention Pain Assessment Form GENERAL INFORMATION: (All Requested Information is Required for a Complete Application) I P,,,~dyAddres$: t'~'¢" '~' ~ } ~1~ ]o I COex~Y- /x~ }J BficfDescfiPtionofConslxuOionAcfivity, ProposedStructuralBMPs, Soil $.G.T.M.#: 1000 I ~-;-- [ -~ ~, ] StabalizationBMPs, ProjectScopeand/orSequenceofConstructionActivity Will this Project Dlsturbe five (5) or More Acres at ~ Any One Time During the Proposed Development ? Yes No a. Does the Applicant have a Qualified Inspector On ~ ~ Staff To Conduct the Required Inspections ? Yes No Inspections will Occur and for What Pealed of'Hme ? Yes No c. Does the SWPPP Adequate{,/Identify Ali Temporary ~ ~ .................................................... d. Does the SWPPP Adequately Identify a Complete ~ [7~ ................................................. Pro~ect Phasing Plan ? Yes No e. Does the aWPPP Indicata Additiona; Site SpecHic ~ ~ s~atu$ ~ '~o' f. Has the Applicant Submitted a Complaled DEC Notice .................................................. Of Intent and SWPPP Acceptance Form for Review ~ {.~ Typ* o~' ~mpact*,/Wat*rbndy: leg. Cake, Cr~k, Say, Pond, Sound. rr. hw~t~ W~...I 'Yes' '~o' ........................ STATE OF NEW YORK, <~ /~ ri ~.~ NotaryPub(--7-t------Yorkm-~$taeofNeW COUNTY O~ :..~..,,~....'~...~ ............ SS No. 01BU6185050 Qualified in Suffolk Cou q-~t ! .............. r~of~a,~=.~,..(~;~;~;;t') be' dui sworn, d .................... m~ y eposcs and says u..~ .~.m~~~2rm~' And that he/she is the ............................................ {"~;;~5;,~;~i;'~i;'Bi~:.'~j ................................................................ Owner and/or representative of the 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 herewith. Sworn to before me tiffs; / ................................ ~ .............. Y, ..'..:~.?..-..¢¢ ......................... 20.../.0-- ........... .......................... ) TOS "SWPPP" Preparation - Chapter 236 Article II Storm Water Management Storm Water Pollution Prevention Plan Review Checklist Checklist # .... Plan Sheet REQUIRED PLAN INFORMATION AND IMPLEMENTATION DETAILS: I YES I NO I N.A. ~ Explanation for NO or N.A. (Does the SWPPP Adequately Provide for and/or Indicate the Following:) ~ ; ~ t Location (pg. #) e. Contours IndicatingProperty Elevaflons(Min 2')' - f. Spot Grade & Finish Floor Elevations for Exfsflng and Proposed Structures- [~1~ ~ F g. Locatmn 0~ ~To~deE.~,reas [ Isolated ?tees ~th a Mm~mum bimensmn ~Y~*l 8 ~,ametar !r.-~l r---]!~:=~ 5. Background Information about the Scope of the Project, Location & Description of the Site, , b. AIIExcavation, F ng, Stdpping & Grading Propesed and ldentified as to depth, Volume d. All Areas Where Topsod ~s to be Removed Stockpded and where Topsod wll ultimately e. All Teml~ora~/.& Pem3anent Vegetation to be Placed on Site f. All Temporary & Permanent Storm Water Runoff BMP Co0bol Measures Proposed h. The Location ~t'~l'~oads, Driveways, Sidewalk'{, Patios, StTuctures, Utilities & ~er , Improvements, Includ ng ~emporery Access & Construction ~aging Areas; A Schedule of the Sequence for the thstsllation of All Planned Soil Erosion, Sedimentation & Stormwater RunoffControlMeasures. ;~[~'~iI II / I! -7~~ Description of Pollution Prevention Measures that wi I be 1.m~lementad 8. A Descr ptmn of the M n mum Erosion & Sediment Conbol Practices to be Installed and/or 10. Temporary & Permanent Ball Stabilization Plan that meets the Current Version of the New York State Storm Water Design Manual Technicel Standard. ~ ~' · ' ', 14 mp ementat on Schedule for StaJ]in~ Temj~_rar,j Erosion Conbol Practice or BMP } r-'-'l; [~II ~ i - - 15. Maintanance Schedule to Ensure Continuous & Effeclive Operstion of Erosion & I Sediment Control Preclices. 16. Names of Potential Surface Waters of the Stata of New York and/or MS4 that may be 19. IdentificationofAIIContractor(s)/Sub-Contrector(s) Respensiblefotlnstalling, Constructing, Repairing, Replacing, Inspecting and Mathtaininc. I the Erosion & Sediment Control Practices. ' ' ' ' ;'' ' Storm Water Management Control Plan Checklist # I: 03-12 ) DEC "SWPPP" Preparation - Chapter 236-19, Article III - Storm Water Management Storm Water Pollution Prevention Plan Review Checklist Checklist # 2 (Additional Items to be included with Checklist # 1 when Article III is trigered.) REQUIRED PLAN INFORMATION AND IMPLEMENTATION DETAILS: YES NO '~ N.A. :~ Explanation for NO or N.A. Must be Approved by SMO Plan Sheet (Does the SWPPP Adequately Provide for and/or Indicate the Following:) ~ ~ Location (pg. ~. D~s'~h~ ~!~_l_nd_i_ce_t~and/orShowallltemsRequired by "Checklist #1" in this Packet ? '[---'] [~l ~ 2. Does t h e Pla n I nd(cate ~ ~ld-/~r-S-h-~v-a- [~e-s-c~i~ti~(~l ~)~ ~'a-c~-P-o~.(~s~ ~i~r "1 ii ~ ManagementPracflce? II ~ I 3. Does the Site Plan/Construction Drawing(s) nd cate and/or Show the Location & Size of 4. Does the SEe Plan/Consbucfion Draw ng(s) nd(cate and/or Show Hydrologic & Hydraulic Analysis -- F9[ Al! StrU~I Co~j~onents of the Stormwater Mana~e~ment Sy~s. tem for Applicable Storms ? I I I I I r ! 5. Does the Site Plan/Construction Drawing(s) Indicate and/or Provide a Comparison of Post- / ~v~!0Pm~gt_S_to_ _r_m_w_a_te_r Runoff Conditions with Pre. Development Conditions ? I I I II I -' ~ i ~*Does t h e Site Pla n/Con st ~ ~t¥o~-D-r~i~y i~a~t~ ~ ~/~r-~h~-~l -bi~ ~/M ~(~al- specifications & Installation Details for Each Post-Construction Stormwater Practica ? I II II ~ I; the Constractor(s) to Ensure Continuous & Effective Operation of Each Post-Construction I I I II .I EnsureAccesst~A~~St~m1waterMa~ageme~tPracficesattheSitef~rthePurposeof~nspecti~n I II IIr I ~reerne~t~(~). ~t are Binding on All Subsequent Landowners ? I I I I 10. For AIl Activfiies meeting the 'rhreshold in 236-19(BX1), the SWPPP shall be Prepared & Signed By a Profeseiocal in the Principles and Practices of Sformwater Management & Treatment Who I I r--I Who Sha Certify theft he Design Meets the Re uimments of Chapter 236 11. Does the Plan Indicate and/or Identify All Potential Sources of Pollution which may affect the Ouality of Stormwafor Discharges ? I I[----Ir''7-3 ~, 12. Does the Plan Provide Documentation Suppoding the Determination of Approval with Regard ~1 I to Historic Places or Archeolo(lical Resources that Inciudos the Following: · an effect on a preper[y that is listed or eligible for listing or eligible for listing on the i'~ ~ I I I~ I State or National R_egister of H sfodc Placesj ~ c. Description of Measures Neceosary to Avoid or Mthimize Adverse Impacts on Places Listed, d. Where Adverse Effects May Occur, Any Written Agreements in Place with the NYS O~ca ~ of Parks, Recreation and Hieforic P~aces (OPRHP) or other Governmental Agency to I'--]~ r--'l ~ ~; Mitigate Those Effects. 13. A Descr;ption of the Soil(a) Present at the Site, Including an Identitication of the Hydraulic Soil Group. I I [----J~ 14. Identification of Any Elements of the Design that ara not in Conformance with the Design manual, Including Reasons for the Deviation or Alternative Design and a Description I II II / II 15. A Hydrologic and Hydraulic Analysis for AIl Structural Components of the ~p[m wa t~ [ ~ a_~_a.g_e _m_en_t_c~_ _n_~j _S~st_e~- .................................. r~ Igt_l 16. A Detailed Summary, with Calculations, of the Sizing Criteria that was Used to Design All post :c(~,~ _t?_c_ti~n_ _St_o_ _rr?_?_t _er_M_a_n_a_g._ ement practical. I'~11 ir"T"] ~i -~.~ ~ Operations and Mathtenanoe Plan t~a-~t~ln"¢l"u-d~ I~l~n~l~a~n~n-a~l~e- Schedules and Action to Ensura Continuous and Efective Opemtion of Each I I II/'1 Post-Construction Storm Water mana~lemect Practice. ~ -- Storm Water Management Control Plan Checklist # 2: 03-12 3 7'/':/b BUILDING PERMIT EXAMINER CHECKLIST ~Date Submitted: --~-/-J ~-- Date Reviewed: -~-? A~hi~-~/Engineer: ~ ~0~~~- Estimated Co~t.TM aoa. SCTM#1000--I~'~" ] -- ~ Sub*vision:~x Zone: Conforming? Property Address: ~ ~) ~o0~ ~~~ Ci~: ~~ Pre COs? Building Permits (Open/Expired): BP -Z / C/O Z- , Info: BP__-Z / C/0 Z- , Info: BP __ -Z / C/0 Z-__ Info: Single & Separate Search Required? Y 00 Determination: REQ. Lot Size: ACT. Lot Size: REQ. Front ACT. Front REQ Side ACT. Side REQ. Height 3.~'~ ACT. Height. BP -Z / C70 Z-__, Info: BP__-Z / C/0 Z-__, Info: __ REQ. Lot Coy. ~o~o ACT: Lot Eov. REQ. Rear PROP. Rear ACT aterfront? Y o~). ff -~ . - s - // If yes, water body:. - Panel# ~ Flood Zone.. Bulkhead/Bluff Distance: " ADDITIONAL APPROVALS REQUIRED Suffolk County Health: Y or If yes, *Bed#: *Date: / / *Permit#: - If no, certification required: Y or N Received: Y or N By: NYS DEC: eR~-OECgm7S Y oq~)- Date: / / Southold Trustees: Y 0C(~- Date: / Southold ZBA: Y o0- Date: / / Southold Planning: Y o~)- Date: / / Town Landmark C of A: Y o~N~TE: / Notes: 5'lre p~,q~/ ~ Town Septic: Y- N Permit #: Permit #: Permit #: Permit #: / L hnBIt. I TY or NJ Letter - Notes: or NJ Letter - Notes: - Notes: - Notes: *N'YS CODE Compliance (page 2): Y or N Fee Structure: Foundation: SF First Floor: ] 3 ~t SF Second Floor: SF Other: ~ SF Total: 13~ SF Calculation: AS 8UIL. T FE.E' + Initial Fee: + Additional Fee ( ): SF X $. + Initial Fee: + Additional Fee (_ ): ,5'3,60 NEW YORK STATE CODE COMPLIANCE CHECKLIST C~LIMATIC/GEOGRAPHIC D~SIGN CRITERIA: Grounll Snow Load: i~O Wind Speed: I20MPH__ Seismic Design Category." B , _ Weathering: Severe__ .Frost Depth: 36" __ Design Temp: 11 __ ][ce Shield Underlay: YES ~ USE/OCCUPANCY CLASSItZlCATION: HEIGI:IT/FIKE AREA: TYPE OF CONSTRUCTION: .... DESIGN CRITERIA: ENGINEERED~SC~T~ FULL FRsA_M[NG DESIGN ELEMENTS: Y/lq HEAl)ERS: Y/ix/ WALL STUDS: Y/N CEILING JOISTS: Y/lq FLOOR JOISTS: Y/iN LUIV[BER SPECIES A_ND Gl:lADE: Y/N Termite: M-H' Decay: S-M Flood Hazards: GI[ILD ERS: YfN ROOF R_AFTERS: YfN WINDOW AND DOOR SCHEDULE: · NIISSLE TEST REQUIREMkENTS: Y/N EGRESS 5.7 S.F.: Y/N LIGHT 8%: Y/N ~rENT 4 %: NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: Y/N PLUMBING RISER DIAG1LAId: YIN LOCATION OF FIIGE PROTECTION EQUPMENT: YiN TRuSs DESIGN: CERTIFICATION: YIN ENERGY CALCS: YiN TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE) Town Hall Annex 54375 Main Road P.O. Box 1179 $outhold, NY 11971-0959 Telephone (631) 76,~1802 I'~ ~,~--' BUILDING DEPARTMENT TOWN O1~ APPLICATION FOR ELECTRICAL INSpEcTION REQUESTED BY: Company Name: Name: No.: Phone No.: Date: *Name: *Address: *Cross Street: *Phone No.: Permit No.: Tax Map District: JOBSITE INFORMATION: (*Indicates required informat on) 1000 Section: /fla~; BlbCk:_,, / *BRIEF DESCRIPTION OF WORK (Please Print Clearly) Lot: (Please Circle All That ApPly) *Is job ready for inspection: *Do you need a Temp Certificate: Temp. 'Information (If needed} ~ *Service siZe: ' 1 phase ~;~P~ 100 *New Service: Re-connect Underground Additional Information: Final 150 ~ 300 350 400 Other Number of Meters Change of Service Overhead PAYMENT DUE WITH APPLICATION / 82-Request for Inspection Form 'ipin<J Hatcrial: Breck Ir~ ;uppty piF~ Size: 3/8 ;as VaLve t~Fe: x4~'~ Size )erector Temperature rating : flood Size: ~ood Size: Max length ~o' Hax Rise Duct Size: /~z4 D~t S~ze:. ~X Fm/ers to have High Limit Contro[ to shu[ off fuel at'~25 'deg.: ~X Detectors shatt be tocated over every piece of ~:Nipcp~-wit. ~X The System irmtatted as ~r ~ac~ure~ s~cs a~ thg AHa_ ~ The ~st~ has ~ i~tatt~ ~ ~r U~O0. 2 The fotto~i~ f~ti~ ~o o~rate ~ sy~t~ discharge: ' * S~Ly air d~r ctos~ * Gas f~t shuts off in kitchen · .~amt f~ r~i~ ~. * Et~tric · Att s~t~ to activate simLt~ty in s~ haza~ area. · Fire Aiam s~ak[ activate if ~ ga~[ Pul[ is t~t~ 10~S5 ft fr~ h~ ~ 3-5 ft fr~ flor. ~ Al I f~'l S~lrC~ are ~S mt~ othe~ise ~t~. [03t~ CONTR~CTOf~: ABT DE:s~GN& F~ PROTECTION~ 1:724 C~CH STREET HOLBROOK, ~ 11741 63!-878-4896' FAX: 631-87825727 ABT DESIGN & FIRE PROTECTION 1724 CHURCH STREET HOLBROOK, NY 11741 631-878-4896 FAX: 631-878-5727 II II Zolo ipirs, j HateriaL: fi[ad Irc~: ;upg[¥ Pipe Size: 3/8 ;as Vatve type: ,/~z~/r S~2e )etectc- Tempe?atuve rating : ~ood Size: Hax tength z-/o.- }tax Rise ~" Brar, cJ~ Pf3e Size: 3/8 DUct S~ze: /e"&z~ DUct Size: GR~)D LE I ~z "x 2~'" WOK FRZER / /~'~ ~CQ~.t~ X Fr3,ers to have High Limit Control to shul~ off fuel at'425 deg. X Detecto'rs shatt be located over eveFy piece of equipment. X_ The S~stem irmtMted as per manufacturers specs a~ th~ AHJ. Th~ ~st~ has ~ 4~tatt~ ~ ~r U~O0. X The to[tov~ f~t~ to o~rate ~ syst~ d~schar~: * S~ty air d~r c[os~ * Gas f~t shuts off in kitchen * ~a~t f~ r~i~ ~ *'Et~tric * Att s~t~ to activate simtt~ty in s~ haza~ area. * Fire A[a~ shat[ activate if ~ Ma~[ Putt is [~t~ 10-~5 ft ~ Att f~t s~rc~ are ~S m[~ othe~ise ~t~. [03t~ CONTRACTOR: ABT DESIGN & FIRE PROTECTION] 1724 CHURCH STREET HOLBROOK, NY 11741 631-878-4896 FAX: 631-878=5727 ? ALTEP,,ATIONS BAGEL STORE CENTER MALL FLO0~ PLAN© ~ ~ ~ SCALE: 1/8" = I"0" COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED ~ PLUMBER CERTIFICATION ON LF-.N)~ ~.FORE CERTIFJCA TE~)F OGCUPANC Y SOLDER USED IN WATER SUPPLY SYSTEMCANNO T EXCEED 2/10 OF 1%LEAD. APPROVED AS NOTED ~C""F ~ GdlLDING DEPARTMENT AT 7~5,-~ :802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: I FOUNDATION. TVVO REQUIRED FOR POURED CONCRETE 2 ROUGH.FRAMING. PLUMBiNG, STRAPPING. ELECTRICAL & CAULKING 3 INSULATION 4 FINAL - CONSTRUCTION & ELECTRICAL MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RE&oONSlBLE FOR DESIGN OR CONSTRUCTION ERRORS. ELECTRICAL INSPECTION REQUIRED PLUMBING ALL PLUMBING WASTE & WATEI~ UNESNEED TESTING BEFORE COVERING or gri3und ~n~ac~ ~lall ~mpiy wlLh r -[ i ~ ~ ~ ~ -~ ph .... ~ ~ /i"~ ' ' ~,~' ' ' "~' ~, '", ~' 2 .- ; ..... , D~WN BY: ~H ~ril 13, 2012 - l_ ~ ,~ ~ ~ =-' 1'" =:"~ , ~ S~LE: (SEE P~N) SHEET NO: ~.ENEt~.L NOTE5 W,ND F~M,.G NOTES .A.',.O SC..D.LE, CONSTRUCTION NOTES: ~eaChel~°flfl~cc~rerfl~rleed~l°~exce~dt~flabula~d~ur~ber°f~dna~in~'~P ~EETO 8'WALL:~COM~k ~CH TOE-~[I ") ~PEI)~TERIOR~H~RW~CONNECTIONS: ~"~TETO: ~" ~ ~L CLIMATIC & GEOG~PHIC DESIGN CRITERIA ~ ..... ~llso~in.~roru~a~ ~) CONNECT~NS~OUNO~R~RWALL~ENtNGS: iI~,TOpp~ORGI~I JO~ST ~ ROOF SH~THING REQUIREMENTS FOR WIND LOADS: ~) o~,~.n,.~.~.,~.~.,~, DECK AND COVERED PORCH NOTES: 2).Unl~i"~.~i~l~ml~m~)~2*STR ~g~'P~eswtffi~"~'~l~"l~"~ ~"~g~'" ~RT~3'S WALL SH~THING REQUIREMENTS FOR WIND LOADS: I ,~.~w~~.~,v~. D~WN BY: ~H '""' HVAC SYSTEM NOTES 1).P~VIDE~8'TYPE-XSHEE~KFI~8TOPPINGATt~~Wl "~~'"="~'~'(~ ' ~LE: (SEE P~N) ~ ~. ~.~,~ ~ ~,~ ~ ~ ~ .., ~- ELECTRICAL NOTES: ~,or~ ~,, ~.~~,~.~.~,.~ SHEETED: