HomeMy WebLinkAbout34811-Z Town of Southold 2/23/2018
�m P.O.Box 1179
k 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 36100 Date: 1/4/2013
THIS CERTIFIES that the building COMMERCIAL REPAIRS
Location of Property: 28195 MAIN RD CUTCHOGUE
SCTM#: 473889 Sec/Block/Lot: 102.-5-4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/24/2009 pursuant to which Building Permit No. 34811 dated 6/26/2009
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:
re rt mintc�ior/exterior altew��lio�rs to�utl_c existing ct�s r��,c�°ci�tl �aijrl�d�r� s�applicdMfor.
Corre ted 2/23/1-018 to rein v ,bare rep, it front this CIO.
The certificate is issued to ALFRED J JR&MARIE TERP
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
.... _
..... _..
ht1 Sigtialure
m. Town of Southold Annex
�tigFF6(� 1/4/2013
P.O. Box 1179
54375 Main Road
Southold, New York 11971
It
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CERTIFICATE OF OCCUPANCY
No: 36100 Date: 1/4/2013
THIS CERTIFIES that the building COMMERCIAL REPAIRS
Location of Property: 28195 MAIN RD CUTCHOGUE,
SCTM #: 473889 Sec/Block/Lot: 102.-54
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
6/24/2009 pursuant to which Building Permit No. 34811 dated 6/26/2009
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:
Fire Repairs - Interior/Exterior Alterations to existing Commercial Building
The certificate is issued to ALFRED J JR&MARIE TERP
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
/Kuthori7d6d Signature
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 34811 Z Date JUNE 26, 2009
Permission is hereby granted to:
ALFRED J JR & MARIE TERP
PO BOX 325
CUTCHOGUE,NY 11935
for
EMERGENCY REPAIR, INT/EXT ALTERATIONS. CERTIFICATIONS AND
CONSTRUCTION PLANS MAY BE REQUIRED
at premises located at 28195 MAIN RD CUTCHOGUE
County Tax Map No. 473889 Section 102 Block 0005 Lot No. 004
pursuant to application dated JUNE 24, 2009 and approved by the
Building Inspector to expire' on DECEMBER 26, 2010 .
Fee $ 250 . 00
Authorized Signature
ORIGINAL
Rev. 5/8/02
Form No.6
TOWN OFSOUTHOLD
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:
I. Final survey of property with accurate location of all buildings, property lines,streets, and unusual natural or
\ topographic features.
2. \Final Approval from Health Dept.of water supply and sewerage-disposal(S-9 form).
3. A)proval of electrical installation 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. Commercial building,industrial building,multiple residences and similar buildings and installations,a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings(prior to April 9, 1957)non-conforming uses,or buildings and"pre-existing" land uses:
1. 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
I. 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 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
Date. f'� q
New Construction: Old or Pre-existing Building: Ll"*� (check one)
Location of Property: I %- ) 9 S
J-K'
House No. Street Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000,Section /d 2 - .5--' Block Lot
Subdivision Filed Map. Lot:
Permit No. 3 I Date of Permit. Applicant:
Health Dept.Approval: — Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: ✓ (check one)
Fee Submitted: $
���� Applicant-Signature
`AOF SDUIy��
f®�
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLOD.
[ ] FOUNDATION 2ND ( ] IN LATION
[ ]
FRAMING / STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ) FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
d
DATE 6 INSPECTOR
DEODAT RAMSARRAN
285 Grand Blvd, Deer Park,New York 11729
Telephone 631/667/4539
D E C E I W E
SEP 2 42009 D
September 17, 2009 BLDG.DEPT.
Town Of Southold TOWN Of SOUTHOLD
Re: Cutchogue Drug Store, located on Main Road, Cutchogue, New York.
Attached are the as built plans for a completed repair. The pictures attached,
reflect the repairs as drawn by Design Den, Engineers and Planners of#6
Howe Rd., Coram , New York.
Yours truly,
SE
�0* NEIyY
h�P�
Deo
oFess�or'P
FIELD INSPECTION REPORT DATE COMMENTS f _
FOUNDATION(1ST) y
ac
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FOUNDATION(2ND) �
�O
U\ lryv�f,
ROUGH FRAMING& y
PLUMBING
x
INSULATION PER N.Y. y
STATE ENERGY CODE
Q
FINAL
ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval _
FAX: (631) 765-9502 /j( f�l l Survey
SoutholdTown.NorthFork.net PERMIT NO. pJ t l Check
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Examined �� , 20 Storm-Water Assessment Form
( Contact:
Approved Mail to:
Disapproved a/c
11\\ ,/ Phone:
Expiration � ,20 V ,1/,L �1
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date 6- 24/- D 206`1
INSTRUCTIONS
a. This application 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 showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and waterways.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant. Such a permit
shall be kept on the premises available for inspection throughout the work.
e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of 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 onr ises and in building for necessary inspections.
JNuERWRITERS CERTIFICATE •
P16 ALL CONSTRUCTION SHALL (Signature of applicant or name,if a corporation)
CERTIFICATION OF MEET THE REQUIREMENTS OF THE
NAILING &:CONNECTIONS CODES OF NEW YORK STATE
ba REQUIRED. Mailin address of applicant)
APPS OVE6 AS NOTED
State whether applicant is owner, lessee, agent, architect, engineer, genC64 : t� pQlec}i i 1 er or builder
o Qm -en FEE:(90i
1FY BUILDING CFFARTMENT AT
i /! / 765-1802 8 AM TO 4 PPS FOR THE
Name of owner of premises e 0�,8^02 O 4 PS.M
1 (As on the tax roll q. FC3F�
- TWO REQUIRED
If applicant is a corporation, signature of duly authorized officer FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
(Name and title of coQQ0UMCY (DR 3. INSULATION
USE IS UNLAWFUL 4. FINAL - CONSTRUCTION MUST
Builders License No. BE COMPLETE FOR C.O.
Plumbers License No. ITHOU I uERTIFICATE ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
Electricians License No. YORK STATE. NOT RESPONSIBLE FOR
Other Trade's License No. DESIGN OR CONSTRUCTION ER RS.
1. Location of land on which propos W
work il e done: CO V� >� as
r eal I )— ��� ��T� /6 ve� &-4k-& co1s+rvx-h co*J
House Number Street Hamlet bAAA Yvia.c -1
County Tax Map No. 1000 Section �o� Block Lot _
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy 13U,</U t SS
b. Intended use and occupancy ,Sk-lc
3. Nature of work eck which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars &�
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. Sxd-e
7. Dimensions of existing structures, if any: Front Rear '33 Depth GJ
Height %O Number of Stories rSaJP-,
Dimensions of same structure with alterations or additions: Front Rear _
Depth Height D / Number of Stories 0 4Z-
8. Dimensions bentire new construction: Front /✓(/ Rear Depth
Height / (J Number of Stories
9. Size of lot: Front Rear 35 Depth
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated H 13 /
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NOy
13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO
14. Names of Owner of premises ' 7-e4rll Address if X00/A&Phone No. 93 67 Y
Name of Architect 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 RE ED.
b. Is this property within 300 feet of a tidal wetland? * YES NO c> y.
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
Q�A�uL�n
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
2•VtCMi' .:.3VMt J
17. If elevation at any point on property is at 10 feet or below, must provide topographical d/til
18. Are there any covenants and restrictions with respect to this property? * YES NO
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTYOF
f4) J4,�
being duly swom, deposes and says that (s)he is the applicant
(Name of f
idual ing contra ) above named,
(S)He is the
(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 true to the best of his knowledge and belief; and that the work will be
performed in the manner set forth in the applicatio
tio.Ol A615306N4"*�
Sworn to before me thisQualified in Suffolk Counlv
Z day of S�. 20 O Cgonnissloa Expires Sept.25.�q
494-14- '� �� b*14A 2'2/�
No ary Public Signature o A plicant
TOWN OF SOUTHOLD PROPERTY RECORD CARD � � r
Z600 a
OWNER STREET 195 VILLAGE DIST.1 SUB. LOT
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RES. SEAS. VL. FARM COMM. CB. MICS. Mkt. Value
LAND IMP. TOTAL DATE REMARK SZ /k?5f -1014 k6 ocl pOle 1-f
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AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value ,
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Tillable FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD a _
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House Plat BULKH D
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OF SOUryolo
Town Hall Annexy Telephone(631)765-1802
54375 Main Road H Fax(631)765-9502
P.O. Box 1179 • O
Southold,New York 11971-0959 Q
�y�OUNTV,Nc�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
October 9, 2009
Alfred Terp
PO Box 325
Cutchogue, NY 11935
RE: 28195 Main Road, Cutchogue
TO WHOM IT MAY CONCERN:
�The following items are needed to complete your Certificate of Occupancy:
V Application for Certificate of Occupancy. (Enclosed)
\ 1 Electrical Underwriters Certificate.
v A fee of $50.00
Final Health Department approval.
Plumbers solder certificate (all permits involving plumbing after 4/1/84.)
Trustees Certificate of Compliance.
Final Planning Board Approval.
Final Fire Inspection from Fire Marshal.
Final inspection from the Building Department.
Final Landmark Preservation approval.
Building Permit: 34811-Z repair
pf SOUlyolo
Town Hall Annexy Telephone(631)765-1802
54375 Main Road T Fax(631)765-9502
P.O. Box 1179 CA
Southold,NY 11971-0959
CON%
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
November 18, 2011
Alfred Terp
PO Box 325
Cutchogue, NY 11935
Re: 28195 Main Rd., Cutchogue
TO WHOM IT MAY CONCERN:
The ZApplication
Following Items)Are Needed To Complete Your Certificate of Occupancy:
for Certificate of Occupancy. (Enclosed)
/Electrical Underwriters Certificate.
A fee of$50.00.
Final Health Department Approval.
Plumbers Solder Certificate. (All permits involving plumbing after 4N/84)
Trustees Certificate of Compliance. (Town Trustees#765-1892)
Final Planning Board Approval.
Final Fire Inspection from Fire Marshall. — Bob Fisher
Final Landmark Preservation approval.
BUILDING PERMIT : 34811 - Repair
pf SO!/TyOlo
Town Hall Annex yy Telephone(631)765-1802
54375 Main Road T Fax(631)765-9502
P.O. Box 1179
Southold,NY 11971-0959
AOUNi'I,�c�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
May 7, 2012
Alfred Terp
PO Box 325
Cutchogue, NY 119
Re: 28195 Route 25, Cutchogue
TO WHOM IT MAY CONCERN:
The Following Items Are Needed To Complete Your Certificate of Occupancy:
^� Application for Certificate of Occupancy. (Enclosed)
Electrical Underwriters Certificate. (contact your electrician)
A fee of$50.00.
Final Health Department Approval.
Plumbers Solder Certificate. (All permits involving plumbing after 411/84)
Trustees Certificate of Compliance. (Town Trustees#765-1892)
Final Planning Board Approval. (Planning #765-1938)
Final Fire Inspection from Fire Marshall.
Final Landmark Preservation approval.
BUILDING PERMIT : 34811 - Repair
�o��pF SOpryolo
Town Hall Annex yy yy Telephone(631)765-1802
54375 Main Road T T Fax(631)765-9502
P.O.Box 1179 A Q
Southold,NY 11971-0959 :Z%
Colvin
N
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
December 26, 2012
Alfred Terp
PO Box 325
Cutchogue, NY 11935
Re: 28195 Route 25, Cutchogue
TO WHOM IT MAY CONCERN:
The Following Items Are Needed To Complete Your Certificate of Occupancy:
Application for Certificate of Occupancy. (Enclosed)
Electrical Underwriters Certificate. (contact your electrician)
::R'A fee of$50.00.
Final Health Department Approval.
Plumbers Solder Certificate. (All permits involving plumbing after 4/1184)
Trustees Certificate of Compliance. (Town Trustees#765-1892)
Final Planning Board Approval. (Planning#765-1938)
Final Fire Inspection from Fire Marshall.
Final Landmark Preservation approval.
Final inspection by Building Dept
BUILDING PERMIT : 34811 - Repair
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