HomeMy WebLinkAbout37144-Z ,f Town of Southold Annex 6/10/2014
41 P.O.Box 1179
Qe, &
- 54375 Main Road
t� Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 36964 Date: 6/10/2014
THIS CERTIFIES that the building HOOD FIRE SUPPRESSION SYSTEM
Location of Property: 50 N Sea Dr, Southold,
SCTM#: 473889 Sec/Block/Lot: 54.-5-22
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
4/17/2012 pursuant to which Building Permit No. 37144 dated 4/18/2012
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 suppression system as applied for.
The certificate is issued to Cliff&Phil's Lobster House
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
A� �J— —
Authorized Signature
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 #: 37144 Date: 4/18/2012
Permission is hereby granted to:
Cliff& Phil's Lobster House
PO BOX 985
Southold, NY 11971
To: install a Fire Suppression System
At premises located at:
50 N Sea Dr, Southold
SCTM # 473889
Sec/Block/Lot# 54.-5-22
Pursuant to application dated 4/17/2012 and approved by the Building Inspector.
To expire on 10/18/2013.
Fees:
EXHAUST HOOD AND/OR FIRE SUPRESSION SYSTEM $300.00
Total: $300.00
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 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
1. 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. 5 - 2-q — I q
New Construction: Old or Pre-existing Building: (check one)
Location of Property: �Jy Jy �j�A �%-t
House No. Street Hamlet
Owner or Owners of Property: CL'o F F Fr'+( (- s 4V-S
Suffolk County Tax Map No 1000, Section .5� Block Lot 2 2—
Subdivision
Subdivision QQ Filed Map. , / Lot:
Permit No. ?� Date of Permit. �'�C7 '�Q-Applicant: �/ ("PA3A0
Health Dept. Approval: Al
+ Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ 14
Applicant Signature
1
�o • �o
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLUMBING
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
C� 3�
DATE INSPECTOR
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MDAZEC�11I!tTS. .
Fo ATION(2ND)
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PLUMiNG
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INSUL•ATION P93t N Y.
STATE MMGY CODE
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FINAL
8 I (o ADDITIONAL.COD=NTS —
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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 p /a Survey
SoutholdTown.NorthFork.net PERMIT NO. c7 l`'[ Check
Septic Form
N.Y.S.D.E.C.
rAPR
� Trustees
Flood Permit
Examined 20_� Storm-Water Assessment Form
Contact:
Approved I 20 ZMail to:
Disapproved a/c
OLD Phone:
Expiration (" S(20�
PCA
building Inspector
APPLICATION FOR BUILDING PERMIT
Date �"/ �(o� , 20 /a
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 @ounty,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 necgoary inspections.
(Signature of appli-eant or name,if orporation)
rico �,/W;�
(Mailing address of a licant)
State whether applicant is owner, lessee, agent, ar*tegtz engkrt�pr, general contractor, electrician, plumber or builder
AU (0,kf5-1QXTION SHALL MEET THE
f�Z F _uUiFta RJTS OF THE CODES OF NEW
RESPONSIBLE FOR
Name of owner of premises DESIGN OF CONSTRUCTION ERRORS.
(As on the tax roll or latest deed)
If applicant i p co oration, signature ofduly authorized officer
2. State existing use and occupancy of pre ses and inten ed use and occupancy of proposed construction:
,
a. Existing use and occupancy ep
b. Intended use and occupancy
3. Nature of work(check 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 car's
6. If business ommercial,.ofi mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
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 Address Phone No.
Name of Architect Address Phone No
Name of Contractor&%l AW 1Ee Le§M.�i� Address ?l D OY
V24 f Phone No. (0.3/. 1 PG yoo 0
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. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
18. Are there any covenants and restrictions with respect to t 's roperty? * YES NO V
* IF YES, PROVIDE A COPY. BAR� B+ ARBA SKIDMORE
Notary Public-State of New York
STATE OF NEW YORK) //���a NO. 01SK6030131 .
ii SS: Qualified In Suffolk County
COUNTY OF��11�f k) � � '�` MY Commission Expires f3
bein duly sworn,deposes and says that(s)he is the applicant
(Name of indivilguarsigning contract)above named,
SCOPE OF WORK: DSS
WL-1- C wt XA-L_ 6(ZF- 5419194F56I a N 5-qSTEM k5 PF-fz' uL -_&do
AES MANUFACTURE:4 4/,,f 6r X aAh �v far,4uoi✓ DATE: 512 3 /22_
PIPING MATERIAL.5M��10a—�-MAX LENGTH: MAX
SUPPLY PIPE SIZE:—BRANCH P E SIZE:' �2 C�
GAS VALVE TYPE Iy[EC!�. SIZE: 3-- - MANUFAGTU ER: ado 4 u�N CDK r(ZpL
DETECTOR TEMPERAJSIR��tATING:�y.S'a`3(O UANTITY: 3 °
2=- 3 40' �E
HOOD SIZE: 7S X 4/0 DUCT SIZE: rl / X Z pf�tivo-i'�.oA -opt
HOOD SIZE: DUCT SIZE: 2 y (�
EQUIPMENT SURFACE NOZZLE
TYPE AREA QUANTITY TIP# HEIGHTS LOCATION 1—}-1 -
Duct
Plenum ely yam' / TER..
Plenum /_: ! d y' /O C�
Range __ N,X 28 ?_ L P /G-ZO 7 E Aollr_A -
Griddle 2 1028 1 'A A7- -113-119 E4j1SVr
Wok
F er - _._._ �y. 2. _ F —Z—
Fryer
ri ht 3'y}�3D
iJ / AA P ToP �" P1N 77Co
Gas Rad- _ _
Elec. Rad.
Elec. Rad. .----
Lava-rock
Natural Gas
Mes ite to _ RA t*t �t21Dfl
5'Ie�LPtMf'kN F 2 }( � -- -V E1X,EOF�oKtt?E �'�-" R"Ei!V�O'rl� I�.�NUi1}i
X-Fryers to have high limit control to shut off fuel at 425 degree.
X-Detectors shall be located over every piece of equipment. �A�.Jay+�thNQi< P/N 60 I Z.O l 10 -,vc
X-The system installed as per manufacturers specs.and the AHJ.
X-The system has been installed as per UL". APPROVED AS NOTED
X-The following function to operate upon system discharge.
'Supply air damper closes *Gas fuel shut off in kitchen u PRI(PW T
`Exhaust fan remains on •Electric fuel shut-off under hood3 �� serol L-m FRYEA, ATE;.. B.P. # 371'f
4�
"All systems to activate simultaneously in some hazard area l'y / .so �/
`Fire Alarm shall activate if one is installed in building.
X-Manual pull is located 10-35 fee from hood and 3-5 feet from floor. F 11Tt F( 6;1!'t-Q!NG DFPARTM4�-Nl AT
X-All fuel sources are GAS unless otherwise noted z
76�5 r�,J: e r,.M TO a Prat FOR THE
CONTRACTOR:All Island Fire Protection )N TVVI
1180 Montauk Highway _. :>C .0"'--.RETE
i.t?�H 1N! a_ JRVA JI:VG�
East Patchogue, NY 11772 FIRE 19SRECTIGIi� ,at .;-R ELECTRICAL P' I%AL&CAULKING
Tel: 631-286-4000 Fax: 631-286-7044 t✓` i� y do a v V f
REQU WED BEF0 RE i VITc��� � 3. INSULATION
OP � � CERTIFICATE 4. FINAL-CONSTRUCTION &ELECTRICAL
LOCATION: L T MUST BE COMPLETE FOR C.O.
'` "`' ' ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
�5;0 44,7'14 o Z_ f /Vlezo`1dk/e, /,.97/ YORK STATE. NOT RESPONSIBLE FOR
,5/�L-- 7S"/Z 3._._. a� DESIGN OR CONSTRUCTION ERRORS.
�, N .P'