HomeMy WebLinkAbout40918-Z Of Four Town of Southold 11/21/2016
P.O.Box 1179
o ® 53095 Main Rd
��10 Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38648 Date: 11/10/2016
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 54280 Route 25, Southold
SCTM#: 473889 See/Block/Lot: 61.-4-22
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/18/2016 pursuant to which Building Permit No. 40918 dated 8/18/2016
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:
"AS BUILT"INTERIOR ALTERATIONS FOR A FITNESS STUDIO IN AN EXISTING COMMERCIAL
BUILDING AS APPLIED FOR
The certificate is issued to Laoudis of Southold LLC
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40918 09-28-2016
PLUMBERS CERTIFICATION DATED 11/17/2016 Mike Jacobi Plumbing
ut 6
ed Signature
�U ktcp'� TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y z TOWN CLERK'S OFFICE
P . SOUTHOLD, NY
y 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#: 40918 Date: 8/18/2016
Permission is hereby granted to:
Laoudis of Southold LLC
PO BOX 579
Alpine, NJ 07620
To: as built" interior alterations to existing commercial building converted to fitness studio
as applied for. Additional certification may be required.
At premises located at:
54280 Route 25
SCTM # 473889
Sec/Block/Lot# 61.-4-22
Pursuant to application dated 8/18/2016 and approved by the Building Inspector.
To expire on 2/17/2018.
Fees:
AS BUILT-COMMERCIAL ADDITIONS/ALTERATIONS $500.00
CO -COMMERCIAL $50.00
Total: $550.00
Buil 'ng 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.
New Construction: Old or Pre-existing Building: (check one)
Location of Property: S Ro
House No. Street Hamlet
LQ
�-,
Owner or Owners of Property: l Q l Q U S
Suffolk County Tax Map No 1000, Section Block Lot
Subdivision i Filed Map. Lot:
Permit No. `V Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
Applicant Signature
pF SOU��®�
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 �� roper.riche rt(a)-town.southoId.ny.us
Southold,NY 11971-0959
COMM
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To Laoudis of Southold LLC (Body Smart)
Address: 54280 Route 25 City: Southold St: New York Zip: 11971
Building Permit#: 40918 Section. 61 Block: 4 Lot: 22
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Custom Lighting of Suffolk License No: 38893-ME
SITE DETAILS
Office Use Only
Residential Indoor X Basement Service Only
Commerical X Outdoor 1st Floor X Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt 28 Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture 11 Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures3 Time Clocks
Disconnect Switches 9 Twist Lock El Exit Fixtures 4 TVSS
Other Equipment: 3- Paddle Fans, 1- Exhaust Fan, 3-combination smoke/co detectors
Notes:
Inspector Signature: Date: September 28, 2016
0-81-Cert Electrical Compliance Form.xls
v 0,v-
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9501
P.O.Box 1179
Southold,NY 11971-0959
D DD BUILDING DEPARTMENT
NOV 1 7 2016 TOWN OF SOUTHOLD
BUILDING DWr.
TOWN OF SOUTHOLD
CERTIFICATION
Datc: 11117114
Building Permit No. vo
Ownerin'ouj 15 O�- 6—" '-f4o
(Please print)
Plumber: P� ,7&-c,a(a; &(/ 7
(Please print)
I certify that the solder used in the water supply system contains less than 2/10 of I%
lead.
(Pynbers Signature)
Sworn to before me this
day of 20 ( LYNDA M RUDDER
Notary Public,state of New York
No.OIRU6020932
Clualified in Suffolk County 4 9
Commission Expires march 8,20—L l(
County
Notary Public,
Of SOUTyolo
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
KELECT (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
DATE INSPECTOR
SOUlyolo
Qui l �ycou►�,N
4
TOWN OF 'SOUTHOLD BUILDING DEPT.
765-1802
. INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ] ELECTRICAL (FINAL)
REMARKS:
DATE INSPECTOR'
rAf s 0
coulm,
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
I FOUNDATION IST ROU H'PLUMBING
FOUNDATION 2ND I ULATION
S L
FRAMING / STRAPPING FINAL
FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION
FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION
ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
CODE VIOLATION CAULKING
REMARKS: a &.4.4 42
N-
C441 04,r Vf Wj -
DATE INSPECTOR uv
sww SOUTy�� tq
��y00UM'1,�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: F- Y,4T- !�2161t/ Pc------2Wl� tLIg
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DATE �Z� �� INSPECTOR
FIELD INSPECTION REPORT DATE 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 Survey
SoutholdTown.NorthFork.net PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined ,20 Single&Separate
Storm-Water Assessment Form
Contact:
Approved 20 Mail to:
Disapproved a/c p
Phone: ✓o �� �/�
Expiration ,20
D Lib ("� B i i for
AUG 1 U 2016 APPLICATION FOR BUILDING PERMIT
Date 9/(3 —, 20 1(o
����DEPT. INSTRUCTIONS
UPHOLD
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 bididing 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 andulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
ignature(jf applicant or name,if a corporation)
60V97/
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
00 rMa ��OY
Name of owner of premises
(As on the tax roll or latest deed)
If applicant is a corporation,,signature of duly authorized officer
(Name and'titl&-of'corpor'ate officer)
Builders License No''.'
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed wo will be done:
SLI a&U
House Number Street Hamlet
County Tax Map No. 1000 Section 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
A
b. Intended use and occupancy , � ``(At(yd
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work j[C0%,)o torN
(Description)
4. Estimated Cost as,oc)o 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. C-C I S F-
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 8torisr `t
8. Dimensions of entire new construction: Front Rear �� Depth,;i
a +-figs
1,,
Height Number of Stories
9. Size of lot: Front Rear Depth ��Y' , G as
"s._ � �
-.)z If
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 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. 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 this property? * YES NO
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF )
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
CONNIE D. BUNCH
(S)He is the Notary Public,State of New York
No.01 BU61 85050
(Contractor,Agent, Corporate Officer, etc.) Qualified in Suffolk County
Commission Expires April 14,K�O
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.
S orn to before me thisA
r' day of ' 20
Notary Public Signature of Applicant
Town Hall,Annex Tel
.54375 Main Road 1N1676u5fA&ny.us
P.O.Box 1179 g rogerAchertco!
I j . JUL 2 8 2016
Southold,NY 11971MJ 9
ti
BUILDING DEPT.
BUILDING DEPAKTMFA'TF TOWN OF SOUTHOLD
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUE
S
TED BY: a h+1
Date:
Uc
Co parry Name:
Name: VY)I
S,K
License No.:
Address:
C
113hone No.: 01'
JOBSITE INFORMATION: (*Indicates required information)
*Name: ZxdLA5rno.,r-4-
*Address-
*Cross Street:
*Phone No-: 4 4C
Permit No.:
Tax Map District: 1000 Block: tot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
1H ot4le--f-� Cl pct P ��� -n
(Please Circle AJI That Apply)
*Is job ready for Inspection: YES 1,dO Rough In Final
*Do you need a Temp Certificate: YDS / NO
Temp information (if needed)
*Service Size: I Phase 3Phase 100 150 20P 300 350 400, Other
*New Servics: Re-connect Underground Number of Mdters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
52-Request for Inspection Form,
Pontino, Susan
From: Chris Czartosieski <bodysmartstudio@yahoo.com>
Sent: Thursday, November 10, 2016 8:10 PM
To: Pontino, Susan
Subject: Re: CO
Ok Thanks! I sent the contractor a message and he will relay to the plumber.
Sent from my iPhone
>On Nov 10,2016, at 12:57 PM, Pontino,Susan<susan.pontino@town.southold.nv.us>wrote:
> Hi, I started to type the C of 0, however we do not have the lead solder certificate from the plumber. Once you get
that to me I can type the C of 0. Thank you.
>
>-----Original Message----- C I
> From:Chris Czartosieski [mailto:bodysmartstudio@Vah_oo.com] �� a(
>Sent:Tuesday, November 08,2016 8:50 AM
>To: Pontino,Susan
>Subject: Re:CO
> Hi Susan,
> Here are the updated pics of what the building inspector needed.
,�
. � .>
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PROJECT TITLE
J -v INTERIOR
OCCUPANT LOAD PER TABLE 1 .1.2 BCNY5 2010: NOTE: NO CHANGES WILL REPLACE WITH TEMPERED GLASS RENOVATIONS
EXERCISE ROOMS TOTAL BE MADE THE THE
1703 5F @ 50 5F/PER5ON= 35 OCC PANTS BUILDING ENVELOPE OR 54280 MAIN ROAD
MECHANICAL SYSTEMS. SOUTHOLD
PER SECTION 303.1.1.TH15 IS GROUP'13'OCCUPANCY. , NY n971
PER TABLE 10 18.1, 2 EXITS REQUIRED, 2
EXISTING/PROVIDED DRAWING TITLE
D ���Od� FLOOR PLANS
D
EXISTING GROUND FL00K FK0P05ED FLOOR FLAN SEP 302016
A I
KCAL 114"= SCALE: 114"=1' A I Bu mmm;DEPT. SCALE
EX15T1 NG EXCEPT A5 NOTED TOWN OF SOUTHOLD sept 30, 2016 114" = 1'O"
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5CTM NO. 1000-G 1 -4-2 2 DRAWING NO.
v v l / %1'%V I u I I ISSUES/REVISIONS
�"")E IS UNLAWFI I,!-
WITHOUTCERTIFiCAT LE
OF OCCUPANCY
APPR WED AS NO ED Q
DATE: L;.P.# v
FEE: 'P)l BY:
NOTIFY BUILDING ljhPA. ET AT
765-1802 8 APA TO 4 FM FOR THE
FOLLON NG INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
-- -- - -- EXIT u ALL CONSTRUCTION SHALL MEET THE
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REQUIREMENTS OF THE CODES OF NEW
I P-0'AFF x 0 YORK STATE. NOT RESPONSIBLE FOR
2 LAYERS%- FIRECODE GYP. BD. = O + I
2x2' DESIGN OR CONSTRUCTION ERRORS.
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FLUORESCENT COMPLY WITH ALL CODES OF
LIGHT NEW YORK STATE & TOWN CODES
AS REQUIRED AND CONDITIONS OF
RECESSED DOWN LIG , 2"',
PROVIDE
ALL PERIMETER WALLS:
PROVIDE(2)LAYERS%8" 3068 „w 3—
FIRECODE GYP BD. X
EXISTING OFFICE PER UL Des U344.
*CEILING FAN 141-011
2'X4'
FLUORESCENT
LIGHT NEW EXERCISE ROOM
ELECTRICA
350 SF/50 5F(PER5ON = 7 OCCUPANTS.
INSPECTION REQU`RED
- PLUMBER CERTIFICATION
EM RGENCY O ON LEAD CONTENT BEFORE
sD CERTIFICATE OF OCCUPANCY
4LIGHT
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SMOKE DETECTOR N SOLDER USED IN WATER
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FLUORESCENT SUPPLY SYSTEM CANNOT
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CEILING FAN PROVIDE ACOUSTIC BATT
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EMERGENCY n' ALL PLUMBING WASTE
N LIGHT DROP CEILING IN THIS AREA: / V &WATER LINES NEED
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FIRE-RATED CEILING PANELS INST D PER
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RECESSED DOWN fGHT PURSUANT TO CHAPTER 236 ARCHITECT.INFRINGEMENTS WILL
2x4' ,I, BE PROSECUTED
FLUORESCENT y OF THE TOWN CODE.
1 LIGHT 2o16 ALL RIGHTS RESERVED
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o EXIT 11 \ I � T PROJECT TITLE
INTERIOR
OCCUPANT LOAD PER TABLE I O .I.2 BCNY5 2010: NOTE: NO CHANGES WILL REPLACE WITH RENOVATIONS
EXERCISE ROOMS TOTAL BE MADE THE THE TEMPERED GLASS
1763 5F @ 50 5F/PER5ON= 35 OCC PANTS BUILDING ENVELOPE OR 5428o MAIN ROAD
PER SECTION 303.1.I,THIS IS GROUP'EY OCCUPANCY. MECHANICAL SYSTEMS. SOUTHOLD NY ng7i
PER TABLE 10 18.1, 2 EXITS REQUIRED, 2 DRAWING TITLE
EXI5TING/PROVIDED
FLOOR PLANS
E X 1 5 T I NG GROUND FLOOR I PROPOSED FLOOR PLAN I
A I SCALE: I/4"'=1'-O" A
�.I EXISTING EXCEPT AS NOTED aug 17, 2016 SCALE 114" = 1'0"
SCTM NO. 1000-6 1 -4-22
DRAWING NO.