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HomeMy WebLinkAbout36911-Z oS�FFpt,rco Town of Southold Annex 2/3/2012 =o Gym 54375 Main Road C* Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 35425 Date: 2/3/2012 THIS CERTIFIES that the building COMMERCIAL REPAIRS Location of Property: 10095 Route 25, Mattituck, SCTM#: 473889 See/Block/Lot: 142.-1-26 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 12/28/2011 pursuant to which Building Permit No. 36911 dated 1/9/2012 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: Commercial Restaurant Repairs "as built."(Big City Burgers) The certificate is issued to Mattituck Plaza LLC (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 36911 1/19/12 PLUMBERS CERTIFICATION DATED 2/2/12 ertsand Plumbing Corp u o ' d Si' gnature TOWN OF SOUTHOLD BUILDING DEPARTMENT y TOWN CLERK'S OFFICE o . 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#: 36911 Date: 1/9/2012 Permission is hereby granted to: Mattituck Plaza LLC PO BOX 77 Mattituck, NY 11952 To: Commercial Restaurant Repairs "as built" At premises located at: 10095 Route 25, Mattituck SCTM # 473889 Sec/Block/Lot# 142.-1-26 Pursuant to application dated 12/28/2011 and approved by the Building Inspector. To expire on 7/10/2013. Fees: NEW COMMERCIAL, ALTERATION OR ADDITIONS $500.00 CO -.COMMERCIAL $50.00 Total: $550.00 Building Inspector SO(/ryolo Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O. ox 117 Southoldld,,NY 11971-0959 c Q roper.richert(a-town.southold.ny.us �` � o�yCOU ,� , BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Big City Burgers Address: 10095 Main Rd City: Mattituck St: NY Zip: 11952 Building Permit#: 36911 Section: 142 Block: 1 Lot: 26 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Celi Electric Lighting Corp License No: 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 8 Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel A/C 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 TVSS Other Equipment: alteration to Counter, move recpticles Notes: Inspector Signature: Date: Jan 19 2012 81-Cert Electrical Compliance Form O�QgUFFO(�-co . a y Z Town Hall,53095 Main Road Q ` �� P.O..Box 1179 'Fax(631)765-9502 0 Southold, New York 11971-0959 ��� ,1� �a Telephone(631)765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: ebruary 2 2012 Building Permit No. 3 6911 Owner: �/(s Cc U r - ii- l Ue(C L L (Please print) Plumber: RP,-tGand P1 lmbi ng Corp (Please print) lead. I certify that the solder used in the water supply systen, contains less than 2/10 of 1% (Plumbers Signature) Sworn to before.me this 2nd day of February 2012 Notary Public, Suffolk County �lliooA Eifl.Roac�ho Notary Public,state of Now York Edo•4826942 QualiSled In Suffolk County Commission Evolres January 31,20/V 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: l. 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 I% 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,I957) 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: \C)o s S -bA C�, House No. Street Q� Ham et Owner or Owners of Property: ► {—'�'`J� Suffolk County Tax Map No 1000, Section d` Block Lot p2 6 Subdivision Filed Map. Lot: Permit No. -3 69 1 Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ �b - d pplicant Signature H - j hod °la 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: DATE � �� INSPECTOR c sour u►�, �� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOU ATION 1ST [ ] ROUGH PL13G. [ IF UNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING [ ' ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL.(ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: L DATE ` lOhl INSPECTOR OF SOpT�olo 1 coul l,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE l l �� -INSPECTOR\ �pf SOpr�, - - - h �O COU ,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1602 INSPECTI [ ] FOUNDATION 1ST [ OUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE INSPECTOR ^ OF SObr�o� lU� c0UN1`i, I 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: DATE C11q /-Z---- INSPECTOR)E `� o�yco ,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] IN TION [ ] FRAMING/STRAPPING [ '-FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE �� INSPECTOR r �99 � SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOOD INSPECTION NARRATIVE Action: CONT Estab.ID: 28663 Estab.Class: 110 Estab.Name: ,?x iv.Code(s): 12 Inspection Date: 1/25/12 Time of Inspection: 1:58 PM PART 1: RED CRITICAL ITEMS These items relate directly to factors which lead to foodborne illness and must receive immediate attention Code Section Description of Violation Corrective Action 760-1333.9 When food of animal origin is served raw or not cooked to temperatures prescribed by this Article,the consumer is to be notified by brochures,deli case or menu advisories,label statements,table tents,placards,or other effective written means of the significantly increased risk associated with certain especially vulnerable consumers eating such foods in raw or undercooked form;except,(a)Unmarinated beef steaks that meet the definition of "whole-muscle,intact beef'may be served without a consumer advisory if cooked on the top and bottom to a surface temperature of 145 degrees Fahrenheit(63 degrees Celsius)or above and a cooked color change is achieved on all external surfaces,if:(1)obtained packaged and labeled as"whole-muscle,intact beef steaks"from a food processing plant;or,(2)cut in the establishment from beef labeled at a food processing plant as meeting the definition of "whole-muscle,intact beef',prepared to remain intact,and individually packaged and labeled as"whole-muscle,intact beef steak". (b)Raw or undercooked food of animal origin shall not be served to a highly susceptible'population. To Wit: CONSUMER MENU ADVISORY IS INADEQUATE IN THAT THE PRINTED CONSUMER ADVISOR' CONSUMER REMINDER STATEMENT ON THE MENU IS INCORRECT. TO BE it ADDED/CORRECTED .0... /^Sn(-o�Wy IF YN )VXVC' 6ere-1W'A1 MOOL C01141-2>17_iVAIS I) 760-1352.2.a The potable water system and equipment connected thereto shall.be installed in such a manner as to preclude the possibility,of backflow. To Wit: THE SPRAY NOZZLE AT THE 3-COMPARTMENT SINK CAN HANG BELOW THE REPROCESSED FLOOD RIM OF THE SINK,AND THE POTABLE WATER SUPPLY IS.NOT PROTECTED BY AN AIR GAP OR APPROVED ANTI-BACKFLOW DEVICE. PART 2: BLUE MAINTENANCE ITEMS These items relate to maintenance of the food service operation and cleanliness,correct as scheduled. Code Section Description of Violation Correct By 760-1303.2 Any person desiring to operate a food establishment shall make written'application for a permit on forms provided by the department. Such application shall include the applicant's. full name and post office address and whether such applicant is an individual,firm or corporation,and if partnership,the names of the partners,together with their addresses;proof of the applicant's authority to collect sales tax in the State of New York;the location and the type of food establishment;and the signature of the applicant or applicants. If the application is for a temporary food establishment,it shall also include the inclusive dates of the proposed operation. To Wit: THE OPERATOR FAILED TO SUBMIT PROOF OF AUTHORITY TO COLLECT SALES 2/8/2012 TAXES IN NEW YORK STATE. To Wit: THE OWNER/OPERATOR FAILED TO SUBMIT PROOF OF INCORPORATION OR 2/8/2012 VALID PROOF OF OWNERSHIP OF THE BUSINESS. To Wit: THE OPERATOR FAILED TO SUBMIT PROOF OF POSSESSION OF WORKER'S 2/8/2012 COMPENSATION AND DISABILITY INSURANCE. Person Receiving Report: Sanitarian: 808 KITEMMEL Page 1 of 2 Action: CONT Estab.ID: 28663 Estab.Class: 110 Estab.Name:—Ehkfff*' Sig C jj Glr&rzf S Activ.Code(s): 12 Inspection Date: 1/25/12 Time of Inspection: 1.:58 PM PART 2: BLUE MAINTENANCE ITEMS These items relate to maintenance of the food service operation and cleanliness,correct as scheduled. Other Notes ESTABLISHMENT BUILT SUBSTANTIALLY ACCORDING TO APPROVED PLANS. OKAY TO ISSUE PERMIT ESTABLISHMENT MAY OPEN ONCE ALL FOOD CONTACT SURFACES HAVE BEEN THOROUGHLY WASHED,RINSED AND SANITIZED. Thermometer Used: Cooper Min/Max 808 Inspection by Adam Kuemmel,9808 Suffolk County Department of Health Services Food Control Unit 360 Yaphank Avenue, Suite 2A Yaphank,NY 11980 Phone:(631)852-5999 Fax:(631)852-5871 THE FOOD MANAGER'S COURSE IS AVAILABLE ONLINE To register for the Food Manager's course,please visit http://apps.suffolkcountyny.gov/health/foodmgttrain/or call (631)852-5997 Person Receiving Report: Sanitarian: 808 KUEMMEL Page 2 of 2 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOOD ESTABLISHMENT INSPECTION SUMMARY REPORT Action:CONT Activ.Code(s): 12 Estab.ID: 28663 Estab.Class:110 Estab.Name: BIG CITY BURGERS Estab.Address: 10095 MAIN RD-STORE#15 Estab.City: MATTITUCK Permit Restr: S Z Capacity: 16 Owner: GEORGE MALAMAS,MANA( Corp Name:BIG CITY BURGERS Mt Mgr.Cert.#1: SAFE: Corp.Address: 10095 MAIN RD.-STORE#15 Inspection Date: 1/25/12 Insp.Status(es): 06 Risk: 0 Corp.Zip: 11952 Time of Inspection: 1:58 PM PART 1: RED CRITICAL ITEMS These items relate directly to factors which lead to foodborne illness and must receive immediate attention Code Section Description of Violation Corrective Action 760-1333.9 CONSUMER MENU ADVISORY CONSUMER ADVISORY TO BE ADDED/CORRECTED 760-1352.2.a CROSS-CONNECTIONS REPROCESSED PART 2: BLUE MAINTENANCE ITEMS These items relate to maintenance of the food service operation and.cleanliness,correct as scheduled. Code Section Description of Violation Correct By 760-1303.2 FAILURE TO SUBMIT APPLICATION 2/8/2012 Signature of Person Receiving Report: _ Sanitarian: 808 KUEMMEL Page 1 of 1 Print Name: Joint Sanitarian: "The items noted above are violations of applicable laws,rules and regulations found during an inspection of the operation of the facilities in this establishment which must be corrected as indicated.Failure to comply may result in the initiation of legal action against this establishment as provided for in Articles 2 and 13 of the Suffolk County Sanitary Code including a hearing, possible suspension of your food operation,and or the publication of the violation and fines." F, N. Y. S . DEPARTMENT OF STATE i E "DIVISION OF CORPORATIONS AND STATE RECORDS ALBANY, NY 12231-000 FILING RECEIPT ENTITY NAME: BIG CITY BURGERS MATTITUCK LLC DOCUMENT TYPE: ARTICLES OF ORGANIZATION (DOM LLC) COUNTY: SUF FILED: 12/19/2011 DURATION: ********* CASH#: 111219000040 FILM # : 1112190000' EXIST DATI FILER: RICHARD T. HAEFELI, ESQ. 12/19/201: 48F MAIN STREET WESTHAMPTON BEACH, NY 11978 ADDRESS FOR PROCESS : -------------------- THE LLC 130 JESSUP AVENUE P.O. BOX 815 QUOGUE, NY 11959 REGISTERED AGENT: P --------- ----- SERVICE CODE: 1: SERVICE COMPANY: GERALD WEINBERG, P.C. - 13 PAYMENTS 2 FEES 225 . 00 --- a ------ CASH FILING 200 . 00 CHECK TAX 0 . 00 CHARGE -ERT 0 . 00 DRAWDOwN 2 COPIES 0 . 00 OPAL HANDLING 25 . 00 REFUND DOS-1025 (04/ " New Yark State D"epa'rtment of-T. ton"and Finance j Certif O teat sty u . VALIDATED 1- Identification number r43 i;W�'-`AF,:' 4, 5410219112 3 r o - (Use this number on-all refums and..correspondence) I .�,' s Dept of Tax and , =BIG CITY BURGERS MATTITUCK LLik C u BIG CITY-BURGERS ' 15 NfAT31TUCKN1(11952 1529 ` r _ - v-5 t 2 F h k ^ f 1 r is authorized to collect sales'and use taxes under Articles 28`and 29`of the New York State Tax Law C , r _. Nontransferable LThis cet#icate trust be•prominently displaye d at your place of business Fudulent er athet tmpt oiler useof this;certificate wttl cause it fo be revoked a i :The certificate;may not be pho#ocopidd or reproduced k ` ht of NYS Em ire State Development g Photographs<capyrtg P `4 0 _010 Q00 rhea 427Q635. P0000209 41 T� A(9/1' Din. 17 FIELD MORT DATE COMMENTS FOUNDATION(1ST) FOUNDATION(ZND) C p� ROUGH FRAMNO& PLUMBING �y G INSULATION PER N.Y. H STATE ENERGY CODE ;T,41 FINAL ADDITIONAL COMMENTS ,-LA, Z l C�)� �e 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 14 TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey South oldTown.NorthFork.net P Check DSeptic Form N.Y.S.D.E.C. Trustees DEC 2 8 2011 C.O. Application Flood Permit Examined / 120 0 - Single&Separate BLDR DEPT. Storm-Water Assessment Form TOWN OF SOUTHOLD Contact: Approved 1 20 Mail to: Disapproved a/c Phone: 5/ `,rr I` 3. 3000 Expiration V10 ,20 Building Inspector APPLICATION FOR BUILDING PERMIT Date /,7- — , 20 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 on premises and in building for necessary inspections. (Signature of applicant or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder - ec- Name of owner of premises /-(A-erGK &+Z/�_, L(� (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. 1 4 ?o( M P Electricians License No. /O ^ z 2- Other Trade's License No. 1. Location of land on which proposed work will be done: _r_0 o9'S Pi-i,,J 120� S7-0tL �S House Number Street Hamlet County Tax Map No. 1000 Section `'(2 Block 1 Lot 2-�4 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 ?'j{ G© A b. Intended use and occupancy 13 e"K 64"� g 3. Nature of work(check which applicable): New Building~ f Addition Alteration Repair Removal Demolition Other;Work (Description) 4. Estimated Cost 3 006 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. 7. Dimensions of existing structures, if any: Front I cl Rear 5'' Depth 31 Height / 2 ` Number of Stories ^J-E— Dimensions of same structure with alterations or additions: Front / Rear �9 Depth 3 Y, Height / V Number of Stories Ow 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 Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO 'IC— * 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 ) L,4�t,9'S being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, CONNIE D. BUNCH Notary Public,State of New York (S)He is the No.01BU6185050 (Contractor, Agent, Corporate Officer, etc.) Qualified in Suffolk County Commission Expires April 14,2jo4l 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 tljks Q —day 20� omr _-p L AWE, Notary Public Signature of Applicant tf So�jy �o ova Town Hall Annex Jt l Telephone(631)765-1802 W75 Main Road y m�ax(631)76 �52� P.O.Box 1179 G @ roger.richert(pRown.sou oQ .ny.us Southold,NY 11971-0959 '�� Owl BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: me-L 1 /Y6d-,4,e 4�5 Date: . Company Name: Na me: License No.: 7- 2 ^ ' Address: Phone No.: 2 -y2-2 7 JOBSITE INFORMATION:. (*Indicates required information? *Name: *Address: *Cross Street: *Phone No.: ,�^(� L(V 3 3o D O Permit No.: j 9 J Tax-Map District: - 1000 Section: L(7- Block: ( Lot: 2­6 *BRIEF DESCRIPTION OF WORK (Please Print Clearly) -�- ��J� 0 c,'fL,�_ %6 N 9 �/ Ca �,w%,✓/C /�v� G'�g Z_ �/i�✓�s -7-U s (Please Circle All That Apply) Is job ready for inspection: E NO Rough In Final *Do-you need a Temp Certificate: YES/ NO Temp Information(if needed) *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other *New Service: Re-connect' Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION .82=Request for Inspection Form _- *qfS) Town Hall Annex 1 Telephone(631)765-1802 54375 Main Road y ax(631)76 5 P.O.Box 1179 71n ' Q roQer.richertCa town sou1t9i56 ny us Southold,NY 11971-0959 \` Cow,N BUILDING DEPART TENT TOWN OF SOUTflOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: _ �_L 1L1 e(_4°C 1 Date: Company Name: Name: �� License No.: 1p _ Z 2 _ 16 ( 12 V- L Address: Phone No.: �(� _ JOBSITE INFORMATION: (*Ind-icates required information) *Name: *Address: *Cross Street: *Phone No.: c f If 9 3a o Permit No.: .. 9 Tax-Map District: 1000 Section: yz. Block: ( Lot: ?� *BRIEF DESCRIPTION OF WORK(Please Print Clearly) -7-V S (Please Circle All That Apply) *Is job ready for inspection: .NO *Rouh Final *Do-youneed a Temp Certificate: YES/ NOtiTemp Information(ifneeded) *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other *New Service: Re-connect Underground Number of Meters Change of Service Overhea Additional Information: PAYMENT DUE WITH APPLICATION .82=Request for Inspection Form 7-f� C w� S o-� ICI c� �2 aJ �h INK H.C. < IL EXISr4 H.C.GRAB BARD ' fibfL�- i FIXTURE KEY . t f —_— 0 74'x24• (3) COMPARTMENT SINK x � aEd m 1 a a 12 xlb HAND SINK (�`,, 15• DEEP WIRE ® {1`�ST�'V� ABOVE SHELVES I IO (' EXISTIG LOCKER•! " �'_7• 4• 11'-r © 60'X30' PREP SINK L�� 57 'V lY •SHCWES ® 16' FRYER II'-O'x4'-3• EXHAUST HOOD W. (EXISTING) © 6O'x32' LOW REFRIGERATOR (BELOW) f oaBrG 3°x6" J �. LL DBL.ACTING -I DOORS W/ WASTE LINE VENT Q 12' (2) BURNER STOVE W CLOSER �L, -- (EKIST'6) 48' FLAT GRILL W 60'x30• LOW BOY 3 lV }� ❑ Z:;; GAS SUPPLY LINE ® 60'x30' PREP STATION :T II MILK SHAKE MACHINE (n1 I • I ® FOUNTAIN SERVICE STATION I I EXISTING SLOP SINK ® i EXISTING WATER HEATER ABOVE 000 © EXISTING WALK-IN REFRIG. (2)HIGH TOP I TABLES W/SEATING y_ EXISTING ICE MACHINE 17 7 F �'-s•I r-0' WASTE LINE VENT pJ L 4Y X 3 O (EXIST'G) Iry l GI a COUNTERTOP II s,ci SPRINKLER LINE W/SHUT OFF VALVE(EXISTG) {`W IS ING FULL HT. WALL W/ SION P/W/ELL' 12' WIDE SHELF p, 1!o tlxFl% Wmy� l FLOOR PLAIN SGALE� 3/6"�I'—O" IL`�I - i�• i 1 1, I� GENERAL NOTES I�t�q 17: 71 I) ALL CONSTRUCTION 15 TO CONFORM TO THE BUILDING CODE OF - OILE EXIST'G N.G. GRAB BARS NEW YORK STATE AND LOCAL BUILDING CODES. I 2) ALL PLUMBING IS TO CONFORM TO LOCAL AND COUNTY HEALTH EXIST'G DEPARTMENT REQUIREMENTS. 3) ALL ELECTRIC IS TO CONFORM TO LOCAL, N,E,G. AND TOI LET UNDERWRITERS REQUIREMENTS. jam, 4) NOTIFY THE ARCHITECT OF ALL CHANGES. THE ARCHITECT IS NOT RESPONSIBLE FOR CHANGES MADE WITHOUT NOTIFICATION. »: ..;. 5) THE CONTRACTOR SHALL VERIFY ALL EXISTING CONDITIONS • AND NOTIFY THE ARCHITECT OF ALL DISCREPANCIES. ' FIXTURE KEY THE ARCHITECT IS NOT RESPONSIBLE FOR FIELD CHANGES / MADE WITHOUT NOTIFICATION, U' t3 I I4 ON 6) ALL MATERIALS, ASSEMBLIES, CONSTRUCTION AND EQUIPMENT 74"x24" 3 COMPARTMENT SINK-EXISTING SHALL CONFORM TO THE REGULATIONS OF THE STATE O O r� � O ( ) p BUILDING AND FIRE CODES AND SHALL CONFOR 1 TO `� o \ I N 15 DEEP WIRE d' FRAr SHELVES 00 GENERALLY ACCEPTED STANDARDS. w m ABOVE I O 12"x]G" HAND SINK—EXISTING I p 7) EACH TOILET SHALL BE PROVIDED WITH EXHAUST FAN AND O LIGHT. I I ) W Q 5) INSTALL APPROVED ILLUMINATED EXIT SIGNS AT ALL EXITS R PLAC SHELVING " " AND APPROACHES THERETO. DIRECTIONAL EXIT SIGNS SHALL O3 60 x30 PREP SINK-EXISTING w BE INSTALLED IN EVERY LOCATION WHERE THE DIRECTION OF EXIST'G LOCKERS c��_7�' 4" R F. E DIP, GUTS t2'-7' u TRAVEL TO REACH THE NEAREST EXIT IS NOT IMMEDIATELY 4 o" A SI IELVES APPARENT. _ p ,_6„ I ® IG" FRYER—"PITCO" MODEL *$ 45C Z `� i 15 4 REFER TO EQUIPMENT CUTS q) DO NOT SCALE THE DRAWINGS, USE INDICATED DIMENSIONS. Q 10) ALL STEEL COLUMNS TO HAVE STEEL BASE PLATES. SIZE AS O �� �� NOTED. �5 ,,1I�1II _�-LIO x4 -* fftEXHAUST HO D-EXISTING 11) FLAMMABLE MATERIALS SHALL NOT BE PERMITTED AS S f Q, INSULATION OR FILL. 12) FIRESTOP ALL DUCTS, PIPES AND CONDUIT PENETRATING © ro0"x32" LOW RERIGRATOR—EXISTING L1a THROUGH FIRE SEPARATIONS. INSTALL FIRE ACTUATED EXIST'G 30xG O DAMPERS WHERE REQUIRED, IL DBL. ACTING 13) WHERE A FIRE RATED CEILING 15 PIERCED OR RECESSED FOR J DOORS W/ �� WASTE LINE VENT O7 12" (2) BURNER STOVE-"WELLS MANUFACTURING" FIXTURES, DEVICES OR DUCT OUTLETS, ADEQUATE PROVISIONS = CLOSER (EXIST'G) MODEL # 1-IDHP-123OG REFER TO EQUIPMENT CUTS W SHALL BE MADE TO MAINTAIN THE INTEGRITY OF THE CEILING ASSEMBLY. \ " " �� 14) STEEL FABRICATOR TO PROVIDE THE ARCHITECT WITH SHOP W ro ® 48 FLAT GRIDDLE- APW WYOTT MODEL # GGT-48H 7 DRAWINGS FOR REVIEW, // O REFER TO EQUIPMENT CUTS >j 15 ALL OPENINGS IN FIRE RATED SEPARATIONS TC' BE PROVIDED - // V " " �� WITH SELF-CLOSING OPENING PROTECTIVE DEVICES. (00 x30 LOW E30Y— TRAULSEN MODEL # UHT—GO—LR REFER TO EQUIPMENT CUTS Q p 16) INSTALL APPROVED EMERGENCY LIGHTING THROUGHOUT THE - [� o PREMISES. N GAS SUPPLY LINE 10 60"x30" PREP STATION-"TRUE FOOD SERVICE EQUIPMENT" �r 17) INTERIOR FINISH AS FOLLOWS: CORRIDORS AND EXIT ACCESS I (EXIST'G) O v � AT LEAST CLASS B . ENCLOSED STAIRS GLASS �"A" . I �� (v -- — — �� �� �� �� r- — MODEL # TSSJ-60- I(o REFER TO EQUIPMENT CUTS � s, �'� O O KITCHEN AND ASSEMBLY SPACES CLASS A OR' B . CLA55 C II MILK SNAKE MACHINE 00 ,� MAY BE USED ELSEWHERE. O 18) INTERIOR FLOOR FINISH IN CORRIDORS, EXIT AND AREAS OF � ® � M PUBLIC ASSEMBLY SHALL BE AT LEAST CLASS I. Iq) EXTEND FIRE AND SMOKE DETECTION SYSTEM TO COVER ALL I 12 FOUNTAIN SERVICE STATION-EXISTING � AREAS OF PREMESIS A5 PER N.Y.S, CODE. ALL. WORK 42"x O" TABLE SHALL BE PERFORMED BY A LICENSED FIRE AIL ARM TECHNICIAN, W/ EATING 20) ADEQUATE ESCAPE FACILITIES SHALL BE MAIN-:-AINED AT ALL I O I 13 SLOP SINK-EXISTING TIMES IN BUILDINGS UNDER CONSTRUCTION FOR' WORKER'S USE, 30"0 WIG TOP I Oq I 21) HANGINGS OR DRAPERIES SHALL NOT BE PLACES OVER EXIT TABLE / SEATING DOORS OR OTHERWISE LOCATED AS TO CONCEAL OR OBSCURE I I 14 WATER NEATER ABOVE-EXISTING ANY EXIT, MIRRORS SHALL NOT 3E PLACED IN OR ADJACENT TO ANY EXIT OR ON EXIT DOORS. 22) FURNISHINGS OR DECORATIONS OF AN EXPLOSIVE OR HIGHLY I - I O OO 15 WALK- IN REFRIG.-EXISTING FLAMMABLE CHARACTER SHALL NOT BE USED. - 23) PROVIDE AN INTERCONNECTED FIRE AND SMOKE DETECTION SYSTEM A5 PER CODE, I I IS 16 ICE MACHINE-EXISTING 24) THE ARCHITECT IS NOT RESPONSIBLE FOR CONSTRUCTION O MEANS,METHODS, TECHNIQUES, SEQUENCES OR PROCEDURES, OR FOR SAFETY PRECAUTIONS AND PROGRAMED IN CONNECTION 10 IO FREEZER-EXISTING WITH THE WORK, AND HE SHALL NOT BE RESPONSIBLE FOR THE CONTRACTOR'S FAILURE TO CARRY OUT THE WORK IN 30"m WIG TOP I " ` ACCORDANCE WITH ZHE CONTRACT GOGUMENT�,. THE ARCHITECT - TABLE / SEATING. 42 x..-CJ" TABLE SHALL NOT BE RESPONSIBLE FOR THE ACTS OR OMISSIONS OF TOASTER ON .,. 4ELF ABOVE-"BELL ECO" I`1OI r-I 'i• _;T2--•F- W/ EATING4„ D-_ THE CONTRACTOR, SUBCINTRACTOR OR ANY O.1"HER PERSONS REFER TO EOUIPMENT CUTS U 10 PERFORMING ANY OF THE WORK. ARCHITECTS STATEMENT a I, PETER TOKAR - ARCHITECT, STATE THAT TO THE BEST WASTE LINE VENT OF MY KNOWLEDGE BELIEF AND PROFESSIONAL_ JUDGEMENT (EXIST'G) LC) THAT THE PLANS AND SPECIFICATIONS CONTAINED WITHIN THESE DRAWINGS COMPLY WITH THE NEW YORK STATE ENERGY CONSERVATION CONSTRUCTION CODE. �'^6" m 7'-�" , 12 Q ------ �� ----------------------------- PETER TOKAR - ARCHITECT COUNTERTOP 11 V < ~ L 1e _6 O 0-1 ' V APP OVE D AS NOTED EXIS •ING FULL PT. WALL SPRINKLER LINE DATE B.P.# 3�/ W/ I SIGN PANEL W/ SHUT OFF VALVE (EXIST'G) 15 i (4) STOOLS FEE: _. =-BY 1 NOTIFY BUILDING DEPARTMENT AT 765-1802 8 AM TO 4 PM FOR THE PLUMBING FOLLOWING INSPECTIONS: A!_!_PLUMBING WASTE 1. FOUNDATION-TWO REQUIRED &WATER LINES NEED FOR POURED CONCRETE 12" WIDE SHELF TEST!"v; BEFORE C^VERING 2. ROUGH FRAM PLUMBING, " STRAPPING,ELECTRICAL&CAULK'"!^ 3. INSULATION REVISIONS: 4. FINAL-CONSTRUCTION &ELECTR'' PLUMBER CERTIFICATION MUST BE COMPLETE FOP C 0 NO. OAT) 11TLE ° ALL CONSTRUCTION SHALL MF' T•�E r W ON LEAD CONTENT BEFGi; REQUIREMENTS OF THE C Dr:E Xy ° CERTIFICATE OFOCCUPA;d;;Y FORK STATE NOT RESP!.1^+�' F t- DESIGN OR CONSTRUCTION ��•� w m w SOLDER USED IN WATER - SUPPLYSYSTEM CANNOT v ' EXCEED 2110 OF 1% LEAD, ELECTRICAL c INSPECTION REQUIRED � • Q FIRE INSPECTION �0 OCCUFANC OR REQUIRED BEFORE'- OPENING N ., � DRAWN BY: 1 USE IS UNLAWFI�� W PET FLOORFLAN WITHOUT CERTIF ICATF I � DATE u O 1/03/12 ��E D A pL, N SCALE : \r�� '�s� N � DRAWING NO.: ALL FALLS SHOWN ARE EX1STING `� A-9� 01719� OF NEB o Q OF I SHEET