HomeMy WebLinkAbout37024-Z FF Town of Southold Annex
�o�OguFFat,f 5/24/2012
P.O.Box 1179
c co54375 Main Road
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tp • Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 35710 Date: 5/24/2012
THIS CERTIFIES that the building FIRE SPRINKLER
Location of Property: 260 New Suffolk Rd, Cutchogue,
SCTM#: 473889 Sec/Block/Lot: 102.-6-5
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
2/24/2012 pursuant to which Building Permit No. 37024 dated 2/29/2012
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:
upgraded fire system in kitchen as applied for.
The certificate is issued to Cutchogue Fire Dist
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Authorized ignature
TOWN OF SOUTHOLD
o�g�FFO(,�co
�� oy BUILDING DEPARTMENT
y 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#: 37024 Date: 2/29/2012
Permission is hereby granted to:
Cutchogue Fire Dist
260 New Suffolk Rd
Cutchogue, NY 119352037
To: Upgrade Fire System in Kitchen
At premises located at:
260 New Suffolk Rd, Cutchogue
SCTM # 473889
Sec/Block/Lot# 102.-6-5
Pursuant to application dated 2/24/2012 and approved by the Building Inspector.
To expire on 8/3012013.
Fees:
EXHAUST HOOD AND/OR FIRE SUPRESSION SYSTEM $0.00
CO -COMMERCIAL $0.00
Total: $0.00
Building Inspector
i
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:
Af For new building or new-usm
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. "Sw.om statement from plumber certifying that the solder used.in system contains less than 2110 of 1% lead.
S. 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. Certificaie of Occupancy- New dwelling$50.0%Additions to dwelling$50.00,Alterations to dwelling.S50.00,
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- $100.00
3. Copy of Certificate o€Occupancy-$_25
4. Updated Certificate of Occupancy- $50.00
5_ Temporary Certificate of Occupancy -Residential $15.0%Commercial$15.00
Date_
New Construction: Old or Pre-existing Building: ' (check one)
Location of property: 26 O pew SU P�FO L.Y—. PL- > CV I-Lk-1 O U V F
House No. Street Hamlet "
Ownor or Owners of Prnpertyt C:0 -kOL y 11?`C 1 S jl?JIC.T
Suffolk County Tax Map No'1000, Section t O 2- Block Lot 5
Subdivision Filed Map. Lot:
Permit No. 3-1 02_4, Date of Permit. D 2, bi ?_012 Applicant: C0_fCA60C-i0 2 RE QL5TVALT
Health Dept.Approval: Underwriters Approval: 646
Planning Board Approval: IVIA
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
Applicant Signature
FIELD ORT DATE COMMENTS
FOUNDATION(18T)
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FOUNDATION(2ND)
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ROUGH F1G& H
PLUMBING
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INSUL•ATION PER N.Y. H
STATE ENERGY CODE p
FINAL
ADDITIONAL COMMENTS c
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BOARD OF HEALTH ...............
FORM NO. 1 3 SETS OF PLANS ...............
TOWN OF SOUTHOLD SURVEY .........................
BUILDING DEPARTMENT CHECK .........................
TOWN HALL SEPTIC FORM ....................
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
CALL
Examined.........."-im" 19.I MAIL TO:
.00 172ZI <:�-I-ya,--Cl-r
Ap . .. . .................................
Di: 11-7."o
a1: ....... ...........
OB;t4, 2,912
ki ilding Inspector)
T"=wr
F16po APPLI IrION FOR BUILDING PERMIT
Date....
;�-Aob---
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wit
3 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 giving a detailed description of layout of property Taust be drawn on the diagram Which is part of
this application.
c. The work covered by this application may not be camenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such
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 Whatever until a Certificate of
Occupancy shall have been granted by the Building Inspector.
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, Ordinanres,or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein
described. the applicant agrees t6 c6mply with all applicable laws, ordinances, building code, housing code, and
regulations, and to admit authorized inspectors on premises and in building'for,neces necessary
.......... . . ...... .. ..........
(Signature of applicant, or naw, if a corporation)
Ofa"ZC4 IZS7" A/0/-&4
............. .... ................
(Mailing address of applicant)
State Whether applicant is owner, lessee, agent, architect, engineer,.general contractor, electrician, plumber or builder
......... ..............................................................................................................
......................................
Name of owner of premises ...........
..................................
(as on tJv-- tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
..................................................e.......
(Name and title of corporate officer)
Builders License No. .........................
Plumbers License No. .........................
Electricians License No. ......................
Other Trade's License No. ....................
1. Location of laod an Which proposed work will be done..............................................................
0.............../0--tv
.............. ...................... ................ ................................
House Number Street Hamlet
Canty Tax Map No. 1000 Section ......I. Block .......kQ...... Lot ......5.......
.......
Subdivision ...................................... Filed I-lap No. ............... Lot ...............
(Name)
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 ..............................................................................
..........
Nature of'work (die&which applicable): New Building .......... Addition .... Alteration .......
Repair .............Removal ............. Demolition ............ Other Work
—01> (Description)
Estimated Cost ...... ................ fee ........................................
(to be paid on filing this application)
If dwelling, nud>eer of dwelling units ............ fbiber of dwelling units on each floor ................
Ifgarage, nunber of cars ......................................
If business, -camercial or mixed occupancy, specify nature and extent of each type .........., of use..... //OU
......
Dimensions of existing structures, if any: Front................ Rear ............... Depth .................
]]eight ......................... llxd)er of Stories ......................
Dimensions of same structure with alterations or additions: Front ............... Rear ...............
Depth .................... Height .................... Nmber of Stories ................
Dimensions of entire new construction: Front ................ Rear ............... Depth ..............
Beiglit ......................... &ubear of Stories .....................
Size of lot: Front ..................... Rear .................... Depth ....................
Date of Purchase ..........*............ None of Former Owner .........................................
I. Zone or use district in which premises are situated ...............................................................
Does proposed construction violate any zoning law, ordinance or regulation: ......../U.0.............
3. Will lot be regraded .................... Will excess fill be removed from premises: YES ND
i. Names of Owner of premises ........................... Address .............................. Phone No.
Name of Architect ..................................... Address .............................. Phone No. .............
Naiie of Contractor / 4 9 6
.AT 2V�5--dA�4 /Fx-logo7,Ecrro rs, /7Z4 ..........
.............................. Add .................. ....Phone No.
5. Is this property within 300 feet of a tidal wetland? *YES .......... NO ..........
*IF M, SWIIEM M-N IMMMS PERMIT Mff BE MVIRED.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bark dimensions
ran property lines. Give street-and block number or description according to deed, and show street names and indicate
Nether interior or corner lot.
rAIr Or NEW YOM
)UNIT Or Sul-fro
................. ..being duly sworn, deposes and says that he is the applicant
,lame of individual signing contract)
xyve nwed,
? is dle ........ .............................................................................
(Contractor, agent, corporate officer, etc.)
r said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
pplication; that all statements contained in this application are true to the best of his knowledge.and b6lieH, and
hat the work will be perfonTed in the manner set forth in the application filed therewith:
worn to'before me this
......day ofT e— NICOLE HOPKINS
Notary Public - State of New York.
Notary Public ....;W ............... NO. 0 1 H06097132
. ................. ... ... .... ...... Qualified In Suffolk Co nt
(Signature Jg�mture of i ant) MY Commission Expires/,
SO!/jyolo
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
C00-
Southold,NY 11971-0959
y�OUNTY,��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
May 17, 2012
ABT,Design & Fire Protection
1724 Church Street
Holbrook, NY 11741
RE: Cutchogue Fire Department,260 New Suffolk Road,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 4J1/84)
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.
Final inspection by Building Dept.
BUILDING PERMIT : 37024-Z Fire system
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AES MANUFACTURER-:
R ANGEGUARD — 5 QT — 2sgd gal — 6gal
Piping Material SCn 90 '54a Kax Rise
Supply Pipe Size /zF Branch Pipe Size 3/4'
.Gas Valve type: /� C_ size 2'' Manufacturer L�sc_o
Detector Temperature rating .3co` Quantity: -5
Hood Size: /z �X %��c z' Duct Size:
Hood Siie: Duct Size: Ain
EqurPMENT QUANIITY SURFACE NOZZLE -
TYPE AREA TIP# HEIGHTS LOCATIONS ,9vP 3LU• o AnP (
DUCT .Z'f'' ADP
PLENLIM / /2' ADP ucfl
Qur.1Cj> / 3G'X 2y'' LP(L 16720 ADP
RANGE R 2f1-f2 CENTEX
SALq/JANOE/�
GP4DDLE / 2't A9_5 ADP 13-18 did
PERIMETER SHED / aor 29"X/y'
1VOK GRW 35-56 CENTER
D.vcn'
FRYER PLENUM 27-45
UPRIGHT. ADP' iATzonl
• .. .. /ZRNaE " �/oT Ter _
GAS•PLAID . GRW 2f-48 S A P
l Afr / zo')c Zo'' /4t,1� Gasaoic f
ELECTRIC ,ZAD \II.DP 24-48
LIVAROCK PLENUM 2"8
NATURAL/MES ADP 2"S 3L a X zy" tee" zz9' -3Z`X 2y" ys''
MESQUITE LAGS 96980 24-48
�aT Tvi° ! 32-k �9'• . LPR /G`-Zn'' "
X Fryers to have High Limit Control to shut off fuel at 425 deg:
X Detectors shall be located over every piece of equipment.
X The System installed as per manufacturers specs and the AHJ_
X The System has been installed as-per UL300:
X The following functions to operate upon system discharger APPROVED AS NOTED
* Supply air damper closes * .Gas' fuel shuts off in kitchen -•FIRE INSRECTIN
* Exhaust fan remains on * Electric fuel shut off under hood* All systems to activate simultaneously in same hazard area. DATE •2 B.P. # '3= REOUIRED BEFORE
*- Fire Alarm shall activate if one is Installed in building: we'NING ;
X Manual Put l is IocAte-d 10-35. ft from hood-arid 3-5 ft -from floor. FED�= ..�._BY
NOT -BUILDING D PARTMENT A-
-- Cylind�er:33120006 765-1802 8 AM TO 4 PM FOR THE
A.BT DESIGN & FIRE PROTEaCTION- Control Head:131 2009R. FOLLOWING INSPECTIONS:
Pull sta' tion:9197463 I. FOUNDATION - TWO REQUIRED
1724 CHURCH STREET - L�inx. xtt:'. /ZOO6y O. F .RPOf RED CONCRETE -OCCUPANCY OR
Micro Switch• ;$/2au39-50l 2. ROUGH-FRLIVINI�'PLUMBING.
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Ga.a Valve:B-1-2 00 75 f* . STR�,ac- :._=yTRICAL&CAULKI�
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vent Plug;919.7430 4. FINAL-� ,� ,�� I WIM."I CERTIFICATE
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Diachargc Adapter:e4-09c8 r $ * �h�S11;EC��n�:PLIr�EFORCO n @ �
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