HomeMy WebLinkAbout37448-Z osoFFo4& Town of Southold Annex 11/26/2012
,
y� P.O.Box 1179
z 54375 Main Road
oy �, ti4 Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 36055 Date: 11/26/2012
THIS CERTIFIES that the building WINDOWS
Location of Property: 54265 Route 25, Southold,
SCTM#: 473889 Sec/Block/Lot: 61.-2-12.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
8/9/2012 pursuant to which Building Permit No. 37448 dated 8/16/2012
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:
window replacement to existing commercial building as applied for.
The certificate is issued to N F Bank&Trust Co
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Author' ed Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y z TOWN CLERK'S OFFICE
"oy . 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#: 37448 Date: 8/16/2012
Permission is hereby granted to:
N F Bank & Trust Co
PO BOX 8914
Melville, NY 11747
To: Alterations to a Commercial Building;
Window Replacement, as applied for.
At premises located at:
54265 Route 25, Southold
SCTM # 473889
Sec/Block/Lot# 61.-2-12.2
Pursuant to application dated 8/9/2012 and approved by the Building Inspector.
To expire on 2/15/2014.
Fees:
NEW COMMERCIAL, ALTERATION OR ADDITIONS $250.00
CO -COMMERCIAL $50.00.
Total: $300.00
Building Inspector
Form No.6
TOWN OF SOUTHOLD.
BUILDING DEPARTMENT
TOWN HALL
765-I802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This.application must be filled in by typewriter or ink and submitted to the Building Department with the following:
Ar 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 2110 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% 1957) non-conforming uses,or buildings and "pre-existing" land uses:
1. Accurate survey of property showing all property lines,streets,building and unusunl natural or topographic
features.
2. A properlympleted 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 $1 5.00,Commercial $15.00
Date. $ -/Co
New Construction: 1•� Old or Pre-existing Building:' (check one)
Location of Property: �� O�J�
House No. Street Hamlet
Owner or Owners of Property: _ ,/�, .t4 / b s4— .
Suffolk County Tax Map No 1000, Section Block Lot /o7 -
Subdivision Filed Map. Lot:
Permit No. 2J 7Cl. ��Date of Permit. g l(o - f1- Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
V
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ �d �zz�o
icant lirnature
FIELD DATE COMMENTS
FOUNDAVON(1ST)
FOUNDATION(ZND)
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ROUGH FRAM WO& y
PLUMBING
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IMULATION PE11 N.Y.
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STATE ENERGY CODE
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ago
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 Survey
SoutholdTown.NorthFork.net PERMIT NO. / T Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Q / E C E W E Flood Permit
Examined U ` ,20 D Single&Separate
AUG — g 2072 Contact:Storm-Water Assessment Form
y n
Approved '� !O ,20 Mail to:
BLDG.DEPT.
Disapproved a/c TOWN OF SOUTHOLD
Phone:
Expiration 02 — //S,20�
Building Inspector
APPLICATION FOR BUILDING PERMIT
"Date �(CUS`� 9-' 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.
IV,F 9� �L7?-0QST C 0.A
(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
CHfi-KEL c0NT9fiC--' /AJG
Name of owner of premises 0��( • "- 4 b�- ���� C'0 , f
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
� p )
Builders License No. C �-0 0 , 0,0
Plumbers License No.
Electricians License No. _
Other Trade's License No. ToW- 300 , 00
1. Location of land on which proposed work will be done:
Sy- D-��5- leOg-TE u -f{oG.�
House Number Street Hamlet
County Tax Map No. 1000 Section Block Lot 1 aZ
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 ,IL R"q/4
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work WAID 0W XC"C"6-/1Cz1V
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units ,oDdwelling 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. 4W�, a�F�CE
7. Dimensions of existing structures, if any: Front '7a..:5-/ Rear --S-7o / Depth
Height Number of Stories �2
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 °�(9 t Rear 7 ,3 �'r Depth 3
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/VF151f1V v'-r1k#5rAddress Phone No.
Name of Architect Address Phone No
Name of Contractor C <rz L C-041-9/tcT IAGAddress ! 6X 1 TT,41V X WAY Phone No.
RoN-Ka N kOAOJ , Al y I/777
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 NY )
Jo S E P# C4/1 P 0 being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the
(Contractor, Agent, Corporate Officer, etc.)
of said oLvbgf fr fltyLrW,and.is duly authorized to perform or have performed the said work and to make and file this application;
that all. application application are true to the best of his knowledge and belief; and that the work will be
performMit$ @ffi,��Qp ;fp�rth in application filed therewith.
Qualified in"�u'fTo� C� iY
commission Expires Mamh 23,20 f
Sworn to before me this t I -
tl
day of ��G�'— 20
N ry Public n e of App ca