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Home My WebLink About21018-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22422 Date J~NE 28, 1993 THIS CERTIFIES that the buildingu ADDITION Location of Property ORIENTALAVENUE & THE GLOAMING~ House No. Street County Tax Map No. 1000 Section IO Block 10 Subdivision Filed Map No. FISHERS ISLAND Hamlet Lot 5 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 1,1992 pursuant to which Building Permit No. 21018-Z dated OCTOBER 13, 1992 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 ADDITION TO AN EXISTING ONE-FAMILY DWELLING AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/D UNDERWRITERS CERTIFICATE NO. PENDING JUNE 22~ 1993 PLUMBERS CERTIFICATION DATED JUNE 21, 1993 RAYMOND DOYEN & WF Building Inspector Rev. 1/81 · OB, M NO. Il TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°-N? 21018Z Dat..f_~/...~.. ............................ . Co~.~ ~o, ~p No. ~000 s.~,o. ...... Z.~. .......... m~k ....... /~ ....... ~ot No...~ ......... pumuant to application dat~ .~ ....... ~ .......................... , 19.~nd approv~ by the Building Inspector. Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HA~L SOUTHOLD, NEW yORK 11'971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Date...June 7, 1993 ...... NEW CONSTRUCTION..X..0LD OR PRE-EXISTING BUILDING ..... VACANT LAND ..... Location of Property ........ The Gloaming ............................. Owner or Owners of Property ..... Mr. Raymond F. Doyen ................ County Tax Map No. 1000 Section ...10... Block ...10... Lot...5 ....... Subdivision ..................... Filed Map .......... Lot ............ Permit No...21018Z ..... Date of Permit 10/13/93.. Applicant.A.J. Gada.. Health Dept. Approval ................ Underwriter Approva~N-25~... Planning Board Approval ................. Request for Temporary Certificate ........... Final Certificate...X... Fee Submitted: $...25.00 ......... Applicant A. John Gada General Contracting, Inc... BLDG. DEP]~ ~ TOWN OF SOUTHO~D ~ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit Owner I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ~re) Sworn to before me this o%/ a~ day of 19~3 Notary Public, County OUNDA~ION (1st) OUNDATION (2nd) OUCH FRAME & -PLUMBING IISULATION PER N. Y. STATE ENERGY CODE FI;IAL ADDITIONA'L COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS ~.~?~012 BUREAU OF ELECTRICITY ~- B5 JOHN STREET, NEW YORK, NEW YORK 10038 Date ~OV~]~]~I~ ~)~ t~2 ApplicationNo. onfile 78848352/92 N 2§5,~37 THIS CERTIFIES THAT only the electrical equipment as d~scrlbed below and introduced by the applicant named on the above application number in the premises of in the following location; [] Basement [] Ist FI. [] 2nd FI. 0[1~ Section Block Lot ~sexaminedon 0~0[~[[ ZT~.~ andfoundtobelncontplianceu,iththerequirementsofthisBoard. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS OTHER DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: S E R V I C E NO, OF CC COND NO. OF HI-LEG A W G, PER ~ OF HI-LEG OF CC, COND, GI~N~RAt. N~ANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by their credentlaJs. COPY FOR BUILDING DEPARTMENT. TNI$ COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. Exa nine,d .................. 19... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.; 765-1802 Disapproved a/c ..................................... BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ........ ~ ............ CHECK ...................... SEPTIC FORH ................ NOTIFY~ CALL ..................... MAIL TO: (Building Inspector) APPLICATION FOR BUILDING P~RM IT INSTRUCTIONS a. This application must be completely filled in by typewriter orin ink and submitted to the Building lhspector, with sols of plans, accurate plot plan tO~cale. 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 lhyout of property must be drawn on the diagram which is part of this appl/* ca~,ion. c. The work covered by thls application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued 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 Sduthold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for iemoval or demolition, as herein descr/bed. The applicant agrees to comply with all appilcab]e laws, ordinances, building code, housing code, and regulations, and to admit authorized inspecto~ on premises and in building for necessary inspections. . ~ fi,Signature of applicant, or name, i f'a~'l~o'r~r~ffn'/' ' ' - (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................... ....................................... :,;amc of owner of premises ........... ,.. ~ ............................. (as on the tax roll or latest deed) ;f ap~ is a corporation, signature of duly authorized officer. (Name and titldof corporate offic~ Plumber s License No. '~. ........ Electrician's License No. / Other Trade's License No ...................... Location of land on wit/ch proposed work will be done; Ii ............................ ' .................. ',' q' .............. . ..... ,. ouse Number Street, ' Hamlet ..... , ' ge ' ' . ..alT.. County Tax Map No. 1000 Section .......... ..... ck Subdivision ..................................... Riled Map No. (Name) .............. Lot ............... State ex/mn, use and occu an of rem~ses and intended use and Occu an · ,, p' cy p ' ' ' P Cyof ro osedc · ' -- , p p onstruction: / ./) - . -.q ..... ,. ~ ~...~. ..... ,~. ~, ..... ~ :% .;.,'. ,. ·.. B. Intended use and occupancy ...... .l/..v~....~$~..~~V',,L ~.~ ,Q.M. . 3, ature'ofwork (check which appliqable) New Building ......... Addition .... Alteration Repair . ' ..... ........ R~emovall .............. Demohtmn .............. Swzmtaxng pool ............ Tennis Co~' ' ' ........ Accessory Buzlding .......... Fe~e._u ...... Other Work ............ (to be paid on filing this application) L If dwelling, numberofdwe nguni~s ............... Numberofdwcllingunitsoneachfloor ................ If garage number of cars ' 5. If business, commercial or mixed o~cupancy, specify nature and extent of each type of use ......... : ........ 7. Dimensions of existing structures, i( any: Front..,...~.2. ...... Rear . Depth Height Numbe~ of Stories Dimensions of same structure with ¢lterations or additions: Front ................. Rear ..... Depth ............... Height ..... i.&.~.., i ..... Number of Stories ~. Dimensions of entire new construction: Front ............. Rear .............. Depth ......... Heieht .Numbei of Stories /. 9 Size of lot: Front ' Rear Depth ~ Date of Purchase Name of Former Owner Zone or usc district in which premi½es situated I. , arc ................................................ ... 2. Does proposed construction violateiany zoning law, ordinance or regulation: ......................... 3. Will lot be regraded ....... ~, .~,. ................ Wdl excess fill be removed from premises: . Yes .... No 4. Name of Owner'of premises ,/..~z~,~,~¥~..'~..~..~r~q?..~. Address'-7~.%~Fw~, .~. ~..~. Phone No??4: .~0~.-.'~..v~..~. .... Name of Architect . .~ ~ ..... ,.. g. ~ ...... ,~ ..... Address .................. Phone No ................. .5.Is this property lo~itteld within 300 feet of a tidal wetland? *YES .... NO..~/... *If yes, Southold Town ~rustees Permit may be required. ' PLOT DIAGRAM Locate clearly and distinctly.all bdildings, whether existing or proposed, and, indicate all set-back dimensions from roperW lines. Give street and block number or description according to deed, and show street names and indicate whether lterior or corner lot./ ;TATE OF NEW.yOlk, I(, ~ 30UNTY OF .~ ..... S.. ....... ; ..................... being duly sworn, deposes and says that he is the applicant (Name of individual signingI contract) bore named. , (Contractor, agent, corporate officer, etc.) ~f sa,d owner or owners, and ~s duly authorized to pegform or have performed the said work and to m~e and file this pplication: that all Statements containod in this' a~pli~ation are tree to the best of his knowledge and belief; and that ~ork will be perlbmmd in the m~ner s~t forth in the application filed therewith. ,worn to betore me~lus : ,,, ' . NO. OIWA~gl8~ (Signature of . TERM ~RIRE800ToBg~l, 1~ t~