HomeMy WebLinkAbout18071-z
~ ~ FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-17977 Date APRIL 28, 1989
THIS CERTIFIES that the building ADDITIONS
Location of Property 1480 SIGSBEE ROAD MATTITUCK, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 144 Block O1 Lot 7
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 24, 1989 pursuant to which
Building Permit No. 18071-Z dated APRIL 25 1989
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 DECK & BATHROOM ADDITIONS TO EXISTING ONE FAMILY DWELLING
The certificate is issued to GERALD & CATHERINE GALLAGHER
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. H 009090 - APRIL 17, 1989
PLUMBERS CERTIFICATION DATED N/A
e Building In ector
Rev. 1/81
roses xa s
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)
NO ~807~ Z Date ...y~:~ 19.9
Permission is hereby gwnted to:
.1....7.xQ...~a:.a:,,a,~,,~.........
.C.'r......lZf.'.r~..`caxt.....G~i..c~ . ~.cf~~
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at premises located at .....KR./
L~s~F~.....................................................................
County Tax Map No. 1000 Section ...~~~T.'../T. Block Lot No .......7. .
pursuant to application dated ...........1.l~yf.T 19.~, and approved by the
Building Inspector ~//2T
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Fee Stu
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Rev 6/30180
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4 TOWN OF SODTIIOLD
BUILDING DEPART2IENT
TOWN HALL
SOIITIIOLD, NEW YORK 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
DATE...I~
NEW CONSTRUCTION ..OLD OR P~tE-E%ISTING ~7ILDING.._.__VACANT LAND..._....
i
~ ~y~
Location of Property..~7.~G. ~j~:~Y.Y`...V1L:....... vj`~~~!!?G~......
HOUSE N0. STREET HAMLET
Owner or Owners of Property.......//
County Taz Map No. 1000 Section .1~~ Block ~ Lot ..LPL
Subdivision Filed Map ........Lot..........
Permit No. ......._..Date of Permit .._.......Applicant
Health DepC. Approval Underwriters Approval......._..._._
Planning Board Approval
Request for Temporary Certificate Final Certificate
/oo
Fee Submitted:
Oi-ec. 3 ? 1.~ 2
~o ~
rev. 10/14/88
l~°~~~
765-1802
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ~NAL
REMARKS: 1l~ 4 d~-s~.~
DATE __~~~~~INSPECTORv ~~Q~,
THE NEW YORK BOARD OF FIRE UNDERWRITERS f'AGF:
801.11,0,. BUREAU OF ELECTRICITY
83 JOHN STREET. NEW YORK. NEW YORK 10038
APRIL i'1,~1Si89 APPIIcotionNo.onjile G778(i089/89 H 0040!!0
THIS CERTIFIES THAT
orsly the alectr4ol equipment ae deeerihed 6ehsw and introduced by the spplicant named on the shove application numher in the pronJeee 4/
i:RAi.h f3. c;Ai.LAGHF:R, 1480 ..^,1 ;Si±F:F: ROAll, KA'I'TITllCK ARK, N.Y.
in the folbwinA Incot' g..e nt ~ I et FI. ? Ynd Fl. Sertion Block Lot i
A~~YL ~,i.'.fi~
woe a:amined on and
found to 6e in compliance with the reyuiremend of ehia Beard.
NXiUM AClRS fYYITQI6 RXTURRS ~ NOlS COOKING alCKS OVRNS DFJII WASIgR$ RXNAUST FANS
OUITJTS INCANOESCEm nU011ESfEM aTNER AMT. K. W. MAT. K. W. NAT. K.W. AMT. K. W. AMT. N. r.
fXtYRRS FURNACR MOTORS IUTURR ANMIANCRT~RRS SMOAlRK7T TIME CIOfKE pu UNIT NEATNf MWTIAYTIRT DIMM~S
AMT. K. W. al N. r. GAS N. r. AMT. NO. A. W.O. AMT. AMr. AMT. MMS. TRANS. AMT. X. r. N ~T AMT. WATiS
5lRVICR gSCONNRCT NO.Oi S F R V 1 C E
AMT. AMI. Tyre ~F. I X ri/ 1 / 3W 813W e / .w RNCe~ONU. ~ CC ~ oHD. NO. or NbIFG a~H1 NO. or m a
NeuTGNAI
OTHER AMARATUS: :Kr
ANb V.T5UAL I)1::FECT5: "An el::'{ r'r cal
survw,y Lae3 been made of the ex.poseQ
~rtertrical i~qu:iyroenC in the
prt^m1tX9R indicated," "Nn l~bvious
ulsSalisfasrt.ory ecmdit:io? was 1ou11d.
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GF:RALll f!. GAId,AGHF:R
7.77(5 ;1ASMUNI AYF..
NFiI NYAF: PARK, NY, Lltf40 06NA1
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This certificate must not be ahsrad in alry mamlar;.raturn to the office of the Hoard if ihcomd. InspeNOn'may.F» identdia~ their cro entiak.
B I A ANY MANNER.
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" BOARD OF HEALTH
3 SETS OF PLANS
FORM N0.1 SURVEY • .
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIG FORPI
TOWN HALL
SOUTHOLD. N.Y. 11971 NOTIFY 3?R- SY4'y' /~otcE
QQ TEL..765.180c~ CALL
Exanuned ~~~5........, 19~,1qG MAIL T0: ,
Approved . ~I,/.~!0........., 19 V. / PCTInlt No.l t~V 7f~
Disapproved//////a/c ~ ~
~r,~,~~, 1
pia' BLDG DEPT
TOWN UF'
(B ing Inspector) SOUThj~LD
APPLICATION FOR BUILDING PERMIT q
Date ...~.~Z. y./8.4 15
INSTRUCTIONS '
a. This application must be completely filled in by tgpewnter or in ink and submitted to the Building Inspector, wi
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 adioining premises or public str
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is Bart of this a;
cation.
c. The work covered by this application may not be commenced before issuance of Budding Permit.
d. Upon approval of tuts application, the Building Inspector will issued a Building Pcnnit to the apphcant. Such pea
shall be kept on the premises evadable 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 Occupy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY hiADE to the Building Department for the issuance of a Building Permit pursuant to
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance-
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descnb
The apghcant agrees to comply with all applicable laws, ordinances, budding code, housing code, d regutahons, and
admit authorized inspectors on premises and in building for necessary inspection
~S~ature of a phcant ~ name, if a cpprporanon)~
• / (Mailing address of applicant) `J
State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or build
Name of owner of premises ~-k~:'~:4!!`~ • • • • • • ~~~tY~~~~J/~tQ~ .
(as on the tax roll or let deed)
!C applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No... , p•..~~?~ ~ ~,~C~~iFs`q,
Plumber's License No. y~,S~~
Electrician's License No. 9C.W:~'•C~OOt~A!-t=. .
Other Trade's License No . .
1. Location of land on wluc roposed work `}yll U done .
4lCJ(/if~ • p .
. ~~,f..~'~.. :~R . .
House Number Sfrcet, ~ ijiamlet
1
County Tai hl,ip No 1000 Sdction I.'~ . • . • • • . Block Lot .
Subdivision . Filed Map No. Lot .
iName)
2. State c~isung use and accup.incv of premises and intended use .ind occupAan~y of proposed construction:
a. Exispng use and occupancy .....P((jjM ..~n.~ /'A ~ ~•y• yT.../,J ~ ti (~~i l ~C! ~ .
b. Intended use and occupancy N.~
~ ~ l~!~ t-• • • 'J.t. T ~ O ~C.~ 5~ ~ • • _ , , _ _ . ,
3. N:rzure cf
work (check which applicable): New Budding Addition Alteration .
Repair Removal Demolition Other Work .
(DcscnpUOr
4. EstrmatcdCost......... Fee...................................
(to be paid on filing this appliraUOn)
5. if dtvellin„ number of dwelling units Number of dwelling units on each floor .
]fgara;e.numbcrofcars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .
7. Dimensions of existing structures, if any: Front Rear Depth .
Height ...............NumberofStoncs.....................................................
• Dimensions of same structure with altcrauons or additions: Fwnt . Rcar .
Depth licight , . , Number of Stones
8. Dimensions of entire new construction: Front Rear ...............Depth
Height ...............NumberofStones.....................................................
9. Size of lot: Front Rcar......... Depth
10. Date of Purchase .............................Name of Former Owner .
11. Zane or use district in which premises are situated . . . .
12. Does proposed construction violate any zoning law, ordinance or regulation : .
13. 1Vdl lot be regraded 1Vi11 excess fill bc'removed from premises: Yes
14. Name of Owner of premises ....................Address ...................Phone No............. -
Name of Architect . . ...Address ...................Phone No, ,
Name of Contractor . , . . . .Address ..Phone No.. .
15.Is this property located within 300-feet of a tidal wetland? *YES....NO.X
*If yes, Southold Town Trustees Permit may be required:
PLOT DIAGRAM
Locate clearly and distutctly all buildings, whether extstmg or proposed, and, rndreate all set-back dunenstons fry
property lines. Give street and block number or descnption according to deed, and show street names and mdreate wheti
rnLenor or corner lot.
STATE OF \EtiV YORE, S.S
COUtiT1' OF .
. . . . . . 6cing duly sworn, deposes and says that he is the applic.
(Name of nidividual signing contract) ,
above named.
ficist}ie ......................................~E....,...........................,...............
(Contractor, agcnf,corporatc oCficcr, etcJ
oC said owner or owners, and is duly autlionzed to perform omhave performed i~ie nerd work and to make and file ~
application: that aA statements contauicd m this application arc true to the best QGlus knowledge and belie C; and that
work wdt 6e pcrlormed m the manner set forth m the apphcauon tiled therewith.
Sworn to before me this
. .day of 19 ~
\otary Public, J':~44$~7!.. ~ ~ ~ ...d.'~:... County
N4TARYPUetIGSt4atEeo~fNewYork (Sim arureofapplie:
Na 4747818, SuSf~i%CauMycir ~ 111
Term Fxryires Msrah 30.19_