HomeMy WebLinkAbout17892-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 217829 Date MARCH 10, 1989
THIS CERTIFIES that the building RENOVATION
Location of Property 49925 MAIN ROAD SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 70 Block O5 Lot 02
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEB. 24, 1989 pursuant to which
Building Permit No. 178922 dated MARCH 8, 1989
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
15sued is RENOVATION OF THE 2ND FLOOR AS APPLIF~ FOR.
The certificate is issued to GERARD W. GAUGHRAN
(owner, )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N737791 MARCH 3, 1986
PLUMBERS CERTIFICATION DATED N/A
Bu lding Inspector
Rev. 1/81
f'08~M NO. f
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~ 017892 Z Date 19. a./
Permission is hereby granted to• I - l
......""~"~'1..... ~
aD.s.,~`.....~.fa-Lk.
4.
..!~..........r<c.Q..... ~
.
ct premises located at .....................9925'... ~-nr
.......................................:.~.~..~.~.?-?~....~i..~.....................~.1..~~/.
.........................................................~.j..............................................................
Caunty Tax Map No 1000 Section ~~~yy.,,.,,~~... Block .....~:5.......ppLot No , O L,. .
pursuant to application dated .,T~'"!{! 19.6../., and approved by the
Building Inspector.
Fee 3
Building Iiupector
Rev 6/30/80
CIT18AN10
F .r ~ ~ 'O Box 10
~'nank NA I~
Melville NY ~
77747 I
V-- 1~
(576~39t 2300 I JAN 3 i 198.9
GerardW Gavghran °I
Assistant Vrce President L
~?LG3 u2PT
~t TO'. r,t SC:USHOtp
Fraud ~nvesngatrcrns 7y 7 `7_. ~ - -
MaStelC3fd-VISA ~rG[wL'
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
rlS'f
DATE r
.3f
NEW CONSTRIICTION .......''O/ILD OR PRE-E%ISTING BUILDING. ..VACANT LAND.../.~.__.
Location of Property...T~~?~.~hif/(J ~~....,,_SUUyttO.~~,_y{1~ _ 1~;17j
HOUSE NO. STREET HAMLET
Ovner or Ovners of Property..~enr!9:~.4..~/1~.:. `Y.'`~
County Taz Map No_ 1000 Section . 7U.. Block Lot .r.~?'.
Subdivision Filed Map ........Lot..........
Permit No. ..........Date of Permit ..........Applicant
Health Dept. Approval Undervri[ers Approval......._......
Planning Board Approval
Request for Temporary Certificate Final Certificate
;
Fee Submitted: $..~U' .
Cr.~ ~#~6QO
~ cCl~/ . J~Uti~
APPLICANT ....L.......
3G?~S
~ tir?gag
C~ q
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rev. 10/14/88 ~Q
C!TlCORP - U.S CARD PRODUCTS GROUP
~ - 918
6LDG.DcPT.
D ~ 7(}WN OF SOUTHOLD
~~vL~`-tr~ ~ /ywy 7JJf~ /Uf..C~c~~ //GZ,/
aye
_~~~Y~~,
GERARD W.GAUGHRAN
THE NEW YORK .BOARD OF FIRE UNDERWRITERS ° ' ~i_i m III
II ; I- II ul 'n
I u nl Inu II:
~~0014J,3 BUREAU OF ELECTRICITY I t I 11 ,I 711 III 11J1 `11111j JI11'llll~ 1,
85 JOHN STREET, NEW YORK, NEW YORK 10038 , ~ 1 II 1i=11 III .I-III 11; 1 -
~ ~ ' - - ;-1 1 1
- 1 Dote A /icahon no on~ de-" 1 , /sl ~ ~.Q~ I I
-March 3, 3986 pr I I 323874/85 ~I_, nl V !I I .
THIS CERTIFIES THAT =1'4~ I - ~ ..III=III II IIrlh hl In
only the eleetricol equipment as deuri6ed 6e/ow and introduced by the opplic¢nt ranted on the above opplic¢twn numberlFnlEhe ~eniiaea of 1.
'Gerard w. Gavghran Main Road 49925 Southold N. -111 ~ - 1 i~_ ,=g II' m-ul ul II ll-
t~; Y• ~-III I I I,'- II ~ II-111111111 i1U I'I III III='
in ~thefolloteing locati¢ni - ® Basement -.II ill III !I'
? 7at FL ®2nd Ft. '_-Outside III ' Seer' II 1~T1,. III III ill
I, Pebrtra 24 1986 andfound [o be int»mpli¢nce FUFth q irementa of thir-Ill II =1i III III°
-d on rS s. - - .I--III III IIL-
toga examine t
- here u Board. !ICIII-III-~.1'
RXTURE 1 ~ FIXTURES RANGES COOKING DECKS OYENS OISN WASNEItS EXHAUST FANS
OUTLETS KEAAClES SWI7p1F5 N[ANOFSCENT rllxxFS[ENT
v.ron MIT' N. W. AMi. K. W: AMt. KW AMT.. - C Wnl. AML... I _M;P-
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ORYERS =,-FURNACE MOTORS - El1TURE APPUAOICE FEEOEK S/ECIAL REC'PT TIMECLOCKS g~L `UNITNEATERS MULTFOUTIET '-0IMMERS
ANT k W }qL :RPI. GAS H. P.. r AMi, r NQ A. w.'G. . AMTC AMP.: AML AMPS.-.TRANS. MtT _ I[Y ~PIO.OF FEET Ai`TT. 1MA1T5?--.
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METER ' NO, OP CC GONa~ A W G. ~ ~ ~ - - - -
'iTNT I AW-:1. IIivR EQUIP. t.~xw tfaw aP ax^ sP ~w PExB CG CGND. I' No.OC_MI-LEQ I jlf ntFP" NQ.4fl NF1iKAlp.='I! NFWui4iv~t
1~~ G$ =1 = I =I I II - II iP=yl =III II I "'d=111 'll ,11..111 III II -11 L- II 1
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OTHER A??ARATUS: I - _ _ 1 I- I _ r~ ;.i- f~
11 - ul II , _ ~ 1 I 1 I -1 ' _I ; 1 I I III I I
' I .=111 I I _ ~ I I~ - u i I II I I 1 - I III I ; 11 II III=1;1 ;II-
YII~ I I it ~ i'-.1 II I I 11' l I I I I 1, I I I' = I 1 I' li' 11 I I 'I=111 I I II =II 111 III
11 III III =11 III II II II I" I!='ll II J III I' 111 I r_~II III 1.
I~.P.G7I.' I~--tgi1D];e L~.'teCtOr 1 'I I I -n I l = I ,I III II' II I 'I ,q I I III=
I = i lu II !1= ' I" I I 1-' ~I' -III-" II 1 Ih- 4 III=111-
1-4.5kN~Ot water Heater ',I 1! 11 -V II 11.:11 II III - IL ;1 I ~-111JI I I 111 .III=
I = I I 1 -31 I ~°',I III II 4=n 'I ' :i II G i!= ;I II I :ill II' Ih PI 1 !I",
Panelboards 1-16cTr 200atnp5. ~ 1' - 'll~ ul III III I IiL ' I I IJL 111 II IL°I'I II 11 11 II II'='
IIectric Room Heaters 2--2.Okw, I 1 5kw, 2 1 25kw. -'u lu I ;u I In r =11 I'I -I ITI III II I III I'I n
1 I I 'il III- III III- II' III I - II IP 'I 71;=11 ' I I'- ; III
'1=III III II ' I II :!'I 'I II I I II 'll III 1.1=III III III II' ' I I h - I 'I -Ilf II' III 11! III- 111 III Ib.
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!111111,11 II I I -III . 1 r. 1 I L=11111; ° ' I I. I Ill I -11 ill I1 , ~I
old H Hau t Southold Electric 111 11 -.III 1 " II .
II-III III I I~'r ' p .;I 1. II III 111 III I" 11hi" 111 ' I ii- 111 'll III II I I'1i1~111 ~ I'1 III X111!1111111111111 III:
fIICIII III lu Grittens Zane I I 11 .1 I
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~ ~ _-Southol ~'Y 11971 11= ~ II :I 111 III JI-III ;1 I1~1~-J' I" 'i- III III III-°II III 111== III II III=111 III-!li
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II h; I 11- II 1- ' _II , - lit q 1 111-III 11- 11; I III Ii= 1 u" -~1 L',Ih~ 1
This certificate must not be~nltered in any manner;'refurn ~o the office bf the Board ~ ~ncorred. (nspettors iridy-be nlen~li -by.NT6q cre en I
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BOARD OF HEALTH
3 SETS OF PLANS
FORM NO t SURVEY .
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORM
' TOWN HALL
SOUTHOLD, N Y 11iJ71 NOTIFY
TEL.. 765-1802 CALL
,Q' 194 MAIL T0:
Examined . s[[R ~pq/
Approved ..~X/ • • 1:1! / Permit No o/T~9z ~ ~{Q~
Disapproved a/c _iL ~ Z
BLDG DEPT
_ Tt14'/N OF SQt/1Ts~fOID
. • . f{ Ing InSpeCLOi) • • . ~ ~ ~ "
U/>'`
APPLICATION FOR BUILDING PERMIT
Date " - - 15
INSTRUCTIONS
a. Tlus apphcatron must be completely filled in by typewriter or m ink and submitted to the Building Inspector, with
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 adloinmg premises or public stree
or areas, and giving a detmled description of layout of property must be drawn on the diagram which is part of this appl
cotton.
c. The work covered by this application may not be commenced before issuance of Building Permit
d Upon approval of this apphcaUOn, the Bwildmg Inspector will issued a Buildmg Permtt to the applicant. Such perm
shall be kept on the premises available for mspectton throu~tiout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanc
shall have been granted by the Buildmg Inspector.
APPLICATION IS HEREBY MADE to the Buildmg Department for the issuanc ~ it pursuant to th
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ws, Ordinances c
Regulations, for the construction of b~ erauons, or for removal ~i
r119~p,~,,,,,~,5,,it8i'~in descnbe~
The applicant agrees to comply with all applies. ordinances, buddi?C o e, iousm~ code, and regul~t~~ins, and t
admit authorized inspectois on premises and in building for necessary i pec ~ t"~t'fr'-
(Signature of appl• S~C%~ai'borpb4$uon)
li~tp 111 •
State whether applicant is owner, lessee, agent, azchitect, engineer, generai~agplt~t'~an ph17h5lier or builde.
`'v.."r2 ....~gI1A..1.11if+1~.T?NfS~
Name of owner of premises ? ~ w . ~C1• ~ ~2 ~dO!l~A. A #~T`~D' B-~
(as on the tax roll dk~te~Gtf~~'?~ ° _
If applicant is a corporation, signature of duly authorized officer
.
(Name and title of corporate officer)
Builder's License No .
Plumber's License No . . .
Electrician's License No ~..v • • .
Other Trade's License No . .
I. Location of land on winch proposed work will be done . .
House Number Street Hamlet
County Tax blip No 1000 Section .....7.~~......... Block ..U S~, , • • , , , . Lot ..~.Z°
Subdivision . . .Filed blap No. Lot .
(Name)
State evisUng use and occupancy of premises and intended use and occupancy of proposed construction
a. Existing use and occupancy . 7C..~'g:^•?'• ~ i' ? S 1 C~~ c-iv~' c .4- ~ jlc~wi
a,.t+.. .
b. Intended use and occupancy
3. Nature of work (check whuh applicable)' New Building Addition AlteraUOn . .
~.r~ .
Repazr .....X Removal Demohgon Other 1Vork~t!: S ~'(2 f;td,
v~~ ynadeil, (Dcscnpdon
[ eo0f ~'1zc~it~c
4. Estimated Cost Fee .
(to be paid on filing this application)
5. If dwelhng, number of dwelhng units Number of dwelhng units on each floor
If garage, number of cars . ( .
6. If business, commercial or mixed occupancy, specify natunc and extent of each type of use . ....:J. .
7, Dimensions of existing structures, if any Front . ~ Rear Depth ~ .
Height Number of Stones ....`y'.
Dimers~f,~sstructure vvtth alterations or additions Front Rear .
Depth height Number of Stones . .
8. Dimensions of entire netiv construction Front . Rear . .Depth .
Height Number of Stones
9 Size of lot Front f Y.~~.... Rear . P Deppth yO°~ E
10. Date of Purchase G3^ ~ q " Name of Fou~rriier Qcaner ~:t, 5A 1,4 e~[lyp, ; ,~I;„r, Cs~iU((~ ~
I I. Zone or use distract in which premises are situated . , ~E`~. 1 :lr-w ti,~3 l ...1f'.. .
t ~ Dees prepcsed construcu~n violate any zoning law, ordinance or regulation : .
13. Will lot be regraded . , Will excess ~1 be re~io~d from premises: Ye I
14 Name of Owner of premises~irznn~,tv',Cr?~y.~It~rl,t,,.(sitgddress PN-s+.ME~4ciss~~~''~'.PhoneNo.S~~:~y.~'.~Y~;
Name of Architect ...................Address ~ y.s~ Phone No............. .
Name of Contractor .....Address .............Phone No .
15.I5 this property located within X00 feet of a tidal wetland? *YES....NO.L~..
*If yes, Southold Town Trustees PLOT DIAGRAM a required.
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dunensions fry
property fines Give street and block number or descnphon according to deed, and show street names and indicate wheti
intenor or comer lot.
r • vQ 1f
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~-+aot s ~ io a nn t~
Fou.annwo ~
1. wur+o~?T+o~e. - ~a+~au~a
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2. ROtION . • w
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8E COMPf.ETE WRC.O.
All CON811NJC710N S1LAtl LM[$T
THE !A~ OF M II.Y.
ST/iTE GONRT4MJClIOf! ii tl1~QY
CODES. NOT RE~O!!$1BLE POR
DEStGk OR CONSTRUCi1ON ERRORS
STATE OF \E~V YO/R~'K, S S
COUNTY OF ~:FJ.Q) k.... .
~ et2g-i2 ~ lAf C.4tJ~ ~l PZr9-~f f2 be,ng duly sworn, d?poses ~^.d says that he is the applica
(,',iaie of mdrvidual signing contract)
above named
He istlte....~'-~n.~-+~.v ~...~l~?;sr.'.~.~:9:t.~..~~:...~t1t1~C~c~..~. ~~'....1~.~~.7.1........
(Contractor, agent, corporate officer, etc )
of said owner or owners, and a duly autlionzed to perform or have performed the said wort. and to make and file ti
application, that all statements contained in this apphcquon are true to the best of his knowledge and belief, and that t
work will be performed m the manner set forth m the applicaUOn sled therewith.
Sworn to before me this
day of ]9 %
\otary Pubtic, , County f' r ,
MAUREgiC. ,L1C~LG2 ti(.! / /G(.(C c
NOTARYPUr6~L1~~Nlf11NIR
@uatfiedinSuHdk ~ ?(Si;nature of applica~
C~-y~t1l~r-r C ~<<7`~'