HomeMy WebLinkAbout17461-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z18712 Date JANUARY 12, 1990
THIS CERTIFIES that the buildin~ ALTERATION
Location of Propert~ FOOT OF THE GLOAMING FISHERS ISLAND
House No. Street Hamlet
County Tax Map No. 1000 Section 010 Block 09 Lot 019.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
1746l Z
Building Permit No.
SEPT. 26, 1988
dated SEPT. 26,
pursuant to which
1988
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 ALTERATION WORK ON OFFICES.
The certificate is issued to
A. JOHN GADA FAMILY PARTNERSHIP
(owner,
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N055456 JAN. 27r 1989
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
Building fn~ec'tor -r~
TOWN OF $OOTI4OLD
~Ii~ILDIN6 D£PART~4ENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~ 017~8! Z
Permission is hereby granted to: .~ ,, ;._.__..
A :,,~....~.~......~~........n.~
., ,.r..,,... ,,..., ., ............ ~~......:....,~.....~.~ ....
.............................................. .:~...~..~...~....~Lz,~ ........
Coun~ Tax Mop No. ,000 Sec,o. ..... /...~ .......... B,~k ....... ~. .......... Lot No ....... .z...~...../..
pursuant ,o application dated ....... ~,~ ............ /"1 .............. , 19~.ff, and approved by the
Build, Inspector.
Fee $.../.~.~..,...~'.~..
Building Inspector
Rev. 6130/80
APPLICATION
TOWN OF SOUTHOLD
BUILDING DEPART}lENT
TOWN HALL
SOUTROLD, NEW YORK
765 - 1802
11971
FOR CERTIFICATE OF OCCUPANCY
NEW CONSTRUCTION -.~ .... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND
Foot of the Gloaming Fishers Island
Location of Property
ROUSE NO. STREET HAMLET
Gada Family ~a[~[shi~
Owner or Owners of Property.~ ~q~q ......
County Tax Map No. I000 Section ..lQ.. Block ...~... Lot .i.%..1 .....
Subdivision ....................... Filed Map ........ Lot ..........
Permit No. 0~7~6]Z..Date of Permit 9f~ A licau~.0~n ~da ~ral ~n~acting, Inc.
Realtb Dept. Approval .................. Under.fliers Approval.~.C~.~.~.~...
Planning Board Approval ................
Request for Temporary Certificate ....... Final Certificate ...~ ............
Fee Submitted: $.25.90 ..............
APFLiCANT~...~pbg. G~d~.General Contracting, !~c.
~0/~4/88
FOUNDATION (1st)
FOUNDATION (2nd)
ROUGH FRAME &
·PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
Ye
FINAL
ADDITIONA'L COMMENTS:
If copper tllbing is used ~ ~.~
for water dist~ ibutir~g
· ystem; piping shal~ be ~ ~
of types K or [~ only,
'~HE NEW YORK BOARD OF FIRE UNDERWRITERS '"~: ~!
~ ()'~ ~r~()'~ '~ BUREAU OF ELECTRICITY
~-- B5 JOHN STREET, NEW YORK, NEW YORK 10038
Date ,i~ilt~¥ ~/,'/,'~}~t'i /~pplicationNo. onfile ~('~()~0<~/~:) i~f 0%~
THIS CERTIFIES THAT
o~ty the el~trical equipment ~ ~scrlbed belo~ and introduc~ by the applicant ~med on ~he abo~e appllcatio~ number in the prem~es of
DRYERS
OTHER APPARATUS:
NO OF HI-LEG
OF H~-LEG
(~f~e ~te~e~ in ~ m~er~ ~ef~rn fo f~e off~ce o~ f~e ~o~ ~ i~correct. I~pecfor5 m~v be i~em~fie~ ~ ~re~e~ls,
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFI~TE MUST HOT BE ALTERED IN ANY ~NNER
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Disapproved a/c .....................................
Received ........... ,19...
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date . .4Ug.u.s. 1;.
INSTRUCTIONS
a. This application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 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 must be drawn on the diagram which is part of this appli-
cation.
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 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 ~--t-he Building Inspector.
APPLICATION Iff 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 necessaw inspections.
. ~,. 9. QON..~.~.0.~..~.[.~..[.~.Ak . .Cp. NT..~.&C.!I.~. ¢.,..!~..C...
(Signature of applicant, or name, if a corporation)
o.~ b!~.~.R..~ ....................................
'F E ISLA?_p, NY 06390
· I ~ H..R~ ~&~iii.~ ..... ' ....
· 'aad~asa'.~.~'appiii,~ _'~',
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electncmn, plumoer or omlaer.
.... ?2 e.T.a.!, c. ??).r. ? c.).o.r. ......................................................................
Name of owner of premises .... A~..30HN..GADA..E AMI.LY.. P A.P,I ~1E R.S.H I P .................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
..... .........
(Nam~ ~ titie' ~} ~;~o~te o )
Builder's License No. 2.81 .- H.I ..................
Plumber's License No..4 62 ~.P ..................
Electrician's License No. 296.-.E ................
Other Trade's License No. ~ 9.4. g A R ..............
1. Location of land on which proposed work will be done.. § pJ;.t. Q .m..o.f...t .h 9.. ~. ] 9.a.m. i..ri 9 ......................
.................................................................. .F.i.s..h .e.r.s.. ! .s.l.a.n..d ..........
House Number Street Hamlet
County Tax Map No. 1000 Section ..... /...~. ......... Block ...~. .............. Lot .... /...~.,../ ......
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..... O.f f j ~.e.s. ........................................................
b. Intended use and occupancy . o.ff. iCe~ ...........................................................
3. Nature of work (check whmh apphcable). New Building .......... Addition .......... Alteration ...X ......
Repair ........ ~y.. Re~noval .............. Demolition ....... 'd' ..... Other Work ...............
i ~ (Description)
..................... Fee .... ..................
4.
Estimated
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................
If garage number of cars I ' .....
.6. If business, commercial or mi~ed occupancy specify nature and extent of each type of use ... 13 U .s.i.q e..s .s .........
7. Dimensions of existing structqres, if any: Front..": .'..'. ...... "... Rear .... ' .......... Depth ...............
Height ............... Nu, mber of Stories ........................................................
Dim nsions of s t ' 'th alterati dditio F Rear
e amc s ructure iWl ons or a ns: rent ...................................
Depth .................. ! .... Height ...................... Number of Stories ......................
8.Dimensions of entire new con~truction: Front ....... Rear .. Depth
Height .............. NUmber of Stories .~ ........................................................
· '- ' Rear.. ' Depth
9. Size of lot: Front ......... , .......................................
10. Date of Purchase ...... ................... Name of Former Owner
1 1. Zone or use district in which premises are situated .....................................................
12. Does proposed construction v!olate any zoning law, ordinance or regulation: ................................
13. Will lot be regraded ....... ! ..................... Will excess fill be removed from premises: Yes No
14. Name of Owner of premises gi3:Gad~ F0mi.ly. P. art .... AddressFi shots. Is.la0d,. NY .0fi3~ Phone No.7~x7~.31 .........
Name of Architect ........ , ................... Address ................... Phone No ................
Name of Contractor A. Oohrl Gads ¢l,r.1. Cor~tr,, .I0c, .. Address Fj 6~e.r.s.I.s.1 ~t.nd. ,. NY .~.3.9Q. Phone No. 7~7.2.3J .........
15. Is this property locate~ withinl,00 feet of a tidal wetland? * Yes ..... No .....
· If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and blodk number or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW YORK, ' S.S
COUNTY OF .S u f fo.l.k .......
.... A....~OHN..GADA.,..~R ..... J .....................
(Name of individual signing contract)
above named.
being duly sworn, deposes and says that he is the applicant
He is the .C0 RP.QR~I£..0 .F F.I.C.E R ....................................................................
! (Contractor, agent, corporate officer, etc.)
of said owner or owners, and is d~ly authorized to perform or have performed the said work and to make and file this
application that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith·
Sworn to before me this
........................ day of ............. ,19 .~.
Notary Pubhc, ......... ,~...,..leiS. ................ County
[,~I[R¥ B. PANKIEWIGZ [ ( ignature o applicant)
NI, IIA~Y PUBLIC, 81All~ OF NEYV] YORIq
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