HomeMy WebLinkAbout17470-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218713 Date JANUARY 12, 1990
THIS CERTIFIES that the building ADDITION AND ALTERATION
Location of Property EAST END AVENUE FISHERS ISLAND
House No. Street Hamlet
County Tax Map No. 1000 Section 003 Block 003 Lot 005
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPT. 28, 1988 pursuant to which
Building Permit No. 174702 dated SEPT. 28, 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 ADDITION AND ALTERATION WORK. _..
The certificate is issued to ELIZABETH ANN STRUPP
(owner, )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N105003 NOV. 29, 1989
PLUMBERS CERTIFICATION DATED N/A
Building Ins ector
Rev. 1/Sl
rosat xo. s
TOWN OP SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON 7HE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N ~ ~ 1 ~ )f j ~ Z Dare ..~J.( ..~~!~ ~.~1 ................ 19.I~~
Permission is hereby grouted to: ~ /~
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.. ...........
III .~. r..~.......--...1.~'~ .~.~.........,~..~/.~
to ................. ... ~... ~ .....17~.........~P.1~~~1.A.../~f..~.T`r..~ ......,~d~z%.....~..~................
.......................................................`................................. ..................................................................
at premises located at ......~..`~E~R//J~!/....~!~~, ..~rl.(~...~•r•.r..r.•'~•L• ....................................
................................................fir... ••:•••v,ld~ e~a~',~~,"~'•'~.......~~~~!!................................
................................................................................................................................................................
Cvunty Tax Map No. 1000 Section ........,.~~ ............. Block .....~...........dLot No...:~.-.......
pursuant to application dated .I~_i~..........~..y ............., 191!.,;1., and approved by the
Building Inspector.
Fee $...~~.ll..ll...
Building Inspector
Rev. 6/30/80
.•
TOWN OF SOUTHOLU ~~.
BUILDING DEPARTMENT ~~~ ~~`.;°,,?„~ ~
TOWN HALL
SOUTHOLD, NEW YOKK 1 197 1 ~ ' 31989
APPLICATION FOK CERTIFICATE OF OCCIIPANCY
DnTE.October 25,.,1989.
NEW CONSTRUCTION ,.x....OLD OR PRE-ERISTING BUILDZNG......VACANT LAND........
Location of Property ..................Pr1v~lie,Drive Fishers Bland,.,,
MOUSE N0. STREET HAHLL'T
Owner or Owners of Property....EllZdbeth,Qpq,$~rURR .........................
County Tax Map No. 1000 Section .~.... Block ..~.... Lot ..,5...,.
Subdivision ....................... Filed Map ......,.Lot..........
Permit No. .D1J,4]D,Z.Date of Permit9/2$($$„„Applicant P~,7ohq,C,~da,Cieneral,Contracting, Inc.
..~- /
Health Dept. Approval .................. Underwriters Approva l /.Q.!rU~l,3.
Planning Board Approval ................
Request for Temporary Certificate ......, Final Certificate ..,~,
Fee Submitted: $„?5:00_ ._ _.
APPLICANT. A..John. Gada.Geoeral.Contractin9,.~nc.
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rev. 10/14/88
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THE NEW YORK BOARD OF FIRE UNDERWRITERS I•A~:1
a
)JJgI)yt:9 EUREAU OF ELEGTRIGITY
68 JOHN STREET, NEW YORK, NEW.YORK 10038
Bata NOVEMBER 2x,1989 Application No. on file F•fi~f h:S189/69 N i(16f1U:i
THI!< GERTtP1E8 THAT
owly tke alactrkal squipwtatta dsaeri6sd below snd intnttkteed 6Y tAe applicant nswtsd on the show sppliwtion nuln6sr Jrs tAspwnnlws of
I)AV[Y) 9TRIIPP, PRTVAiF Nq., PCYHER'~ 1'il_ANU, N.'V.
in thefotbwlnR krstion;. ^ Bswtnsnt ® Ist Fl. ^ !nd Fl. :Section Bloek Lot
ma esatnined on . NOVE MBk. N 14 , L 9.S Y sndfound to 6e in rnmplienre with the reyuirentenes of this Board.
R1nuRE Rx RANOES cooRlNOttEas ovEVS oRww usr rANs
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tS1t1SErS
NWgt6CTM HIKMItSCEM OTNEP NAT. K. W. AMT. K. W. AMT. K.W. AMT. K. W. AMT. N. t.
17 5 7 17 1 5.G
wrErR RJRNACE NOtoRS nlrflu urtlilNta RRRREt twaullRC'R T;MRtXOCES E~ VNi 1tRA1RRS M1IL14aRM1Er gRIMRRS
AMT. K. W.. tNl N. r. OAS N. r. AMT. NO. A. W. O. AMi. AMr. AMT. AMrS. ?FANS. AMT. N, r. ~. a ~T M1T. WAiTt
7EtVICf ONOONEEOr NO.Or S E R V I C
E
AMC AMy. iRt ~ T,1 [vI t / Tv t a 7W s l IV/ ND. OF C iCOND'
Mt or cc ' NO. a NFIE¢ ~G~
Of MWi~[o NO. oc NEUIRAlS OF 'NeUUN
011M MMr-rY&
f'AN1CAf_ C~R1tEtGA1E ONIY FON-1
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WALL. Ri18ER t ff . L. i C . ti..i 55 F
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AI F'tNE AVE
P]SHf'H'S 1'i I. ANU, NY, f1r,39ii
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nN bR ttlMrad. in ttm atannan ratarn ro
COPY FOR 6UNi~NAC:DEPARTMQIT.
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fZLM~~~p .d'' R~PLAC~~
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1. ~OUNtDATION TWO REf~Uii;E
FOR POIjRED CONCRETE
2. ROUGH"- FRAMING E~ PLUMBING
3. INSULATION
4. -FINAL -' 'CONSTR~IG'j`-ON INUST
BE COMPLETE FOR C:O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES, NOT RESPONSIpLE FOR
DESIGN OR CONSTRUCTION ERROR$
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FORM N0. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
' TOWN HALL
SOUTHOLD, N.Y. 11971
0 aa TEL.: 765.1802
Examined l~r~~..{(.~~~//~•., 19~iv
Approved ~s!~G~C1...., 19llCi• Permit No.. ~..~. y ?~Z
Disapproved a/c .................................... .
BOARD OF HEALTH ............
3 SETS OF PLANS ............
SURVEY .....................
CHECK ......................
SEPTIC FORM ................
NOTIFY
CALL .....................
MAIL T0:
............................... ~~~~ ~`...~~,..,~~.~-tom
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date ....Sept.ember..'t4, 19.88
INSTRUCTIONS
a. This application must be completely filled in by typewriter 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 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 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 insg~ctions. l~'`~'`~-~f,~
(Signa ure of applicant, or name,1•f a corporarron)
.D•ralv.e.r..6<. F.i.sbe.r.s.Is.l.and.,..NY...Q639A....
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
....9~ner,~l.contrac,tor ..................... .......................... ............
Name of owner of premises ~ o h n S t r u , "~ ' " ~
.............PP...--.1.. .. Z~..../~...... .r ....ll~j~..
as the tax roll or latest deed) ,
If applicant is a corporation, signature of duly authorized officer.
~•
....9..?.Qhp. G.ada.,. fir .....................::
(Name and title of corporate officer)
Builder's License No. .. 28.1.:H I ............... .
Plumber's License No. .462.:P ................. .
Electrician's License No. 2~,6, : E • • • • • •
Other Trade's License No. ..1.94..-AR ........... .
1. Location of land on which proposed work will be done. ...Ea S t..E.n d . A.v.e n u e ............................ .
Fishers Island
House Number Street Hamlet
County Tax Map No. 1000 Section ..... ~s .......... 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 ....... re•si dent t a 1 • • • • • • • • • • • • • • • • • • • • ............................ .
b. Intended use and occupancy r e s i d e n t i a l
....................................................................
3 Repair of work check whiRem~ licable): New Building .....'... , . Addition ... x...... Alteration ..g....... .
......( P
val ..... . ........ Demolition ........ ~..... Other Work .............. .
/~ (Description)
4. Estimated Cost . ~~a~J/.~II~~ .................... Fee ..~Jr.+dt ~.v'.......... .
(to be paid on filing this application)
5. If dwellin number of dwellin units .....1.......... Number of dwelling units on each floor ............... .
g> g
If garage, number of cars .....' ...................................................................
' ¢ occupancy, specify nature and extent of each type of use ,,,,,,,, , , , , , , , , , , , , ,
7. Dimensions of exishnalstructures, if any: Front ...............Rear .............. Depth ... , .......... .
g
Height Number of Stories ................. .. ...... .... ...... .
Dmtensions of same structure with alteratiotts or additions: Front ................. Rear .....~............ .
Depth ................... .Height ........... , .......... Number of Stories ...............
~• ... ...
$ Hem hYsions of entire new const ',ruction: Front ............... Rear ............... Depth ... , .......... .
g ..... Number of Stories .................. ..................... .
9. Size of lot: Front .......... .......... Rear ...................... Depth ......... ........... .
10. Date of Purchase .......... ,~ . ......... . . ......Name of Former Owner . W....D...Gampb.e.l.l .......... .
11. Zone or use district in which premises are situated ......................................... . . . ........ .
12. Does proposed construction violate 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 .a0,hn..StCUP.P.......AddressFjsher~, Is1,~nd,NXPhoneNo..7.8$-7,15~,,,,,
Name of Architect ......... ................Address .... ... .. ...Phone No............... .
Name of Contractor .A.. John. Gala. General i:ontractingAddressDrawer. B, Fishflrs.ISlantl Phone No..y.88-7231.:.. .
IS.Is this property located within 300 feet of a tidal wetland? *YES....NO.x..
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate cleazly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block 'number or description according to deed, and show street names and indicate whether
interior or corner lot. ~
i
I~
STATE OF NE~~YORK.
COUNTY OF ..."~:~?....... , , , S.S
John Gada Jr
• • • • •A' • • • • • • • • • • • • ~ • • • • ~ ~ •g • . • • • • . • .. • .......... being duly sworn, deposes and says that he is the applicant
(Name of individual si nijtg contract)
above named.
He is the . P,r,@$j dent, an,~ ,contractor
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements contajned in this application are true to the best of his knowledge and belief; and that the
work will be performed in the mannerset forth in the application filed therewith.
Sworn to before me this ~'
.......~ 4 ...............day of ; ...~?(afe;,y~ier........, 19~~.
N`o'~tyahry.~P,ub~lic, .. F°a ~ ............. County
M RY B. PANKIEvv1t;~ ~ •~r~ •'~~'" ~`~//. .
NUTARY PUBLIC, STATE OF NkVI Gov" (Signature of applicant)
IdU. 52.8267850 -SUFFOLK Wuai~
COMMIS310N EXPIRES tif3o~9o