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Home My WebLink About17713-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17633 Date DECEMBER 22~ 1988 THIS CERTIFIES that the bulldln~ Location of Property 60 SHEPARD DR. House No. County Tax Map No. 1000 Section 78 Subdivision ACCESSORY SOUTHOLDr NEW YORK Street Hamlet Block 2 Lot 9 Filed Map No. Lot No. conforms substantially to the Application for Building Permlt heretofore filed in this office dated DECE/~BER 19r 1988 pursuant to which Building Permit No.17713-Z dated DECEMBER 21~ 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 ACCESSORY EXISTING STORAGE SHED AS APPLT~D FOR The certificate is issued to THOMAS GADOMSKI (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A ' y ~ld~ng In~pe'ctor 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] Ui]713 Z Counb/ Tax Map No 1000 Sechon , .~1~ pursuant to opphcohon dated . ,~....~-..~ ~... Budding Inspector. Block ·., 19.(,:~'~', and opproved by the Rev 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL BLDG. DEPT. TOWN OF SOUTHOLD SOUTHOLD, NEW YORK 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANC~ December 8 1~88 DATE ........... : ....... oas rue ~on~.'~..O or pre-ex£s in§ ui in~ .... Vacant land ...... 60 Shepard_ Drive, Southol~, New York Location of Property Douse No. Street Hamlet ~omas Gado~ki Owner or Owners of Property ......................................... Couuty Tax Map No. 100 Sectio~ 78 Block 2 Lot 9 Subdivision .................. Permit Health Plannlng Filed Map .............. Lot ............. No ........ ,... Date of Permit ......... Applicant ................. Dept. Approval .................... Underwriters Approval ............ Board Approval ..................... Request for Temporary Certificate ....... Final Certificate ........... Fee Submitted: $.. '.~.5...0.o. .... Vacant Land Certificate .$ ....... APPLICAN~ Co rev. 10/14/88 SH~PA~D N.26 06 30 E, DP.I vE FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y 11971 .2-- .,~? TEL.. 765-1802 Exam,ned / /~- .. ,' 19~..~ Disapproved a/c .................................. INSTRUCTIONS BOARD OF HEALTH .......... 3 SETS OF PLANS .......... SURVEY ................... CHECK .................... SEPTIC FORM .............. NOTIFY CALL ................... MAIL TO: Date .... I ......... 19c a. This apphcation must be completely filled m by typewriter or in ink and submitted to the Building Inspector, wl sets of plans, accurate plot plan to scale Fee according to schedule. b. Plot plan showing location of lot and of bmlflmgs on premises, relahonsh~p to adjoining premises or pubhc str or areas, and gxvmg a detmled descnptmn of layout of property must be drawn on the dmgram which ~s part of tlus al cation. ~ ¢. The work covered by tbas apphcat~on may not be commenced befor~ ~ssuance of Budding Pe~t d. Upon approval of flus apphcanon, the Budding Inspector w~I issued a Building Pe~xt to the apphc~t. Such pe~ shall be kept on the premises ava~able for mspectmn throu~out the work. e. No bmldmg shall be occupmd or used m whole or m part for any purpose whatever until a Ce~xficate of Occupa shall have been granted by ~e Bmldmg Inspector APPLICATION IS HEREB~ MADE to the Bmldmg Dep~ment for the ~ssuance of a B~lding Pe~t pumuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New Yor~ ~d~other apphcable ~ws, Ordm~c~ Regulations, for the construction of buildings, additions or alteratmns, or fore. moral or dmohtmn, as hereto desoto The apphcant agree~~lapphcab~e laws, ordinances, hu~dmg~od~ ~ ~e, and regutatmns, am admit authomzed ~s~~*~nd m bmldmg for necessa, mspqc~~r~// // '~ ... ~; ~,;~ ~ .................. ~ ~ . ,~ (~=nature ot ~t or name, ~ a corporanon) - :~C~9P~ O~ ' e~ ~ t~ ~ ' (Madras address ~f app[ic~t) / State wheth~capphc~~e~nt, ~chxtect, enDneer, general contractor, electrician, plumber or bml~ ~~l~a'}'~ / ~', x ~ ~ ' .............. . . If apphcant ~o~tz~l~rl pf dul9 authorized offer. (Name and title of co.orate officer) Builder's License No ........................ Plumber's License No .................... Electrician's License No ...................... Other Trade's Ltcense No ...................... I. Location ofland on whmh proposed work w,ll bedone...~..~.~(~.~.~ff...,_~(.~-.. .................. House Number Stree~ mtet County Tax Map No 1000 S~cnon ................ Bl¢ck ............... Lot ...... Subdzv~smn ................................. ~led Map No ........... Lot ............. (Name) ~" 2. State existing use and occupancy of prsmls~s and mtendc~ kts~ and occupancy of proposed construcnon a Extstmg use and occupanc~ ............... 3. Nature of work (check which apphcabie). New Budding' n ... Alteration ........ Repmr ............ Removal ............. Dcm ol{l'ion ............. Other Work ............. (Description) 4-. Estlmate'd Cost ...... ~'...'~... ·. ................. Fee .................................. (to be paid on filing this apphcat]on) 5. It' dwelhng, number of dwelling un]ts ............. Number of dwelhng umts on each floor .............. It'garage, number of cars .............................................................. 6. If business, commercta[ or mixed occupancy, specify nature and extent o f each type of use ................... 7. D]menmons of exmt]ng struc[ures, If any Front ............. Rear .............. Depth ............. Hmght ............... Number of Stones ................................................... D]menmons of same structure with alterations or addmons Front ............. Rear ........ · pth ght N De ...................... IIm... ............. umber of Stones . .............. 8. Dimensmnsofentirenewconstructlon Front ....... ~.. .... Rear ....,ZI~. ....... Depth ......... Height .............. Number of Stones .................................................... 9. Size of lot Front .................... Rear .................. Depth I0. Date of Purchase ........................ Name of Former Owner ........................... 1 1. Zone or use district in which premmes are mtuated .................................................. 12. Does proposed constructzon wolate any zoning law, ordinance or regulation .............................. 13. Wall lot be regraded ........................... Will excess fill be removed from premmes: Yes N 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-'~00 feet of a tidal wetland? ~YES .... NO .... ~If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly ail buddings, whether exmt]ng or proposed, and mdmate all set-back dunensmns fro, property hnes. Give street and block number or description according to deed, and show street names and md]cate wheth. OCCt.l? NCf OR NOTIFY 2 ROUGH 3 INSU~ 4 FINAL ALL ~N~ THE REQ~ cOOES ~FSIGN OR STATE OF NEW Y~ P~..,/~ ......... --. f'~..t~?..s.s.s.s.s.s.s.s.s~...~~...~.. ! ........ being duly sworn, deposes ~d says that he is the applica (Name of mdwld~mgnmg contract) tte ts the ...... ~~ ...................................................... (Contractor, agent, corporate officer, etc.) of smd owner or owne~, ~d Is duly authorized to perform or have perfo~ed the satd work and to m~e and file tl apphcatton, that all statements contained mttus apphcatmn are true to the best oflns knowledge and behef, and that Work wdl be perfo~ed m the m~ner set forth m the apphcatmn filed therewith. Sworn to before me~ , .................. Nota~ P tc . , . unty -/