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Home My WebLink About5422-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Cerlificate Of Occupancy NoZ~7~ ....... Date .............. &~.. ~..., 19.'~. Ave extendefl ) THIS CERTIFIES that the building located at .l~.,gate. ltea~. (,riental. Street Map No. F.,l,Bat&$e~lock No. 8 ......... Lot No..~... Ft~herJ..l~lal'~d....1~,~, .... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... JUly.. 2It.., 19~/1.. pursuant to which Building Permit No.. ~'2.~... dated .......... J.~.l.2 ..... 2.6., 19..~.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is P~iv~te · ~e · fami-ty, d~elt.i~g ........................................ The certificate is issued to -l)X'i .Edward' 'Howe' ~k '~/if'e ...... Owners ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . lO~n(l~l .......................... UNDERWRITERS CERTIFICATE No...p~l~l:l~g ....................................... HOUSE NUMBER..l~gl~ ...... Street ................................................. Building Inspector FORM NO. ~ TO~VN OF ~OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTNOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5422 Z Permission is hereby granted to: · &~1'~a..gel~t~'.'~ae"~/~" ~vv"&'l~e~/ ~ ...... ~Tae,~s...te'~e.~: ....................................... ........... i,~,..a~,~9e ............................................ to ..~L~ .. my ..e~e. · .~'3.?.. ~.~.L"~ .................................................................................. at premises located at ........~d~t,....~l.....~.~,~,e~'J..,T,l..~l~ .......................................................... ........................ ~..Nea~.&/,e..Ze~.r ..~:e~s¢..~.....~elmme..~.~ ...................................... pursuant to application dated .............................. ,1'a.1~: ....... ,~ ........ , 19..~1~.., and approved by the Building Inspector. :Fee $..$G.4~' ......... Building Ins~ctor FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy THIS CERTIFIES that the building located at . [M~. ~. ~ .g&~-~ .~ · · Street Map No.ll%~[.~[~$ .... Block No.. '8 ....... Lot No.. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. ~,~.. ~ 19.~l. pursuant to which Building Permit No...~t~ dated .......... ~l~y...~..., 19.~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .10~,~,~ ~MI..~.llil~.l~ .~l~'~!~ ...................................... The certificate is issued to .. 'Dr ~t~a$~. li~. & ~ ..... ~11 ................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic featu res. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5, Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5,00 2. Certificate of occupancy on pre-existipg-~g or land use $5.00 Copy of certificate of occupancy ~.~ $1.00~ 3, Date ... D.e.q em~.e~... '~ 9.,.. 1 cj7~.. New Building ............. Old or Pre-existing Building .. :.X, ........ Vacant Land ............. Location of Property ....... ~. ~,~.~.a,1;~. ~q~d..(.0X';[~.tal. Avenzze. ex.~ender3 ).. Fishera .Is. House No. Street Ham/et Owner or Owners of Property ...... D32....]~.~q[. ~o.w.(~. ~ .w..:¢,. ............................. County Tax Map No. 1000 Section ... 5 ........... Block ..... ,1 ......... Lot ..... .~. ......... Subdivision .F:j.$~6tz3$. ~S ~ . ]~$.-~e..1;.e.s. ......... Fired Map No ........... Lot No.., .'1 .......... Permit No..SZ~22Z... Date of Permit . .7./..2.~.?.,1Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ... ~ ................. Fee Submitted $.. z~.,. ~ ..................... Construction on above described building anti, mit meets all app~i~lyod~ regulations. Applicant,, ,~~.v ..... ; ~'/.,... ~/(~/4'Z,,¢..~, ........... FOB~ NO. I TOWN OF soUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exom,ned ...... :..2 ........... , Approved ........................... ~.~ ........... , 19...~... Permit No..-~......~....~......~......~',. Disapproved a/c ............................................................... (Building Inspector) APPLICATION FOR BUILDING PERMI'T July 24~ 1971 Date ............................................................ , 19 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining prem res or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of thie application. 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 issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until~a Certi.ficate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pureuant 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. A~ ..~..o..h...n...G.~..d.a....G..e...n. eral Contr. Inc. (Signature cf applicant, or name, if a corporation) 06390 ~,l~.4,....N...q~... ~.o_r...k. ....................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contractor Name of owner of premises Dr, ~dwar~ .R., Howe and Mary Howe If applicant is a corporate, signature of duly authorized officer. A. John Gada, Jr V~ce President (Name and title 'of corporate officer) 1. Location of land on Which proposed work will be done. Map No,: ........................... ..../.~... Lot No.: ....... .~...~- ......... Stre~ and Number P~k ~ea , ' Munici~li~ 2. State existing u~ and ~cu~ncy of promises and intended use and occupancy of prop~ const~ction: a. ~isting u~ a~ ~cupancy ................................................................................................................................... b. Intended use and ~cupanc,' 3. Nature of work (check. which applicable): New Building ,.......x~.. ....... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) 4. Estimated Cost ~.40 000 O0 $10.00 ........... z ........ e. .................................... Fee .......................................................................................... (to be paid on fi~ing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. 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 ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Pear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... Frcnt ..S..e.e Attached~ 9. Size of lot: ....................... t~ear ............... Depth ................................ 10.Date of Purchase 11/1/70 ........................................................ ,ams of Fo,,,, Ow,., Residential 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulatlon~ ............................................................ 13. Name of Owner of premises ,D.,z.,?.....~..d.~..~,..,d,...~...°.~,e....,&A~r~.~:~-~,u;...L~,laz~cl.. ...... Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... ..A......J..o...h.n Gada Genl. Cont~. Fishers Island 7887-231 Name of Contractor ................................... ~aaress .................................... Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from P~et.erty Ii. ne?. Give street and block number or description according to deed, and show street names and Indicate w emer interior or corner lot. See Attached STATE OF NEW~Y,Q,~,~. COUNTY OF ................................ j' ~. John G&cla~ Jr. ................................................................................................. being duly sworn, depoeqs and says that he Is the applicant (Name of individual signing application) -. above named. He is the. Contractor (Contractor, agent, corporate officer, etc.) of said own.e.r or owners, and Is duly authorized to perform or have performed the said work and to rna~e and file this applicahon; that all statements contained in this application are true to the best of h s know edge and belief; and that the work will be performed in the manner set forth In the application filed therewith. Swam to before me this ' .......... ~ ..... aay .pT ~l., ....................................... .ota P.bl,c, .................... , .... ...................... t[~:'.'30HN GADA County ~ ' (Signature of appllcan~/ NOtary Pul~lic. State of NeW York ~Reaidin~ in S~ffolk Co. Off. No. §2-6¢39000 ~ommission Expire~ March 30~ ~ ~r~..