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Home My WebLink About5831-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-22214 Date THIS CERTIFIES that the building. Location of Property 430 GRIGIONS PATH House No. County Tax Map No. 1000 Section 70 Subdivision MARCH 24~ 1993 DWELLING SOUTHOLD~ N.Y. Street Hamlet Block 3 Filed Map No. Lot 8 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 24~ 1972 pursuant to which Building Permit No. 5831-Z dated APRIL 24~ 1972 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 ONE FAMILY DWR. LLING WITH ACCESSORY APARTMENT AS PER ZBA #4149' The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED MARTIN & NICOLINS BUSSANICH 9/20/73 - R. Villa N-139585 - 1/23/1974 N/A 3/76 /~'1' pector *THIS UPDATED CO Z-7172 DATED 8/1 Rev. 1/81 FOI~M NO. :~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 5831 Z Permission is hereby granted to: ..... ~.s. ~.~....J,.~.......e.~....~ ................................... .......... aatl....llt, lLl~.~ ........................................... ,o ...~.~..X..a....?....,....??... ~....~....~..~.,...x..x.....~... ................................................................................... at premises located at .......... ~'(~.~....~. ....... ~..~"?~).~.t~..~#J ............................................................... ................................................ 6r~gJ~LJ..~.a~ ............. a~.....li.o¥~ ................................ pursuant to application dated ........................ ..~.~?....~... ....... ~ ...... , 19....~...., and approved by the Building Inspector. Fee $..~..1! ~..J~j ........ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that_the building located at .G..r.~.~o..i~..s..P.a..t.]a. ........... Street Map No.~;337 ........ Block No ........... Lot No, 2. ...... 8..o~...th.o..1.~...N.~.Y.: ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... ,tier. Si....~.., 19.7..2.. pursuant to which Building Permit No. ~..~.~.Z... dated ........... .~.p.r..~l.' . .2~.., 1~.2..., 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 Pri~at~ 01~ The certificate is issued to . ~a. l~c.~.n..&..~.~.e..o..~...s....B~..s~.~?.i.e.h ..... . .0~n. ?.~.~. ......... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE No. ~$39g~ .... .Z, .~.., .~.3...S.9..~. ................ HOUSE NUMBER ...... 1~30 .... Street ...... (tl'~4~o~a .Pa~a .... 8.c~a.o.~4 ...... Building Inspector~ Form No. 6 TO,tN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY · This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, · streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildimg and unusual natural or topographic features. . 2. 'A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant~ C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ......~/~.~.~. ......................... New Construction....~.. .... Old Or Pre-existing Buildin~ ...... '~"'~ ......... ~-- Location of Property...~.~ .......... ~.~..~.~,//~.. ~./~ ............. · .-~4'J]-/.f~..~.~ ....... House No. Street Hamlet Onwer or Owners of Property..'..,~¥''.~'.-.~~' · ~ ..................... County Tax Map No 1000, Section .... Z.~. ....... Block....~. .......... Lot ..... ~. ................ Subdivision .................................... Filed Map ............ Lot ...................... Permit No..~f~.l~ ...... Date Of Permit. ~.L.-l~.~.Z.~pplicant... ~/.~...~.~,~..~. f.'.~.~. · Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval Request for: Temporary Certificate. . Final Certicate.. . .~ Fee Submitted: $. ~-O,~ ~C_~-y ~Pr. ~.~ ~p~/~f'? .......... · ~PLIC~ ' ~ - co.g l y THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~-- 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date Application No. on fileN ' ~ ~ ~ THIS CERTIFIES THAT i ~,~ . only the electrical equipment as described below and introduced by the applicant natned on the above application r~umber in the premises of in the followlng location; ~ Basement []' 1st FI. [] 2nd FI. Section Block Lot was examined on ~ and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES NCANDESCENT FLUORESCENT VAPOR A,~T. K, W. AMT. K W. AMT. K.W AMT. K.W. AMT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS PECIAL REC'PT. TIMECLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS ,~V~T. K. W, OIL H.P. GAS H, P. AMT. NO, A, W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO. OF FEET AMT. WATTS I SERVICE DISCONNECT NO. OF S E R V I C E METER OTHER APPARATUS: I '+ ' r GENERAL MANAGER Per_ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. OFFICl~ OF l'm~ TOWN CLERK TOWN OF SOUTFIOLD F~I JT~BETH A. NEVILLE, TOWN CLERK P.O. BOX 1179 SOUTHOLD, NEW YORK 11971 Telephone (516) 765-1801 Const ruction Alteration $10.00 - Residential $25.00 - Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ DATE APPLICANT NAME: ~-~ ~ APPLICANT ADDRESS:._ ~-~ SEPTIC CESSPOOL ~-~ DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER MAILING ADDRESS: _ ~'~.~ ~,,(//.,~l~ #-/~ ~' f~:/~J' OWNER PROPERTY ADDRESS: -.~~ TELEPHONE NUMBER OF CONTACT PERSON:/-~,,~-~ TAX MAP NO.: Section ~7~..~,, .Block ~)~ Lot ~/ ~ CROSS STREET: BUILDING PERMIT NUMBER CROSS REFERENCE: RECEIVED BY: DATE: Signature of Apl~ica'nt Town Clerk's Office L c.. "T, ' i'