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Home My WebLink About6438-zTOWN OF SOUTIIOLD BUILDING DEPARTMENT Town Clerk's Office $onthold, N. ¥. Certificate Of Occupancy THIS CERTIFIES that the building located at . N/.~.. Main. Koael ....... Street Map No... XX ....... Block No...X,X ...... Lot No.. ~... ~tM;¢h0gue. conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... .Y~!'...2.6 ....19.73. pursuant to which Building Permit No.. 6h'~SZ. dated ........... ~'!9~ .... 26..., 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 Private accessory (storage) *~uild!ng The certificate is issued to , .~dward. dc .(~ra~.e.. Wylie ....... 0whats ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~N,E ................................ UNDERWRITERS CERTIFICATE No.,. ~'l.'tB ? ............. ~ ............................. HOUSE NUMBER, 2[~.~0 ...... Strccl ....}'i~lltl. ~.O.~(t ..... : ............................. Building Inspector FOR~I NO. 2 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) N? 6438 Z Permission is hereby granted to: ................................. ............ ~.:~x.....R~ .................................................. .................... ~t~h~e ........................ i ............. to ....~.~ ..b.u~d...a...~ o.Q L .s ~zed...a~d it ia~L..cm.. ~x& s.ti~g~, hard......~ .a...q g..e..s...s..o. ~Y. ~ ........... ot premises Iocoted ot ..... ~%:[~..B.c~a~ .......... ~ ................................ J ..................................................... ............................................................ R~;¢kogae.....]~, ~. ~ ................................................................ pursuont to opplicotion doted ...................... ~a~. ......... .~ ........... ., ]9.~.~.., and opproved by the Building Inspector. TOWN OF $OUTHO~-D Building DePartment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector with the following; for new buildings or new us~: 1. Final survey of property with accurate location of all ~uildings, property lines, streets, and unusual natural or topographic features. 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, Muttiple ReSidences and similar buildings and installations, 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, o~cupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use' $5.00 3. Copy of certific~t,e of occupan,cy $1.00 .-~ , / '-z-~/c~ ~ New Building .................... Old or Pre-e)~ing Building ././~ ....... i .......... ¥oeont I~anc~./,~.M..~ .................... Subdivision ................................................................ Lot No ........... ,,~k No ............. H use No......t · .. . . Perm,t No.~..~i~..¢~..~, Date Of Perm,t .~./~.Apphcant ~ .............. '.~/,~.,. Health Dept. Approval ............................................ Labor Dept. ,~pproval ................................................ Underwriters Approval .............................................. Planning Boa~d Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .... ~ ............................... Fee Submitted $ .................................... Construction on above described building and/~rmit meets all a~plicable codes and regulations. Sworn to before me this Y 'f~¢/ Notary Publ[~"-~~..J~.....~. County TEI(~I LEE t~tBLIC, State at flew York rio. 52 (stamp' or seal)