HomeMy WebLinkAbout6443-zTOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No.Z?5'36 ....... Date ...... ....... F. eb.. 25' ...... , lg.
THIS CERTIFIES that the building located at .. zer~a, ltoad ............... Street
Map No. Cap.t .Kid~l. Block No ........... Lot No...].?.3 ..... Ma.t.t.~,~;uck ............
conforms substantially to the Application for Building Permit heretofore filed in this office
dated .......... ~4.~.~,...28...., 19.?.3. pursuant to which Building Permit No..
dated ......... Mar.. 28 ..... , 19.73., 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 .. Pr£vate..o~e. f. amily:, dwalling, w. ith. add it&or~ .....................
The certificate is issued to . .Nick .Soullas ..... ~ner .............................
(oWner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval N,R., ...............................
UNDERWRITERS CERTIFICATE No.. ).~3.~..~.~.3 ..... .Sgp.~...2.0.. J97.6. .............
HOUSE NUMBER .... 2~.~ ....... Street ... Z~, P~ ....... ~ia~ti.~u~k ..........
...... ..... ....
Building Inspector
FORM 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)
N? 64~3 Z
Permission is hereby granted to: '.
~.:~,~ ~.~e.~./~ .....................................
i""~'"'~'v'~,.,z....,.~.~ ......................
at premises located ot .........~..~.-~. ...... ~,~...~'.....N.....,~. ............. .~.-....O...A..i../~.' .................................................
pursuant to a~pl'ication dated ......................... : ................. ~ 19~.., and approved by the
Building Inspector.
Fee $ ........................
Building Inspector
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICtTY
ak 85 JOHN STREET, NEW YORK, NEW YORK I00:B8
i B.,eSeptember 20, 1976 '~"p'icati°"/~°'°n'file878040 N 304143
~IS CERTIFIES THAT :
the electrical eqttipment o~ described below and introduced by the applicant ~amed on the above applicatlo~ number in the premises of
Nick Souiles, 605 Zena Road, Mattituck, L.I.
I the following location; ~ Basement ~ 1st FI.
~s~,~.,nl.e,lo,,September 16, 1976
I ~C FIXIURES
SW~TCHES NCAND~ ENT FLU~ESCE~
[] 2nd fl. outside Section Block
and found to be in co.~pllance with, the requirements of this Board.
Lot
EXHAUST FANS
FOI~M NO. $
TOWN OF $OUTHOLD
, 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 DUPLICATE to the Building
Inspector with the following; for new buildings or new dse:
1. Final survey of property with accurate location of all buildings, property lines, streets, and
unusual natural or topographic features.
2. Final approval of Health Dept. of water supply and sewerage disposal--iS-9 form or equal).
3. Approval of electrical installation from Board of Fire Uhderwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and
installations, a certificate of Code compliance from th~ 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 rUSeS, 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, ;OCcupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildihgs or premises, or other pertinent in-
formation required to prepare a certificate.
C. Fees: 1. Certificate of occupancy $§.00
2. Certificate of occupancy on pre-existing dwelling or land use $5.00
3. Copy of certificate of occupancy $1.00
Date .
New Bqilding Addition /' , Old o e- isting BU' di g ............... Vacant Land ..............
............................... r Pr ex ii n .
Property .../g//~: ,.... ~...~.~ 7...:,......~...~.~..~,.. ~x~.~'. ........
Location
Of
Owner Or Owners Of Property ....... ~.C/.-' -- ~~.~...~~ ................................................ / .....~...
Subdivision .~:i~..,.~.,....,.~,,~,q~,_~,,,..Lot No./,.~'.,'~"~..,/~lock No...~.... H~ouse No.~,.,~..'-,~,
Permit No. ~,~,..~,,~,.~, Date Of Permit ,~,,~,?/~,,~,,Applicant ~.~:~..
Health Dep,. Approval ....... ~..,/,~ ...................... Labor Dep .~"Appraval ..._.~../..~,...: ..........................
Underwriters ApprovalS,...~,./....~.~...~../...~.,.-~... ........ Planning BOO'rd Approval ..~..../../~,~ ....................
Request For Temporary Certificate ........................................ Final Certificate
Fee Submitted $ --~' ~
Construction on above described building ar(_d~:~r.mlt meets all
Sworn to before me this
..... day of ........
Notary Public ..... .~y:.,. County
(stamp or seal)