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Home My WebLink About6446-z FOI~i~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N'. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE Pi~EMISES UNTIL t:ULL CQMPLETION OF THE WORK AUTHORIZED) N? Z D~te ......................................................... 19 ........ Permission is hereby granted to: : Donald D~nnis A/C Cheste~ ~a~er 8~ Mead~ Lane Eiverhead build new private swirling pool ~ith pool house & fence Private Road # b~t MUr~n ~ ( north at premises located at ...................................................................... : ..................................................... Orient N.Y. ~ Ma eh 27 73 pursuaut to opplication dated ...................................................... J., ]g ........, and approved by the Building Inspector. Fee $ TOWN OF SOUTHOLD Building Department Town Clerks Office $outhold, N. Y. 11971 APPLICATION FOR CERTIFICATE O.F OCCUPANCY Insi'ructions 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 use: 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--(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 installations, a certificate of Code compliance from tb, e Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plah 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, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of build!ngs or premises, or other pertinent in- formation required to prepare o certificate. C. Fees: I. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $,5.00 3. Copy of certificate of occupancy $1.00 ~ . . & Pool New t~u amg ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ............. Owner Or Owners Of Property ...q,~,.e,..s.~,e,.?,....~,,~.~,9,z',. .................... ................................................................ Subdivision .................. .~....~.. ....................................... Lot No.......~..... Block No.._~c.~...... House No....!!.O.~.~ Permit No...~...~....6.~. ....... Date Of Permit ~./.,.2.c~../.~..,~...Applicant ..~.9~.l..~....D..e..~..~.J-...s. .................................. Health Dept. Approval ..... .~..:..~..? .............................. Labor Dept. Approval .....~...'..~..P. .................................. Underwriters Approval ~'.!..2.?...~..~...2. ....... ?..1./.1..~../.~.~....Planning Bo~rd Approval ..~..:.~.~. ............................. Request For Temporary Certificate ........................................ Finc(I Certificate ~.00 ....... r~od, e~s n Fee Submitted $ Construction on above described building and perrr~t meets all ~pplicg151e d regulations· Apphcant ................................................. Sworn to before me this ...... !.? ...... dayof ........ at P Ii , ~ v F~ Nary ub c ...................... ~ ......... County (stamp or seal)