The URL can be used to link to this page

Home My WebLink About8864-zFO~,,M NO. 4 TOW~N OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, BI. Y. Certificnte Of Occupnncy No...Z?.8.71 .... Date ............ aept .... 6 ...... ,19.7.7. THIS CERTIFIES that the building located at . H~Lglz~oed..Road- .......... Street Map No. t~Lghwoc~d.. Block No...:z~ ... Lot No. 2.. ~5.... $o.utho]__~_.. N.,.Y, ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... Sept. · .~ ~ 19. ?6. pursuant to which Building Permit No..886.1+z. dated ...... Sep.t .16 .... , 19.7~, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . P~':tva~;a .one. £a~lZ.y .dwelling ...................................... The certificate is issued tol~:~-~Lw.c~Od ~c~me~ .Ltd ..... 0wnel, ....................... (owner, lessee or tenant) oi the aforesaid building. Suffolk County Department of Health Approval ...Allg .. 25;...19F.7... by,R,. ¥~_~La .... UNDERWRITERS CERTIFICATE No, 1~3.~227... F~ay..~,2....~ .~.7 .................. HOUSE BIUMBER . .. .~.~... Street .. B:~gh~oocl. Ro~d ...... ~outk~e.lc~ ........ .... I~TE~...K[~;ahe~. ~.eor..to. he .~[n~.l[Led..by. o~rner. ..................... Building Inspector ~ FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMEHT TOWN CLERK'S OFFICE SOUTHOLD, H. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COJ~PLETION OF THE WORK AUTHORIZED) N°. 8864 Z D~te ......................... "$e~; ........ ~6' ......... Permission is hereby granted to: M~ 11~o.c~ .~[ome~..Lt& ................... ....... · l~2.....~3~leans..:La ......... J~&cho.....l.l.753 TOWN OF $OUTHOLD Building Depa~tment Town Clerks Office So,thold, 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 use: 1. Final survey of property with accurate Iocahon of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage d~sposal--(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 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, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare o certificate, C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date .~.,~'.,~,.~ ...... New Building ......'~.. ............ Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ..... ..4~.~.~/~.. ..... ;~';'-~.~.b.~.',~.~,.~......~...~...~..'~ ..... ..~'.h~.~.~..4.~?.~....~....~. ................... Owner Or Owners Of Property ...... . .~.:.~J.t.~:.~..~.,.~G:~ ...... .~.~..,.~.. ~,,~.~..L..~;;~ ................................................... Subdivision -~.~.~.~.,~/~.~....~.~....~i...~..t4~.~ .~.....Lot No..(,~ ....... Block No ............. House No....~...-~..~ - Permit No..r~.~:~..~.Z~ Date Of Permit ~.//.~../.7.~.Applicant .................................................................. Health Dept. Approval ...~....;T~..~...?..!.~... ............. Lobar Dept. Approval ................................................ Underwriters Approval .... ~ ............. '~'~"~"'7 ........... Planning"~ '~' ' Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate Fee Submitted $ ~,..~'~.~ .................. Construction on above described building and_l;~rmit meets ~all appl!cabl? codes and regulations. C AppI cant ............ ~.~ ......................................................................... Sworn h ~efore me this ................~day of Notary Public (stamp or s~~ ~; / H , _ , ' ' ')': ';' ~ ~ '. , l, , ,, ,< 1,~ ,t~, THE NEW."YORK BOARD':OF ~:[~c '~ ~'~ ~ ' , ,_ , "~, :~h, LUREAU OF ELECTRICITY the ~l~trzcal equipment ~ descr,~d before ~d mt~duc~ by t~ appl.an[ ~d on t~ abo~ appl,catm, number in t~ premhes of [~Millwo0d Homes~ 'e/s Hickwood Rd., Southold,~'L. i. , ', , int~e/ollo~vmgl~tton~ij~ent ~ lstFt~ ~ 2nd Ft. Odtside RXTURE OUTLETS ' DRYERS · FIXTURES FLUORESCENr [25 ? ,, 29,, ~' 'UR.ACE ' TORS ' ' FUTURE APPLIANCE TIME CLO~KS SYSTEMS NO. OF DIMMERS FANS ~, Si~RV/CE DISCONNECT' 'c ~".~ f- ill HI ~l OWNS'R: ._,L. ,..,C,L., {mOME5, LTD. DEED: LQ'f' :,~ o 0 0 LOT' MAP OF LOT ~ OF ~l~i4~,,/0OC, AT Tow~4 o~' 5ou"rv, o,_o . N .Y. DATE: NO.: :~UFF. CO. DEPT. OF H IKAI..TH R~ODEI~CK V,-I~ TUYL. P. C. f.{C. L~ND SURVI N.Y. llrOR AIIPROVAL OF COHFf'IIU/..,'iiON ONLY ~rrAT~M ENT OF LOT ~ LOT ? SUleF. ¢0 H[.ALll'i D£PT. APPI~OVAL ~,~= IQ. IG 25 1971 s. ~. ~. :~-._r,~:/~]: 0 The sawage flt.-poseI and water supplF facilities for this location have been inspeo%ed by this department ~d found ':~~eral Engineer in. G'""3 $ , CO. DEPT. OF HF..AL.T]4 ~dllVl,~ll~ OATI:: H. S. REF. NO,: APPROVIE~: