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Home My WebLink About8923-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF ocCUpANCY No Z-23793 Date JULY 25, 1995 THIS CERTIFIES that the building. ACCEBBORY Location of Property 1280 BAYBERRY ROAD House No. Street County Tax Map No. 1000 Section 118 Block 2 Subdivision Filed Map No. CUTCHOGUE, N.Y. Hamlet Lot 10 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 18, 1976 pursuant to which Building Permit No. 8923-Z dated OCTOBER 18, 1976 was iseued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ACCESSORY INGROUND SWIMMING POOLWITH ATTA~D D~CK & FEN~ ENCLOSURE AS PER ZHAAPPEAL %2339 DATED 10/13/1977, The certificate is issued to of the aforesaid building. ANNE A. & WILLIAM J. FLEMING (owner, lessee or tenant) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-334754 - APRIL 27, 1977 PLUMBERS CERTIFICATION DATED N/A *THIS UPDATES CO Z-t0154 DATED SEPTEM~ER 22, 1980. ~ // Bui~ing InspeCtor - Rev. 1/81 8923 Permission is hereby granted to: Built~ new p. rivate swlmmzng p. ool ,With~.ence ~ accessorYs at premises ~ocafed at .~..La~,..~.~.9.~-~.amm~md.... N~ss...P.t...... ............... ~.~..~...,~-~.... ................... ,.. ~ ~. Ba~berr~ Road E~ ~a~ . 2~ ~.~b~g~ · }., }'pumuant to cation ~ ~'~' FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No ....Z..101.5/* ...... Date .... THIS CERTIFIES that the building ................................................ Location of Property .... House No. County Tax Map No. 1000 Section ... ~..1 ~. ..... Block .... 02 ......... Lot . .0.10 ............ Subdivision. ~g~.~¢~ .17~..(j ,lg~..t?:cOp .... Filed Map No..~.~9 .... Lot No...'1 .lg. ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ·. 0c.~Obel~ .'~ ....... ,19 '7~ pursuant to which Building Permit No...892,~ .g ............ dated ... Oc:~,o~e'z% .'I~, ~ ............ 19.5[.~, 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 ......... ....... g ec.essor~¢ · Tng.~o~md..Sw£mm~-zag..£~oo3. ................................... The certificate is issued to ..... . .J~..~...A....~.'~. ?.l/l.:[.~. g .................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .... lX.I/.R ................................... UNDERWRITERS CERTIFICATE NO ............ *~. ~./4.~.5./4 ........... ~. ................. f") I / ......... 7' ' 'l~ii~i~'I~;c't;; ............. Rev 4/79 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall 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 Inspec- tor 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 installa- tions, 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty 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 informa- tion required to prepare a 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 $5.0O Date... ~.//..{./Y~) ........... New Building ...~/ ......... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ................ ~ ......... ~ House No. Street ..... -- Ha~nlet Owner or Owners of Property . .~..~.('/~..f'.~..,~.. ........... ~../../~.. ..................... County Tax MapNo. 1000 Section ..(ff.~ ........ Block ....~ ....... Lot..~/~ .......... Subdivision .,~*~, ~.(~. '..Filed Map No ........... Lot No.. ............ .... Permit No.~¢4~... Date of..~'t/~h4. Health Dept. Approval .... ~./~ ............. LaborDept. Approval ..~/~............... Unde~riters Approval .~ ...................... Planning Board Approval ..................... Request for Temporary Certificate ..................... Final Certificate .... .~ ................ Fee Submitted $ .~ .~i ..................... Construction on above described building and p/elm/it meets, all,ap.~,ljcable codes and regulations. · . .... ....... :. ...................... Rev, 10-10-7a ?/ Receipt f'#~7639 9122180 cio #z 154 Check # 1109