The URL can be used to link to this page

Home My WebLink About8985-zTOWN OF $OUTHOLD Building Department Town Ha~l Southold, N.Y. 11971 i TO~,';i ' 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY hlstructions A. This application must be filled in typewriter OR ink, and submitted m ~ to the Building ~nspec- 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- tians, 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 iprior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~'operty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of ownor or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings ar premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of oc_cupancy $5.00 2, Cartificate of occupancv on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 .Vacant Land C.O. $5.00 .Updated C.O. $15.00 Date .......................... NewC°net~ucti°n ...... Old or Pre-existing Building ............ Vacant Lan~ ............ Owner or Owners of Property . ./~.~ .~/. ~. ~ ~'Z..~ .'/~ ~ ~ ~{¢~ ............ ' County Tax Map No. 1000Sect'on. & 2 .................. 7 ........ ....... ...... Subdivision..~.~.0.%~ .(~ ?.~,/.../...Filed Map No.:. , ....... Lot NC .~.. ..... Health Dept. Approval ........................ Labor Dept, Approval ....................... Underwriters Approval ........................ Planning Board Approval ..................... Reqnest for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building an, d/pefmR meets al~'~;pff-~ibfe-codes and regulations. Applicant ,. k,.. .............. Rev. ~0-10-78 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 topograph ic featu res. 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. 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 '- ~c 'z ~ .~r:~ Date . .~ ...... -~ ..... : ........ New Building ............. Old or Pre~existing Building ............ Vacant Land ...~,,~ ....... Location of Property .. ~C2 ~- .... ,~.?./~-~--.~l../~..q~.z?. Z ~- ,~d~//</L/' · House No, Street Hamlet Owner or Owners of Property ..... ~ . . ~ .4. C-.~(~ .... ~ ............................. County Tax Map No. 1000 Section .44Z~ Block r2 ~ .... Lot Subdivision ...~-~4~)~'.~ ~d~': ..... Filed Map No ........... Lot No. . . ....... (. ..... Health Dept. Approval . ~,.. ~ ~ .............. Labor Dept Approval :.: :./,::: ........ . ............. Request for Temporary Certificate ..................... Final Certificate .,. ~': ................ Fee Submitted $ :. 7::': .................... Construction on above described building and ~,~mit mee,,ts~all applicable c/o)des and regulations. Applicant . . .z.. --,. :/.,.. ,-.....~/¢~c, ............ ,,, ..... FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Ot~ice Southold, N. Y. TEMPOP, ARY Certificate Of Occupancy No. Z7606 Date April 61+ 19 THIS CERTIFIES that the building located at ....Se.wa. 9p.d..D¥.iy.o. ......... Street Map No.S.e,,aWQP.d..A..~. Block No ........... Lot No, .~..~ .... ~. 9.u.~.h..°.1.d, ................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ ~¥., .~.., 197~. pursuant to which Building Permit No. dated .......... ~?.v...~? ..... , 1ff6..., 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 ~?.~.y.a?.~. ?~ .f..a.~.~.~y.. ~?;.~.~.~.n.g ........................................ The certificate is issued to . !4~.]:.I..a~.~...Cg.n.t..r.a~.t.~..n.g' .I.n.q ..... ~Le?. ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval &P.~..~. ~...].??~...b.¥..R.,...V.~.~..a ...... UNDERWRITERS CERTIFICATE No... ~337 .].~?. ..... ~.a..~...3.O.,, .]?.7? ............. HOUSE NUMBER ·..~..t) ~ ..... Street . .~.~..a.w.o.o.d...D~i.v..e ...... .S.o.u..~.h.o.l.d. ......... Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y., Certificate Of Occupancy No .... 7.'lDO..A3 ....... Date .... THIS CERTIFIES that the building ................................................ Location of Property 505 So~I~'OOCl DriYe.~ Street SOu~chold, Iq.Y. County Tax Map No. 1000 Section ....0.7.9. ..... Block ...... 0,7. ....... Lot 067 Subdivision.. $.e.a. vfOOfl../~9I.-..e~. ............. Filed Map No. *0..57.5 .... Lot No...~8. ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated November 8 197.~. pursuant to which Building Permit No. 8985 7 dated November 29 19 76, was issued, and conforms to alt of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Pr~¥ate One-F~milX Dwellin~ The certificate is issued to Joan Richter ..................... ?o¥.'o',', ~dd~ .................... of the aforesaid building. Suffolk County Department of Health Approval 6-S0-206 l[/12/77 Robert ), Villa UNDERWRITERS CERTIFICATE NO.. N '~31159 / f . /i,/." Rev 4/79 , ,:; ~. ~HE~ NEW; :YORK, BOARD only the e~tr~al equ,pment ~ ~scribed belo~ and introdhcbd b~ ~ ~ , Egwar~ E. Williams~.Co'ntr.,~S~aw~o? 76~ 3OOO -facilities