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HomeMy WebLinkAbout8333-zTOWN 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? 8333 Z Date ............................ ]~2 ............ 9 ...... , 19..~..~.. Permission is hereby granted to: premises lo~ot~] ot ..~.t..3~ ~Ltt~.~.. ~0~* ...................... , ................... :. ....................... ~ .Tmt~ ~ .~o~ .-~ .... ;..:.~ .................. ~ .... .. ......... :_.~_,~ ................................................ ........ ~ ............ ~ .................................................................................................................. , ..................... ~ ="~ " ' -- . .... ~aO.--.;--~ ............. 19~..., and approved by the ~&~p~r~gnt ~6 ~pphc~hon d~ted .' .................. Buildin~ I~pecfor "(" - '' uiding I FOl~ NO. $ TOWN OF SOUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewnter OR ~nk, 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 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 a certificate. C. Fees: 1. 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 New BHilding ................ Addition ....,,~ ...... Old or Pre-existing Building ................ Vacant Land .............. Subdivision ................................................................ Lot No. ............ Block No ............. House No ............. Health Dept. Approval ..... ~./~. ........................... Labor Dept. Approval .............. ~../Z~. ...................... Request For Temporary~r..~ ]Certificate .......... ~ .................. Fincd Certificate ......~ ..................... Construction on above described building and permit meets all applicable codes and regulations. Applicant .. d~...~/.~...~.. ...... ~ ......... ~ ........................ Sworn to before me this .... o, Notary Public ............ ~/~.., County THE NEW YORK BOARD OF FIRE UNDERWRITERS d I BUREAU OF ELECTRICITY I 85 JOHN STREET. NEW YORK, NEW YORK 10038 l,a,e Aprll 6, 1976 Appl,ca,,on~'o. on/,te 837265 N 277483 THIS CERTIFIES THAT only the electrical e~lnipment as described below and introduced by the applicant named on the above applicatton number in the premises of Thomas Longnecker, Vanston Road Nassau Point cor. of Vanston Road & S~nset Roa~L~ Cutchogue, L,I. .,the/o:lowi,,~lo~atlon; L_] Sa~e,.ent k3 ;~'FI. [] ~,~d Fl. outs i de Section ~l~ ro~ 326 u~s~exam~nedon Apri I 5,1976 and found to be ln compl~ance w~th the requlrentents of this Baard. 6 I0 7 6 ) t I17.0 I I 5'0/ -! I.SJ I IF DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'PT TIME CLOCKS BELL JUNIT HEATERS i MULTI-OUTLET J DIMMERS OTHER APPARATUS ThomasHLongnecker Vanston Rd.(Nassau Point)Box 269 Cutchogue. L.,. ,,g35 GEN,RA£M,I~i~ This cerhflcate must not be altered in any manner, relurn to the ofhce of the Board if incorrect Inspectors may be tdenflhed by ~e)Fcredentlals