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Home My WebLink About7757-zBUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 7757 Z Permission is hereby granted to: Pa ~.-~ ~c..&..~a~.~e ..~e~'l ~ ............................. ....... i~ea%-he1~ ...................................................... ........................................................... l~'""- to. ~Uil~ ,.n. ew p. rivat.q ......... ,~.¢~.¢t~O.e....~ ~,~.;1.xt ~...6.!...+_...~.g.~ ........................................................................................ at premises located at .~../..~....,~...~.g~.O...~..~.....~..O...~..~.. ......................... ~ ......................................................... ............................................. E.o..u..e..~.o. ~t.....~ .,.~. :. ................................................................................. pursuant to application dated ................... ~'.~.~ ....... .~.~. ............ , 19~.~. .... and approved by the Building inspector. 1~.00 fene ~u~ Fee ~,~Z~.~,,~.~ FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCOUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ to the Building Inspec- tor with the following; for new buildings or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic featu res. 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pm-existing" land uses: 1. Accurate survey of pzbperty 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 $25. O0 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of occupancy on pre-existing dwelling $ 50. O0 3. Copy of certificate of occupancy $ 5 00, over 5 years · $ i0.00 __ 4.Vacant Land C.C. $ 20.00 /(.~..~.--/. - I-Z 5.Updated C.O. $ 50.00 Date .. NewCOns t~uction....~/.. Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .~.~..~) .~ .... ~(~.~. -~. · 4).~/..:-~).. ~"~.~ .................... -.-~'O Owner or Owners of Property .... ~ · -.'. ~.~i,v~./~-~. · · . ................ County Tax Map No. 1000 Section .?./. Block ¢ Lot...~...'~. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No..7.'~¢~.'~.. Date of Permit .Applicant ..... ~/~./ /f...~.¢f.z¢../.~/! ....... Health Dept. Approval Labor Oept Approval Underwriters Approval .... .~..-~.~'~/. .......... Planning Board Approval ...................... Request for Temporary Certificate ..................... F inaJ Certificate ....................... Fee Submitted $ .... .~..~.~'/ .................... Construction on above described building and..p, erm~ _m~_eets ~.ll applicable codes and regulations. TO~N OF $OUTHOLD Building Department Town C:lerks Office Southold, H. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPAHC:Y 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 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 electricOl 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 os 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 3. Copy of certificate of occupancy $1.00 $5.00 Date .................................. New Building ...... ....~.... ...... Old or P.x~.%existing Building ............................ Vacant Land .............. .~.. ........... Lo a,,on of Pr erty ....... ...... ..... Owner Or ~ners Of ,rope,y .~<~..~...~:..~"'~ .............................................. Subdivision ........Z: ........ '..' .......................................... Lot No.~ ..... Block No.= ........ House Permit No.Z.Z~:ZZ. Dote Of Permit ~.~Z~ZApplicon, ..~Z~.~:..~ ................. Health Dept. Approval ....... ~/~ ..................... Labor Dept. Approval ..... ~:....~. ................. , ...................................... ..... ..................... Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building an~ me~ets~ll~appI.icable/~/..' ~ /~ ---' codes and regulations. Ap pi ica nt'i~......, t....~...~....~.q .~C ..~t~ .~...C~:~ ..................................................... Sworn to before me this ................ day of ............................................ (stamp or seal) Notary Public .................................... County OUNDATIO.U ( 1 s t) OUNDATION { 2nd) OUGH FRAME & PLUMBING i:~SULATION PER N. Y. STATE ENERGY CODE U FI,,AL ADDITIONAL COMME~TS: S.3Z"e, 4 0©" :2, ~ 'n' .