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Home My WebLink About7804-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17649 Date Decer~ber 29~ 1988 THIS CERTIFIES that the building Location of Property 210 MTILLWATER AVE. House No. County Tax Map No. 1000 Section 103 Subdivision ACCESSORY CUTCHOGUE, NEW YORK Street Block 7 Lot Filed Map No. Lot No. Hamlet 1 conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 8, 1975 pursuant to which Building Permit No. 7804-Z dated APRIL 8~ 1975 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 ACCESSORY SHED The certificate is issued to of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 MARK WILCENSKI (owner, N/a Building Inspector FORM NO. 2 TOWN 01: $OU?N0/D BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 7804 Z Permission is hereby granted to: .Maz'k..~gJ.~ceaskJ. ............................ ~ ................. · ..~to~og. ue ....................................................... to~.~ild..~e~..~.cc~ ss.~r~....tool..ato:~a~e ..hu/&&in$ .......................................................... et premises Iocoted et ~.~.0 .......~t~ll~a.te~...A.v~ ................~ .......................................................... ..................................................... .q.~;Ch~u.~.....~.,.Y., ....................................................................... pursuant to application dated .........................~,~..~.~. ....... ~ ........ , 19..~.~'., and approved by the Building Inspector. Fee $1..0..,~..0..0. ............. Building Inspirer FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY- Instructions A. This application must be filled in typewriter OR ink, and submitted i -- __ 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. B. For existing buildings (prior 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 topograph ic 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 requ ired to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 ]. Certificate of occupancy New Dwelling $25.00, Accessory ,$I0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ lO0.O0 3. CopY of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .../~-..-,~..';~.~..~.~.. ...... New Cons truct i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .~'../..4). ............. '.~, 7~.,://'..u~.~.~.~-. ~,~. ......... .~..~.~,. Hou~ No. Street Ham/et Owner or Owners of Property ~,~, J ~ ~,..¢~. (.d~,, . (, ¢ ..¢~.=,,/./,~ County Tax Sap No. 1000Section/.~.~,, ........ Block ..,7,,... Lot. ~ /. Subdivision ......................... Filed Map No ........ Lot No ....... Permit No.~.d.~ .~...Z~7. Date of Permit ./-~.-/.%2~..~..Applicant ................................ Health Dept. Approval ........................ Labor Dept. Approval ...................... Underwriters Approval ........................ Planning Board Approval .................... Request for Temporary Certificate Final ..................... Certificate .................... Fee Submitted $ ............................. Construction on above described building and permit meets all ap~icable codes and regulations. Applicant .'~'¢~.~ ..~..~.,,,~_~... ' · Rev. 10-10-7e