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HomeMy WebLinkAbout7963-z FO~M NO. ~ TO~'~ N 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? 7963 Z Permission is hereby granted to: .C~13~..Ctoz~z~r.~c.t~u~z~.Cozp.....A/.C..]~ez~t & J~tith Bo~.~a ............. ~.m~tk~t~. ............................................ to ...~.1~,i 2...n~W...Q~.. ~.~m;L l~....~.g.l 1.$.~. g .................................................... : ............................ at premises located at ...l~.~..~;~]=~..~-3~f~ ......................................................................................... ................................................... P~c~.e ..... ~,~.~t~ .............................................................................. pursuant to application dated ..........................]~r ....... 3.0. ............ 19..~.., and approved by the Building Inspector. Fee $..:[~:. ....... Buildi~ FOIkM NO. 6 TOWN OF SOUTHOLD , Building Department Town Clerks Office $outhold, N. Y. 11971 AFPLIGATION FOR CERTIFICATE OF OCCUPANCY Instructions ^. This application must be filled ~n typewriter OR ink, 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 buddings, Industrial buddings, 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 ~.~. Rte ................................... New Building .... i.~.. ...... Addition ................ Old or Pre-existing Bui~ing ................ ~XJvacant hand .............. location Of Property ..... J~... ........ . .~...~....~.....(~... ............. ~..'~.....?..~.~.~ ........................ Subdivision ......... ~ ................................................ Lot No .....~.. Block No..,.,~,.. .....House No.J..ff....9./~ Permit No. Z,,~,,.~.,,~.. ..... Dote Of Permit .....~.'~..~,~ppplicant ..... 8~.,~,.~...~,~,.C~t~, ............ Health Dept. Approval ~/J..~/Z,~.....~. ..................... Labor Dept. Approval ............. ~..:..I.~.;~. ................... Underwriters Approval .~.////...Z~.'...,.. ...................... Planning Board Approva ..... ................. Request For Temporary Certificate ........................................ Find Certificate Fee Submitted $ ..~...~ ..................... Construction on above described building and pe~, it meets qJl apEI,cable.~codes ancjL, r~gulations. Applicant ............ ~ .......... ,...~ .......................... Chief of General Engineering I---I £N LIVING ROOM FAM JLY' ROOM / KITCHEN DINING gOON I3£D~00~, =FLtLL TFIIQK ," - 23KASPHALT ' P1 IIJL LANE' ELEVATION -HL- .................. L ....................... LINE FLOOR 'L~NE lq E~' ~ O~>~' ~_T ~.?,.q BtLCO DOOR