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Home My WebLink About7982-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No ....~9 .q.'l.6 ..... Date ..... J..a~.u.a..x?..~. ................ 19~.0.. THIS C~TIFIES that the building ............................................... ~.~.0 LorJg C~'eek I~tve Southold~ N.Y. Location of Property h3g~se'No: ................... 'S't/ebi ...................... County Tax Map No. 1000 Section .... 55. ..... Block ..... .6. ....... Lot ...... .6. ......... Subdivision .... ¥.e~rlOgO.~/q .t?.a?.~ .......... Filed Map No...5..'1.8.7..Lot No....~.~. ........ conforms substantially to the Application for Building Permit heretofore fffled in tkis office dated ..... ff.g~. ~ ......... , 19.7.~ pursuant to winch Building Permit No..79.8.~.Z...&..6..8/77.Z ..... dated .. fftme. 5 .................. 19.75, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for wl~ch ttus certificate is issued is ......... ......... ~e.~..~.ehe:e...~..o...c.a?..g.a?.a. ge...a.n.a., ?oo~., .She. a. .......................... The certificate is issued to ......... R. 9.b.e.~.t...L....B..oL~e. zT. ................................ fowne~~ of the aforesaid building. Suffolk County Department of Health Approva~ ........... .N~.. ........................... UNDERWRITERS CERTIFICATE NO ................... ~1'].1~ ........................... Building Inspector Rev 4/79 FO]P,~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CI.ERK'S OFFIGE SOUTHOLD, N. Y. BUILDI~NG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7982 Z Date ........................ ~e ........ t~ ............ , 19...~z.~ Permission is hereby granted to: ........... ¥~O.h erJ;..~...C~ol ...... ~B~gac ............. .................... ..~t~.].& ...................................... to ...~.ttJ,~.~..na'~,~...pr±~ra~..g~.~ge...~,,;/...c:.o~..r. tm..~.tc .......................................................... at premises located at ..~L~,,..~t~ ....... .~a~q~/;,tt..~.8.t~4 ................................................................. ..................................................... il;or~§..¢~-ok...~,..d.... ~.~b.5.~..~...Rd. .......8~ed~ .................. pursuant to ~pplication dated ...................... gllr4o .... .~ ................ , 19..~.[.., and ~pproved by the Building Inspector. Fee $..1 ~ ,.(~K) ........... FORM NO. 6 TOWN OF SOUTHOLD Bu ildi ng Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CFRTIFICATE OF OCCUPANCY Ir~structions 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 topographm 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 compleled 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 3roperty lines, streets, buildings and unusua~ 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 inspeclion of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dw,~lling or land use $5.00 3. Copy of certificate of occupancy $1.00 ,~,:,.~/ ~~ ~ ~ ~ ...... ~ _ .. ................ New Building ...... ~ ....... Old or Pr?exi~tin~ Buildino ~ ....... :./. Vacant Land ............. Location of Proper~ ............. ~ ./. ................................................ Hou~ No. / ~ , ~ Str~ ~ Hamlet Owner or Ownerso, ProperW ...~~ .~:./~: ........................ County Tax Ma~ No. 1000 Section ~ .............. Block ............... Lot ................ s,~,~,,,o,..~ ~/~?~.. ~ ...... : .~,,~ ~ ~o.. ~::: ~..~o~ ~o...~ ....... Peri~ .. Date of Permit .-:....- .... Applicant..~--~¢~~. ;; ....... Healt~~proval .... =~ ............. Labor Dept. Approval . .~. ................. Unde~riters Approval ........................ Planning Board Approval ...................... Reque~ for Tempora~ Ce~ificate ..................... Final Certificam ....................... Fee Submitted $. ~ .................... Con,ruction on above described budding and pe~ ~eets all app~icab~ codes and regulations. A,,,,...,... ................... Rev, 10-10-78