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HomeMy WebLinkAbout9375-z(THIS PERMI~ MUST BE KEPT ON ~TI~IE PREMISES UNTIL FULL COMPLETION OF THE woRK AUTHORIZED) ~ N? 9375 Z Permission is hereby granted to: Lester Wallace ............... 31~s~..I~ton ...................................... to .~1~.~.c.~.~'A~`ia`~r~..~b.~..~.~..~i~.~.~...m~..i~..~.~...~..n..g ~ool with dg. qk~ feneing ~nd ~.~, . ..... East'~rion~ ~Y, pursuant to application dated .......................... :~..~...~.....~.~. ......... , 19.~..~..~., and approved by the Building Inspector. TOWN OF SOUT~OLD OFFICE OF BUILDING INSPECTOR ' P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 - Applicant Dear '~. [~J ¢~x%¢x_~ : This is to advise you that the job under Building Permit No. _~ ~-~%~ iss, ued to ~~~ a .... ' ~ ~m~c~ ~,~s completed and · zna~ ~nspection has~ has nos~ been dohe. In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form(s), return same to the above office with a check for $5.00 payable to the Town of Southold. Please indicate to whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspecgion date. Thank you for~.~your prompt attention. Very truly yours, Victor Lessard Administrator VL:ec Enclosures FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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 topographic features. 2. Final approval of Health Dept. of water suppty 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 peopert¥ 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 inspecti,on of buildings or premises~ or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupan(~., $5.00 2, Cer'ti~icate of occupancy oh~p?-existing dwelling or land use 3. Copy O~certificate of occupan~-~,, $1.00 New Building ...... Location of Property Owner or Owners of Property $5.00 ~ ~ '~,: Date ..... ~ ~ "~'~? ~ ,. · O)~d or P?~, ~xisting Building(X) ......... , 'Vacant Land ............. · "~ .... Str~t ...................... Hamlet County Tax Map No. 1000 Section Subd v s on ..... Permit No ........... Date of Permit Health Dept. Approval ........... ~ ..... Underwriters Approval ....................... Request for Temporary Certificate. t,,' · J. Block .. ;-,~. l Lot .... ;2.,.%: ........ · ~ Map No. 'i*'~ .'~.. ..... Lot No. ~'~J .Labor Dep roval ......................... )royal ' . ·Final Certificate ........ - ......... * Fee Submitted $ ' Lt ap~cable~codes and regulations. Construction on above described building and permit'ma~ts all Applicant .; .... ~.,.- ..... ..~ ........ ,./, .......................... , ..... Rev. 10-10-78