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Home My WebLink About9189-zI~IZM N~. 4 TOWN OF SOETHOLD BUrLrtlNG DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..~8009 ..... Date .......... Nav...t.6 ........ ,1g.7.7.. THIS CERTIFIES that the building located at . .Soundvl~.:~ .Aye. .......... Street Map No...~ ........ Block No. ~X .... Lot No, . .-'~ ..... .~.o.u.%..h.o.~.d....N.o.Y. ? ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... agr. ~8, 19.7.~. pursuant to which Building Permit No..9.~.8.9Z. dated ....... April...1.8. , I9.~.~.., was issued, and conforms to an of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . P.~iva. te s~Inuuin5 .poal .~Ji.tk ~enca &, accesaQrys ................. The certificate is issued to .. ~fehard Me.lehione ........ Owner .................. (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval ~1.,?,, .......................... UNDERWRITERS CERTIFICATE No...N.36.2?~R ...... ~.~.o.v...2.,. J.9.?? .............. HOUSE NUMBER .... 1~+~.~0 Street . 'Sound' 'Vie%r 'Ave ..... Sbti%li6Td ......... Building InspectOr l~O~.V,~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 9189 Z Permission is hereby granted to: ............... ~.~:~,.e.~.~ ....... .~.~. :. Z :. ............................ ~n~tall orivate sw!~,ing pool with fence & ~,~j ~ - 6t~.p~mise~. . l~at~ at ..... ~.~...~.~2..~ ..................................................................................... - :..~.,.~:...,~ .................................. ~~ ...... ~.~ ......................................................................... d.ted ...:....~%. ................... ~.....~8., 1~'.~.~.., ond ~ppr~ved by the FORM NO. 6 TOWN OF SOUTHOLD , Building Deportment Town Clerks Office 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 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 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 ]957), Non-conforming uses, or buildings and "pre-existing" land uses: ]. 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 New B~tilding ...~,../~.../.../~...~i~'r~....~,~.~..,J~ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ...,~..~...~.~.,,~...~/ ....... .~../....~...~....~..~....~. ......... . .,,~'...~...../~....~..~...~...~...~.. ..... ~..~ .~.,. Owner Or Owners Of Property ..,~./...~.~.~.,~..,/~ ....... ,/~..~.,,~..~-..~.../..~..~...~ ...................... Subdivision ................................................................ Lot No ............. Bl.~k N~ ........... House No ............. Permit No f~..~..... Date Of Permit .~./../..~,./.~/Applicant ..... Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval~ ...................................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ FinaJ Certificate .......... ~ ...................... Fee Submitted $ .~....~ ................. Construction on above described building and permit meets all applicable ~.odes and regulations. Sworn to before me this ......... /.~.. day of"-'~L-~//g/{'~/.:.~...Z.:...;~,..Co (stamp or Notary Public ..... ...~. ~..~.//.~. ~.~ ..... ty -J \ DA ~ .... ... ,~ · · - ~,.o4,~ ' inSpeCtou ~ -' ~,n ow~ ~a%isfactOr~ n ~, / / Service~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~L[ BUREAU OF ELECTRICITY 85 JOHN STREEET, NEW YORK. NEW YORK 10038 THIS CERTIFIES THAT chis t he ele~ t rtcaI equ,prnen! as described bel~ and introduced by the applicant ~med on the above appltcation number in the premises of ~ck Me%eh~one~ Sound VSew Ave.~ s/s~de e/o ~o~ton L~ne~ ,~outho ~d~ r-~.!. FtXTbRi ~ ~ FIXTURES ~ RANGES ~CKS~ OVENS ~~ ~ST FANS RECEPTACLES SWITCHES ~ ..... SYSTEMS OTHER APPARATUS (~w~mmin~ Pooh) This certificate covers compliance at the date of insnection only. Because of unusual environments it is advisable to have freouent test and/or repairs made by a qualified person. ~ox 2~ 5 ooutho3, d, L.I. !.19?i LiO.578E ~ Th,s cert~f,cate must not be obered m any manner, return '0 the officem of ,ho Boord If ifCOF[~C' Inspectors may be. ,dentmfmed~~