HomeMy WebLinkAbout9248-zFOILM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No..Z77¥.3 ..... Date ......... J..un,e..2.8 .........., 19..7.7.
THIS CERTIFIES that the building located at . D. el~a~..6. ~r~a ........... Street
Map No. Lau,¢ty....E~lock No ........ Lot No, 3~ ...... Laurel ..... I~ .Y ..........
conforms substantially to the Application for Building Permit heretofore fried in this office
dated ........ [,'-ay 16 , 19.??. pursuant to which Building Permit No.92?!~..Z...
dated ........ Lay.. ~6., 1977.., was issued, and conforms to ~11 of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is . .Pr;~vat~..~z~..f.~$!Y .d~:re.ll lng. ~r~,th. ackd i t ~.o.n ......................
The certificate is issued to I'Iel~ry..Cor~w. ell ..... Owner .........................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval L. ~:~; ..........................
UNDERWRITERS CERTIFICATE No. It ~ ~.t.. ......................................
HOUSE NUMBER ~+0~ . .. Street .. 3e~mar. ~ ..... Lau~.ol ..............
· .NOTE:. Ga~.age..f. irer. etar~i~g. 20 .be. b~ .owner. ..........................
Building Inspector
TOWH OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTH'OLD, N, Y.
hereby granted to: '
BUILDING PERMIT
Ci'HIS PERMIT MUS'i' BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Dote .......................... MII;~ ......... t6 ....... :, 19..~,
l~O~W NO. 6
TOWN OF SOUTHOLD
, Building Deportment
Town Clerks Office
Southold, N. Y. 11971
AFPLIGATION 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:
]. 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 farm 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 ]057), 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. Swam 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: ]. Certi{icate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use $5.00/3
3. Copy of certificate of occupancy $!.00
New B~lilding ................ Addition x×x Old or Pre-existing Building Vacant Land
Location Of Property I~Q.l:...,,3.Q...~J~.~..~.~...~.o.~.~.l~Y...~.~.G...t..e..s..~.....~....3L..m.~...~...~..~...~.e...~.~.~.
Owner Or Owners Of Property .H...e..n...z~.....C..o.~.w..e..~. .......................................................................................
Subdivision ................................................................ Lot No .....3..0. .... Block No ............. House No ............
Permit No .~.,~..~..8...~. ....... Date Of Permit .................... ~plicant ..]:..n..~...a:.~...~.....H..o..m,..e..s,.!....I...n..c..; .......................
Health Dept. Approval ............................................ Labor Dept. Approval ................................................
Underwriters Approval .............................................. Planmng Board Approval ~.es
Request For Temporary Certificate no Fin~ ~ertificate 3/es
Fee Submitted $ .5..'.9.0.. ..........................
Construction on above described building,a;_/?/permlt~-ne~/,.~,~,e;odey, n,L~nd regulations.
Applicant l~5~-<w~l,~,~~ ..................
.............
...... o,
NotQ~ Public .................................... Coun~ ~
~9.°° ~
T E LocATiON OF WELLS AND CESSPOOLS
$~0~¥N HE.qEIN ARE FROM FIELD OBSEEVATIONS
ANDIOR f'~OM DATA o~T~I?~D FROM OTHEES
NO r~ ,'
~ = MONUM~N T
SUBDIVISION MAP FI£~D IN ~-NF OFFIO~
OF THE CLERK OF SUFFOLK COUNTY ON
dUNE 22, 1970 A,~ FIL tZNO. 548~.
R~V,S,O.$ YOUNG & YOUNG ~
ALDEN W. YOUNG //~/.O,~'~ ~'-':~G '
SURVEY FOR. i~ ~~~_q~,'~ ~
0" .. ~ '~ ~' ~
LOT NO.. 3 , LAUREL COUNTRY.. ESTA~
GUARANTEED TO:
AT LAUR EL SECURITY TITLE ~ GUARANTY CO,
SOUTHOLD SAVINGS BANK
TOW~O~ SOUTHOLD
aY ~
co.,