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Home My WebLink About9255-zNo Z17755 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date FEB. 14f 1989 ADDITION THIS CERTIFIES that the building Location of Propert~ 280 HENRYS LANE House No. Street Hamlet County Tax Map No. 1000 Section 74 Block 02 Lot 35 Subdivision Filed Map No. 4181 Lot No. 34 PECONIC conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 19, 1977 pursuant to which Building Permit No. 9255Z dated MAY 20f 1977 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ADDITION ON EXISTING DWELLING (WIDEN GARAGE) The certificate is issued to JOHN & BARBARA BOKINA (owner, ~Y~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING SLIP 1/30/89 PLUMBERS CERTIFICATION DATED N/A ~uilding Inspector Rev. 1/81 ~ORM N~. 2 TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ........... : ........... ~¢~ut~:~....a,:~,.... : ................ .. ~ , ~, ~, ........ ~ ~; ..... ;~K%..ff3.:S.;.L.J.,..,~;?~ ~ ~. ,o ~z~ .~ ~aa~o~ o~ ~~ ~ozz~ ~ ..................... '~"7 :': ...................................................... ; ....... ' ........ : ...... ~ .............., ~ ' ~ :. ........................................ ~,..~..~,...,~_ ......~ ....... ~.. ................................... ' ' ,; ....... ~.., ............I .... an~ ,a mv~ by the ..... Fee salem .............. ~¢f'~ ..... FORM NO. 6 TOWN OF SOUTHOLD Bullding Department Town Hail Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor w~th 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 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses' 1. Accurate survey of peoperty 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 buddings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date ...... New Building ............. Old or Pre-existing Budding(X) . _. X . =/Vacant Land -. ........... Location of Property ~, .~0, ....... ~.C'. i)~ ~/i ~... 4r,~Z')~. ..... ' ....... .~ ~./.-~ ......... House No. ~ _ Stree~-'~ ~ Hamlet Owner or Owners of Property ..~..~t~,~-~ ~ ./~..~..~.~:~=_~../.'.~.?~' ./~..'./~.~ ................. County Tax Map No. 1000Section ...q/~.~ ...... Bo~ck' ...... ~ .... Lot ................ Subdivision ................................. Filed Map No. ~/..~/...Lot No..J..LT{. ........ Health Dept. Approval ........................ Labor Dept. ApproVal ......................... Underwriters Approval ........................ Planning Board Approval .................. Request for Temporary Certificate ..................... Final Certificate ....... .- ......... * Fee u mitted $ ..... Z ..... Construction on above described building and permit' meets all app~cable,~codas and regu lations. A~plicant .; .; ............................... z t TOWN OF SOUTHOLD [:ICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTItOLD, N.Y. 11971 To Whom This May Concern, TEL. 765-I 802 We are unable to complete your Certificate of Occupancy because .of the following reasons. /_/ An application for Certificate of Occupancy is not on file. //~_~ No Underwriters Certificate on file. The check is (~not on file. )~- OO /-/ No IIealth Dept. Approval on file. /~ No final inspection has been made. Pluasc contact our office on this matter. Thank you for your cooperation. Building Permit ~t O' ~ ~ ~ '~ Z Building Dept. ***/~/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) OCCUFANCY OR USE IS UNLAWFUL WITIlOUT A CERTIFICATE OF OCCUPANCY. CLEAR UP THIS MATTER AS SOON AS POSSIBLE SO THAT LEGAL ACTION DOES NOT HAVE TO BE TAKEN. Thank you. Bo FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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 buddings, 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 installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Piannmg Boare approval of completed site plan requirements where applmable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty 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 informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $6,00 New Building ............. Old or Pre-existing Building(X) . _..~- ..... =/Vacant Land '. ........... Location of Property 2. C ..... ¢.. .......... ...... ........ Hou~ ~o, Stree~ Ham/et Owner or Owners of Proper~ . ~.~ . . ~ . . ................... County Tax Map No. 1000 Section ............... Block .. ~ .......... Lot ................ Subdivis,on ................................. Filed Map No...~./~.4..Lot No .... ~.~ ..... , Health Dept. App~owl ........................ Lsbo~ Dept. Approwl ...................... ,.. Underwriters Approval ........................ Planning Board Approval .................. Request for Temporary Certificate ..................... Final Certificate ........ - ......... Fee Submitted $ ............................. Construction on above described building and permit~me~s all app~cable..g, odes and regulations. Rev. 10-10-78 ~3 r E T~qF_£-JFFOLP'~ODUNTY CLE[2j~'¢ OFFI_C~.. · ~80.00 MAP OF PP..OPEP._TY 5U~VEYEJ) FOP~ PEF_OftlC TOWN O~ SOUTHOLD IN,Y,