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Home My WebLink About9071-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No,Z76. 7.~ ....... Date JtU~e 2 19. THIS CERTIFIES that the building located at . .0.t~p~gy..~.e.~ .Rga~ ....... Street Map No. ~gVe~..P~ Block No .... ~ ......Lot No, . ~ .... ~0~...E,Y., ........ conforms substantially to the Application ~or Build~ng Permit heretofore filed in this office dated ............. l~r.. ~.., 19.~?. pursuant to which Building Permit No. dated gar 8 19 7~, was issued, and conforms to ~1 of the requff~ ments of the applicable provisions of the law. The occup~cy for which this certificate is issued is .. Pr.~va~o..~e..~. ~.3~lng. ~i~h. ~dd~l~n. &..A~t., ............. The certificate is issued to . .~.~e~ .q$~ ....... ~ ....................... (owner, lessee or ten,t) of the aforesaid 'building. Suffolk County Department of Health Approval N*.R~ ................................ UNDERWRITERS CERTIFICATE No...N3~8~7... ~r. 2~.. ]~77 ................ HOUSE NUMBER .. ,i. 8~ ........ Street .. Q~l~ZY. ~. B~ad ........ ~nrort... Building I~p~or TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, fl., Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9071 Z Permission is hereby granted to: 0 ~.~ 0..,..,,~.9.,b,,,o,g~ .s,.t,~ ~.,~..,,.& ./.g,.....~ Z.~.~..e.~h .. ge ye z- ...................... .~ ~...~.~.e..~. ...................................... at premises located at ..... .~...O..f,....~ .......... ~.]....e..a..¥..e..~..?...~. ......................................................................... ........................................... ..0.~t~.~..~... ~.~ ~..~...~f~.~d, .............. gxe~.~.t .......................................... pursuant to application dated ...................... ..~..~.......~ .................... 19.~..~..., and approved by the Building Inspector. Fee $..~ .~. n.0.Q ........... Building Inspector TOWN OF SOUTHOLD , Building Department Town C:lerks Office Southold, H. Y. 11971 APPLIGATION FOR GERTIFICATE OF OCCUPAHCY Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the fallowing; for new buildings or new use: I. Final survey of property with accurate location of oll buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal~(S-g 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 1957), 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. 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 formation required to prepare a certificate. C. Fees: ]. 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 BHilding ................ Addition ............... Old or Pre-existing Building ................ Vacant Land .............. Location Of Property Owner Or Owners Of Pro err ,~,l~3 ~--~ / ~ '~- ~?~...~...../~..' .C~-~ EY P Y ........................................................... ; ....... ,...~... ........ ~ .......................... Subdivision ............................ ................ .T: ............ Lot No.....~....... Block No ............. House No.... ......... Permit No...d./..('.?..Z./.:::.~... Date Of Permit~...~¢Z.Z..Applicont ~..~....?..?...~..~..~.....~../)...~'~...~.....~..~.../~.' ....... Health Dept. Approval .............. .~ ................... Lobar Dept. Approval ................................................ Underwriters A royal Y Plannin Board A ro al pp .............................................. g pp v ........................................ Request For Temporary Certificate ........................................ Final Certificate Fee Submitted $ .....~........~ ...................... Construction on above described building and permit meets all Opplicable codes and regulations. Sworn to before m~is ........... day ...... Notary Public ~~',- County (stamp or seal) /0 ~ .j{~l~ I fl 'THE:NEW YORK BOARD Of FIRE UNDERWRITERS ' ' ' i3UREAU OF ELECTRICITY i' ' ; , ',, , ; ' NEW YoRK 10038 ~ ~ . I ~' [..~ j ..; I I 85 JOHN STREET, NEWYorK, , D,,t~ ZMay. 24,-1977 ~ , ,' APPllcati°'~ ~'°' °"J'il~ 909259 ' - N8977 only the electrical, equipment ~ described below and introduced by the applicant named on the above application number ~ the premises Ge'y Greeapor't ~ ElizaSeth er,~Osp=eyNest Rd. ~ L.I.~ .~ ~ in the following locatioh; :, ~ ~ B~e~e~t -~' ]st Fh ~ 2nd Fl.. , '' I ~ Section ~ . ' ' ~, ~ ,l arid found to b~ i'n c'omplianc; wi~h the ;~quirements of this Board ~,~e~.,~ .~do. ~'~8 1977' ~: D.YE.S I.NACE' MOTORS RE APPLIANCE F~EDERS TIME C[OC[S UNIT .~ATE.S MULTi-OUTLET DIMMERS SERVICE DISCONNECT Paul R; Bur~s - Tow~ 'Harbor Lane Southold, L.I. 11971 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified their credentials. CD 16'4" 35° :reit. 22' .r- j PLAN ~[an. ~j I~TZ