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Home My WebLink About9081-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9081 Z Date ....................... .~.4..a..r. .......... Permission is hereby granted to: A~l~h~ ~d..~Q~.....~Zg...~..~..~9~°¢hY Mealy Mattituck ~att~ tuck pursuant to application dated ................... .~..,,~......~..0.. ................ , 19....~,~.., and approved by the Building Inspector. Fee $. ~.0.....~..0. ........... Building Inspector FOl~b~ NO. 6 TOWN OF $OUTNOLD , Building Depo~tment 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: ]. Final survey of property with accurate location of all buildings, property lines, streets, end 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 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 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~ilding ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ~ ~ '~ ~ ~J~l,~) J~Vi~ J~.~-'~'VT,/c-JC. Owner Or ~ners Of Prope.y .......... ~.h ....... i ........ ~ .......................................................... Subdivision~ ¢~ ~,~-~ i~ ~ ~,~'~lc_~_;.....~.;.~,.~.)~j,,)~...~..;.:...~,__.. ........... Bilk No ............. House No ............. Permit No-0 .. Date Of Perm,t ..,.,...., .......... Appl cant ........................................................ H..~h O.p~. *~p~ov.~ ....... ;?..~..L~ .................... Lo~r ~.t. Approw~ .................. E ............................. Unde~riters Approval ~..~.~ ....................... Planning B~rd Approval ............ ~ ........................... Request For Tempomw Ce~ificate ........................................ Fin~ Ce~ificate / Fee ~bmitted $ ........Z..~ ....................... Construction on above described building and permit meets all ~al~,_licable, codes and regulations. Sworn to before me/t~is ~ ,~ ,z' ' ..... . ./...z... day of .... Notary Public .... County. : ,~ :::~ ~'-'., "q'HE'~NEW"YORK BOARD OF FIRE:~UNDERWRITERS C~, -~ ;A ,½: ' BUREAU OF ELECTRIC TY ' ' ~ ~ I I~ ,. ~:~ : q'=:~ STREET, NEW YORK NEW YORK 10038 , ;-~ , 3uae 9, 197L ........ ~ ~o.~oo~-~ 908875- _,~. ~,,o~nnne r o~y the electrmal equipment ~ ~scr bed ~el~ ~n~ ~ntroduced by the applicant named on the above apphcat~on number m the prem~ses of RXTURE ~ - ' RANGES '~:~ 'OVENS DISH W~HERS EXHAUST FANS Mr. Walter Finger ,,'~, ' ' ,, P.Oo Box 991 , Ma~tltuck, L.I.' 11952; , LiC~#1845-E~ This certificate must not be altered in any manner; return to the office of the BoarO if incorrect.' Inspectors may be identified by th,