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HomeMy WebLinkAbout9287-zFOI~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No .... Z. 9..09.2... Date . . ~.ur3..e... 3.0 ........... ,19...7.8 THIS CERTIFIES that the building located at ...~.145. S.tars. Road ........ Street Map No.. 386/4. · . Block No ......... Lot No ........ 7 ......................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ... June I ..... , 19..7.7 pursuant to which Building Permit No.. 92,87Z. dated . dune 6,. ....... , 19.77., was issued, and conforms to nll of the req,~;~re- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... P~.i. yat. e...0n.e..F..a~n..t, iy...Dw..e.l.l.l .n~. ............................ The certificate is issued to .... .I..nl .~..d..H.o.m.e.s. ................................... ( owner, of the aforesaid building. Suffolk County Department of Health Approval 7.-S..0.-.~.2. .................... UNDERWRITERS CERTIFICATE No ...... .N.~.8. 2. .8.2.9. ............................. HOUSE NUMBER ...~.1/,5 ..... Street .... .S.~..ar...s..R.o..a.cl .......................... East Marion, New York / ..... .//, ......... Building Inspector FORM NO. ~ TOWN 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? 9287 Z Permission is hereby granted to: ...z..~.'t.~....~.o...~..~...~..~.~.. ...................................... to.' t~.~ new o~e £aai~y. dvell...~.. ........................................ : ................ :.::...:.~..:.: ......... : ............................... : ..... : ........ :~...~ ~ ......................... at premises I~at~ at . ~ .~ ~. ...... ...... ~ -.7~:- - 7'"~ ........................................... ~ .................. ~,;,~ ..............................................._ . :..~.~ar.~..~o~ ...... ~.~..~om~ ., ............ ~ ......................... ~. ................. -_.~ Building Inspector. ' : -~- ' ~ ~ ' ' I~'ORM NO. 6 TOWN OF $OUTHOLD , Building Depa~tment Town Clerks Office Southold, N, Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY !nstructions 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 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 Date 9.Z ............... New Building .... :~¢ .......Addition ................ Old or Pre-existing Building ................ Vacant Lend .............. Location Of Property ~~1~`a~d~1:~:~~-~ ................................................. Owner Or Owners Of Property Inland Homes, Inc, Subdivision ................................................................ ,or No .... Z ...... B,ock No ............. ,ouse .................... 6/6/77 Inland Homes, Inc. Permit No. 9287' Z Date Of Permit .................... Applicant .................................................................. Health Dept. Approval ..6../.2...g../...7..8....Z .... .~.S...O..T..6..~....Labor Dept. Approval .... .n.../..a.. .................................... ~/ ~ ~ c~ ~' ~'~ ~) Plannln yes . Underwriters Approval ................................. ~ ............ g Board Approval ....... ~ .................... Request For Temporary Certificate ........................................ FinoJ Certificate .......................................... Fee Submitted $ .5..:..0..0.. .......................... Construction on above ~ described building and~permit meets all applicable codes and regulations. Applicant Sworn to before me this '"[~~~"~ "~ ....... .3.9 .... day of ...~.u.,.~..,e. ............................... Notary Public .....~.,..~.~..o.~..~. ................ County (stamp or seal) TOWN OF SOUTHOLD Building Inspector's Office Town Clerk Building Southold, N.Y. 765-2660 F SOUTHOLD Building Inspector's Office Town Clerk Building ~o~,~o,~.,. ~. ,~-~?~,>:.~' THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND/OR FROM DATA OBTAINF-D FRON~ OTHERS THF WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR T~JS RESIDENCE WILL CONFORM TO THE STANDARDS UF THE SUFFOLK COUNTY D~PARTMENT O~ HEALTH NO TE : m: MONUMENT SUBDIVISION MAP FI£ED IN THE OF'~ICE NE~EST WATER MAIN - t MI~E ~ WATE~ SUPP~ Y - P~I~A TE WErE ~ Lot 8 ~ Lot 6 VA CA A~ f dU~Y 6, AUG, 26, 19Y7 YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W YOUNG HOWARD W YOUN SURVEY FOR INLAND HOMES,/NC. LOTNO. 7, "MAPOF STARS MANOR ' AT EAST MARION zown oF SOUTHOLD SUFFOLK CO, N.Y. SCALE i.= '~0' IDATEMI~Y2 GUARANTEED TO $OUTNOI. D ..e,41/llVE$ 8.4NK SECUEID' TITLE & ~UAR,4NTY ~0. 19 77 JNO. 77-Z~; THE LOCATION OF WELLS AND CESSPOOt. S SHOWN HEREON ARE FROM OBSERVATIONS AND/OR FT~OM DATA OB'~AINED FROM OTHERS THE WATER SUPPLY AND SEWAGE DISPOE,AL SYSTEMS FOR TliUS RESIDENCE WILL CONFORM TO THE STANDARDS OF THg' SUFFOLK CQ~NTY D~.PARTMENT ~ HEALTH A~ICANT ~ ~~ ~'~'I _ _ _ SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES LOt 8 VACANT Lot vAcANT NO TE : m : MONUMENT SUBDIVISION MAP FILED IN THE OFF/CE OF THE GZ. Et?K OF~UF~K COUNTY ON S~P~ 19,196~ AS F/LEND. 5~. ~[EP SUPPL~ - P2/ Vd [E ~ELL S /O0 . REVISIONS YOUNG & YOUNG 400 OSTRANDER AVENUE~ RIVERHEAD, NEW YORK ALDEN W YOUNG HOWARD W YOUN( StJRVEY FOR INLAND HOMES,/NC. IOTAIO. 7, "MAPOF STARS MANOR" N'L-'°×4' ,si 0 L HL~©O ~