HomeMy WebLinkAbout9120-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20512 Date JANUARY 31, 1992
THIS CERTIFIES that the building ADDITION
Location of Property 1565 SMITH DRIVE SOUTH SOUTHOLD, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 76 Block 2 Lot 37.3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 25, 1977 pursuant to which
Building Permit No. 9120-Z dated MARCH 25, 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 SCREENED PORCH ADDITION TO EXISTING ONE FAMILY DWELLING
The certificate is issued to CHARLES HART
(owner)
of the aforesaid building.
SUFFOLK COUNt7 DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/a
N/a
Building Inspector
Rev. 1/81
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? 9120 Z
Permission is hereby granted to:
Corne:L:L. Const;....A/C..C~a.~..Ba~.t ....................
....................... .~]~;L~ .....................................
at premises located at ...~o.t...1.tO...&..1.1.1.....f]o. ose..~e~ll...Es.t. ..................................... : ............
pursuant to application dated ....................... ~'a~t~ ....... 2~ ............. , 19..~.7.., cnd approved by the
Building Inspector.
Fee $..~.~.~.0.0 ..........
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
-\- This-application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building or new use:
1. Final survey of property ~ith accurate location of all buildings, property lines,
Streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of i% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
pre-exzstzng land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C.' Fees
l. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2.Certificate of Occupancy on Pre-existing Building - $100.00
3.Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Co,~ercial $15.00
~;ew Construction ~(. Old Or Pre
.......... existing Building .......
qocation of Property../.~-- ~.~g '.~. .~.~ ~.~.~
House No. Street Hamlet
~:nwer or Owners of Property .~..~.9~J~a
;oul, ty Tax Map No i000, Soction....(~P.~ ...... Block .... ~. D., ..Lot .~.~%.~.
iubdivlsi°n ............ · ............... Filed Nap ............ Lot ......................
.......... Date Of Permit. .--.Applicant ~'~.~.~ ..~'~..~.~.~.~.
lealth Dept. Approval...
....................... Underwriters Approval
Inning 8oard Approval
{quest for: Temporary Certificate ........... Final Corticate..~: ....