HomeMy WebLinkAbout12201-Z Unit 3 Apt HFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z13174 Date January 28 19 85
THIS CERTIFIES that the building ....C 9.n.d. 9..u.n.~..g..#.3...~ p.~...z .H..I~ ~ 0 ...#.~ ...........
.s.h..~ py.a.r .d' .~.a.n. ? .....................................
Location of Property .... 2.~ 2..0. East Marion .
House No. Street Hamlet
County Tax Map No. 1000 Section 0. 3. .8...0. 2. ..... Block ....0.1 .......... Lot ..... 2. 9. ..........
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.... J. ~ O.u.a,v. 7..1fi. ...... 19/~ }. pursuant to which Building Permit No..~.2.2. 0. ! .Z ..............
dated ..... M..a .v.c.h...2 .2 ..............198. 3.. , 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 .........
The certificate is issued to .. ~L.~gV~b..?9I~IT. ~/.I.L.L.~. 9.E..I. ~.C.. .......................
.... (owner, ]FKae~'qC Xqga~)X X ' ' '
of the aforesaid building.
Suffolk County Department of Health Approval ....8./.3. .0 (.8.2....E.M.8?. .......................
UNDERWRITERS CERTIFICATE NO ........... J~.N. 6. 7 ~.3.1.3. .............................
LOFT AREA IS NON-HABITABLE
Building Inspector
Rev. 1/81
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
$outhold, 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 Inspec-
tor with the following; for new buildings or new use:
1. Final survey of property with accurate location of all buildings,~'~roperty 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.
B. 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
$5.00
Date NOV.15, 1984
New Building .X. ,x,x ......... Old or Pre-existing Building();) ....... =/Vacant Land .......... y.
2820 Shipyard La, East Marion, NY Unit 3H, Bldg 3 ~ "r~
Location of Property , .. .............................................. ~ ........ ~ ..........
House No. Street Ham/et
Owner or Owners of Property Cleaves Point Vi_l_~age Inc.
038.02 01 Z~
County Tax Map No. 1000 Section .............. Block ............... Lot 29
Subdivision ................................. Filed Map No ........... Lot No ..............
E.M. Kontokosta ·
for Cleaves Pt V~tlage
Permit No.1?.~. .0 .~,Z .... Date of Permit .......... .~.ppHcant ....... ; ..........................
8/30/82
Health Dept, Approval ........................ Labor Dept. Approval .........................
8/31/82
Underwriters Approval... d. ~.?..~. ~./.? .......... Planning Board Approval ..................
.yes
Request for Temporary Certificate ..................... Final Certificate ................. -
5.00
Fee Submitted S .............................
Construction on above described building and ~~gulations.
Applicant
Rev. 10-10-78
Smithtown, N.Y. 11787 Lic. 717
11
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.