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Home My WebLink About11159-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Zt.2391 o . Date March 28. .............................................. 19 84 THIS CERTIFIES that the building--recreational buil~inqt Location of Property 6.90 Queen Street Greenport I~,sO ~oi ...................... Street Hamlet County Tax Map No. 1000 Section .... 4,0. ......Block ...0.3 ........... Lot.. 00.5 Subdivision... X ............ Filed Map No. X ...Lot No. conforms substantially to the Application for Building Pormit heretofore fded in this office dated ......................Ap. ril 27 19 ........... .8.1pursuant to which Building Permit No .11.159 Z .......... dated MaX .18 81 .......................... 19..., 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 ......... .b ' d a buildin~ for recreational .u.s.e.as approved y ~he Planning Boar . The certificate is issued to E. L. I. KAMPGROUND, INC. (owner, lessee-or 'tenant/ of the aforesaid building. Suffolk County Department of Health Approval ....... .N/?. ............................... N527641 UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 BUI&DjNG pEI~I~ (THIS PERMIT MUST BE KEPT QN THE P~RE COMPLETION OF THE WORK A0~HOFLIZ~D) No. 11159 Z ilSES UN' IL FuLL Date ! ..................... ~ ................................. , ....... PermiSsion is hereby granted to: ............. .............. ! ....... ............................... -,4 ........ :"-q'-,'~ ................ ~ ....... ........................... ~...,.,~. ........ ,.,..~....q.., ........... ~ ..... at premises located fit .................................... ,,.~ ........ ~ .........~., ............. ~ ......... ................................. ,, ~l(a~ u~ ~ ........... ................... : ........... ~ .......................... ~ .............. ; .~....~ ............... ~: .... ,.. · · ~Oun~ TOX ~op i~. IUUU ~ociion ................ , ....... u~,.~ .............. ~ .... ......................... pursuant to application doted .......................~ .......... d:~; ,.~.Z., '~.~Zand opprov~ by the' ' : ~' ' Building Inspector. : } g ~l~ector Rev. 6/30/80 , ,~ ~ ~ ~ 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, 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 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. C. Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling/ land 3, Copy of certificate of occupancy $1.00 use --Pre-Existing C,0o $15.00 Vacant land C.0. $ 5.00 Date,.,)~...~9~.,~ ~..¢. ~... ~.~(... New Building .... .~. ....... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ,.. ,~..~, .L~. ..... ,~. ~)..~: .~../~. ~. ~...~Z~. ~ .~.~ ~ Hou,~e No. Street Hamlet Owner or Owners of Property , .~[; .~..: .................. .~, ) ,~, ~ .'. ! ....................... County Tax Map No. 1000 Section .... O %/© Block .~. Lot. ~.~ Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo. IIl~,'~..'~ Date of Permit Applicant.... ~...,. . .. ' ~f'~ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ..................... Planning Boar royal ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building ~ p;rmit meets all applicable codes and regulations. Applicant ~' ,,t~-~,,..~.. ~: ~.~. ~ '~ ...........