HomeMy WebLinkAbout12119-Z Bldg 2 Unit 2G1FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No..Z.l.~. ] .6.7. ......... Date ......... .D.e.c.e.m..b.e?..~..8 ........... 19.8.~.
THIS CERTIFIES that the building ....B.u. J: .]..d.J_.n.g..2.,.. U..n ~.I;...~.q ] ....................
Location of Property . .2.8.2.9 ............... S..h.i.p.~..~.d..L.~..n.e ............ .Bfi. s..~..~.a.r..i.o.n..
House No. Street Hamlet
County Tax Map No. 1000 Section . .0.3.~, ~)~ .... Block ...0.1 ........... Lot ...0.2.7. ....... :. ~_~z..
Subdivision....X. .......................... Filed Map No...X ...... Lot No....X ..........
conforms substantially to the Application for Building Permit heretofore fried in this office dated
.... .0 .c.~ q b..e ? ......... , 19 .8.0. pursuant to which Building Permit No... 1. 2. .1 .~ .9...Z ...........
' dated .... .0 .c .t,.qb. e..r..2.0. ............ 19.8 .0., 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 .........
....... ~.~. ¥ ~.n.~ .u..n3.~..v.~.~.~.~..n..m.q ! .~.~.~.~.' .~e. ~..J_.i.n.g: .............................
The certificate is issue d to ........... E..i3 .A.N.U.E..L..K.0. N...T .O.K.Q S..T ? ...........................
(owner, I~ss=~ u~ ~narr~)
of the aforesaid building.
Suffolk County Department of Health Approval ....E.~ 8..R ................................. ~.
UNDERWRITERS CERTIFICATE NO ........... ?.6. ~..7 .2.5.1 ...............................
Building Inspector
Rev. 1/81
' a .r /s3 N 617251
THIS CE~IFIES THAT
~ exam~d oR ~ ~ ~ ~ a~d~oa~d to be ~ compliance w~th t~e requirements o~ t~is Board.
FIXTURE FIXTURES RANGES ICOOKING DECKS L OVENS IDISH WASHERS EXHAUST FANS ~i
OUTLETS SWITCHES FLUORESCENT VAPOR T. K.W. AMT. K~ W. A,V,T. K.W. AtRT. K.W. AMT. H.P.
7 ~ 10 7 2 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS EClAt nEC'PT TIME CLOCKS BErt ~ MULTI-OUTLET ~[
AMT [ K O [ H P t GAS [ .e. AMT. [ NO. ] A.W.G. A~T, ]AMP. *MT. lAMps. [TRANS.] AMT.I H,P. [ N~.Y~TFEP~%T AMT. [WATTS
SERVICE DISCONNECT [ NO. OF I S E R V I C E []1-"
~c 1 1/0 1 1/0
A/c
.ca,,, Z. hCc~, lq. Y. 13L787 L/c#717 ~~
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 BU LD NG DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
FORM NO. 6
TOWN OF $OUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
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.
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 featu res.
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 occupancv on pre-existing dwelling or land use
3. Copy of certificate of occupancy $1.00
$5.00
Date..A, ug 12, ,1983 ..
New Building . .Y.e.s. ........ Old or Pre-existing Building(X) ........ = ZVacant Land ............
East Marion, NY UNIT G1
Location of Property 2820._ Shipy. ard Lane~ _ ,Bldg 2
House No. Street Hamlet
Owner or Owners of Property .G. 1. Q .a y.e.s.. Po i n.t...V.i.]._l..ape .G.o..n.d.o.m. ~..nj .u.m. ....................
038.02 01 27
County Tax Map No. 1000 Section ............... Block ............... Lot ................
X X X
Subdivision ................................. Filed Map No ........... Lot No ..............
Jan.20,1983 E.Kontokosta for Cleaves Point
Permit No. 12119Z.... ...... Date of Permit .......... ~kpplicant .......... Vf t ~ ~'ge · -I~-c: ..........
Health Dept. Approval 8/30/82 .Labor Dept. Approval ..........
Underwriters Approval .Planning Board Approval 8/31/82
Request for Temporary Certificate ..................... Final Certificate . .Y.e..s ............ .
Fee Submitted $..5..
Construction on above described building an~ 'e~~ee d regulations.
Applicant., ..C_..,._. <. ............ .....
Cleaves Poiht ~t-i~la~J'6 In~'.
Rev. 10-10-78