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Home My WebLink About22296-Z (2)FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO Z-24791 Date DECEMBER 11, 1996 THIS CERTIFIES that the building M~LTIPLE ]~ESIDENCE Location of Property 1955-A-1 CALEBS WAY G~EENPORT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 40.1 Block I Lot 1 Subdivision Filed Map No. ~o~ No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 17, 1994 ~ursuant to which Building Permit No. 22296-Z dated SEP~MBER 5, 1994 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 UNIT iA-MULTIPLE RMSIDENCE-- ~O~PLEX "A" -- ONE BEDROO~ & ONE DEN. The certificate is issued to of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R-10-95-0011-JAN. 19, 1995 UNDERWRITERS CERTIFICATE NO. PENDING - DECEMBER 4, 1996 PLUMBERS CERTIFICATION DATED DEC. 4, 1996-DOOLEY PLUMBING & HEATING Rev. 1/81 FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPAJ~'rMENT TOWN HALL $OUTHOLD, N.Y. N~ 2229G BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNtiL FULL COMPLEtiON OF THE WORK AUTHORIZED) z ~'~'"'~ .......................................... ~ ~' CountvTax Map No. 1000 Section ...... . .~.~.. ........... / ' Blod( ........ ~ ..........Lot No...,~..<......~.....~... ........ pursuant to application dated ..... . ~.'..~.. ........................................ 19../~....Z~... .... / Building Inspector. and approved by the Rev. 6/30/80 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 with 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 1% lead. 5. Commercial buildiqg, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: i. 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. ]. Fees i. 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-existin~ Buildin~ - $100.00 3. Copy of Certificate of Occupancy - . .25~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $I5.00, Commercial $15.00 ./ Date .................................... 4ew Construction .... -~'...... Old Or Pre-existing Building House No. Street Ha~et )nwer or Owners of Property...~<~$...~q<.~&jAp...d ................................ ,o n y ax a No 000, ...... .... .... .... / ................ ~ubdivisi°n ' ~4~ff~ ¢ ff~~ .......................... Filed Map ~ ~ Lot ?ermit No ~.~.~.~. ..... Date Of Pe~it/ ................ Applicant..~. ~. ~f~ ........ qealch Dept. Approva~ .......................... ~nderwrSrers Approval ......................... '].ann~ng Board Approval ........................ equesr for: Temporary Cerr~Scare ........... F~na~ CarrScaee Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD CERTIFICATION Building Permit No. 22~ ~-~ Owner: /~//~/)f£~ ~ ~F~.~ ~"'~, (please print) '(-please ~rint) v I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ( Plumbers Signature~/ Sworn to before me this ~ day of /~.~&~;~-;~ t 19 ~ Notary Publ~~ounty