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Home My WebLink About22296-Z (3)FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. u~TIFICATE OF OCCUPANCY No Z-24073 Date DECEMBER 8, 1995 THIS CERTIFIES that the buildin~ MULTIPLE RESIDENCE Location of Property 1955-A-2 CALEBS WAY (PVT. RD. ~1} GlusF~ORTf N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 40.1 Block I Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 17, 1994 .pursuant to which Building Permit No. 22296-Z dated SEPTEMBER 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 A2 - MULTIPLE RESIDENCE - COMPLEX A AS APPLI~ FOR The certificate is issued to ~0ORES LANE DEVELOPMENT CORP. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R-lO-95-OOll-JAN.19~ 1995 UNDERWRITERS CERTIFICATE NO. PENDING - NOVEMBER 30, 1995 PLUMBERS CERTIFICATION DATED DEC.8, 1995--AR'£~UR MALAUSSENA~ JR. Rev. 1/81 f~ Buildifig Inspe~or 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 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" 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 1. 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 Buildinm - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Connnercial $15.00 Date . . /. /. ......... New Construction..~....... Old Or Pre-existin~ Building ................. Location of Property .... ~~.~./~~;~ ......... ~:~ ....... Onwer or O=ers of Property__~__~.__~~ ..... ' .... County T= ~p~o 1000, Sectio~...~!.~ .... Block ...... ~ ......... Lot...~ ..... Sub division ~~~. ~ Filed Map ............ Lot .... Permit ~.~.~.~.Dare 0~ PemS~..~ ..... App~cant~~ ..... Health Dept. Approvai .......................... Unde~rSrers Approvai ......................... Planning Board Appro~ai ........................ Requesr ~or: Temporary CerrSf~care ........... F~nal Car~Scara ..... ~.. Fee Subm~tt ed: $ ..... ~' ~ ............. ~~i.~~~ ~PLIC~T 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