HomeMy WebLinkAbout22024-Z (7)FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
C~RTIFI~ATE OF OC~umANCY
No Z-23384 Date
NOVEMBER 30, 1994
THIS CERTIFIES that the building ~LTIPLE RESIDENC~ ~NIT
Location of Property B55-12C MEADO~ COURT (PRIVATE RD. ~24) SOUTHOLD,N.Y.
House No. Street Hamlet
County Tax Map NO. 1000 Section 87.1 Block i Lot ]2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 6, 1994 pursuant to which
Building Permit No. 22024-E dated APRIL 27, 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 C12 MULTIPLE DWELLING WITH ATTAC~ED GARAGE
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
CO~E TOWNHOUSEB AT SOUTHOLD INC.
S-69
pENDING - NOVEMBER 17, 1994
NO~.29, 1994-S~M PLUMBING & H~ATING
//~/~l 1 d/~I nspector
Rev. 1/81
A
THE NEW YORK BOARD OF FIRE UNDERWRITERS
WE ARE IN THE PROCESS OF ISSUING A
ELECTRICAL iNSTALLATION AS COY
IN AN APPLICATION NOTED BE L~W,.
LOCATION
Form No. 6
TOWN OF sOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
BLDG. DE, 1.0 D
ToWN OF sOUTHO
,,s,~mo,~ _~ %1%~)~ ICATION FOR CERTIFICATE OF OCCUPANCY
,B~(mav~ ~1% ~__. ~?"~= ~illed 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 ail 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
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 Buildinz - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updat9d Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy- Residential~$15.00,/Commercial $15.00 '
Date ..~//~../~.~.//~ ....................
Construction~,~..~..~ Old ~r Pre-existing Building ....
oc~tion of Prop ry .... ~.../~. ..... ,~m.~..~....'~'Y~ ~',~ g~) ..~. Y.
House No. Street Hamlet
nwer or Owners o~ Property...e'~.O~. ......... ff. ..... ~... ~F...~.~.UF..~...C.~..~--
ounty Tax Map No 1000, Sectioo...f%..~ .... Block ...... l ......... Lot ....... /~ ...........
.... Lot ..
~rmit No,,~...*Z~. .... Pa~e Of ~ermit.~l~[..~l.."l-~...Applicant ......................... ·
ealth Dept Approval Underwriters Approval . ..
lanning Board Approval ....................... .
zquest for: Temporary Certificate ........... Final Certicate.. ' .....
ao< ~3a- · ·
' ~ "~ TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
· P.O. BOX 728
TOWN ItALL
$OUTHOLD, N.Y. 11971
TEL. 765-1802
~ E RTI F.I CAT I ON
(please print}
{please print}
I certify 'that the solder used
contains less' than 2/10 of 1% lead.
Sworn to before mo this
'~-'~ day of f/O,/'~4f~k---. ,.
Ilotary Public, ~ ~o~lL County
GEORGE E LEWIS
NOTARY PUBUC, State of New Ym~k
No 484O722
_ _ Ouellfied. In .Suffolk COUtl~y
~..ommiasion Expires March. 30, I~
in the water supply system
(p~umbe~
' s siq'naturm)