HomeMy WebLinkAbout22024-Z (10)FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OC~uwANCY
NO Z-23165 Date AUGUST 15, 1994
THIS CERTIFIES that the building MULTIPLE RMHIDENCE UNIT
Location of Property 655-15D MEADO~ COURT (PRIVATE RD. ~24) SO~T~OLD~N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 87.1 Block i Lot 15
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-Z dated ~RIL 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 D15 MULTIPLE Dw~r~.ING WITH ATTB,~HK- GARAGE
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
SUR,,~CT TO ONE YEAR REVIEW
Rev. 1/81
COVE TOWNHOUBES AT SOuTuOLD INC.
S-69
PENDING - AUGUST 9, 1994
AUG. 2, 1994-$RM PLUMBING & HEATING
Building In~
APPLICATION FOR CERTIFICATE OF OCCUPANCY
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN Ib\LL
765-1802
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 i% 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:
i. 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.
C. Fees
1. Certificate of Occupaney - 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, Commercial ~15.00
Date. .... . .~.~.~.~. ....................... . ..
New Construction ........... Old Or Pre-existing Building ............ ... ..
House No. Street Hamlet
Onwer or Owners of Property ..................................... ... . . .. · .. . · ...- · --
Coonty Tax Map No 1000, Section...~J.~ ...... Block ...... ~ ......... Lot ....... ~. ........
Subdivision..o. ......................... . . .. . .. Filed Map ............ Lot ................... .. .
Permit No. Z~0 ~-~ Date Of Permit. .~./~/~-~.. cant .......................
.................. Appii ...... '
Health Dept Approval Underwriters Approval .....
Planning Board Approval ................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $ ............................ ~
-- .
,fi 6.5' ' ' '
THE NEW yORK BOARD OF
WE At:IE tN THE pROCESS OF
CE..E,C~TE Or CO~"~'AR~
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
CERTIFICATION
Building Permit No.
Owner: ~_o~' ~O~ (please print)
Plumber:
(please print)
contains less than 2/10 of 1% lead.
I certify that the solder used in the water supply system
( [Ti~mbers/Signature )
Sworn to before me this
~. day of ~'~--
Notary Public, ~c/~c~ Z~/~-
GEORGE R LEWIS
NOTARY pUBLIC. State of New York
No. 48~.0722
County