HomeMy WebLinkAbout33679-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33679 Date: 11/06/08
THIS uKKTIFIES that the building ACCESSORY
Location of Property: 215 MEDAY AVE MATTITUCK
(HOUSE NO.) (STREET) (FLA_MLET)
County Tax Map No. 473889 Section 113 Block 8 Lot 11
subdivision Filed Map No. __ Lot NO. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 31, 2008 pursuant to which
Building Permit No. 33679-Z dated FEBRUARY 11, 2008
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 ACCESSORY UNHEATED BARN AS APPLIED FOR.
The certificate is issued to MICHAEL C & CAROL R GIORDANO
( OWNER )
of the aforesaid building.
SUFFOLK COOI~IYDEPARTM~T OF HEALTH APPROVAL
ELEC"ialCAL C~RTIFICATE NO.
PLOMBERS c~KTIFICATION DA'r~u3
N/A
N/A
N/A
~uthori zed signature
Rev. 1/81
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-180~
APPLICATION FOR CERTIFICATE OF OCCUPANCY ['
This application must be filled in by typewriter or imk and submitted to the Building Departlt[~ent with the folIowu~g:
A. For new building or new use: 1. Filial stuvey ofprope~y with accurate location of all buildings, property lines, streets and untlsual natula[ o;
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 fern0
3. Approval ofelectlScal installation from Board of Fire Unde~Sters.
4. Sworn statement from plumber crucifying that the solder used in system contains less than 2/10 of 1% lead
5. Colmnercial building, industrial building, multiple residences and~similar buildings and iustallations, a cet~ificate
of Code Compliauce fi-om architect or engiueer responsible for the building.
6. Submi~ Planning Board Approval of completed site plan iequirements.
B. For existing buildings (prior Io April 9, 1957) uon-conforming uses, or buildiugs and "pre-existing" land uses:
1. Accurate survey ofp~opel% shmving all piopertv Iii*es. siieels, building and unusual natul al o~ topog~aphi.'
features. ~
2 A p~operly completed application and consen~ 1o mspecl signed by tile applicant, l/a te~/ificaic, of Occupa~c'~ is
denied, the Buildiug lnspeclor slaall slate lhe ~easons lhei'efB~ in whting to tlae applicanl
C. Fees
Swinuning pool $2500, Accessory building $2500, Additiox~s lo accessory buildiu~, S2501h s ~(,, se~; 55(} (iii
2 Cc~xificateofOccul)ancyouPre_cxist ~g 3 ild g- ~10000
3 Copy of Ce~2ificateofOccupancy $ 25
4 UpdatedCe~tificatcofOccupancy_ $5000
5. l'empo~ary Certificate of()ccupancy - Residel~tial $15 00, Commercial 81500
Dat __ 1
New Constmctiol'~: Old or Pie existing Building: ____~"' (cheek one)
House No. St~ eot ~ i Iamle~
Owner or Owners of Properly: ~/O f~ O .~ .~ _
Suffolk C6unty Tax Map No 1000, Sect,on //g Block ~ ~ Ix~t [ /
Subdivision Filed Map
Health Dept Approval: ~ [I lce-wlilelS Approval: ~
Plamsng Board Approval:
Request for:
Fee Subufitted: $ __.
Ttmporao' Certificate __ _ Final Ce~lilicat¢: _ _~/'/ (check one)
Applicant Signature