HomeMy WebLinkAboutKuck, HaroldSUPE~RVISOR'S OFFIOE
16 South Street
Greenport, N. Y.
Tel. Greenport 7-0~0
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y.
TOV~N C:LERK'S OFFIGE
Maia Street
So~tho~d, N. Y.
Tel. Southold 5-3783
BUILDING FNSPE~TOR'S OFFICE
307 Fourth Street
Greenport, N. Y.
Tel. Greenport 7-0101 J
CERTIFICATE OF OCCUPANCY
t
B~. ' '., , da~d ~ '~ , w-. ~.-~. and conforms to all of the require-
m~+s of +he appli~b~ ~v~l~ns of +he law, ~e occupancy for ~ich ~is cedlfic~e IS issu~ ~s
d ~ de--Id bufl~n9.
(The Certificate of Occupancy will be issued only after the Building Inspector is ¢onvinced of the completion of the
construe{on in compfiance with the fdulflple Residence Law and with other laws, ordinances.or regulations affecting
the premises, end Tn conformity with the approved ~lens end specifications.)
Original for Municipal Building Department
STATEMENT OF REGISTRY
To be filed in duplicate with the municipal building department or local enforcement agency by every
owner of a multiple dwelling, as defined in subdivision 33 of sect/on 4 of the Multiple Residence Law.
Within 30 days after the filing of this statement, the municipal building department or enforcement agency
is required by section 300. Multiple Residence Law, to file a duplicate copy hereof with the State Build-
ing Code Commission. 1740 Broadway, New York ]9, New York.
I. Location of multiple dwelling:
(a) Street and number
(b) h4unlcipallty
2. Description:
(a) Type of construction
(b) Height of building, including number of stories
{c) Type of heating facilities
{d) Number of apartments
(e) Number of living rooms
(f) Number of kitchenettes
(g) Numb~~;
(h) Number of water do.ts ~-~ ~,~ ~
(1) Number of occupants {o.r which buildlncj was deslgned or intended to be~occupled or used
3. Age of multiple dwelling:
(a) Date when constructed ,J~'~?'- '~
(b) Dates of substantial addltions, alterations or modlficatlon$ of dwelling, wlth brief descrip-
tion thereof
(c) If now under construction, state when construction commenced and anticipated date of
completion
Use:
Describe the principal use made, or, in the case of buildings under construction, to be made,
of the multiple dwelling (such as apartment house, hotel, apartment hotel, lodging house, board-
ing house, school, convalescent, old age or nursing home, private dwelling two or more stories
in height with five or more boarders, roomers or Iodcjers, or other classification of multiple
dwelling including those specified in section 4., subdivision 33, Multiple Residence Law}:
/ , -
Dared at New York
(Name ~ Ownerl
~/^ddress of Owner)
STATEMENT OF FILING
(~Name of Municipal;k) ~/ / / ( a e~f Filing) ~
(Signature and Designation o{ Official with whom
Statement of ~~