HomeMy WebLinkAboutVail, VernonSUPERVISOR'S OFFICE
16 South Street
C~reenport, N. Y.
Tel. ~oreenporf 7-0550
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y.
TOgVN CLERK'S OFFICE
Main Street
So~thold, N. Y.
Tel. Southold 5-3783
BUILDINC~ I'NSPECTOR'S OFFICE
307 Fourth Street
C'-reenport, N. Y.
Tel. Greenport 7-0101 J
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES that the building located at ~-,~__~ t~_~_~ _~: (.~_~ _~*~_ ~t_a~) Street,
Map No. ~ , Block No. ]~J(-Y~]~( , Lot No.
in the Town of Soufhold, conforms substantially ~.~L ....... .I .I ..... ~ .... :z:__.:__. L ..... f_ ~4.~ .....
o~'~ce _. : ............... r_ ......
Buildi~, '~ "" - ........ ~.~_.~,~[~-~.~,~: ~ +o all o~ the require-
meets m< the applicable provisions
Thrs certificate is issued fo
(owner, lessee or tenant)
of the aforesaid building.
{The Certificate of Occupancy will be issued only after the Building Inspector is convinced of the completion of the
construction in compliance with the Idulf;ple Residence Law and with other laws, ordinances.or regu;aflons affect;ag
the premises, and in conformity with ~he approved p'lans and 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 section 4 of the
Multiple Residence Law.
Within 30 days after the filing of this statement, the municipal building department or en-
forcement agency is required by section 300, Multiple Residence Low, to file a duplicate
copy hereof with the State Building Code Commission, 1740 Broadway, New York 19, N. Y.
1. Location of multiple dwelling:
(a) Street and number ..~..(~..~...~...E.-..I~.....,./~....~...~....~.......~...T..: ............ C.~...~.~.[...-....~...~.~..~....F~I?.~ ~t$d
(b) Municipality .......... .~., .1.?(...~....~../~.., .~..0....(~.,, [ ......... L.,..I., .......................................
Description:
(a) Type of construction ......... ./../~'.~...~.....~... ........................................... ;Z' ...............
(b) Height of building, inck,ding number of stories .......... Z.~.....~...../....~.L~...¥ .....
(c) Type of heating facilities ....~...I...L....]~.~...~../~.~...~...(~......~...~..~...A:.....~.. ................
(d~.~.".;mkcr cf :pc.-t...~;;: ............ .~.~ ..........................................................
{e) Number of Jiving rooms ................... .~. ................................................................
(f) Number of kitchenettes ............... ~ .........................................................
(g) Number of bathrooms ............. ~ ...................................................................
(h) Number of water closets ................. ~ ...........................................................
(i) Number of occupants for which building w_as designed or intended to be occupied
or used ..............................~ ....... . .~... ..........................................................
3. Age of
(a)
(b)
multiple dwelling:
Date when constructed ......... .~...~...~......~....' .~.... ...............................................
Dates of substantial additions, alte~ifications of dwelling, with
brief description thereof ...........................................................
(c) If now under construction, state when construction commenced and anticipated
4. 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, aportment hotel,
lodging house, boarding house, school, convalescent, old age or nursing home, pri-
vate dwelling two or more stories in height with five or more boarders, roomers or
lodgers, or other classification of multiple dwelling including those specified in sec-
tion 33, Multiple Residence Law).
................................... ........ ..........................
(Address of Owner)
STATEM~r,~T OF FILING
....................
(Nl~ne of ~unictpality) __ (Date of Flltn~)
wltom Statement of RectOry was FLied)