HomeMy WebLinkAboutZ-9085 roast xo. a
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Ctf Occupancy
No. ..?9Q$~.... Date JuIIe...26..........., 19.. 78
THIS CERTIFIES that the building located at ~ 395 gray . Aye , Street
Map No Block No........... Lot No................................. .
A ES$ Y 3 U tjIL ,BEFORE
conforms substantially to the CC~~1 gg
1968.. pursuant to which o.
~~f8Tl9~I~cN ~~9085~
dated .....J!~e 26 19.r~, was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is Detached, garage . , , , _ _ .
The certificate is issued to .......Aldo , FeBSia . . . . . . . . . . . . . .
(owner, I r~
of the aforesaid building.
Suffolk County Department of Health Approval .......PTe-k~lAtimg .
UNDERWRITERS CERTIFICATE No . ...............Pre-Existing , , , .
HOUSE NUMBER ..375........ Street Bray. Ave
Laurelt.New, rk
Bmlding Inspector
FORM NO. 8
TOWN OF SOUTHOLD
Building Department
Town Clerks Offiee
Southold, N. Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instwctions
A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building
Inspector with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and .similar buildings and
installations, a certificate of Code compliance from the Architect or Engineer responsible for
the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of property showing all property lines, streets, buildings and unusual natural
or topographic features.
2. Swam statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in-
formation required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use $5.00
3. Copy of certificate of occupancy $1.00
Date .........June 26, 1978
New Building Addition Old or Pre-existing Building Vocont Land
Location Of Property 1375 Bray Avenue, laurel, New York
Owner Or Owners Of Property .........A].do.F.essia
Subdivision ................................................................Lot No............. Block No............. House No.............
Permit No.... Date Of Permit ....................Applicant
Health Dept. Approval ...............?`?........................Labor Dept. Approval
Underwriters Approval .................RiA........................Planning Board Approval ...~1...................:............
Request For Temporary Certificate Final Certificate .........X.................
Fee Submitted $ ..........5_00 ~i / ~/~5~`,~
C.PJ•~''l~d'~
Construction on above described building and permit eet a op t6 '~c rl6s n ulations. E?a~/iP
Applicant .........NO...........__,--
i ickham
Sworn to before me this
0
....26th.... day of J???~ (sta or seoq ,+Yp~N h~
4'e
sic sat~M
Notary Public ......SL7££Q~ County n n ed . 1." b q
r n 0 - I I• - / QAMtsie-~68aot7 ~'~•K ~~e °'4
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