HomeMy WebLinkAboutZ-11283 FORM N0.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. x.1.1293.......... Date ......October, 22 19$?.
THIS CERTIFIES that the building .
Location of Property 035,, , , , , , , , , , , , , , ,Calves. Neck Road Southold
House No. Street Hamlet
County Tax Map No. 1000 Section ..063.......Block ..Q7...........Lot ...032, , , , , , , , _ , ,
Subdivision X .......................Filed Map No. .X ......Lot No. X .
Requirements for a private one-family dwelling built prior to
conforms substantially to the App}ieativn-Fer~Enilding-Penmt~i[erCtatbTC-tlted'1tiZltiSroffiCrr-Qki€d'
Certificate oc Occupancy
....AP.r~~..23........ , 19 57. pursuant to which Baiidmg~ernrit No. , Z t 1,283
dated ...October , 22 . . . . . 19 82 ,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 .
a, ,one-family, ,dwelling, with attached a_,arage.
The certificate is issued to Mildred I. Filardi
/owner, leaseeortenantl
of the aforesaid building.
Suffolk County Department of Health Approval °~8
UNDERWRITERS CERTIFICATE NO........... n/.g .
Building Inspector
Rev. 1/81
FORM N0. 6 -
TOWN OF SOUTHOLD
Building Department-
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and sut~mitted in duplicate to the Building Inspec-
torwith the following; for new buildings or new use:
1. Final wrvey 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 equatl.
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, acertificate 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 peoperty showing all property lines, streets, buildings and unusual natural or
toporraphicfeatures.
2. Sworn 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 informa-
lion 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 .-October 13, 1982
New Building .Old or Pre-existing Building(X) . RX Vacant Land
Location of Property ~a3~ Calves Neck Road Southold
House No. Street Hamlet
Owner or Owners of Property , ??ildred I ~ Filardi
063 Block Lot
County Tax Map No. 1000 Section 07 032
Subdivision .........................Filed Map No. ..:.......Lot No. .
Permit No. Date of Permit ..........Applicant .
Health Dept. Approval ........................Labor Dept. Approval .
Underwriters Approval ........................Planning Board Approve!
Request for Temporary Certificate .....................Final Certificate , , XX
Fee Submitted 5.00
Construction on above described building and permit meets all app!{cabl~odes and regulations.
~i(IL- C.Q. APPlicant . , .
~ ~3 IrVing L. Price, Jr, as Attorney/Agent
Rev. 10~10~78 for Richard F~ ~Mu11en, Jr.
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