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HomeMy WebLinkAboutZ-7300 i'(?Ha[ N0. 4 TOWN OF SOUTHOLD BUlLD1N6 DEPART1~PiT Torn ©uk'e Offico Southold, N. Y. Certificate Of Occupancy No.Z7300....... Date Cct ~ 5 19.76 THIS CERTIFIES that the building located at . P:sTkrray..11T Street Map No. 5outln.~ood .Block No...........Lot No.. Q Soutl~a:id . requii.rementa for one family dWell.i.ng.t..zuksiag code conforms substantially to the built ~ert~.f]~st~ _ of occuFancy dated Yeeforc ..:,rr..?_?.., 19.5?. pursuant to which 9~1 1~1oD4 No. ~/3Ca . dated q t.... ? , 19 . , 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 ..PF1v^te, on4'.'.~'!?-~9..4!t,,P7.11~P The certificate is issued to ...'::altar. (i..Kaz~p .....owner . (owner, lessee or tenant) of the aforesaid building. Suffolk Countq Department of Health Approval ..gl's^.r..~ZCj.~,i;a.ilg . UNDERWRITERS CERTIFICATE No. ..yre-..existing HOUSE NUMBER ....la5o...... Street Yaxkwa3! ......;;outhold Building Inspector I FORM NO. e TOWN OF SOUTNOLD Building Department Town Clerks Offiee Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Imtructions 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. 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 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 October 13, 1976 Date New Building Addition Old or Pre-existing Building Vacant Land Location Of Property ..050„Parkway„Drige,,,.S~uthold,,,New,.York,.,~lggl,,,,,,,,,,,,,,,,,,,,,,,, Owner Or Owners Of Pr ert Walter Geor&e...~aPF op y Subdivision ....I+O.~i...4?...SA.L1~k4HA.0.C~ .....................Lot No.....(.1...... Block No............. House No............. U. ~ Permit No Date Of Permit ....................Applicant a " G Health Dept. Approval ............................................Labor Dept. Approval ` V `,:'D Underwriters Approval ..............................................Planning Board Approval ~ `~r Request For Temporary Certificate Final Certificate Fee Submitted $ 1~.~ 00 c~ ~resently occupied as a ~ne family elli condition good. nstruction on above described buiding and per t meets a pplica le c sand regulations. .............................w . APPlicant Sworn to before me this ~~~C~~ 7~ 4v ' ~ 13th day of .....October...7r4.Z6.......... (slam r eo%i~ ~`~,(/~6~ t' Notary Public County ~ ~ /i ~ r Teram Exo~ires Merch 30. t