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HomeMy WebLinkAboutZ-4904FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 24904..... Date ...........NOT ...14 ....... , 19.72 THIS CERTIFIES that the building located at . N.I.S. Sound. Vi.ew. Ave. Street Map No. .Xx......... Block No. ..XX ...... Lot Nom ..Sounthold N -*Y. ... • • . conforms substantially to the t t AtkWK • before. April. 23 • • • , 19.57. pursuant to which � $. Occupancy X4904. . dated ........ NOV .. tl. ...... , 19.72., 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 .Non- conforming two •family • dwellling ............................... The certificate is issued to . John p. Murry. :;r • • • • • • • • . owner • • • • • • .. • • ... • • • • • . . ( owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval pro—existing • • • • • • • • . • • • . • • • . • UNDERWRITERS CERTIFICATE No.... pre .existing ............................... HOUSE NUMBER.21625 ...... Street .... SoUnd.view•Aves ........................... ................................................................................. EXCeptionss 1* two family use in one family district - 2. Insufficient sideyard W/S Building Inspector 1 3. Steps on W/S over P.L. FORM N0.6 TOWN OF SOUTHOLD Building Department i Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate 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 dispcsal—(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 ry�/ Date.................... New Building .................... Old -or Pre-existing Building ...... X................ Vacant Land ............................ qr s d.e Location Of Property u...... sou Lp0 ..J�4(..ttd.v. WAR Owner Or Owners Of Property.4 . n.....F..� r!.ti !! r�/..S j' ..:...................... ....................................... Subdivision................................................................Lot No. ...... x... Block No.�.... X.... House No..A. .. ......... Date Of Permit Applicant ....\[OX..n....1......m.�'4.!i r � Permit No............ .................... A/ ...... ..... .......... Health Dept. Approval ..........��! ...Labor Dept. Approval .....I .:. �2.- .............................. E�- Underwriters Approval .........:...f.^E-� .�::. `.............Planning Board Approval ..... 1....��....`..........�... Request For Temporary Certificate ........................................ Final^Certificat v� Fee Submitted $ .................................... Construction. on above described buildi and p it meets all applicable codes and regulations. Applicant ...... ............................................ Sworn to before me this ti �1 r ! F0 Y 1�..'. da �. �7Y (stamp or seal) too c / 7 F 7 .......... County STATE OF NEW YORK : ss COUNTY OF SUFFOLK : JOHN F. MURRY, residing at (no number) Soundview Avenue, Southold, New York 11971, being duly sworn, deposes and says: THAT he is the owner of a two family house on the North side of Soundview Avenue, Southold, New York; THIS house has been used and occupied as a two family dwelling only for some part of each of the past nineteen years. 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