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Home My WebLink About8525-zFOB~ NO. 4 TOWN OF SOUTHOLD BIB~.DING DEPART~ak'NT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.Z.7.2-0. ? ....... Date Aug ~? 19. ?.6. THIS CERTIFIES that the bui]dini~ located at . ~T ./~....T.r.a.c..k..A.v..e .......... Street Map No.M ,~;..Band... Block No ........... Lot No, . 7.7../~.. ~.8.....C.u.t.c..h.o.//u.e. ......... conforms substantially to the Application for Bui]di,ng Permit heretofore filed in this office dated .............Apr... 22., 19.76. pursuant to which Building Permit No...8.~..2.~.. dated ..........A~r....2.2. ..... , 19..7.6., was issued, and conforms to al/of the requh-e- ments of the applicable provisions of the law. The occupancy for which thi~ certificate is issued is .Pr£v. ate..~ne. £.~: .Qw~,llI~t ....................................... The certificate is issued to .~.Diz.c.e.f..l.e.l.d..H..o.~.e.s., .I.n.e. ............................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .A. Bg...2..0...1.9.7.6...b.y...~ :. y.i.3:..1.a.,. UNDERWRITERS CERTIFICATE No. N295805 July 29 1976 Ave HOUSE NUMBER .... 9~ ........Street ..... ~I'i~.e~. ............................... .... .... Buil&m~ Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS 'PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8525 Z Date April 22 19..~..6... Permi~ion is hereby grant~ to: ~£~l~..~me~..Iac .................................. .......... ~Q~ ....... ~.~..~h~ ......... at premises located at .... LDtS...~.~'..,&..~ .......~i.~,..~u,a.~C~..S3.tb .................................................... E/S Track Ave Cutcho~ue pursuant to application dated A~rll 22 19?6 , and approved by the Building Inspector. Fee $.~. ~..*..'~.~ ........... " Building nspecror THE NEW YORK BOARD OF FIRE UNDERWRITERS ~- ak BUREAU OF ELECTRICITY I 8~5 JOHN STREET, NEW YORK, NEW YORK 10038 ~,. Ju~ - ~ ~ 1976 ~.;c.,~.,~o.o.~/. 860230 Spacefield Homes n/side Track Ave., , C ' ' 70 e/o S~illwater Ave. utcnogue~ L.I. JOb 202 11 , ~ zoo Future appliance feeder/s: 2-2Jlq. 1-3J8 1 G.W.I. - - Smoke Detector SeLden, L.I..%'178Zi Lie. 325E ,,,,, cen,ncam must n~t be altered in any manner;, return ~o the office of ~ ~)ard if incorrect Inspectors be ~ 7 .~W., I I II ~ / I~ / II I II I lit IlllF~l::l Ili!l~l~ m~l~k'~,,~,~<~ ..:m:,~=.-,~*.~.~,~m~=~.. ,. FOr~1 NO. 6 TOWN OF $OUTHOLD , Building Department Town Clerks Office $outbold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions 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: ]. 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: ]. Accurate survey.of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner os to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent formation required to prepare a certificate. C. Fees: ], 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 / New Building .....~.... ..... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Owner Or Owners Of Property ~?~/~/~/~`C~.~4'~.~/~q.:/~~g ............................................. Subdivision ................................. Lot No.7..7., ....... Block No ............. House No ............. .ea t Dept. A rova, ...... obor pt. A prova, ................................................ Underwriters Approval .~..~..~..~...o....~.. ........................ Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ ...;~.,...~...O. ...................... Construction on above described building anj;J~er,~/[~eet~'J~'~/'~"~JicabJe codes a~ regulations. Applicant ~ellfied in Suffolk Coun~ Tu-~~" ' T"'"" "~ ~ ~':=:~=g''-- ~ BUILDING DEPARTMEH ~ ~ ~ ~ - ........ ' FF E ~ · TO~ C~RKS 0 I~.,n., ~,/ ~ ~ _~ ~D, N. Y. ~/~(~ ~ ~ ~ ~ prov~ ........................... ~ ......... , I~..~... Pe~it N~..~..~ ..... .......................... ...... / ' .................. o. lhis ~lic~tion mu~ b~ compl~t~l~ fill~ in by ~p~wriIor o~ in ink ~nd ~mi~ in triplie~t~ Insp~tor, ~ith ~ ~t* o{ pl~, ~ceumI* pl~ plan ~ ~l~. ~ ecco~ing to b. ~lot plan showing l~tion o{ lot ond o{ building~ on premises, rel~tlonshlp to ~oining pr~mise~ or public ~re~s, and ~iving ~ det~il~ d~ription o{ I~out o{pr~ mu~t be drown on the die, mm which i~ c. Th~ work c~r~ by thi* ~lic~tion m~y n~ b~ commenc~ before i~uance o{ Building ~rmit. d. Upon ~ppmvol o{ thi* ~pplicotion, ~* Building Ink,tot will issu~ ~ Building P~rmit to ~h* ~pplic~nt. Such ~h~ll be k~pt on th* premise~ ~v~llab~ for in~ti~ ~r~hout th~ work. e. ~o building ~h~ll be ~cupi~ or used in whol~ or in po~ for ~ny pu~ ~h~,ver until ~ C~ificot~ o{ ~holl h~v~ b~n omnt~ by th* Building Insp~tor. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described. The applicant agrees to comply with oil applicable lows, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ........ ............. (Signature of applicant, or name, if a corporation) 17o/' ./~ ~'/~ ............. ....... L ....... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......................... ..,~.~.:.*.~..~.~ ....... ~.c~.~.~.~. ............................................................................................................... Nome of owner of premises ........... ~ ......................................................................................................................... If app~t i~ signature of duly ~horiz~ officer. ~ (Name end title ~co~orate officer) Builder's Lic~se No ..................................................... , , , /~ ~ ~ 7V ~her Trode's License No ............................................... ~. ~ion o~ ~ o~ w~ p~ose~ wor~ wn~ ~ aon~. ~p ~o.: ...~ ....................... ~o~ ~o:....~.~ ~unici~li~ 2. State existing use and ~cuponcy of prorates and intended use and ~cu~ncy of pried const~ction: o. ~siting use o~ ~cuponcy ......... ~.~ ........................... : .................................................................... b. Intend~ use Qnd ~cu~ncy .............. ~ ........ : ~ . .... '. ................................................. 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ............... Repair .................. Removal .................. Demolition .................... Other Work .................................................... (:~ ,~,~ (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... ./.. ................ Number of dwelling units on each floor .... ,/.. .................... If garage, number of cars ....... .,'~.....~...~Z.~,~... ...................................................................................................................... 6. If business, commercial or mixed occupancy, speci~ nature and extent of each ~pe of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ....... ' ......................... Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................R~r ............................ Depth ................................ Height ............................ Number of .Stories ................................ 8. Dimensions of entire new construction: Front ............ ~ ............... Rear ...... ~ ..............Depth ..~ / , oht ....... Numbe Stogie, ..... ..................................................................................................... g. Size of lot: Front ...... Z~.~.....~ ................................. Rear ...... Z~.~ ........................... Depth Z~.~....~ ..... 10. Date o{ Pur~hose~...~/~.~....~.~. ....... ~om, o{ Foyer ~nsr ~,~...~.~/~.~ ............ 11. Zone or use d,str,ct ,n wh,ch prom,ses ore s,tu~ted ..... ~n....~2:~ ......... .L~'"'~e'~ ....... 12. ~oes proposed construction violote ony zonin~ Iow, ordinonce or re~ulotion: ....... '..~ ...................................... 13. Will 14. N~me ~ome of Architect .............................................................. A~ro~ ................................ Phon* ~o ....................... ~ome o{ Controctor ....... ~ ................................... A~re~ ................................ ~hon~ ~o ....................... PLOT DIAG~M Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all ~t-~ck dimensions from prope~ lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. /00, 7& STATE OF NEW YORK, [ COUNTY OF ................................ .................... .'-~-..~.~"J~)...~ ..~.~.C/g.....~.._________________~..J.,...; ....... ......... being duly sworn, deposes and says that he is the applicon, (Name of individual signing contracf) above named, c/~ ~'~ ~...~.~., He is the ......................... .~...~x',~//r.~. ........ (Contracto~"~ge~, '~'~rporote officer, etc.) .... of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application-are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application file,d-~erewith~ Sworn to before me this .,~ / / ..... .......... day _ .. . ,,°f ..... ...................... Notary Public, ...--..~ .............. County ......... .~.~~~ ............................ I~. 52-1296850 ~IJellfled in Suffolk ~e~s f~ th s re~ ~ence Will ~onfo~m to the FO~ APPROVAL OF CO~STEUCTION O~LY ; ~ ; % s~;~da;& of the Suffolk Coun~ ~; ~ ¢ me~tof. Hea,th~e~iCe~ / / ., ~ / .o~ 2 / .'' ~cflon 7209 of the New York SJole Education ~a vJo~alio~ of su~ey map fi6j ~arlng lhe Ja~ su~eyoffs ~n~ed seal. or em~osse~ ~eaJ shall hal ~ ccnside.ed I~ bsa voJ;d copy. · r cort;FicaHohs are n~ [~-~ '?~e~omg m~ht~hon, Ouo~nfees SURVEY FOR FI~ 0 ~ INC. -~o. ~t,.~:.~, SP~E HOME_, ~r~ ~ ~ ~'y'~, ~ ~': _~. ~o~ ~UF~OLK COUNTY~ N. ~ : Unauthad,ed alterotioh or addition to this survey is a violation of section ?209 at the New York State Education Law. Copies oJ Ibis sulvey map not bearing the land su~eyor% inked ~eal or erabo~sed seal shaft not be considered to be a ~ohd copy. .... :. ofll~e~ c, certifications indicated hereon shall run on|y to the pe*~on lot whom the suwey is prepared, and on his behalf to the I~ffe company, 'govem~nental agency and lending Jli~tJluiio~ listed heceon, and to the assignees of the lending insiitution. Guamnteel o~ certifications am not transferable to additional institutions ~r SUFFOLE COUNTY ~IEALT~ ~a~Au~ 2 01976 ,. ~. ~. ~-~ ~ ~ ,~,~ ~ ~ ~ ~ ~he ~o~o d~o~l ~d ~,ater supply cannoJ ~ ce~ifi~. ~acilitles ~or tbl~ loc~tton have been inspect e~thl~ de~ar!;n~nt SPACE F/EL D HOMES, lNG. F~ L F_V~Tm i//4-" ~ IL cD" 4