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Home My WebLink About6404-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z~.6~ ...... Date ...... N, .°.v.e.m.b?.~..1~6.~ ........ , 19 73 THIS CERTIFIES that the building located at ... New. auffo~J¢. &v.a,. ..... Street Map No .... X~'~ .......Block No...XX ...... Lot No... XX.. Matti.tl~Ok ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ March..1-~ · ·., 19. -73 pursuant to which Building Permit No...6~01fr.Z. dated ........ March. '1'3~ .... , 19.73., 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 ... P'rtvat. e .one .fani.ty. a, elling ..................................... The certificate is issued to .... S.tever~ .Ske~ro~eZ;Lx ............................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..NR. ............................... UNDERWRITERS CERTIFICATE No. ~R HOUSE NUMBER ... 20~. ...... Street .... ~.W..~..~..~.o.l.k' .A.V.$? ................... Mattituck Building Inspector FOEM NO. 2 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? 6~0~ Z Permission is hereby granted to:~ / .... ~.~~.....~..~..~c :~.~z / ~ ....... ~.~.z~..<~..,. ~....:~.:~ - ~ .... ~ ............ ~.~......ZG~...~.~.....~.~ ~Z~.~...~.~.~;~ ............. ~. ~~.~/~..~.~ ......... ~ ........................... . . ~ /~ ~ pursuont to opphcohon dated ....................... 19 ........ , o d opproved by the Build,Inspector. Fee $.~......../~.....~....~.. guil~n~ In~ector FOR~ NO. 6 TOWN OF SOUTHOLD I~#ilcling Department Town Clerks Office $ou~ho~d, N. Y. 11971 APPLiCATiON FOR G£RTIFICATE oF OCCUPANCY ~ns~ructions 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: I. 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 ................................................ New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ~ ~ ~ ~ ~1~6 Z I~ ~ Owner Or Owners Of Property ~ ~ [/~; ~ ~ Lz ~ ~ /z ~ ~ / ~ Subdivision ............................. ~ .................................. Lot No ......... ~... Block No ............. House No ............. ~.~ No. o~ ~.~ .?Z4.~/ZZ..~.~ ............................................... ............... ............... Health Dept. Approval ................. ~...~ ............ ~lannin~ ~oard Annrowl ......... .~ ..................... Underwriters Approval Request For Temporary Ce~ificate ........................................ Final Certificate ~ F~. Submitted S ...... ~.~ ................ App c a rlE~'.. ~?.. d~.~' .c~x..'.~.../...~......~...~..., ................................................... Sworn to before me this '/-"<:~"7' Z~. day of ..~.~ .... /.2. 7 ~. ....... (stamp o, No, 52-0344963 suffolk Count~ Co~mission ~xpiros March 30, THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ tflb 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date January 17, 197~; Appllc.tlo. No.o.f,. 701239 N THIS CERTIFIES THAT 138570 only the electrical equipment as described belo~ ami introduced by the applicant named on the abo~ application number in the premises of StevenSke vofelix, n/s New Suffolk Ave., 300' e/o Reeve Ave.,#2095, ' g ;X ~asement ~ IstFI. [] 2nd FI. Outside Section Brock Lot was examined on January 15. l~7& andfoundtobeincompliancewiththerequlrementsofthisBoard. FURNACE ~OTORS ' RJTURE APPLIANCE FEEDERS A,V,T. K.W. OIL H.P. GAS H.P. AMT. HO. A.W.G. RANGES SPECIAL REC'E1 1 2( ICOOKING DECKS OVENS J DISH WASHERS TIME CLOCKS B~LI. UNIT HEATERS MULTI-OUTLET SERVICE DISCONNECT "O. OF ~ 1 200 CB A~ETE~ S E R V I EXHAUST FANS DIMMERS AMT. WATTS C A.W.G. NO. OF NEUTRALS A.W.G. OF HI-tEG OF NEUTRAL 2/O 1,8'2W 1.8'3Wx 3~'3W 3~'4W NO:O~ECRC~CONO'~. A. W.G. NO. OF HI-LEG OF CC COND. ~/0 Elect~tc Room }{eaters: ~ _o ,)-,.. OKW 1-1.5KW ].-. 5KW F.W.Brudi 1194 Waverly Ave. Holtsville, L.I. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CiKJiFICATE MUST NOT BE ALTERED IN ANY MANNER, IUILDING i)EI)ARTMENT TOWN CLICK'S OFI~CE SOUT~OLD, N.Y. ~/~ Examined .................... .~. ......... v./...:, I; ........ ~x//3'/?X' ,~,, ,o.~....~..~...~.~. ....... Al:~ro~d ........................................ , 1¢ ........ DL~pprov~ o/¢ ........................................................................................... APPLICATION FOR BUILDING PERMIT "~ ~te ,~,/~ ~ ............ ~, ............ .............. ,,, INSTRUCTIONS e. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, wit 3 sets of' plans, accurate plot plan to scale. Fee according to schedule. 'b. Plot pian showing location of lot and of buildings on premises, relationship to adjoining premises or public street~ or areas, an( giving a detailed description of layout of property must be drawn on diagram which is pert of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of' this application the Building Inspector will issue a Building Permit to the applicant. Such permit,shall be kept or ~ the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have beei ~ranted by the Building Inspector. · APPLICATION IS HEREBY MADE to the Building Department 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 Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, oi' for removal or demolition, as herein described. The applicant agrees to coml~ly with all'aPPlicable ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Address of applicant) State whether applicant is owner, levee_, agent, arChitect, engineer, general contractor, electrician, plumber or builder. ........................... , .......................... ./._~_ ..................... ./..~.. .......... ~...,~,. ............................ : .................................. .~ Name of owner of premises .~...~ ~ If ap licant is a c rate si na . · · -. r ................... /'7- .....~,, ............................................................... ~ p orpo , 'g turn of dray authorized officer, y (Name and title of cOrporate officer) Builder's License No .......... . ..... .~.. ....................... . . . Plumber's License No ......................................................... Electrician's License No. Other Trade's L cense No -- .~. ~ . . . ' .............................................. . ;e-'-..,-. , , 1. Loc. at:on of land on which proposed work will be dOne. Map No.~..~-~......---.~ ........ Lot No...~ - ~L~ St ' 'J ~'"'" ~ '*'" ' '"'"' "'""" ' / / '" /3 ~, ~ ................... reet and Number .'~..~ .:~....... ~/,,,~. ~... (e=,,,~. ~. ~)~4~. ~'~c; ... .2,/'~...¢ .......... ...... ~, · · ~ · ..//7~. .................. Municipality 2. Steate existing use and occupancy of premises~and intended, use and occupancy of proposed construction: a. Existing and occupancy ...~........~....~... ......... Z~..~!/~'"~ ..........~ ,..,I ,L.':'"~ .................................... /~' Use b. Intended use and occupancy 3. Nature of work (check which applicable): New Building ....................... Addition ...~, ........... Alteration...: ........... Repair ......................... Removal ......................... Demo~tion ........................ Other Work ........................ ~:. ......... J~ ~ (DescriPtion~ fz ............ 4. Estimated Cost ..../~,~- .......................... Fee ..,~.~.. .................................................................... ~ (to be paid on filing this application) 5. If dwelling, number of dwelling unite ..... /. ........ Number of dwelling units on each floor ......................................... If garage, number of cars ............ .~.. ............................................................................................................................ 6. If business, commercial or mixed occuoancy, speci~fy~.~ and extent~.o,f~ype of use '""'~"~'~'".~'~'r ......... 7. Dimensions of existi~_l structures, if any: Front .~...~...~'.. ...... .Rear .~,~...~.....~... ........... Depth ..~4~. ...... ..~.. ............... Height ..... ~.~..--~- .................. Number of Stones ........~....~..~./~ .......................... .,..~.~ ............... Dimensions of same stru~cture with alterations o,r ~l~,tlons. Front ....~..~..'..~.~i ...... Rear ...~..7~.....~..~ .................... II/'~I "J · · . / ! ' "' '- ~'- '-- .../.. ............................ Depth ........ ..'~-~......~. ............... ,.. Me,ghz ...~...~ ....... ./. ............ , ......... _~um~er m ~zon~ ..... ~ ..~ .. 8. Dimensions of entire ne~ construction: Front ...~....~"' ....... Rear .~,~...~.. .............. Depth .../.,~. ......................... Height ....... ~..J~ ........................ Number of Stories ...... .~.. ........................................................................... 9. Size of lot: Front ............... , ...................... Rear ............................ ,.....~y.....~De_pth ................ '.'"7~"~':~"-' ............... ..... Name nf Fnrmer C~wner ?..~ ..~.~.~. '~....~.. .....~..Z~../..~....-~..., ............ 10. ua~e OT rurcnase .................................................................... ~-'- 13. Willlot bere~'aded ................................ Will excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premiss ..:~,~....'~./~:t ................................... :':".':"'":"-"': ....... r'"~ ................ :~.'""'"::": ............ :'" Name of Arch,tect ..,,~.~..~~.~ .......................... Name °f C°ntract°r ~'~'~'"(~'":''' ....... ~ ......................... [ ~,~i~ ~')' ...... ~ ...... : ................. ""'(~o~n~.)~''''~'''''' PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whefl~- er interior or corner lot. STATE OF NEW._YOFkK. ) COUNTY OF .....~..~..~.~'~ ........................... ) ............................................................... . ......................................... being duly sworn, deposes and says that he is the applicant above named. (Name of individual signing contract} He is the ...... ~ ............. I~.~....~....~ .................................................................................................................................................................... {Contractor, ~ent, corporate officer, etc.} of said owner or owners, and is duly authorized to perform or have pe[formed the said w~rk 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 he performed in the manner sat forth in the application filed themwlth. ...................... ~ ........ - ........... ~! t' '""~(~752'-6168295 ~/~'-. . /~/~....~'.,~ ~_ / Notary Public, .~......~.~.....Lxi~b~lL~ch ~, ~..~,,"~....-~,~ .............. SUFFOLK SURVEY FOR STEVEN SKEVOFELIX ~ MARY SKEVOFELIX I~A T TI TUCK TOWN OF SOUTh/OLD SUFFOLK COUNTY. NY SCALE, 1'=40' SEPT 2. 1970