HomeMy WebLinkAbout392-zFOI~M NO. ~
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES that the building located ot._.,~./~..~....~'~.~,..~..~.~..~/~..~...~.~..~....~...~..~.Y..®. ....... Stree~t
Map No...~r. ................ Block No...~, ............... Lot No. ~ ......... ~.¢.~.~0~ ...... ,~.,].*, .................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
............................. .~.~......~¢. ........... , 19.~..~...., pursuant to which Building Permit No....~.....~.~..~. ...............
dated .......................... ~u~.....24 ............ , 19~....., was issued, and conforms to ail of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is ..............
................ ~.~ ~..~.~. ~ $~.....-..... ~..~.~.$~.e.....~.e..~...t..e..~.. ~.~.¢. ~. ...................................................
This certificate is issued to ..~:~..,~t~c~l...Q]~..GOt..o~'..~..~,.'~.,D~}~n%~l.~.~%~ .............
(owner, lessee or tenant)
of the aforesaid building.
Building Inspector
FOR~I NO. 2
TOWH OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CL[RK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°. 392 Z
Permission is hereby granted to:
g$ ~.. ~,%a~cl~d...(~z.1.- Go .................................
......... H~;~ te~A .~ m~¥:'~..i~ L~e ~... P~ ....................
.......... P~llh~.....~..Z ........................................
at premises located at
l~ ~h 19 ~ and approved by the
pursuant to application dated ...................~ ~7. ...................................
Bui{ding inspector ~peoi. al exception
Fee $3~O...OO.....pa.~ cash
Permit sl~bject to approval 9~ access by Stat,,~]L..,~o~n~ty .~,ze, hway De
..... ~,~. ~ ~..~,~,.,,L...::~.~ ....... ~.:~. .........
t ' Building inspector ~
PER .........
t~on or.g road construet~ or improved on a couney road .ys~m.
. · . ~ o erhead or under~ound c~stng thereoe, or lay or ma,nra n there n dra ~, s~ w
...... ground ...... tund ..... h condit ...... d regulations ~
WHEREAS, a certain highway known as the ~/t~kht~t~ Averlu~ C.R. No. ~
has been improved and is on the Suffolk County Road System and
WHEREAS,
Esso Standard OJt Co,~ 15 W, 51st Sf,~ New York, New York,
, requests permission to
build pavc~ent~ r~n¢~rel'e curbing, curb ~fs, concrete r~ps~ concrete sidewalks & to
place topsoil ~ seod os p'~r sketch affaci~ed for 8ccess to proposed service stat' "mn'crt
~~~, norti}~ves[ corner of ~latti~uci-Oreenpor~ Rd,~ & Wickham Ave.¢
NOW, THEREFORE, permission is hereby granted to said ~O S~ds~d 0~ J Co* ~
to do said work upon the following conditions:
CONDITIONS AND RESTRICTIONS
1. When concrete is removed, cut concrete with concrete saw two feet outside the
limits of thc proposed excavation and for the full panel width. When the cut is
made in pavement within 10 feet of the panel joint, the pavement shall be removed
for full panel width from the cut on the far side of the excavation to the panel joint.
2. Backfill and thoroughly compact fill using power tamper, placing soils so that
various types of soil are in same relative position as before excavating. Grade to
original surface.
3. Replace pavement, sidewalk or surface same a,s existing; if concrete, replace
using 1:1 3/4:3 I/2 mix stone mix concrete; if bituminous material, replace using
same type as removed.
4.If concrete curb is removed, replace with similar curb 1:1 3/4:3 1/2 mix.
5.Notify the Maintenance Department at Yaphank 4-3470 when work is to begin
so that an inspection can be made of the operation.
This permit shall not be assigned or transferred without the written consent of the County Superintendent of
Highways.
The work authorized by ~his permit shall be performed under the supervision and to the satisfaction of the County
Superintendent of Highways or his representative.
Particular attention is called to the necessity of thoroughly compacting the back fill, which will be required by the
County Superintendent.
The County Superintendent of Highways shall be given one week's notice by said applicant of the date when i~
tends to begin thc work authorized by this permit, and prompt notice of its completlon.
The said applicant hereby agrees to hold the State, County and Town harmless on account of damages of any kind
which may arise during the progress of the work authorized by this permit or by reason thereof.
Applicant certifies all persons concerned with actual work under this permit are duly covered by Workmen's Com-
pensation Insurance and the State, County and Town shall be held harmless on account thereof.
Thc County Superintendent of Highways reserves the right to at any time revoke or annul this permit should the
said applicant fail to comply with the terms and conditions upon which it is granted.
Thc applicant agrees to pay all necessary expenses incident to supervision and inspection by reason of the granting
of such permit as certified by the County Superintendent of Highways, such payment to be made within ten days from the
rendering of the certified account.
Work under this permit to be commenced within thirty days from the date of permit and continued in an expedi-
tious manner.
The applicant shall submit a detailed plan of structure to be built, with a description of proposed method of con-
struction.
It is understood that should future changes in the alignment or grade of the highway require changes in the work
covered by this application and permit, the applicant shall on reasonable notice from the County Superintendent make such
necessary changes at his own expense wiShin the time so specified in notice.
Traffic shall be maintained by the applicant on this s~tion of the highway while the work is in progress and until
its final completion.
A ~~ in the sum ors
Bond ~ payable to the County Treasurer of Suffolk County
on file
~ as security that the highway will be restored to its original condition where disturbed at the expense of the
applicant, as soon as the work has been completed, and ~he said County Superintendent of Highways is hereby authorized
to expend all or as much of such deposit as may be necessa~ for that purpose, should the said applicant neglect or ~fuse
to perform the work.
In consideration of granting this permi~ the undersigned accepts it subject to conditions described.
Applicant [- ]-
Date Goun~ 8upe~nten~n~f Hi~hx~a~s, Suffolk
Co~tssloner o{ Publ lC Work8
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
$OUTHOLD, N. Y.
Examined ........... ..~.....!...19....~...~. '~ ) * -
Approved ........................................ ]Y ........ ~erm~t No ...............................
Disapproved a/c ....j..,~......,¢~ ....... .~.~. ....... /.~ ........ ,~ .......................................
Application No ..... :~...?......~...~ .........
APPLICATION FOR BUILDING PERMIT
Da te...., .~..(-/.....~... ~.': ........... ..~.:...'.: ................. 19..~./~.~ ....
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building
Inspector.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this Jocat]on.
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 on the premises available for inspection throughout the progress of the work.
e. No building shall be occupied or used in whole or in part for any puFpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuanoe 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, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances and regulations.
(Signature of applicant, or nam% if a cgfporati?)
............. ..........
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name or owner at premises.....:'....~.,,~...;a ........ ; .................. *<.~:..~:....~ ...... ~a:....~ ..................................................................
If applicant is a corporete.~ signgture of duly authorized officer.
(Nome and title of corporate officer)
Location of land on which proposed work will be done. Map No: ............................................ Lot No: ....................
Street and Number ,,,~,,~//V' ~z'z .~..:/(' alT// Z/£- ,,4 /)7777Zlz:'
Municipality
State existing use and occupancy of p~emises and intended use and occupancy of proposed construction:
a. Existing use and occupancy...~Z.~.~. .....................................................................................................
b. Intended use and occupancy....~.ZZ~:~.~:..~:(~:..-..~.~..~:.C~:.=...~.....~:%=%- .....
3. Nature of work (check which applicable): New Building ....... .~ .......... Addition .................... Alteration ....................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ....................
4. Estimated Cost.....~./.../..~..~...O...(.J....-.-.'. ............................. Fee ..........................................................................................
(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 ............................................................................................................................................
6. If business, commercial or mixed occupancy, spec ify nature and extent of each type 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 ................................ Rear ................................
Depth .............................. Height .............................. Number of Stories ................................
8. Dimensions of entire new construction: Front ...... .~/'../.~.:...~...~;... Rear ....... ~/../...'.Z...~....'.'.. Depth ..,~.~....~.~,~;..(.¢:'...Z .....
Height ......... /.~'/...~. ......... Number of Stories .......... / ................
9. Size of Jot: Front .......... ./.~?,-..57.~.... Rear ......... /..~,.5~..: ..... Depth ......... J..,~..~...'. ......
10. Date of Purchase .... ,/'.¢..'¢.7,¢.', ....................................... Name of Former Owner ........ /~,..k*~.¢.4 ...... ~:~-1.,¥.¢~..~/.~'.~. .....
11. Zone or use district in which premises are situated ........... '.'...~?...~. ..........................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation? ......... 4/~..~ ..................................
13. Name of Owner of premises.~E~Cf.~..~Z~¢Z.z. ZC.(~...:.f.~;,,Address .. '~.¢.'~,.ffz.~..ff,/Z¢......~./.,~ ....... Phone NO....~..~..~/~.~'~'~.~
Name of Architect.....,.~.~.,),../..'(/./P..(.~.g;Z.~. .................. Address ..~'./,-,¢,/4C .~//.~..~.......~..:../-...?.~.~Phone NO .....................
Name of Contrac,o,...~...gq...~'...~.~.~%~% .............. Address/..~....~..:A.~:;:'.~....~F;~....~..'.~i.~.'lChone NO .....................
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 numbers or description according to deed, and show street names and indicate
whether interior or corner lot.
STAT[-' OF NE~, YORK. ) S S
COUNTY OF ..~.:~.~.~.~;v. Jl~ ......... ) '
................................................................................................. being duly sworn, deposes ~nd says that he is the applicant
(Name of individual signi~ application)
~bow n~med. He ~s th~ .................... ~ ........ .~ ........................................................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner ar owners, and is duly authorized to perform or have performed the said work and to make and file
this app icat on; 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 ~f¢~n the application filed therewith.
Sworn to before me
W Public,~..t~ ......... Cou'n~y
FOR~f NO. 1
TOWN O~ SOUTBOLD
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
E×am ned ...........
?
~xpproveO ........................................ 1~' ........ ~erm~r No ..............................
Disapproved o/c ...~.......~......... ........
..................
(Building Inspector)
Application No.
APPLICATION FOR BUILDING PERMIT
......... ....... ....
INSTRUCTIONS
a. This application must be comp[efely filled in by typewriter or in ink and submitted in duplicate to the Building
Inspector.
b. Plot plan showing location of lot and of buildings on premises, relationship to ,adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this location.
c. The work coYered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue o Building Permit to the applicant. Such
permit shall be kept on the premises available for inspection throughout the progress of the work.
e. No building shall be occupied or used in whole or ir~ port for any pui'pose whatever until ,a Certificafe of Occupancy
shall have been granted 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 Sou'thold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances and regulations.
(Signature of applicant, or name, !,f a c~poratiprt) ,,. ,~,
............ .........
(Address of applicant)
State wheth,er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
................................ ........................................................................................................................................
Name of owner of premises.......~.~..~...~.. ....... ...~..~...~...~..~..~...~.-~. ....... ~.~..4~ ......... ~.~.~ .....................
If applicant is a corporate,)signature of duly authorized o~icer.
....
(Nome and title of corporate o 'rice ~
1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: ....................
Street and Number/~..~../.../~.,....,~..-~....~.,....~.../.C~..~./49....~./...~. ................................................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
o. Existing useandoccupancy....~...~..~..,~1~....~....I ...................................................................................... ' ................
b. Intended use and
3. Nature of work (check which applicable): New Building ....... ..~ .......... Addition .................... Alteration ....................
Repair ............... ;...~emoval .................... Demolition .................... Other Work (Describe) ....................
4. Estimated Cost......'~...../.~.~....~...~....~ ............................. Fee ..........................................................................................
(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 .............................................................................................................................................
6. If business, commercial or ,-nixed occupancy, specify nature and extent of each type of use....,~....~...~'../..,~/..g[."~
7. Dimensions of existing structures, if any: Front ................ . ........... Rear ............................ Depth ............................
Height ............................ Number of Stories .............................................................................................................
Dimensions of same structure with alterations or oddltlons: Front ................................ Rear ................................
Depth .............................. Height .............................. Number of Stories ................................
, ,' .~../~ e/~" Depth
8. Dimensions of entire new construction: Front......~../....':7....~.. ....... Rear .......................................................
Height ........ /.f'/..'..i .......... Number of Stories ......... /. ................
9. Size of lot: Front .......... /..~....~.~..~ .... Rear ........ /...~'...~.~...~. ..... Depth ........ ./....~....~...~ .......
10. Date of Purchase ,._/..~- ,~,.~.. ....................................... Name of Former Owner ........ ..~...?.'~..~. ....... ..7~...../~...../~....~....~.. ......
1 ]. Zone or use district in which premises ore situated ................................................................................................
12. Does proposed construction violate any zoning Iow ordinance or reaulation;~ 4/~ ~.
.....................................
]3. Name of Owner of premises~.~..~..~..~...~.~.,~.~...~..//....~.~,.Address ~.~.~'...~/../~...../~,...,....~..'...~.~. ....... Phone NO ........
Name of Architect..~...~.'.....~..~....~....~..~'~.."'~... .................. Address /~..~.../.~..~'?~,....~'Z~'~.Phone NO .....................
Name of Contractor .................................................... Address ............................................ Phone NO .....................
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 numbers or description according to deed, and show street names and indicate
whether interior or corner lot.
STATE OF NEV~ YORK, ) S S.
COUNTY OF z,,~'g.~.~.°..~.(.~.. ........ )
~"-/}~/,,~,4 ~- ~ , ~ ~ ~ bein~
................................. ~....~ .................................... ~... ~ duly sworn, deposes and says that he is the applicant
(Name of individual signing application) ~
~bove n~med. He s the .............................................................................................................................................................
(Contractor, agent, corporate 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 a)plication; that all statements containe~ in this application are true to the best of his knowledge and belief;
and that the work will be performed in the mann~t ~ in the application filed therewith.
Sworn to before me this ~ ,, ~ta~0E,
,~.~ ~, I ~, ,~ ~t~ 8~ ~e of~
dpy of ,......~ .................. *~,0~ (Sig~tu~,of ~pplicont) ~_ -~
SKETCH SHOWING
CURB, SIDEWALK AND SHOULDER CONSTRUCTION
ADJACENT TO
PERMIT
NO.
SECTION THROUGH DEPRESSED CURB
SECTION THROUGH CURB
ELEVATION SHOWING DEPRESSED CURB
MADE BY: E.J.$. (JUNE 14,1957)
NOT TO SCALE )
' '/ ~ NOTE- INFORMATION SHOWN ON THIS SNE~'r SHALL GOVERN CONTRACTS AND
,, CONSTRUCTION AND SHALL SUPERSEDE CONFLICTING INFORMATION
~'0/~'~//~~ ,'~,~.,~/~' ~ ~.~ APP~RING E~HERE.
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,THIS BLUEPRINT IS THE PROP~R~ OF THE ~-'-~8 J,, ESSO STANDARD OIL COMPANY DI.trlot Mir.
IT IS LOANED TO YOU AND MU~ BE R~RNED CONSTRUCTION a MAINTENANCE DE~. D~,~.~o. Mgr. C & M Supt.
WHICH IT-WAS INTENDED. HUT~INSON RIV~ P~WAY P~M. N. ~. op,mUo,, MS,. Co,~,~r I'=~O'-O' ~ T T / ~'~
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ESSO STANDARDM~KETiNGDEPARTMENTOILOOMPANYi ' DRAWN wJs F OR NEW Y
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ST~DARD OIL OOMPANY~ A SERVIO ENT'ER
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C. C~NSTR~JCTION,
ESSO ST,/:NDAF, D OIL COMPANY MA$OI,J!qY
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,THIS BLUEPRINT IS THE PROPERTY OF THE
ESSO STANDARD OIL COMPANY
IT IS LOANED TO YOU AND MUST BE RETURNED
AFTER IT HAS SERVED THE PURPOSE FOR
WHICH IT WAS INTENDED.
REVISIONS
't
ESSO STANDARD OIL COMPANY
- CONSTRUCTIONi ~" MAINTtENANCE, DEPT.
HUTCHINSON RIV£R PARKWAY PELHAM, N, Y.
APPROVED--
Opera~ions MRr,