HomeMy WebLinkAbout1417-zFO~WI 1~O. 4
TOWN OF $OUTHOLD
I~UILDING DEPAi~TMENT
TOWN CLERIC'S OFFICE
SOUTHOLD, N. Y~
CERTIFICATE OF OCCUPANCY
'['H~S CERTIFIES that the building located at E.1Xj.ah~l{...L~., ..& .~D~......).,. ...... Street
Map No. *** Block No. ~** Lot l~Yo.
conforms substantially to the Application for Building Permit heretofore filed in this office
aatea ............ ....................... ~e.,.~$, pursuant to which Building Permit No .......
dated .......... ~$~.,.~.~ ....................... , 19.~.~.., was issued, aud conforms to all of the require-
ments o~ the applicable provisions of the law. The occupancy for which this ce~ificate is
issued is BUSIneSS BUILDING
'Chis certificate is issued to .... ~.~.~...q~...~.~...,~Z.~...~..~..~...~?}~.~{.~..,o~ers
(owner, lessee or tenant)
of the aforesaid building.
FOF, M 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.° 1417, z
Date ........................ ~.~.....~.~ ................ 196.1....
Permission is hereby granted to:
H,R,Reeve & ~ons .Inc ....... A/C..W~a..~e~te~...Jr...&.Jane...P.,.. Goller
. MaSer ~..t. ue]~.t. · ... ~ ~..~, .........................................
to ... ~u&t~...new...b~e~e~e.. ~u.!.t~i. mg .......................................................................................
ct premises ]ocoted at ...W/.8.,.Bt.~.Jeh.'e...~.'~Aear-"m~.n"R~ad .............................................
.............................................. Fa .~.t ;l,t~ e...li., .Y ................................................................................
pursuant to application dated .................................. l~y.....~ ............. 196.1...., and approved by the
Building Inspector
Fee
Consent is hereby given foe the f.il±n~ of
this endorsemant appears in the office of
This approval does not include structural toaturss and t,s ~ran
on conditi,)n that the proposed facilities ar~ instal3~d i~
form:; [:v t':.i t.b those plans.
D~ Strict Engineer
I~H KD. BY ......... DATE ........
N
12. P EoPJ-E_~ ?o 55~,~. L.~ ~c~!oo~ I ~H H=T
Building Permit No.
SUFFOLK COUNTY DEPARTMENT OF HE,~LTH
Riverhead, New York
Type cE Print Legibly in
Health Department Plan No.
I
~ppl.ication for Aoproval of ~o~ercial Sewage Disposal System
TO: The Suffolk County Department of Health Date ~///~./
Application for approval of commercial sewage disposal system is hereby
requested.
Location: EL .)A~)~ ~Ak ~-- %4/ ~-~ff~ ~J ~l~'r~__ ~
(Name "ahd side of st~eet~ and flame and histance to nearest intersecting street)
Hamlet
Village
I hereby certify that this commercial sewage disposal system has been con-
structed in accordance with plans approved by the Suffolk County Department of
Health on (date) ~--~ ~. ~ and with all the requirements of the latest
bulletins on sewage disposal of the Suffolk County Department of Health.
Ready for inspection .........
rqR USEy H~LTH D-~P~RT~ENT,,,,,~NL~
Installation satisfactory - Yes ~; No. .
Based on the information stated here~n ~Y the applicant and other information
made available, it is the opinion of this department that this system'with proper
maintenance can be expected to function satisfactorily and is not likely to cause
a nuisance, provided designed sewage flow is not exceeded. Structural features
are not included.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ....... .......
Approved ........................................ 19 ........ Permit No. ~' I L~t~ q
Disapproved a/c ........... ..//...,~......,:,~ .......... ~ ........ ~ .......... ~ ......... ;....~.
....................................... ......
........ ..................
(Building Inspector)(
Application No. /i..~....(...7 .............
APPLICATION FOR BUILDING PERMIT
Date ........................ Hay.. 2.~ ................... 19....63, ...
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 location.
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 purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE t0 the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southotd, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or a Iterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances and regulations.
~rold R. Reeve ~. Sons~ Inc.
(Signature of applicant, or name, if a corporation)
Main Road~ Mattitucka N.Y..
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
General Contractor
Wm. J. ~axter and Jane P. Goller
Name of owner of premises ................................... :~ ...............................................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
1. Location of land on which proposed work will be done. Map No: ............................................Lot No: ....................
Street and Number El~Jah's Lane~ ~0' N. Rte.~ Mattltu~k~ ~.Y.
Municipality
2. State existing use and occupancy of p~emises and intended use end occupancy of proposed construction:
None
o. Existing use and occupancy .....................................................................................................................................
b. Intended use and occupancy ....... .~?.?...~..~...~.?...~.~.~...~.g....~_~.~...~..~.O.~'.~.~l~. ............................................................
¥
3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration ....................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ....................
4. Estimated Cost....,.~.3.0. i.Q.0..0.,.Q.0. .................... ............ Fee ..~.~..O..~..O.Q. .........................................................................
(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, specify 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 ...... ~.0.~*. ............... Rear ......1~.0..! ................ Depth .......~..2..0..t. .............
Height .....]'...2..~.....6.~.~. ......... Number of Stories ...... ..1. ...................
9. Size of lot: Front .~J.2...0.1~Q.! ........... Rear ..~.~.~,~..~...~. ........... Depth .....,~..~...~..~. ......
10. Date of Purchase .....~...~.!t...~.~...]~9.~..~ ......................... Name of Former Owner ....... ~.1'...O..O...~.~. ..................................
l i. Zone or use district in which premises are situated ...... ~.~..~.~...~..~...~. .......................................................................
12. Does ro osed construction violate any zonina law ordinance or reaulation~ ~O
13. Name of Owner of premises ........................................ Address ...................... ~}~1[~1 ........ Phone NO.....* ......... .2.~...
Name of Architect.....G...*..K..:..~..h..~.~..~.~.....P..*..~..?. ............. Address .~..8...~..~...~.p..O..~.~............... ........ Phone NO .....................
c^~.~.,^.Harold R,Re®ve ~5 8onst~ress Mat~ltuok~ N.Y. Phone NO. 9-828~
Name of .................................................. ~'i~'(I' ~ ..................................................................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beck dimensions from
property lines. Give street and block numbers or description according to deed, and show street names and indicate
whether interior or corner [at.
See a'ttached plot plan
STATE OF NEW YORK, ) S S.
COUNTY OF ~.U,,f'~.g~kk ........... )
....................... .~.[..a.~..o..]:.~...~..:...~9..9.~.e..~.....'?.~.t ......................... being duly sworn, deposes and says that he is the applicant
(Name of individual signing application)
above named. He is the ................ .g..o.?..g.p.~.:~..e....9.~.~$..g. fl~. ...................................................................................................
(Contractor, agent, corharate officer, etc.)
of sa d owner or owners and is duly authorized to perform or have performed the said work and to make and file
th s application; that ali statements contained in this application are true to the best of his knowledge and belief;
and that the work wilJ be performed in the manner set forth in the application filed therewith./-
'Sworn to before me this £1~Vl~ tea 52 857.0go0 -'~ // /~ // '/ /~5 / //
23rd,., dav of
..................... f /~) ~-' ~-''~ ~ "~olk ' ~,ount~/ at Suflol~
Notary Rublic? %.W."~VF..~~..?,..u.J,.+. .........
FORM NO. I
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Approved .......................... '..: ........... 19 ........ Permit No. -Z, ~ c~/'h1
Application No...~...~.J..../...'Z ...........
APPLICATION FOR BUILDING PERMIT
iNSTRUCTIONS r
a.' Thi$ 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 location.
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 purpose whatever until a Certificate 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 Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or a Iterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances and regulations.
Harold R. Reeve & Sons, Inc.
(Signature of applicant, or name, if a corporation)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
~eneral Contra~ ,t. or -
Name of owner of premises.... Win,....... J,........Haxt.~ .r,~. ", ..~n.ql. ..... ~.~.~...~..,....g.Q:],,$..e.~'. ............................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: ....................
Street and Number ..~i..~.~.~...~...~.~...e.~....2.~.~..~....N.~.....~.~.q~..2.~.j....1~...~.~.~..~..~.~.k..~.. .~..:..~..*. .....................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
~Tone
a. Existing use and occupancy .....................................................................................................................................
b. Intended use and occupancy .......... .M.~,~.1~..~.(]:.$.g.r.:L]~g..aztd...s.~o.r.a~ ..........................................................
property lines. Give street and block numbers or description according to deed,
whether interior or corner lot.
3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration ....................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ....................
4. Estimated Cost.....$.~.0.,,0.00.,.0.0. ................................ Fee ..$.~0.,.Q.Q .........................................................................
(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, specify 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 ...... .~0.~. ............... Rear ..... .l:lr.0.! ................ Depth ...... .~..~...0..~. .............
Height ....,lJ~.!...~.~ ......... Number of Stories ...... .], ...................
9. Size of lot: Front .3~.QL~0.! ........... Rear .],.8.],*.'Z.9..~. ........... Depth .....,.~{~.,,~.~. ......
10. Date of Purchase ....~,y...~.,~...J, CJ~.], ......................... Name of Former Owner ....... .P.~f~..O. fl,..~.. ..................................
11. Zone or use district in which premises are situated ...... )~.1).~.~.$.~ .......................................................................
1;). Does proposed construction violate any zoninfl law, ordinance or regulation? ..... ..N..O. ..........................................
Wm.J,Bm~iter,Jr. and Jane R.Goller ~, ..... p~, ~,,,-. ~,~ ~, ,-,-~.~.
13. Name of O~ner of premls'es ....................................... .Address ...................... ~[~.~j~ ........ hone NO....a ........
Name of Architect.....G..,..E..,..A...hl~.~.s..,...[.,.E..,. ............. Address .~..$..~.~..S.p.O...I'.~.$....N..,~... ........ Phone NO .....................
Name of ...... Phone NO. .....
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-back dimensions from
and show street names and indicate
See attached plot plan
STATE OF NEW ,YORK, ) S S.
COUNTY OF .....S.B~.~.OiI. k .......)
....................... ~.~.~..~..o...2k..~....R..:.,...}.~..q.e,.~.e..~....~1~.., .......................... being duly sworn, deposes and says that he is the applicant
(Name of indi~,idual signing application) ·
above named, He is the ............ .%o.~'.p..q;v.~.t. fl...o.f£.J..o.e,r. ....................................................................................................... '
(Contractor, agent, corlSorate 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 wil! be performed in the manner set forth in thes~f~lii~jcotion fil,~d therewith.
Sworn to before me th.s ~,~_~, ~0. 5~-- ,/o~, "~l~ /~'" '~'///([~/ /]
........................
Narc,,~, Public~'~4 ~,~~ Suf£otk
'"' ....... 7 ..........................
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