The URL can be used to link to this page

Home My WebLink About2944-zFORM N~O. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT %'OWN CI;ERK'S OFFICE SOUTHOLD, N. Y, OEI~T~FIO~TE OF O00UP~NOY No.~..2.4..2.5. ..... Date ................. 0'UI~..2. ........ 19. ~5.6 TttIS CERTIFIES that the building located at . .~1/~ .~!~..S~lr. OO.~ ......... Street Map No.....~. · ...... Block No ..... ~ .... Lot No ...... .8outhold,..l~e~..Y~rk ....... conforms substantially to the Applicati,on for Building Permit heretof~oi'e filed in this office dated .......... l~.O.V.~ll~Ir..~0., [1965.. pursuant to which Building Permit No. dated .......... ]~0.V. QI!~.~I~'..~0., 29.65, was issued, and conforms to all of the require- ments .of the applicable provisions of the law. The .occupancy f. or which this ceztificate is issued is ..... a..d.~..~.t:.~.o..Il..t;..o..t%...~.t~ .silt19 .e.8.s.. ~.tll[J.(~itlcJ ................................. The certificate is issued t.o .J.o.h..n...Hi~.OI%~,C .~0~ .80.11tltc~lcl .Phaz'lnacy,..lille ...... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ......................................... Building Inspector FORM 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) Permission is hereby granted to: ·otm ~ .~....~...~.....~..~;..;..~.e.~b~,~...~..~.~,.~..~e ......... ~.o~t~Q~l. ................................................... to ....~,:~.~...~..e~.~,'l:Lt ~,.o~ ..on ..~z~,. ez ~,~ .~.!n~...li~m~m~a,.i~g,~tz~ ................................ ct premises located at .....~./..~........~..~..~,TA...~.~ ............................................................................................. ................................ .~.o.~l.t,~,~],~ .............................................................................................................. pursuant to application dated ..................... JJ~t'~':l~t~ez'......,!l~O. ........... 1~i~...., and approved by the Building inspector Fee ~...*....('~.. ............... STATE OF NEW YORK DEPAI~TMENT OF LABOR ,OlVI$10N OF' INDUSTRIAL SAFETY SERVICE CERTIFICATE OF APP~OYAL (BUILDING PLANS)' DIVISION OF INDUSTRIAL SAFETY SERVICE BUILDING ]PLANS ENGINTERING UNIT L [] New Building ~ Alteration [] Addition The plans and specifications bearing the stamp and serial of Labor cited above are in compliance with requirements of the Labor Law and the Industrial Code and are APPROVED as subfiitted APPROVED with conditions° Valid only after the conditions set forth on attached Reference Sheets are complied with° This determination is valid only on the basis of the statements set forth in the application for ex- amination of plans bearing the same stamp and number and to the extent that such plans are subject to the provisions of said law and code and within the jurisdiction of the Industrial Commissioner° Notify the Building Plans Engineering Unit of any proposed deviations from these plans; filing of revised plans may be required in these instances° A set of plans should be retained on the premises ~t all times so that inspectors of this department may consult them in the course of their inspections° A certificate of compliance must be obtained, PRIOR TO OCCUPANCY, for: 1o Any building to be used as a FACTORY with more than five employees° Apply at least ten days prior to occupancy~ to the Supervising Factory Inspector~ Division of Industrial Safety Service at 2. Any building to be used as a place of PUBLIC ASSEMBLY. Apply to local building official or~ if none, to Supervising Factory Inspector, Division of Industrial Safety Service at This is not a building permit° To obtain required permit take this certificate, with the approved plans, to the local official The Debartment of Labor assumes no responsibilit3r for the adequacy of the structural elements inv~~vacrion. ~ ~t}~ O C~l Jo Matte~, Director FoR WnE CO~ss~o~ER IS$-640 (7-64) FO~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ............................. Disapproved a/c .................................. ::.~.~...-.~ ..................................... i}~ ....... (Building Inspec{or) APPLIGATION FOR BUILDING PERMIT Date ........................ ~.~! .O. ~ ~ ~ ~..~......~ .0.. ...... , 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 punic streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part 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 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 o 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 alterations, or for removal or demolition, as herein described. The applicant agrees to comply with oil applicable ~aws, ordinances, building code ond regulations. · (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi'neer, general contractor, electrician, plumber or builder. ............................................... Co,~;z.ac.bo.r ......................................................................................................................... Name of owner of premises ...S.Ql~.t~.].r]...}?b.~Z'.rna~(zZ T.~c ......................................... 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.: ...... 7.,;~7~'Z ...................... Lot NO.: .....z...~.~ .......... Street and Number ]~T/.~':.....~.~.J.~..~;.t, ........................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ............................................................. b. Intended use and occupancy ................. ,.a.D.e......wz. ~..&~..A~.~.~-.Q~L .......................................................... 3. NatUre of work (check which applicable): New Building .................. Addition ...~f,x,xxl¢. Alteration Repair .................. Removal .................. Demolition ................ ~. Other Work (Describe) 4. Estimated Cost ...~.Q~Q. QQ...~.~/.~ ................................. Fee ~ · O0 ........... .............. 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor If g~arage, number of cars ........................................ 6. If I~usiness commercial or mixed occupancy, specify nature and extent of each type of use ~usines~ 7. Dir~ensions of existing structures, if any: Front ........ .~..~.'r.9. .......... Rear .....~..~..T.,~. ................. Depth ....~..~..-.~ ....... Height ........................ Number of Stories ,,,Dne Dimensions of same structure with a, lterations or additions: Front ........... .br..~r.c). ............... Rear ........ Depth ...ll.Lkr. g. ................ Height ............................ Number of Stories ..... .o..n...e. .................... 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth Height .................... Number of Stories .................................................................. Size] of lot: Front ...... kk,.25. ......... Rear ............ f ........... Depth ..... Z.6..6...-.~. .............. 10, Dat~ of Purchase ........................................................ Name of Former Owner 1 1. Zone or use district in which premises are situated nB" 12. Does proposed construction violate any zoning law, ordinance or regulation? 13. Name of Owner of premises..............._.......So~tho~c] Pha:rmagkT~dress....... ........ .......... ~.c~,~j~.~.~f]..~ -} ............... Phone No. Na~e of Architect G,, Ahlers -,, J'a~sport .................. ' ................................... ~aaress ............................................ Phone No, Narbe of Contractor .~T~h~.J.g~p.o!ti.c ...................... Address ............. ~g..q?.,,l,%o. 1..cl. ............ Phone No, PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr, property li'nes. Give street and block number or description according to deed, and show street names and indic, whether interior or corner lot. Sc~e fi2ed plans STATE OF' NE~ Y~,K~, /, S S COUNTY ,OF .~?..g.$..Z...o.~.k.i ............. ,f ' ' ...................................... ~.°...h.~...1.!i~.P.~..~..i..9 ............................... being duly,~Swom, deposes and soys that he s the applicc (Name of individual signing application) above no,tried. He is the .......... gQD~.~.q..~..o..r,.. .~~ , . , .// (Contractor, agent, corporate officer, etc.) of said owher or owners, and is duly authorized to perform or have performed the said work and to make end this application; that all statements conta,ined in this application are true to the best of his knowledge and belief; that the wqrk will be performed in the manner set forth in the application filed therewith. Sworn to before me this 30 da, of November o 6~ "-~ ,~ /? , - .LAV M ~licat~on'o~ file in the office of the Suffolk County Departme~ Health. I PT~I ,.iII II 'TYP _ I -I i- P^iUT Ai--L.W^L-L.~ d~Lq a-~<TCt t I I '-Fo -i TYP T~? ~NLL ! I JOE NO. SH£ETNO, DATE REVISIONS ST KA JOB NO, I I JOB'NO, SHEET NO. DATE R'EVISION$ DATE DRAWN DFI&WN By ~KA~ aLOe. NO. .o. l 1' :d ° T o 4 4' ~' v 4~'- o'~ IqG6' E '"F ~ fZ ~ JOB NO, SHEET NO. DAT~'' REVISIONS