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HomeMy WebLinkAbout3864-zTOWN OF SQUTHOLD BUILDING DEPARTMENT 'I'OWN CL~RK'S OFFICE SOUTHOLD. N. Y. m-£1~TIFICAT£ OF Onr. UPANny No.. Z.3~S.. · Date ......... ~.. ]..-~ ~ ...... 19~8.. THIS CERTIFIES that the building located at S/~. Nl[.d~],e .RO~d ........... Street Map No ............. Block No ............. Lot No. l~,g~,. ~..YO/f]~ ............ conforms substantially to the Application for Building Permit heretof, ore filed in this office dated ..... Alibi.-..].~., ...... , 19.~ pursuant to which Building Permit No. '38~4' ~ dated ..... ~.t.]....].6, ........ 19~8., was issued, and conforms to all of the require- merits .of the applicable provisions of the law. The occupancy for which this certificate is issued is ... ~ ~,~..~)~. ~mm~.~.]g. dw~].~, ~..~#~{~) .............................. The certificate is issued to .... ~~ .D;{~].~ .................................... (owner, lessee or tenant) of the aforesaid building. /.~_. Suffolk County Department of Health Approval ..... ~: ........... ~ ....................... Building Inspector FOF,~I NO. ~ TOWN O~ $OUTHOLD $OUTSOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3864 Z Permission is hereby gronted to: ¢la~e,~ee Dille~ to t~c~e...e~.t~J~,...~w.e, ll~u~ .~.~. ~.~l.q..~ ........................................................................... ................. t~l~e..~x~a~..~..~se.~ ....................................................................... at premises located at ..,~/~..J~;~;J.4b..~P-,O~J~[ ..................................................................................... ........................................ l~aen~o . N,1~, ...... pursuant to application dated ................................ A~J~...~k~J~..., 19.~8.., and approved by the Building Inspector. Fee $1.0~0~ ............ Building nspec' ~ (5M)-(5/1/67) rermi'[' Ho ....... .8..3..8.~.. PERMIT UNDER SECTION 136 of ARTICLE VI of HIGHWAY LAW WHEREAS, a certain highway known as the Middle P~ad CR No. 27 has been improved and is on the Suffolk County Road System and WHEREAS, Goldsmith Building & Cov~trv~tion Co. ,IRe. A/C Claz~nue r. Diller Middle Road, Peeon:[e, N.Y. requests permission to as per sketch or map attached. NOW, THEREFORE, permission is hereby granted to said Goldmsith Build/n~ & (:om t~uotton Co. to do said work upon the following conditions: CONDITIONS AND RESTRICTIONS limits of the proposed excavation and for the full panel width. ~Vhen the cut is made in pavement within 10 feet of the panel joint, tho pavement shall be removed for full panel width from the cut on the far side of the excavation to the panel joint. 2. BaakflH and thoroughly compact fill using POWER TAMPER, placing soils so that various types of soft are in same relative position as before excavating. Grade to original surface. 1:1~:3~ mix stone mix concrete; if bituminous material, replace using same type 4. If concrete curb is removed, replace with similar curb 1:1~:3~/~ mL~. 5. Edge of Jacking Pits or any other excavation shah be not less than 5 feet from Edge of Pavement. No undercutting allowed in Pit. 6. Notify the Department at Yaphank 4~3451 when the work is to begin so that all inspection can be made of the operation. This permit shall not be assigned or transferred without the wr/tten consent of the Commissioner of Public Works. 'Phc work authorized by this permit shall be performed under the supervision and to the satisfaction of the Com- missioner of Public Works or his representative. Particular attention is called to the necessity of thoroughly compacting the back fill, which will be required by the Commissioner of Public Works. The Commissioner of PubMc Works shall be given one week's notice by said applicant of tbe date when it in- tends to begin the work authorized by this permit, and prompt notice of its completion. The said applicant hex~by agrees to hold the State, County and Town hm~nless on account o£ damages o~ any kind which may arise during the progress of the work authorized by this permit or by reason thereof. Applicant certifies ali persons concerned with actual work under this peri, nit are duly covered by Workmen's pensation Insurance and the State, County and Town shall be held harmless on account thereof. The Commissioner of Public Works reserves the rlght to at any time revoke or annul this permit should the said applicant fail to comply with tbe terms and conditions upon which it is granted. The applicant agrees to pay all necessary expenses incident to supervision and inspection by reason of the granting of such permit as certified by the Comm/ssioner of Public Works, such payment to be made within ten days from the render/ng of the certified account. Work under this permit to be commenced within thirty days from the d'ate of permit and continued in an expeditious manner. The applicant shall su,bmit a detailed plan of structure to be built, with a description of proposed method of construction. It is understood that should future changes in the alignment or grade of the highway require changes in the work covered by tkis application and permit, the applicant shall on reasonable notice f~m the Commissioner of Public Works make such necessary changes at his own expense within the time so specified in notice. Traffic shall be maintained by the applicant on this section of the highway while the work is in progress and until its final completion. ,10o.0o A ~ ~ .............. payh§]e to tho County Treasurer of Suffolk County is on file as security t~at the highway wii] be restored to its original condition where disturbed at the expense of the deposited applicant, as soon as the work has been completed, and the said Commissioner of Public Works is hereby authorized to expend all or as much of such deposit as may be necessary for that purpose, should the said applicant neglect or refuse to perform the work. In consideration of granting this permit the undersigned accepts it subject to conditions described. TO AVOID SERIOI3S DAMAGE TO VITAL UNI)ERGROUND FACILITIES, PLEASE CALL LONG ISLAND LIGHT- lNG COMPANY AT JUNIPER 2-9000 OR FOR T~LEPHONE FACILITIES CALL N. ¥. TEL. CO. FLOP~T, PARK 2-OFEIc'TAL 25 BEFORE STARTING THE WORK AUTHORIZ~ED BY THIS PERMIT. C, TOWN OF SOUTHOLD BFFII~E OF BUILDING INSPEE~TEIR TOWN OLEIRK'S OFFIOE SOWTHBLD, N. Y. Mr. ~. I{am~errez' Commissioner of Public Works Suffolk County Yophonk Ave,, Yaphank, N. Y. Dear Sir: Dote In accordance with Section 239K of the General Municipal Law of the consolidated Laws of the State of New York, this is to notify the Commis- sioner of Public Works of the County of Suffolk that ...................................... ~.~.$.~.~.b~..~.~;~;t`)~...~::..f~f.t.;r~.q.~$.9.~...~...~D~...~/~..g.~9~ce F. gtlter ..... ~,dd2te...t~ad../,~R,%..)...~eor~J,e ..................................................... has applied to the Town of Southold for a permit to construct o building on .¢./.¢.....Hfc ~ ::~ Z.~._~ e~.;.~.~....LC.J.~.2.2 )....~.~..q.o..~& ~.... ~.~., ~ :. ....................... as shown on the attached plot plan, submitted in triplicate, dated ..... ............................................ and titled ~t~.~.,(:~..~(:..~Z'~.]pf¢;c..t~:..,9.12,:C.~..f,.',~.ft¢,. We shall withhold further action on this application for ten oays or os otherwise provided in the aforementioned Section 239K. Very truly yours, Building Inspector Town of Southold, N. Y. 'y C MAP OF PP--.OPED.'TY C l_.,:'x,~E N C E .F, PE¢OtqtC I..71LLER o PER~ UNDER SEC~ON 136 H'WAY MW FOR AC~ TO COUN~ RO~ TEIWN E)F SEIUTHEILD I-IFFIEIE OF BUILDING INSPEI~T[3R SOUTHOLD, N. Y. Commissioner of Public Works Suffolk County Yophank Ave., Yophank, N. Y. Dear Sir: In accordance with Section 239K of the General Municipal Law of the consolidated Laws of the State of New York, this is to notify the Commis- sioner of Public Works of the County of Suffolk that ...................................... .... ..................................................... has applied to the Town of Southold for a permit to construct o building ..,/~.....~-.~.~...~..i~.~t:~Z)...2~9.n...t:~ .~:?..,:.: ........................ as shown on the attached plot plan, submitted in triplicate, da/-ed ....~,'~,~.. ............................................ and titled ~.~...~.. ~?~'~.1~...~'.~.~.~.. We shall withhold further action on this application for ten aays or os otherwise provided in the aforementioned Section 239K. Very truly yours, Building Inspector Town of Southold, N. Y. ~O,qD FOI~M NO. ! 'I'~OV/N OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........ l;? .......... ...~......C~.. .......... , 1~ Permit No....~....,.~.....~.....L~ ...................... ................................. APPLICATION FOR BUILDING PERMIT Do,e ........... .......... US...: .................. , 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 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 a Certificate of Occupancy shall have been granted by the Buildir~g Inspector. APPLICATION IS HrEREBY 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 all applicable laws, ordinances, building code and regulations. ........ ......... ........... -'-~"" ~) (Signature of applicant, or name, if a corporation) ........................... ............................. · (Address of applicant) State whether applicant is owner, lessee, 6gent, architect, engineer, generai c~tractor,' electrician, plumber or builder. · ........................................................................................................................................................... Name of owner of premises ........ C.~L/~z~.~IJ~.~-~.....*...~...!..Cr~.L-...~'~... .............................................................................. If applicant is a corporate, signature of duly author~ed 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 ........ ,~-~J~.J,~ ~..J.~D/~.. x ......... ..fg~....~ ................................ Municipality 2. State existi.ng use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........... ..~..f~..S..i: .~..-.~....~.~.~.. ........................................................................................ b. Intended use ond o~cuponcy ................................... ~,~ .................................................................. 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) .~O~J,~.cI. 4. Estimated Cost ............................................................ Fee ..,.l~.~f~...: ........................................................................ ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............ 1 ............... Number of dwelling units on each floor ............................ if garage, number of cars .......... ~-~...C~:~ .............. ~.l~.~.'~']~.(,~.'~. ..................................................................... 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 .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ....... ~..°r~, ............. Rear .......... ..~..~-.dc ................. Depth ........ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 1. Zone or use district in which premises are situated ...... .'~,~.t.~.~.'-~,rff..~.. ................................................................... 12. Does proposed construction violate any,zonlng law, ordinance or regulation? ..... ~.o...:..-~-. .................................. 13. Name of Owner of premises .~..,.~...~).t.~L.~..~. ............ Address ...~...C~,~)./.~ ........................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Nome of Contractor .....C?...?..~...°..~...m~....l~'/T~.....~...~..,.,....Address ...~-~.o)_r~..,.~..~f ......... Phone No.]..~..~.....~..g.?..~.,. PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate ail set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether i,nterior or corner lot. 5TAT'E OF NEW YORK, t ¢ ¢ COUNTY OF ................................ ~ ~"~' (Name of individual signing application) (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 ~nd file this application; that all statements conta,ined 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 filed therewith. Sworn to before me this Notary Public, , ........................................................... County // (Signature of applicant) :