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Home My WebLink About3382-zFORM NO. 4- TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BERTIFIDATE OF EllgBUPANDY z 28oo A~m,~ lO 67 No. Date ,,;;, ., Mid~!e Road THIS CERTIFIES that the building located at Street Map No. ~ Block No. ~ . Lot No. ~- conforms substantially to the Application for Building Permit heretofore flied in this o. fflee dated .... FAb.:.. 2~ , 19 67 pursuant to which Building Permit No..3~... dated .. Fob:. 27 . , 1967 , was ~ssued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is l~%ls~ness building - restatu, ant. Bill Cle. y Millers Lou/~ge inc Owner The certificate is issued to (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval J~' Building Inspector NOTEt This is not a place of public assembly (Capacity is less than FOR~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 3382 Z Permission is hereby granted to: ........... ........... :..~..~am~..g6~. ...... l~,ad:~..~ad, ..... TOWN OF SnUTHOLD FIFFICE ElF BUILDING INSPECTOR TOWN CLERK'S OFFICE SDLITHOLD, N. Y. Commissioner of Pubhc Works Suffolk County Yaphank Ave., Yaphonk, N Y Dear S~r In accordance w~th Sechon 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 a budding os shown on the attached plot plan, submitted in triplicate, dated ............... ............................... and titled ~.C,~..?.~.. ~.~. ~ ..'.? ~..C~...~......~..~...~.~. We shall withhold further action on this application for ten days or as otherwise prowded m the aforemenboned Section 239K Very truly yours, Building Inspector Town of Southold, N. Y TnWN nF SIDUTHIDLD OFFICE OF BUILDING INSPEBTOR TOWN BLERK'S EIFFIBE BBUTHrnLD, N. ¥. Commissioner of Public Works Suffolk County Yophonk Ave, Yophonk, N Y 2/i6/67 Dear Sir. In accordance with Sechon 239K of the General Municipal Law of the consolidated Laws of the State of New York, this is to notify the Commas- sioner of Public Works of the County of Suffolk that ............................... Bill Clay M~ller's Lounge Ina ........................... .¥.L. ........................................................................ Box 967 NAddle Road, Southold, N.Y, has applied to the Town of Southold for a permit to construct o bu,ld,ng 8/8 Middle Road (C.R.27) Southold, N.Y. as shown on the attached plot plan, submitted in triplicate, dated ................ ...................................... and titled ..~..~.,.O..~....P..~.~.~....M.?..'...,.~...~.?.,~..?..Y...,~.~.~? el~ We shall withhold further action on this application for ten days or as otherwise provmded in the aforemenhoned Section 239K Approved (as noted on the plan~ew truly yours, to the Town of Southold pursuant to See. 23gK of the General MunfeipaljL~w~ befo~ buildin~ access to. C.R. .27', See. 136 of the Hlg~ay ~,aw will be re~ired. S~FOLK CO~Y DE~. ~BLIC WO~ Building ~nspecto~ R. M. ~-~rer, Co~ssioner Town o~ SouthoM, Chief E~gineer TOWN OF $OUTHOLD BUILDING DEi~ARTMENT TOWN CLERK'S OFFICE SOUTNOLD, N. Y. (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) £ N? 3579 Z ~ ~ ..................... ~ ....... ~ ......... ~..., ,~... Permission is hereby granted to: - ' ...... ~,...~...~.~r~..~..Z,~. ....... .......... ~,~e..:~L .......................................... ............. ~~..~ ......... , ....................... to ...~..~.~~..~..~..~...j~,...~..,~..~.:~ ......... ,...~ ..... ,...~.;..~.:... ,, , at-pr~mises Imated a( ,.~/~..,.~..I~ ................................... }~ .......... ~ ...... :.:.: ...... ,..~.,:,.~}~:., ,~ , ,¢ ~mm,~ E'ECTIO~ 136 H'V,T.Y LAW FOR A~ FOII, M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. APPLICATION FOR ~ PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or m ink and submitted in duphcote to the Buildin, Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o, areas, and g~vmg a detoded description of layout of property must be drawn on the diagram wh,ch Is part of this application c The work covered by th~s applicatmn may not be commenced before issuence of Building Permit. d Upon approval of this application, the Building Inspector wdl issue a Building Permit to the applicant. Such permi, 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 Occupanc~ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of a Building Permit pursuant to th.- Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o~ Regulations, for the construction of buddings, additions or olterahons, or for removal or demolition, as herein described. The apphcant agrees to comply with all applicable laws, ordinances, building code and regulations. · Bill.. ELy.. ~le~..Z~ttuffe...I~ ........................... (S~gnoture 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. ................................................. ~)~e~. ..... bu/,~d, er. ...................................................................................................... Nome of owner of premises ..J~lI...OZ~F..~.~.i,~er,~..Loxm/~e...~rm ........................................................................... If applicant is a corporate, s~gnature of duly authorized officer. (Name and title of corporate officer) t. Location of land on which proposed work will be done Map No.' ...... ~ ......................... Lot No.: ...~ ........... Street and Number ..~/,~..~/~l, d411~..]~Dadl..~tlt, Cho~.~ .................................................................................... Municipality 2. State existing use and occupancy af premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...~Bt~'~,, ...................................................................................................... b. Intended use and occupancy ....... /Inme. ~/-;L.~ut~..~'.l~O~..~/&.~..~t. ............................................................. Nature of work (check which applicable)' New Budding ................. Addmon ................ Alteration . .. Repair .................. Removal .................. Demoht,on ............... Other Work (Descr,be) ...~..a.~.~.....~.~.~.. ............ 4 Estimated Cost ............................................................ Fee ..................................................................................... (to be pa~d on fihng th~s apphcat~on) 5 If dwelhng, number of dwelhng units .... ~.O...Zq~ ......... Number of dwelhng umts on each floor .......................... If garage, number of cots .......................................................................................................................................... 6 If business, commercial or m~xed occupancy, specify noture and extent of each type of use .......................... 7 Dimensions of ex~stmg structures, if any: Front .......................... Rear ................................ Depth .................... Height ....................... Number of Stories ............................................................................................................ Dimensions of same structure with alterabons or addmons Front .................................... Rear ................ Depth ................................ Height ............................ Number of Stories ......................... 8 Dtmensions of enbre new construcbon. Front ................................. Rear ............................ Depth .................... Height .................... Number of Stories ....................................................................................... 9. Size of lot Front ............................ Rear ............................. Depth ............................... 10. Date of Purchase .................................................. Name of Former Owner .................................................... 11 Zone or use district in wh,ch premises are s~tuated ....... ?..~.Lt....0-..$.$..~ ........................................................................ 12 Does proposed construction violate any zomng law, ordinance or regulation:~ ............. .~...O. ................................ 13 Name of Owner of premises ..~..:..0..:.?.~.~...]:.]...e..~...~....~...O...t~:...~d~ .......... ~..C~...~.~...O..]:..d... .............. Phone No ................ Name of Architect ................................................ Address ...................................... Phone No .................. Name of Contractor ........ ..~..0~...¢. ....................... ' .......... Address .......................................... Phone No ................... PLOT DIAGRAM Locate clearly and d~stmctly all buddings, whether ex~sting or proposed, and ~nd~cate all set-back dimensions fror property hnes. Gwe street and block number or description according to deed, and show street names and indtcat whether interior or corner lot. STATE OF NEW,~-Y~I.I~I~ ~ S $ COUNTY OF "'~'~l~.,~.,.~.,, ......... J''' ............................................ ~..~.~...g.?....!'.l..~..]r.]'..~.Z'.. .................. being duly sworn, deposes and says that he is the apphca, (Name of indw~dual signing appl,cahon) above named He ,s the ........ .0..O....~.....0..~...~.~.O..97.. ................................................................................................................ (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 fd th~s application; that all statements contained in th~s apphcahon are true to the best of hts knowledge and belief, an that the work will be performed m the manner set forth in the apphcat~on filed therewith. Sworn to before me this ""~' ' ' ' ' ' '~' "~~'~'t~' ~i~'~~ ................. .2.$.. dov of .................... ..... , Notary Pub ~....~. ..... ~ Cognty [~ ( I }~ARIOI~ A REG£N1 ~J ~OT^R¥ 'PUB~Ic ~t~*e cl ~'~ew Yo~k erin E~p e~ ~arch 30, (5M)-(5/1/67) Permit No. 7935 PERMIT UNDER SECTION 136 of ARTICLE VI of NIGHWAY LAW Whereas, Section 136 of A~hcle VI of the Highway Law provides' "No street surface or other railroad shall be constructed upon any portion of a road constructed or improved on a county road system, nor shall any person, firm, corporation or munlcipahty enter upon or comstruct any works in or upon such road, or construct any overhead or underground croesmg thereof, or lay or malntmn therein drainage, sewer or water pipes underground, except under such condltion~ and regulations as may be prescribed by the county super- intendent, notwithstanding any consent or franchise granted by any town or by the municipal authorities of any village or town Any municipal corporation may enter upon any road constructed or improved on a county road system for the purpose of widening the pavement or ior any other purpose authorized by this section, but only after securing a permit as provided herein. Notwithstanding the limitations In any. general or special law, every municipal corporation shall have and is hereby given authority to deposit with the county superintendent such a sum of money as may be required by the county superintendent as a condition precedent to the granting of the permitprovided in this section Any person, firm, or corporation violating this section shall be liable to a fine of not less than one hundred dollars nor more than one thousand dollars for each day of such violation, to be recovered by the county superintendent and paid in to the county treasury to the credit of the county road fund created under section 117 of Article VI. of this chapter for the construction, reconstruction and maintenance of county roads on the county road system in accordance with the provisions of said Section 117 of Article VI. and may also be removed therefrom as a trespasser by the county superintendent upon petition to the county court of the county or to the supreme court of the State, and WHEREAS, a cert/un highway known as the Mtddle ~d.-Southold CR has been lrnpl-oved and is on the Suffolk County Road System and %VHEREAS, V:[llage of Grem~po~t (i~atev I,;[~trto~), Greenports New York requests peITnlSSlOn to ~stall water service to ~o~tho,]d f, teek House, s/s Middle Rd., Go. Rd. 27, 953 ~/o Herren lane, Hem]et of fouthold, Tt)wri of S~uthold as per sketch or map attached. NOW, TI~'EREF~RE, permission is hereby granted to said to do said work upon the followmg conditions CONDITIONS AND RESTRICTIONS 1. When concrete is removed, cut concrete with concrete saw two feet outside the limits of the proposed excavation mad for the full panel width. %$q~en the cut is made in puvement 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 PO~'ER TAMPER, placing soils so that various types of soil are in same relativo position as before excavating. Grade to origimd surface. ~. Replace pavement, sidewalk or surface same as existing; if concrete, replace uaing 1:1~ :$1/: mix stone mix concrete; if bituminous material, replace using same type ~ rnmov~J[. 4,. If concrete curb is removed, replace with similar curb 1:1~/~ :3~ nflx. 5. Edge of Jacking Pits or any other excavation slmH be not less than 5 feet from Edge of Pavement. No undercutting allowed in Pit. 6. Notify the Department at Ymphank 4-3451 when the work is to begin so that a~ inspection can be made of the operation. This permit shall not be assigned or transferred wlthout the wmtten consent of the Commissioner of Public Works The work authorized by thru permit shall be performed under the supervision and to the satisfact~on of the Com- missioner of Pubhc Works or his representative. Particular attentton ~s called to the necessity of thoroughly cornpactmg the back fill, which will be required by the Commissioner of Public Works The Cornwassioner of Publ/c Works shall be gwen one week's notice by said applicant of the date when ~t m- tends to begm the work autho~zed by this permit, and prompt notice of its completion The said apphcant hereby agrees to hold the State, County and Town harmless on account of damages of ax~v kind whtch may arose durmg the progress of the work authorized by th~s permtt or by reason thereof Apphcant certifies all persons concerned w~th actual work under th~s permit are duly covered by Workmen's Com- pensatlon Insurance and the State, County and Town shall be he~d harmless on account thereof The Commissioner of Pubhc Works reserves the mght to at any tune revoke or annul ~hls permit should the said applicant fail to comply with the terms and conditions upon whmh it is granted. The applicant agrees to pay all necessary expenses incident to supervision and mspechon by reason of the granting of such permit as cerhfied by the Comrmsmaner of Pubhc Works, such payment to be made wlthm ten days from the rendering of the certified account. Work under this permit to be commenced with/n thirty days from the date of permit and continued in an expeditious manner. The applicant shall submit a detailed plan of structure to be halt, w~th 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 flus application and permit, the applicant shall on reasonable not,ce from the .Commissioner of Public Works make such necessary changes at his own expense w~thm the time so specified in notice. Traffic shall be mamtamed by the applicant on this section of the h~ghway while the work is in progress and until its final complet/on. Oil A Bond ~ in the sum of $ ............. payable to the County Treasurer of Suffolk County is on file deposited as security that the highway will be restored to its original condition where drsturbed at the expense of the 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 apphcant neglect or refuse to perform the work. In consideratmn of granting this permit the undersigned accepts it sub'ct to cond~tioI~s described. > TO ~VO/D S~q~/OUS DA1V~AG~. TO VYrAL T_TN-I)ERGRO~ND FACILTTTES, PLEASE CALL LONG ISLAND LIGHT- ]~qG COMPANY AT JUNIPER 2-9000 OR FOR 'r~:LEPHONE ~ACILiT~:S CALL N. ~. T~.q*. CO. FLORAL PARK 2- O~*F~AL 25 B~FORE STARTING THE WORK AUTHORIZED BY THIS ?ER~rr. Form P. 136 Permif No .... J'.?~ .... PERMIT UNDER SECTION 136 of ARTICLE VI of HIGHWAY LAW Wl~ereas, Section 130 of A~tlcle VI of the Hlgh~ay Law Drovldes "No street surface or other railroad shall be constructed upon any portion of a road constructed or Improved on a county road system, nor shall any person, firm, corporation or munlcipaht¥ enter upon or construct any works tn or upon such road, or construct any overhead or underground crossing thereof, or lay or maintain tllereln drainage, sewer or water pipes underground, except under such conditions and regulations as may be prescribed by the county super- the limitations in any general or special law, every municipal corporation shall have and ~s hereby given authomty to deposit w~th the WH~-~REAS, a certain h~ghway known as the l~tddl~ has been maproved and is on the Suffolk County Ro~-Sys[em aRnO~d CR No. 27 Write.AS, Will/ms Clay lBOX 967, SouthOld, ~. Y. r~uests~emnsmon to msp~ltie d~iv~ay, ent~noe foe n~ ~sts~ant, S/s CR 27, 700-' ~o ~r~d Ave., ~et of S~thold, sketch o: map NOW, TItEREFORE, permzssion ~s hereby granted to smd Wlllilum Cllmy 1~1~1[~d work' .~ CONDITIONS AND RESTRI~IONS limi~ of the propo~ exe~v~tion ~nd for ~he ~ull p~nel width. ~en the cut ~e ~ p~vement ~n 10 feet of the p~nel joint, th~ pavement sh~ be removed for full panel width from the cut on the fa~ slde of the excavation to the p~el joh~t. 2. B~iH ~d thoroughly eomp~t ~lH using POIVER TAMPER, pl~h~g soils so that v~ious types of soil are in sine relative potation as ~fore excavating. Grade to o~n~ su~ace. 3. Replace pavement, sldowalk or surf~'e ~me ~ e~sting; ~ concrete, repl~e u~ng 1:1~ :3~ ~x stone mLx concrete; ~ bi~nous mate~al, replace uMng ~ne type $. I~ ~ncreto c~b is remove, replaee with st~l~ curb 1:1~:3~ ~. 5. ~ge of J~c~ng ~lts or ~y other excavation s~l ~ not less than 5 feet from Edge of Pavement. No undereutt~g ~owed tn Pit. 6. No,fy tho Department at Yaph~k 4-3451 when the work is to ~n ~pec~lon can ~ made of the operation. This ~m~t shall not be asmgne~ or tra~err~ w~thout the wmtten consent of the Com~ssmner of Pubhe Works The work authomzed by th~s pem~t shall be per~omed under the su~rmsmn and to the sat~sfae~mn of the Com- missioner of Pubhe Works or h~s representative. Particular attentmn ~s ca/led to the necessity of thoroughly c~pactmg the ~ck fill, which ~fil ~ reqmred by the Co~ss~aner of Pubhc Works. The Commmmoner of Pubhe Works sh~l ~ g~ven one w~k's not,ce by smd appheant of the date when ~t m- tends to be~n the work authomzed by thru pem~t, and prompt notme of ~ts completion The said apphcant hereby agrees ~ hold the State, County and T~,n hamless on account of dmages kind which may arose during the progress of the work authomzed by thru ~m~t or by reason ther~f. Apphcant cerhfi~ aH pepso~ concerned w~th actual work under thru pem~t are duly ~ver~ hy Workmen's ~nsation Insuran~ ~d the State, County and Town shall be held hamless on account ther~f. The ~mss~oner of Publm Works rescues the right to at any t~e revoke or annul thru ~rm~t should the said a~heant fail to ~mply wrth the terns and cond~tmns upon whtc~ ~t m granted. The apphcant a~ees to pay all neeessa~ e~nses inmdent to supe~ision and ins~ehon by reason o~ the ~ting of such ~m~t ~ eerhfied by the Com~ssmner of ~bhe Works, such payment to ~ made within ten days from the rendemng o~ the ~rt[fied ac~unt. Work under this pem~t to be commenc~ w~thm thirty days ftmm the date of ~mit anti eontmu~ m an exp~Rious ma~er ~e applicant shall submit a detailed pI~ of structure to be bmlt, w~th a desenptmn construction. It is un~e~t~ that should future ch~ges m the ~gment or ~ade o~ the highway require ch~es m the work e~er~ by ~s apphcation and permit, the a~h~nt shall on reachable noUm fm ~e Co~ssioner o~ Pubhc Wor~ make such neeessa~ ~anges at h~s om e~nse wSthin the Ume so s~cified in notice. ~c sh~l ~ maintained by the applicant on this section of the highway while the work is in pm~ess and until its ~al ~mpletion. Certifi~ ~eck A ~ m the sum of $..~00,0~...payable to the CCunW ~easurer of Suffolk County is on de~sit~ ~ security that the highway will ~ ~stor~ to its origin~ ~ndition where d~st~b~ at the e~ense of the app~e~t, ~ soon as the work h~ ~en complete, ~d the sa~d ~m~ssioner ~ Public Works is hereby autho~z~ to e~end all or as much of such de~s~t ~ may be nec~sary ~or that pu~se, should the smd applicant neglect or ~fuse tff ~rfom ~he ~rk. In comideration of ~avt~g t~is ~mit the undersign~ accepts it subject to eonditio~ desalt. TO AVOID SEI~IOU'S DAi%TAGE TO VITAL UNDERGROUND FACILITItL'S, PLEASE CALL LONG ISLAND LIGttT- lNG COMPA1N~ AT JUNIPEi% 2-9000 OR FOR TELEPHONE FACILITIES CALL N ¥. TEL. CO. FLOI%A~L PARK 2- OFFICIAL 25 BEFORE STARTING THE WORK AUTHORIZED BY THIS PERMIT. FORM NO. I TOWN OF SOUTHOLD BUILDING DEPAP, TMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. .... ........... Approved ........................................ , 19 ........ Permit No ................................. O,sap~roved o/c .......... ;~Zi.~.~.,:~. ....................................... ..~-~-- - ............................ ....... .... ................ ~~;~;;;i ................................. APPLICATION FOP, BUILDING FEP,~IT Date .................. 19...... INSTRUCTIONS a. This applicohon must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin, Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o areas, and giwng a detaded description of layout of propertymust be drawn on the d~agram which is part of this application c. The work covered by this apphcation 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. Sud 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 Occupanc; shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Buffdmg Department for the issuance of a Budding Permit pursuant to th- Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances oi Regulations, for the censtruction of buildings, additions or alterations, or for removal or demolition, as herein described. The apphcant 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, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ................................................................................................... ~ .............................................. tf applicant,~s a corporate, signature ~f dul~ authorized officer. (Name and t~tle of co~orate officer) 1. Locabon of land on which proposed work will be done. Map No/ .............. ~ ...... ; ..................... Lot No;'. ..... ]'. ............ Street and Number 6'¢-TM ~/¢~ ~/¢~Z~ ~¢~(.~~.~Z~¢ ~ ~ . . ..................................................... ~;;~;i;~ ............................................................. 2. State ex~stmg use and occupancy of premises and intended use and occupancy of proposed construction: a Existing use and ~cupancy ..; ............................................................................................................................. b. Intended use~ndoccuponcy...~..~.~.~.~..~.~ ............................................................................. 3 Nature of work (check which applicable). New Building ~' ' Addition Alteration Repair .................... Removal .................... Demolition ................... Other Work (Describe) .................................... 4. Est,mated Cost ...~.....~...~..~....~...(..~.~...~..~.. ................ Fee ...... ~..~.~..~ ........................................................... (to be paid on fihng thts application) 5 If dwelhng, number of dwelling units ............................ Number of dwelling units on each floor .......................... If garage, number of cars .......................................................................................................................................... 6. If bus,ness, commerc,al or mixed occupancy, spec,fy nature and extent of each Wpe of use~(~.~.~.~. 7. D~mensions of ex~sting structures, Jf any: Front ..........................Rear .......................... Depth .......................... Hmght ........................... Number of Stories ............................................................................................................. D~mens~ons of same structure w~th alterations or additions' Front ................................ Rear .............................. Depth .............................. Height .............................. Number of Stories ........................................ ........................ ,, 8 D~mensions of entire new construction' Front ~ ~ ~r Rear ............................. Depth .......................... He,ght .~..Z..Z .............. Number of Stories ...~.~ ............ 9 S,ze of lot: Front ..~.~.~{..~Zr .... Rear .~.~..~r ....... Depth ...~.~.~..~..~....~-~ I0 Date of Purchase .~A~L...~4...Z..~.~.Z .......... Name of Former ~ner ..~L~.~..~..(.~.~/....~.~[~.~.~. 11. Zone or use d~strict in which premises are situated ............................................................................................... 12 Does proposed construction wolate any zoning law, ordinance or regulation? .................................................... 13. Name of ~ner of prem,ses~.~..~.f.f~.~].~.~.~.~:.~...~r~~ [[~.~.~.Z..~.~.[~.~][ Phone No..~ ........... Name of Arch,tect ~.~..~M~.~.~.~ ............ Address ~.U.~.JJ~.T~,.[,~. Phone No~?.~.]~.~'. Name of Contractor~(~ ~~ /~ Address~ ~ ~ f,TU~4~ Phone No PLOT DIAG~M Locate clearly and d~stinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro~ property hnes Give street and block numbers or description according to deed, and show street names and ind~ca~ whether interior or corner lot. STATE OF NEW¥ORK_ . COUNTY OF .... ~Lu...~.~.~.~.../S.. ...... t S.S. ...... ..J(~..C../...~...~..../...~..)..,.'~_..! ...... .~..J. ..... ..~...../....~'....~...~.....~. ..................... be ng duly sworn, deposes and says that he is the applic, (Name of individual s~gmng apphcation) (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and is duly authorized to perform or have performed the said work and to make and th~s application, that all statements contained m this application are true to the best of his knowledge and beh and that the work w~ll be performed in the manner set forth in the apphcation filed therewith Sworn to I;)iefore me this ,~ ~...a day of ~/~//~ './'....~.. · ....... ...... ~ ~II~'~t.'.,2]?~,~..~//~/d/t.~L(..~,.~.~'C~ (Signature of ~p~licant) ........~ ............. FOltM NO. t TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ..................... (.I. ................ , 19 ........ Permit No..~...~....~...~. Disapproved a/c .............. ~ ............ ~. APPLICATION FOR B~G PERMIT INSTRUCTIONS a. This application must be completely filled m by typewriter or mmk and submitted in duplicate to the Buildi Inspector. b. Plot plan showing location of lot and of buildings on premises, relabonship to adjoining premises or pubhc streets areas, and gzving a detaded description of layout of property must be drawn on the diagram which is part of this applicatic c. The work covered by this apphcation may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector wdl ~ssue a Budding Permit to the applicant. Such pern shall be kept on the premises available for ~nspect~on 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 Occupan shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ssuonce of a Building Permit pursuant to t~ Building Zone Ordinance of the Town of SouthoJd, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as here~n describe The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. Bill Clay Millers Lounge Inc (Signature of applicant, or name, if a corporation) Middle Road~ Southold (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build~ ................................................ ................................................................................................. Name of owner of premises ....~..$.~.];.....g..~..~.~....?.~.$..]:.~..e.?...s....~...o..L~...g.e...Z.~q ........................................................................ 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 ....S.../..S....].v!.J:.d...d:.]r..9...~.o.~..ct:.J....S..o..~.~.°...1..Ct:. .................................................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction' a Existing use and occupancy .... ~..e..s..~..8:..%l...~..&.~.~. .................................................................................................... b Intended use and occupancy ...... ~.&~.~...~.sr..&.~..;~.:R..q~...~,r~.~-~...~,~.~D. .......................................................... :3. Nature of work (check which applicable). New Budding .............. Addition .................. Alteration Repa,r .................. Removal .................. Demohtion ................. Other Work (Descr,be) ..~...8:.]:...].....~..~g.Zl. .............. 4 Estimated Cost ............................................................ Fee .................................................................................. (to be pa~d on filing thru apphcat~on) 5 If dwethng, number of dwelhng units .... .zl...q.~...e ........... Number of dwelhng umts on each floor ........................ If garage, number of cars ........................................................................................................................................... 6~ If business, commercial or m~xed occupancy, spec~fy nature and extent of each type of use ........................... 7 DJmenslons 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 Stones ............................ 8 D~mensions of entire new construction' Front .................................. Rear ............................ Depth .................. Height .................... Number of Stories ...................................................................................................... 9. S~ze of lot. Front ............................ Rear ................................ Depth .......................... 10 Date of Purchase ........................................................ Name of Former Owner ....................................................... 11. Zone or use d,str,ct in which premises are s,tuated ...... !!.~.!!...~.J....S.~. ..................................................................... 12. Does proposed constructton violate any zoning law, ordinance or regulat~on~ ............... ..~..O.. .................................... 13 Name of Owner of prem,ses ..B..:..q.*.?J$.]-..~..e...~..s.....~..°....~..likOdd~e~s° .......... ~.o..q~.o..~.~ ............... Phone No ................... Name of Architect ................................................... Address ......................................... Phone No ................... Name of Contractor ........ ~.?,~l.~ .................................. Address ......................................... Phone No .................. PLOT DIAGRAM Locate clearly and d~st~nctly all buildings, whether ex~stmg or proposed, and indicate all set-bock dimensions fror property lines. Give street and block number or description according to deed, and show street names and ind~cat whether interior or corner lot. ST^TE OF NEW.;r , COUNT* .......... ......................................... .~.~,~...Q.-...~.'!~,~..~.~. .................... being duly sworn, d~oses ond soys thor he ~s the applic (Nome of mdwidual s~gnmg apphcabon) above named. He ~s the ........ ~.~...~.~.$.~D.~ .............................................................................................................. (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 th~s application; that all statements contained m this application are true to the best of his knowledge and behef; that the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this _ ............. .~... day of .................. .~.~ ......... , ,9...~. .................. , ........................ Nota~ Pub~~...~....~ County (Signature of applicant) t~o B2 ~233~20 Sui,oI~ Count~ Term gxDres ~arch 30, 19~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ..................... /.~ ................ , 19 ........ Permit No..~,-~...Z..~..~...~. D~sapproved a/c~....~... ..... ~ (Building Inspector) .~.~.~.~.~.~.~.~.~ ~ APPLICATION FOR Bt~d[YlI~G PERMIT Date August 23 INSTRUCTIONS a. This application must be completely f~lled m by typewriter or in ink and submitted in duplicate to the Build~ Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and giving a detailed description of layout of property must be drawn on the diagram which ~s part of this applicatk c. The work covered by this apphcat~on may not be commenced before issuance of Build,ng Permit. d Upon approval of this application, the Building Inspector will issue a Bu~ldmg Permit to the applicant. Such perr. 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 Occupan shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ssuonce of a Building Permit pursuant to t Building Zone Ordmance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, add,tions or alterat,ons, or for removal or demolition, as herein descr~b.- The applicant agrees to comply with all opphcable laws, ordinances, building code and regulations. (Signature of applicant, or name, if a corporation) Middle Road ~ Southold (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build, owner - builder Name of owner of premises ....~.A.Z..]r....g!~....tL~.$..Z.!..e.~..s...~.°.~.e.....~.a. ....................................................................... If applicant is a corporate, signature of duly authorized officer (Name and title of corporate officer) 1. Location of land on which proposed work w~ll be done. Map No .................................... Lot No: ................... Street and Number ....S../.~..~f¢.~.ct:.]r..e... ~.o.~ct:..,....S...o..~.~..~..o...~.~ .................................................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy .... .~...e..s...~..8:.-g....~..a.~.~. .................................................................................................. b. Intended use and occupancy ....... ~.~..~...~;r.:~.~..~...Z~.~.g~.t~...TC~.~.~,...~,J,.~'Z ......................................................... 3 Nature of work (check which applicable): New Budding ................ Addition ................. Alteration ................. Repair .................. Removal .................. Demoht~on ............. Other Work (Describe)..~...~..]r..]-....~..~.~ ............. 4. Estimated Cost ........................................................... Fee ..................................................................................... (to be pa~d on filing th~s apphcat~on) 5. If dwelling, number of dwelhng umts .... .~...o..~...e. ....... Number of dwelhng umts on each floor ........................ If garage, number of cars ...................................................................................................................................... 6 If business, commercial or m~xed occupancy, specify nature and extent of each type of use ........................ 7. Dimensions of ex~st~ng structures, if any: Front .......................... Rear ................................ Depth ................... Height ........................ Number of Stones ......................................................................................................... Dimensions of same structure with alterations or addmons Front .................................... Rear ......................... Depth ................................ Height ........................... Number af Stones ............................ 8 Dimensions of entire new construction: Front .................................... Rear ............................ Depth .................. Height .................... Number of Stories .................................................................................................... 9 Size of lot: Front ............................ Rear ............................. Depth ........................... 10 Date of Purchase'. ....................................................... Name of Former Owner ...................................................... ]_1 Zone or use district in which premises are s~tuated ...... !].~.!!...~..~ .................................................................. 12 Does proposed construction violate any zoning Iow, ordinance or regulat~on~ ............... ..~.O.. .................................... 13. Name of Owner of premises ..~.:..C..'~!~.~...Z..e...~.s....[5.°~t,P-ddr~e~3 .......... ~°..'gt.~...}'z..q..]..~ ............... Phone No ................ Name of Architect .................................................. Address ...........................................Phone No ................... Name of Contractor ........ ~..~,~.¢ .................................. Address ...................................... Phone No ................ PLOT DIAGRAM Locate clearly and d~stmctly all buddings, whether ex~sting or proposed, and ~ndicate all set-back dimensions fro property lines. G~ve street and block number or description according to deed, and show street names and ind~cal whether interior or corner lot. STATE OF NEVv: ,~O~,, ] S" COUNTY OF ..~, ............... ~' '~' ......................................... ~.:~.~..~.:....~[;~,~.~.:~ ................. being duly sworn, d~oses and says that he is the applio (Name of individual s~gnmg apphcat~on) above named. He is the ......... ~.~...~.~.~.~ .............................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sa~d work and to make and this apphcat~on; that all statements contained m th~s application are true to the best of his knowledge and belief; , that the work wdl be performed m the manner set fo~h m the apphcation filed therewith. Sworn to before me this A~.~ , 19...~.~. ,-~~~' ~~~ Nota~ Pub~~. ~... ']~t'~°un~oq ~ ~ ~'~' (Signature of applic bo 52 3233120 Su~otk Cou~t~ -- T~m ~p~es ~rch 30, ~"~/ L~LLT cr~Lu~ &,r ,f CLAy xaILL~:~L PAA~ C 1' l ! / / ,¢ M~. %/. COUNTY OF SUFFOLK DEPARTMENT OF PUBLIC WORKS R.M. KAMMERER, COMMISSIONER YAPHANK~ N.Y. EXISTING PAVE RAM P 'AOJACENT TO ,//~/.~L~ ...... ,,~ .... ~ .................... _~ .... C.R._.,~,.~_~ ............. PERM IT NO. REVISED; JANUARY 1965 SHOULDER) I GUTTER PITCH AS DIRECTED BUILD TO~D_.R~P_~_L I N E ........... PAVEMENT: : 4" BITUMINOUS MACADAM BASE 1~'2" BITUMINOUS CONCRETE TOP SECTION THROUGH RAM P (NOT TO SCALE) TO ~ PARKING AREA PITGH DOWN