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Home My WebLink About3625-zFORM NO. 4- TOWN OF SOUTHOLD BUILDING DI~PARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE [DF [DBEILIPANEIY No, Z, 29~8 ..... Date ............. No.v. ember., 29., 19.67. THIS CERTIFIES ~hat the building located at . 8/8 .~iddle, ~o~d..(CR2~) Street Map No. ~ .... Block No.~ ......... Lot No..~... ~D~P.~. ~ ....... conforms substantially to the Application for ~uilding Permit heretofore filed in this office dated ......... 8cpi ..... ~., 19.6.~ pursuant to which Building Permit No. ~.~. dated .......... 8epl .... 1~..., 196~., was issued, and conforms to alt of the require- ments o[ the apphcabte provisions o~ the law. The occupancy for which this certificate is issued is .. ~si~es~. ~ild-l~g. · --. Re.tail .'8~o~'e .............................. The certificate is issued to .. ~&~ee~t .K~$ia~ ........ .0~e.~ ..................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval NOV~. 9.-195~.. b~ .~..Villa .... ~udding ~nspec~or >\ 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) N? 3625 Z Permission is hereby granted to: ................ ~.~m,'t,h~3.d. ............................................ at premises located at ...~.~...~I,~i;;1,3,~...]~;~.~,...(.~2) .................................................................... ....................................... e, cmtl~a]At..~. ...................................................................................... pursua:n,t to application dated .............................. ~a~).~.....]..~' ........... , 19..~.., and approved by the Building Inspector. ~1 ]l~ll~.t~ e~e~ to ~ ~pt O~ ~ ~oFkl ~q~nt~ · C~e~l~ ~rage ~tallatio~. Fee $.. I~.,.~ .......... Building Inspector SUFFOLK CODNTY DEPIRTMENT OF HEALTH Riverhead, New York Building Permit No. ~.... ~%~ ..... Health Department Plan No, Application ~or Approval qf Co .n~pr~ial sewage. D. isposal System TO: The Suffolk County Department of Health Date/~0 J. t~, / ~ Application for approval of c~mercial sewage disposal system is hereby requested · Village I hereby certify that this commercial sewage disposal system has been con. strutted in accordance w~l. th plans approved by the Suffolk County Department of Health on (date) /~/Y~/,~. ~ . a~d with all the requirements of the latest bulletins on sewage diSPosal of the Suffolk County Dep~rtment ~f Health. Title iddress~/l~t. ~/~ ~ ~/~/L~qt-~ Ready for inspection Based on the information stated hereon by the applicant and ether information made available~ it is the opinion of this Department that this system with proper maintenance san 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~ COUNTY OF SUFFOLK DEPARTMENT OF PUBLIC WORKS R. M. KAMMERER, COMMISSIONER YAPHANK, NEW YORK, 11980 WILLIAM S. MATSUNAYE, JR. CHIEF ENGINEER Dear Re: Permit No._~.~!.[~ County Road () County ?recsurev has been authorized to refund your security in the amount of (x) Bond NOo,,~~.__to eover work om thi~ pe~t is herew&'kh released and returned° This is to advise you that work done under the above captioned permit has been inspected and found to be completed in a manner satis- factory to this department. Very truly yours, WSM:EWJS:ee Bonding Co. - A~,erlcan i~mployer ' lm'.Co.~ it0 Ira. t, ,NY fHTfl:'~i Building Dept., To~'~n of OUt~}IO.~C ~" 7 ~7.~ Al ~ / / Village of tq~t er D~p~rtme~t Servo In~tallat ton North Ro~ (Cowry) North Southol~ Job ~ 196V~6 ~TATE E}f NEW Yn~K DEPARTMENT E}F LABE]R dIVISION OF INDUSTRIAL SAFETY SERVICE 80 CENTRE STREET NEW YORK, N.Y. 100~3 CERTIFICATE OF APPROVAL (BUILDING PLANS) September 9~ 1967 Address Reply To: 0 .W.Br own ~R .A. A~sociate Industrial En~r. DIVISION OF INDUSTRIAL SAFETY SERVICE t~UILDING PLANS ENGINEERING UNIT STATE OFFICE BUILDING CAMPUS ALBANY, N.Y. 12226 Mr. Donald Denis 85 Meadow Lane Riverhead~ New York ll901 ~ New BuUdJ.g ~ Alteration ~ Factory ~ Mete* Est. ~ PI .... f o~.~: 8/8 Middle Rd. ~ 892.28t ~.~ W/o Railroad Ave. ~o~u°~(To~ of Southold~o~h$td~ (Suffolk Co. } N~.~. The p~a~s a~d spec~ficafions 5eafi~E ~he s~amp and sez~ number o~ ~he New Yurk S~aze Labur eked above are ~n compH~ce wkh requirements of ~he Lair Law a~d ~he ~ndus~ Code ~d APPROVED as submitted APPROVED with conditions. Valid only after the conditions set forth on attached Reference Sheets are complied with° Sheet: 3-1a~ by c~ d This determination is valid only on the basis of the statements set forth in the application for ex- amination of plans beaxing the same stamp and number and to the extent that such plans axe subject to the provisions of said law and code and within the jurisdiction of the Industrial Commissioner° Notify the Bu~Iding 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 at all times so that inspectors of this department mey consult them in the course of their inspections° A certificate of compliance must be obtained, PRIOR TO OCCUPANCY, for: 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 Servlee at 2. Any building to be used as a place of PUBLIC ASSEMBLY° Apply to local building official or, ~f none~ to Supervising l~actory 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 Department of Labor assumes no responsibility for the adequacy of the srtuetural elements JAM:OSinv°lved in the construction° ~C~ ~ ~~ EnOlc o'lC ~plans ~appls ~ 5Z8S600 ~ ~ ~ lc ~plan~appl CastiglioneBy C~l Jo Mattel, Director FOR THE COMMISSIONER J~. L. Malone I$S-640 (7-64) REFERENCE SHEET NO. 3 NOTE: This sheet is an essential part of the action taken on this project~ It shall be attached to the approved plans along with the Certificate of Approval Plan Serial No,. 67-!8!l~ Date September 7:1967 Sanitary facilities shall comply with Industrial Code Rule No~ 9* a. Walls and ceiling shall be of non-absorbent material or painted two coats of a light colored painto b~ The floor and~base shall be of non°absorbent material ~co The base shall be 6" high.and coved where it meets the fl**to do Doors shall be self-el*sing. e. Each toilet room shall be ventilated by windows or skylights, the openable area of which shall be at least 1 sqo ft, for each water closet or urinal° fo IX/hen windows or skylights are not available a mechanical system capable of exhausting 35° cu~ fro of air per minute .for each water closet or urinal shall be installed° An air intake shall be provided by transoms, door louvres or supply ducts° g~ Water closets shall be located in compartments with doors within a toilet room~ h~ If both sexes are employed, separate toilet rooms shall be provided (and the lavatories shall be located in a toilet room or in a wash room.) (Matter in parenthesis, factories only0) L Water closets and urinals shah be separated from spaces in which unwrapped food products are handled by vestibules constructed of full-height partitions and full-size self-closing doors. jr A dressing room for women employees shall be provided~ having a net floor area of at least 60 sqo ft. for the first ten employees, plus 2 Sqo fro for each additional such employee, ko Women's dressing rooms shall be ventilated by a window or skylight having an area equal to at least 1/20 the floor area, or by a mechanical system of ventilation capable of exhausting 1 cu0 fi. of air per minute for each square foot of floor area~ 1, Where more than one and less than six women are employed~ a substantially screened space of at least 35 sq~ fi. shall be provided for use as a dressing room° m~ Toilet facilities shall be located not more than one floor above or below the regular place of work of the persons using them~ n. Toilet facilities shall be located in and be accessible from within the building, o~ Toilet facilities shall be separated from dressing rooms by solid, full-height partitions and self-closing~ full-size doors° p~ Toilet room partitions shall be solid~ Interior sash will not be permitted unless of the fixed type and with translucent but not transparent glass lights at least 6~ above the floor° q~ Trough urinals are not permissible, Urinals shall be of the individual type with sides to give prlvacy~ r. Wash rooms shall be enclosed by solid partitions to a height of at least 7~ (to ceiling when separating an adjoining rnen~s wash room)° Openings in such enclosures shall be dosed by solid doors equipped with self-closing devices~ The space above the partitions may be used for ventilation purposes as permitted by Rule 9-1103 (9-10o5)~ s, The number of fixtures shall be in proportion to the number of each sex as required by Rules 9-4,1~ 9-10o2, 9-11.4 and 36-11 ~2 where applicable~ t0 Toilet rooms shall be enclosed by solid partitions from floor to ceiling with ceiling at least 7~6~ high. 2° If the boiler generates steam at a pressure of more than 15 lbs~ per square inch, it will be necessary to provide the fol- lowing as part of the requirements of Code Rule No° 140 a, Two means of escape from the room located remote from each other consisting of outswinging doors at least 36" wide~ b~ A space of at least 24~ around and between boilers for inspection and maintenance, except boilers other than horizon- tal~ tubular or watertube type or not exceeding 30~ in diameter may have 16~ clear space0 co A clear space of 6" above any valve or other fitting at point of maximum extensiono d~ Where it is necessary to go on top of a boiler for maintenance or operation~ a clearance of at least 7~ of headroom shall be maintained except for an installation in an existing building where clearance may be 36~o e. The boiler shall be enclosed in a room used for no other purpose having walls, floor and ceiling of 1 hr~ construction and self-closing 1 hr. fire doors° (26-1501) If it is desired to obtain the credits allowable for a completely sprinklered building~ it will be necessary to submit plans ff the sprinkler system in triplicate for examination as to compliance with the regulations set forth in Industrial Code ule No0 20, REFEP, ENCE SltEET NO. 3 (CON'FO 4, It will{be necessary to install a fire alarm signal system covering all areas of the building and otherwise complying with the rec~uirements of industrial Code Bulletin Nod 50 N. Bo $,~ecifications in triplicate for submission are,'~ficlo~sd', herewitho ,See' instructions on reverse of form ISS-604. % Flammable liquids storage (I-'aints-~ elco) shall comp'lyi with l~ul'e 1~2-2%'7. a~ Qua titles exceeding 220 gallons shall be stored inca stoffi'geq?ob/n~? 6~ Copie~ of Industrial Code Rules referred to may be obtained by written request to the office of the Administrative Director, Department of Labor, ~tate Campus, Albany, New York 1~22261 7. Chaptqr 1008 of the Laws of 1960~ amending the Education Law~ now requires ,rhatplun~ submitted'for approval bear the seal sod signature of the architect or engineer responsible for the~preparation The ac, lion, taken' in thisqetter: shhll'not be considered'~ffeetix/& u~lti.l the,prBper,seal ~afiit sigflatt/re Ate affixed to {he plans ieturned~ These plans do not have to be resubmitted to show seal and signature° 8. The sqwage dmpOsal System shall be;iastalled in :&omfurmity,wirh, local c/t*dinances or the; rules of the New York State Department of Health. 9. The rahiological, portions 'of' tl~e structure sh~H,obm01y'with ,Rule ~38, ' ad It will be necessary' to register the iustallations with the Divlsion 'of~Industrial Hygiene; 80 ~etltre Street~ New York, b~ Thi,~ letter does not constitute an approval under,Codb Rule 38? ~here' afe,'many fac~urs 'affeCting the installations which are hot ,der&trainable'froM 'the plans. You should,seek {ld¥tce~and~d6uflsel on this matter' at the above address~ co A S,wlnglng door at least 3(V~ (36" if st~bject as a factory or mercaniile exit) wide shall be'prisvided as an emergency exiO, from the radiation areaJ ~A matte or'baffle wall 'to shield this door No tequired path of exit from the floor area of this building shall be required to pass through a radiation area nor structt~re tf avotdableo thtx ugh ,x radiological pol,tiOn of'the ' ' ' i(L It app !ars that the processes to,be condncted in the building will produce air contamin&nts which ma~ be injurious to the healtl of rile employees, Plans for exhaust system~ to remove dust, gases, furnes~ vapors, fibers~ or other impurities shall ~e submilted itl triplicate for approval'to the Division of Industrial Hygien~-80 Centre Stre:ei}'New York~ NoY. 10013 11. Incine tutor and heating ~ostallatmng or other eqmpment d~schargmg pollutants.into th:e atmosphere must be approved° ]Plans for such installations in factories or connected therewith, shall be sXlbmxttt~d to the Dt~,qston of Industrial ttyglene~ 80 Ce ~tre Street, New YOrk, iN,Y= 40013'~ 'If in otl~er types Of'~trttctures; .~ubthit, plans'iO'the Bureau of Air Pollution Contrt Services~ Dapartmeht~of lteMtli~ 84 Holland Avenue~ 'Albany, N~Y.'12208~ 12. This ction shall nor ;be e6nMdered ar/'approval of the fallont shelter facthtxes: Plafis for the fallout shelter shall be subm: ted for approval m~the Ideal' huthorities having jurisdictiOn-for the local.ity involvedo This local authority shall includ~ the department, bureau~ divisiotb agency~ or person~ including any joint agency or a county, city, town~ or village, charged with:the' &nforcement d~'the applicable building code, multiple dWblling law; multiple residence law or other ~aw, as defined in Section 3 of the State Defense Emergency Act, relating to the construction, maintenance and use of bui dings, structures or other re~l propertyo TOWN DF SOUTHE]LD OFFICE DF BUILDING INSPECTOR TOWN CLERK'S OFFICE SEIUTHDLD~ N. Y. Mr, ~, I,~8.DJ~te:~e~ 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 ...................................... .6..?.~.,..~.~..~ ~ ...&.....8...o..~..s....~ .q......A../..C.. ~ .e.~....~.~.~ ...(. ~ .,. ~ .,..&.. r... N~ s s~ RenewaZ P~.s.'.)......~ .o.~.~p_ .z..6..,...~....7:1.~. ..................................................................... has applied to the Town of Southold for a permit to construct a building a.....~/..?....~!.t.'.'.~.~,Z, e...~..°.~...(...C.~,~Z.L...~.°.~.O..Z..~*.. ~.:.~.'. ................... os shown on the attached plot plan, submitted in triplicate, dated ................ ....... ~.~..~...~..?..~....],...9..6.~ ....... and titled ...~Jf.¢,....o...t:...~.....t.?.~,.~.t.~.?..e.~.% ;4~ t~ We shall withhold further action on this application for ten days or os otherwise provided in the aforementioned Section 2391(. Very truly yours, Buildino Inspector Town of Southold lq. Y. TOWN OF SOUTHE)LD nFFIBE OF BUILDING INSPEFI-TOR TOWN ~LERK'S [DFFIOE S~3UTHOLD, N. Y. Mr. ~{, Commissioner of Public Works Suffolk County Yaphank Ave., Yaphank, N. Dear Sir: In accordance with Section 230K of the General Municipol Law of the consolidated La,ws 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 building as shown on the attached plot plan, submitted in triplicate, ~,ted ................ We shall withhold fu~her action on this ~pplication f~r ten deys or as otherwise provided in the aforementioned Section 23~K, Very truly yours, Building inspector Town of Southold, N. Y. ..p M~p Op LALJD ' ' J MJ G' 0 U 'f [4 0 LD .,' STATE OF NEW YORK DEPARTMENT OF LABOR DIVISION OF INDUSTRIAL SAFETY SERVl0E BUILDING PLANS ENGINEERING UNIT STATE OFFICE BUILDING CAMPUS ALBANY~ N.Y. 12226 APPLICATION FOR EXAMINATION OF PLANS Factories, Mercantile Establishments and Places of Public Assembly I SU-BMIT FOUR COPIES EACH OF eNteR PLAN NUMBER OF ANy 1. rroject Location.... ............. ~,.L().~.~. ..... .............. ' ' Mumcipality Street and NmD~er County ~. Own~r...k~.US..~.~.~. .......... ~. ........... &.O.~Zt..d~-m~ .................... ~d&e~_..~.~m~.~:La.C..~.%...~.U.Z~.OCm..,.~..~¢. 3, Lessee .......... ~.~.~.~. ................................................................................ Address ................................................................................................... 4. Doing business as......~.~.(~.....~ ........................................................................................................................................................ 5. Engineer or architect.....~.g.......~.~L~ .................................. Address .....~......~.~.~.....~.~ ............................ OCCUPANCY 6, Approval of plans is requested for use of building in accordance with the fol]owing statements: 7. Total number employed at office work*......~..g.6g.C~ ....... 7a. Total nmnber employed at manufaeturing*2...Z~fo.,k4.~ .......... 8. Will any radiological devices or radioactive materials be operated, used, repaired or stored in this structure? ............. /S~..o .......................... 9. Materials or articles ,nanufactured.........~-../[.c3..~.f.~ ............................................ Merchandise ........................................................................ wholesaled ........................................................................ 10. 11. 13. 14. 15. 16. 17. 18. PROPOSED CO~NSTRUCTION New building {]~/ Addition [] Alteration [] Estimated cost......-/.--&--.t.-~;~C2--O..~.<~---~.-. .................................................................................. Number of floors above ground ................ [ ............... , Below ............... (~.. ............. I2. Automatic sprinklers [] [~ All areas [] [] Materials of walls.....~.~/.~..,...'~...~..~, .................. Floors-.--.~--~---~-~d.-~-..,.....~-.t:~]~ ................. Roof....~d..O.~.~....~.~.~t~4..~ Rooflng~..Pt/~%.~...~.PJ./~g.L~_<? Floor framing~...~bt..~R/SE, Roof framing../.¢~'~a~...~4~.~.., Access to adlmnlng bulld~ng../~.c~.L~ ........... What floors .................................................... y what means ............................................................. Heating system: Type [] [] [~ steam hot xvat er warm air Means and methods used for window cleaning: [~Working from safe surfaces [] Working from window sills or ledges [] Working from ladders: Greatest height - Top of window to floor:- Distribution [] ~ [] [] radiator duct unit heater space heater ft. [] Working from boatswain's chair [] Worl~ing from scaffolds: Height to suspension point: By powered scaffold: ~ Yes Applicants building in communities which have accepted the STATE BUILDING CONSTRUCTION CODE must complete the following /or factories and mercantile buildings: Give name and number designation of standards used for: A.SANITATION AND HEALTH FACILITIES B, GUARD[N~ AGAINST AND MINIMIZING FIRE HAZARDS COMPLETE REVERSE OF THIS FORM Office employees include stenographets~ accountants, typists, engineers~ surveyors~ designers~ draftsmen, bookkeepers, clerks, etc, Manufacturing includes makillg~ altering~ repairing, finishing, bottling, canning, cleaning, iaundering, packing~ sorting, crating~ etc~ ISS-60O (7-64) EXIgTING PART OF BUILDING When Between ~' 1935 ................ ~ erected Prior to ' ~ Between .Oc, t. ,1, 1913~ I ~uly 1924~L I After I - Oet,, , ..... / u,y ................... [ .me ., ................... I u.o 1, 20. Was th! str~ct~re oo,.c~Died as aflactot~,,on July 1, 1948 [] [] by whom ...................................................................................................... Yes No 21, Most r~cent occupant......,;: ............................................................................................. Type of business ...................................................................... 22. No. of !tories above ground ............................ , Below ............................, Sprinkler system over all areas [] [] 23. FIoors Roof Materials ........................................ , .......................................... , ........................................... ~ooimg .............................................. 24. }lave ahy variations been granted relative to features of this sh'ucture? .................................................................................................................... 25. ALTEI~ATIONS. Describe in detail all proposed alterations. 26. Flor plan POIr~T$ OF CO~iPASS IN SPACE ABOVE DRAW PLOT PLAN OF PROPOSED WORK AND ALL CONNECTED STRUCTURES Designate ~eh section by proper nnmber and name; indicate height in stories of each section; give date of erection of each portion; plan must show entire outline of connected structures and approximate overall dimensions; show north point; give name of and show location of adjacent streets, rat ~oads canals, rivers, buildings, 1or lines, etc. Distance to nearest intersecting road or street must be shown. Sec.b~i~.~ac~ory':'i~cl.des a ,frill, workshop or other nranufactnring establishment where one or more persons are employed at manufac- turing . . . Ired includes all buildings, sheds, structures or other places used for or in connection therewith, except (a) dry dock plants engaged in making [epairs to ships, and (b) power houses, generating plants and other structures owned or o, perated by a public service corporation other than ~onstruction or repair shops, subject to the jurisdiction of the public service commission .... Sec. ~J-ll. "Mercantile establishment" means a place where one or more persons are employed in which goods, wares, or merchandise are offeredifor sale and includes a building, sired or structure, or any part thereof occupied in connection with such estabJishment .... , Sec. 1'~12. "Place of public assembly" shall include (1) a theatre, (g) ~npving picture house, (3) assembly halls maintained or leased for pecuniary ~ ain where one hundred or nrore persons may assmnblc for amusement or recreation, except (a) halls owned by churches, religious organizatim s, grange and public association and free libraries as dcflncd by section two hundred fifty-three of the education law, (b) hotels having fifty or ~norc rooms, (c) state and county fair grounds and buildings connected therewith, (d) grounds or buildings of agricultural societies or' assoeiati ~ns receiving state aid." INSTRUCTIONS 1. FIL1N( REQUIREMENTS. Filing of plans and specifications is ~equired for new or altered buildings to be used as (1) factories or mercanl lie establishments except for buildings located in the City of New York, and (2) places of public assembly e~cept for such places ocated in the City of New York or in other cities having a bureau of buildings which is charged with the duty of enforcing a buildln~ code enacted by the legislative body of guch city, or in a city, town, or village which has assumed responsibility under see- tlon 47~ of the labor iaw. 2. ARCHI~FECT~S SEAL AND SIGNATURE. The seal and signature of a New York State Registered Architect or Professional Engineer are required on plans and specifications when such plans and specifications are subject to examination by the Department. 3. EXAMI~qATION FEES. Plans will not be examined until the appropriate fee is received by the Building Plans Engineering Unit. a. Buildings to be used or occupied as factories or mercantile establishments. The following fee, based upon the estimated cost of construction or alteration~ must be submitted together with the plans and appli- cations. $10, $20, Pla Estimated Cost of Construction or Alteration Fee than $10,000 $ 10.00 }00 or mote but less than $20,000 20,00 100 or more but less than $30,000 30.00 :es of public assembly. Estimated Cost of ..... Construction or Alte,ratlon Fee $30,000 or more but less than $40,000 $ 40.00 $40,000 or more but less than $50,000 50.00 $50,000 or more but less than $75,000 75.00 $75~000 or more 100o00 A fl e of ten dollars ($10.00) must be submitted together with the plans and applications. (~u)- (5/J./6?) Permlf M,, PERMIT UNDER SECTION '13& of ARTICLE VI of HIGHWAY LAW Whereas, Section 135 of Article 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 municipality enter upon or construct any works in or upon such road, or construct any overhead or underground crossing thereof, or icy or maintain therein drainage sewer or water pipes underground except under such conditions 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 v age or town. Any municipal cot oration may enter upon any road constructed or improved on a county road system for the purpose of widening the pavement or ~r 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 g yen author ty 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 grantmg of the permit p~ovlded 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 w~th the provisions of said WH~EAS, a certain highway known as the ~.J.~.d~[(~ ~(~1~/~ ~1~ No. 2~ has been improved and is on the Suffolk County Road System and as per sketch or map attache. NOW, THEREFORE, rmmission is hereby granted to said 9'II,LAGS; OF GRI]ENP0t~T IVATI~R DISTRICT to do said work u~n the following conditions: CONDITIONS AND 1. ~en concre~ is remove, tnt concrete with concrete saw two feet outside the limits of the propo~d excavation and for the full panel width. m~e in p~vement witch 10 feet of tke panel joint, the pavement sh~l ~ removed ~or ~ull panel width from the cut on the ~r side of the excavation to the panel jo~t. 2. B~IH ami thoroughly compact fill usin~ POWER ~AMPER, pl~ing soils so that o~nal su~ace. 3. Replace pavement, sidewalk or surf~e same as e~fing; if concrete, repine u~ng 1:1~ :3V~ mLx stone reLY concrete; if bl~nous material, repla~ using ~e 4. If concre~ curb is removed, replace with sl~l~r curb 1:1~ :3~ 5. Edge of Jacking Pits or ~y other excavation s~ll ~ not less than 5 feet from Edge of P~vement. No undercutt~g ~owed in 6. Notify the Department a~ Yaph~k 4-345~ when the work is to he~n This permit shall not be assigned or transferred without the w~tten consent of the Commissioner of Public Works. · he work authorized by this pe~it shall be perfo~ed under the su~rvis~on and to the satisfaction of the Com- missioner of Public Works or his representative. Particular attention is called to the necessity of thoroughly cmpacting the back fill, which will ~ required by the Commissioner of Public Works. The ~mmissioner of PubHc Works shall be given one w~k's notice by said applicant of the date when it in- tends to be~n the work authorized by this permit, and prompt notice of its ~mpletion. The said applicant hereby agrees to hold the State, County and T~n hm~less on account of damages of ~y kind which may arise during the progress of the work authorized by this ~mit or by reason 9her~f. Applicant certifi~ all persons concerned with actual work under this pez~Jt are duly covered by Workmen's Com- ~nsation Insurance ~d the State, County and Town shall be held harmless on account there.. The ~m~ssioner of Public Works rescues the right to at any t~e revoke or annul this ~rmit should the said applicant fail to ~ply with the terns and conditions u~n which it is granted. The applicant agrees to pay all necessa~ e~nses in.dent to supe~ision and inspection by reason of the grating of such pemit as certified by the Com~ssioner of Public Works, such pa~ent to be made within ten days from the rendering of the certified account. Work under this pemit to be commenced within thirty days from the date of ~mit ~d ~ntinu~ Jn an exp~itious ma~er. ~e applicant shall submit a detailed pl~ of structure to be built, with a description construction. It Is underst~ that should future ch~ges in the alignment or grade of the highway require changes in the work cover~ by t~s application and permit, the applicant shall on reasonable noti~ fz~ ~e C~issioner of Public Works make such necessary changes at his o~ expense within the time so s~cified in notice. Tr~c sh~l ~ maintained by the applicant on this section of the highway while the work is in pro~ess and until its final completion. ~ Bond ~a~. in the ~ ....... to the County Treasurer of Suffolk County is on file de~sit~ as security t'hat the highway will ~ restor~ to its original ~ndition where distur~ at the e~ense of the appUe~t, as soon as the work has been completed, ~d the said ~m~s~oner ~ Public Works is hereby autho~z~ to ~pend all or as much of such de.sit ~ may be necessary for that pu~se, should the said appl{cant neglect or refuse to ~rfom ~he work. In consideration of ~anting t~is ~mit the undersign~ accepts ~t~subject to conditiom des~i~. TO AVOID S~IO~S DAMAGE TO VITAL U~ERGROUND ~A~LITIES, PLEASE CALL LONG ISLAND LIG~- ~G ~MP~ AT JUNI~ 2-9~0 OR FOR ~EPHONE FA~LITI~S OAL~ N. Y. ~. CO. ~ PARK 2- O~'~lCXgh 25 BEFORE STARTING THE WORK AUTHORIZED BY ~IS PE~. FOIt.~V~ ~0. 1 TOWN OF SOUTHOLD BUILDIi~G DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ' /'fi' .... 19 ........ Permit No ................................. Approved ........................................ , Disopp roved~5~~~y 18uildi~ ~ector) Application No. '~' APPLICATION FOR BUILDING PERMIT ........................... , INSTRUCTIONS o. This application must be completely filled in by typewriter or Jn ink and submitted in duplicate to the Building Inspector. b. Plot plan showing Iocotlon of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of propertymust 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 Jn whole or in pa rt For any purpose whatever until o Certificate of Occupancy shall hove 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 all applicable laws, ordinances, building code and. regulations. (~not~;e of applicant, or name, if a corporation) ............ ......................... (Address of applicar~) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................... ............................................................................................................. remises ~ (.k7. CLX/,,,// /..~..6~/,..'~.., ~ Nome of owner of p ............................................................................................................................................ If applica~ is a corporate, signat/u~of duly a~horized officer. (Name and tit e of corporate off cer~ 1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Street and Number .~~ ................. ~ .................. r,~.~,~/~.. ............. ~ .......................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~../.~...~.~r..~..~ .................................................................................................... b. Intended use and occupancy ............................................................... ~ ................................................................. 3. Natj~re of work (check which applicable): New Building .................. Addition .................. Alteration Repair .............. Removal .................... Demolition .................... Other Work (Describe) j (to be paid on filing this application) 5. If d,welling, number of dwelling units ............................ Number of dwelling units on each floor ........................ If g~rage, number of cars 6. If I~usiness, 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 D~ens~ons of same structure with alterations or additions: Front ................................ Rear ............................ Dep!th. .............................. Height .............................. Number of Stories ........................................ 8. DiMensions of entire new construction: Front ....,~.~f. .............. Rear ....~.~.. ................ Depth ...~'o Height ..~.,,~..~ ................. Number of Stories .47..,4~..<~ ............... 11. Zoqe· or use district in which premises are situated.....~..f.~..~.. .......................... 12. Do~s proposed construction violate any zoning law, ordinance or regulation? .~..~.. PLOT DIAGRAM clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr. ~es. Give street end block numbers or description according to deed, and show street names and :erior or corner lot. Loc(it property [i whether in COUNTY ! OF~/~ ~~ .............. being duly sworn depose8 ~nd ~ys that he is the ~pplic above na~ed. He is the ........................................................ ~ . (Contractor, agent, corporate officer, etc.) of said o~ner or owners, and is duly authorized to perform or have performed the said work and to make and ~hns annii~ation' that all statements contained in this application are true to the best of his knowledge and bel d th~ t~e w~rk will be pertain the manner set forth in the application filed therewith. Notary P6blic, L J f F~IVE ....*,D, N. Y-