Loading...
HomeMy WebLinkAbout5591-zFORM TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy THIS CERTIFIES that the building located at ][,~. ~iddle ,ROa~l. (Cl~2~)Street Map No..~ ....... Block No. ~ .... Lot No.. ~.. ~t~hO~..],~., ...... conforms subst~ti~ly to the Application for Building Permit heretofore fried in this office dated ............ OCt . ]~., 19 .~ pursuant to which B~lding Permit No. dated ............ ~ . .2~.. , 19 ~ , was issued, and conforms to all of the req~re- m~nts of the applicable provisions of the law. The occup~cy ~or which this certificate is issued is · · ~X~ge. ~e fam~y ~ell~ ................................. The certificate is issued to ... ~lie. ~ate~ .~,. ~e~ .................. (owner, lessee or ten,t) of the afores~d building. NOel ~Ject to e~letion of deo~ Suffolk County Department of HeMth ApprovM ~. Feb 2~. ~.. ~1~ ..... U~e~tters ee~ ~ N~2t ~ .... ( ........ Buil~g Impector TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PEIU~IT ('rillS PER~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5591 Z Permission is hereby granted to: ........ ~;~.....l¢~t~e.~e~..~ ............. · '. ........... ~e~ ...... ~,~, ..... '. .................. i ..... i .... to .;l~Lt~..~ev- ~m~..~ud~/,.e~e:~.~a~ .................................................................................. ............. C.~t~.e~..~...~m~...~e~.t ..~a..~) ........................................................ at premises located at ................. .~r~..~..~..~,,~,)...e~.-~lit~..J~l!~3~..~& ................. .................................................................. ......... ...................................................... pursuant to application dated .................................. ~1~ ....... ~. ..... , 19.~l~.., and approved by the Building Inspector. _ TOWN OF' SE)I ITHE)LD OFFICE OF BUILDING INSPECTOR TOWN OLERK'E~ DFFICE E~rlLITHr'iLD, No Y, cMorit, J~e~ mmissioner of J:~blic Works Suffolk County Yaphank Ave., Yaphank, N. ¥. Dear Sir: In accordance with Section 239K of the General Municipal Law of the consolidated Lows of the State of New York, this is to notify the Commis- sioner of Public Works of the County of Suffolk that ...................................... Zj~...~.-~Ja~.~-52.-.-.V,~t~-:je..~e~...I~e~j..~&~e~.-.li,~, ~'i~"~'~" ~';'"C"g,f,i~"~,a~" ~ .................................................. has applied to the Town of Southold for a permit to construct a building on "~" ~I~ .......... ~1~ as shown on the attached plot plan, submitted in triplicate, dated ................ J~ltJ~"~J~"~J~J~9 ..................... and titled We shall withhold further action on this application for ten days or as otherwise provided in the aforementioned Section 239K. Very truly yours, Building Inspector Town of Southold, N. Y. L.~BORATORY NU~BER ADDRESS L-A.I~ O ~ATO P..I F-. $, INC.. 260 ISI~P AVENUe, I$~IP, N.Y. .4.~PROVED BY NEW YO~ ~ATE D~TM~T OF H~L~ o7"~'q co~r~ aY ~. C~!,!man DArE ~LLECTED DATE REPORTED NAME (2/27/72) 135 .~.~,ta ~---!rt! aild BACTERIAL EXAMINATION PHYSICAL EXAMINATION Most ProbabI* l~uml~r l-Ver~, llight. ~-51rght, 3-Distinct, 4.1~cided~ 5.Extrem* #a//o c/6 . Z'o;~Mll 6c~/¢ : EO' ~ /" MdB % M/41~ OF: CUFCHO&U£, t,I,Y. TOWN DF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN mL~'RK'-q OFFImE SOUTH~LD, No ¥. October 20, 1971 Dote ....................................................... Mr.R. Ke~erer Commissioner of Public Works Suffolk Coun~ Yophank Ave., Yaphonk, 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 ...................................... Le s&ia..~a.ta s...Sr.~...Q~tc ha g.ue..3,~..~ ................................................. has applied to the Town of Southold for a permit to construct o building on as shown on the attached plot plan, submitted in triplicate, d~ed ................ 8el~.t...l.~...:L.c)~>.c). .................... and titled ..~.~./.k.a:.~.....°.?....D..~..°.~..e.~..t.~. ..... .~...o.~....~..e..l±O~L$ Bate We shall withhold further action on this application for ten days or as otherwise provided in the aforementioned Section 239K. Very truly yours, 10/26/71: Approved to the Town of Southold ptt~la, rit to See.239K of the General Municipal Law; a permit required undem 136 of the Hi~hway Law for access to 27, as per revised p,%Ot plsn ........ SUFFOLK COUNTY DEPT. PUBLIC WORKS uuna,ng mnspector R. M. ~3kMMERER, COMMISSIONER Town of Southold, N. Y. liiam S, MatsO6~e, Jr, ~[-( Chief Engineer THE NEW YORK BOARD OF FIRE UNDERWRITERS tab BUREAU OF ELECTRICITY r 85 .JOHN STREET; NEW YORK, NEW YORK 10038 THIS CE~IFIES THAT mT.lSERVJC~100 ~P'DISCONN~d~rCBm~ ' I NC. OF MITEK ~I$1P, OTHER APPARATU$~ *Furnace/s: Oil, 1-1/8hp Motor/s: 1-3/4bp OUTLETS ACt~ SWITCHES [ RXTURES RANGr~ 1 14 t29 19 14- x 1 2-1/12hp EXHAUST FANS AMT. H.P. 1 Fr. DIMMERS George Zimlinghaus 4 Park Place ' Patchogue, L.I. This certificate must not be altered in any manner; return to the office of the Board if incorrect. Impectors may be identified by their cred~sfial~, COUNTY OF SUFFOLK DEPARTMENT OF PUBLIC WORKS P.M. KAMMERER, COMMISSIONER YAPHANK, N.Y. TYPICAL SECTION FOR PERM IT RESIDENTIAL DRIVEWAY ADJAGENT TO, ./~./g.~../.>?- ',Z~ C.R. ,. PITCH ~$ D;,,c",.,,,. --7 J ............... =¥~1'~. ) THEORETICAL CURB LINE~-~ I~ PROPERTY TYPES OF PAVEMENT 1. BITUMINOUS MACADAM BASE WITH ASPHALT CONCRETE TOR 2. CINDER'OR STONE SCREENINGS BASE WITH ASPHALT CONCRETE TOP. CINDER OR STONE SCREENINGS BASE WITH BITUMINOUS SURFACE TREATMENT AND STONE CHIPS. PORTLAND CEMENT CONCRETE WILL NOT BE PERMITTED Permit No ..... ~.0.~,6... PERMIT UNDER SECTION 136 of ARTICLE VI of HIGHWAY LAW Whereas, Section 136 of Article VI of the Hlgh'.~a) Law provides "No street surface or other railroad shall be eonstrdcted upon any portion of a road constructed or zmpro~ed on a count) road s)stem, nor shall an) person, tlrm, corporation or mumcipallty enter upon or. construct any works in or upon such road, or r.onstruct any overhead or uuderground crossing thereof, or' lay or maintain therein drainage, sewer or water, pipes underground, except under sur.h conditions and regulations as may be prescribed by the r.ounty 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 lot 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, emery municipal corporation shall have and is hereby given authority to deposit with the county superintendent such s sum of money as may be required by the county superintendent as a condition precedent to the granting of the permit provided In this section An) person, firm, or corporation v~olatlng 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 treasur~ to the credit o[ the county road fund created under section 117 of Article VI, of this chapter for the consiralction, 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 V/HEItEAS, a certain highway known as the has been unproved and ts on the Suffolk County Road System and Riddle requests permission to ~r ske~h or map flttaeh~. 8~t~d NOW, ~RE~RE, pe~ission is hereby grant~ to said to do said work upon the [ollowlng conditions: CONDITIONS AND RESTRICTIONS I. M~en concrete is removed, cut concrete with concrete saw two feet otltslde the limlt~ of the propo.w~l exeavalion and for the full panel width. ~en the elint ~lo in p~vemeut ~thin 10 feet of tho panel joint, flu. p~tvement shall ~ removed for full p~nel wkith fr.m t~e cut on the fay side of tho excavation to the p~nel jo~t. $. B~III ~nd thoroughly compri fill using PONVER TAMPER, plying soils so that v~rious types of soil are in ~e relative position ~ ~fore excavating. Gr~e to o~ su~ace. 3. ~pl~ee pavement, sidewalk or surf~e same ~ e~ng; if conc~te, repl~e u~g 1:1~ :3V: ~ stone m~ concrete; ~ bi~nous m~te~ai, replace using s~e ~ 4. If concre~ curb is remove, ~place with si~lar curb 1:1~ :3~ ~. 5. ~ge of J~klng Pits or ~y other excavation s~ll ~ not less than 5 f~t from of Paxement. No undercutt~g ~owed In Pit. 6. Notify the Depar~ent at Y~ph~k 4-3451 when the work is to be~n ~ that an ins~ction can ~ made of the operatlom ~is ~t shall not be assigned or tra~fe~ without the written consent of the Com~ss~oner of Public Works. The work authorized by th~s ~;t shall be perfo~ed under the su~ision and to the sat:slacken et the ~m- missioner of Public Works or h~s representative. Particular attenhon is call~ to the necessity of thoroughly ~paetmg the ~ek fill, which will ~ requi~ by the Commissioner of Pubhc Works ~e Commissioner of Pubhc Works shall ~ g~ven one w~k's not~ce by smd appheant of the date when it in- tends to be~n the work autho~z~ by th~s ~t, and p~mpt notice of its ~mple/lon ~e smd apphcant he.by agrees to hold the State, County and T~n hamless on ac~unt of d~ag~ kind which may arise during the p~gress of the work authonz~ by this ~It or by reason ther~f. Apphcant cer~fi~ all perso~ concerned w~th actual work under th~s pe~t are duly ~ve~d by Wor~en's ~m- ~nsahon Insuran~ ~d the State, County and Town shall be held ha~less on account ther~f. The ~m~ss~oner of Public Works ~se~es the right to at any t~e ~voke or annul th:s ~it should the aaid a~hcant far to ~ply with the te~s and -on&trane u~n which It ~s ~ant~. The applicant a~s to pay all n~e~s~ ~ mmdent to supe~is~on and insp~tlon by reason ~ the ~ting of such ~t ~ eerhfi~ by the Co~s~oner of Pubhe Works, such pa~ent to ~ made within ten daya f~ the rendenng of the ~rhfied a~nt. Work under ~is pe~lt to ~ e0~g~ within thirty days f~ the date ~ ~it ~d ~ntinu~ in an ~ applicant shall afl,bruit a detailed pl~ of strUctUre to ~ built, with a doscflptlon M pm~ meth~ ~mtmetion. It is unde~t~ that should future ch~ges m the aligment or grade of the highway r~ul~ cha~es m the work cove~ by t~s apphcahon and perm{t, the a~lic~t shall on rea~nable not~ f~ ~e C~ssioner of Public Works make such n~essa~ ~ges at hm o~ expense ~tbm the time so s~ffi~ m no~, ~c shffil ~ mmntalned by the apphe~t on th~k s~ion of the h~ghway while the work is in p~ss and until its ~al ~mpleUon. A ~2~/~ in the sum o[ $ .... ~V~,~.payable 'o the County ~asurer of Suffolk County on file de~it~ ~ s~unty that the highway will ~ ~tor~ to its original ~ndition where dmtur~ at the e~ense app~c~t, ~ soon as the work h~ ~en complete, and the said ~m~s~oner ~ Public Works is he.by authoOz~ to ex. nd all or as much of such de.sit m~ may be nec~sary [or that pu~e, shovld the said applicant negl~t or ~fu~e te ~rfn~ tho Approved " ~'~- 19..?...!. Pemit No~' Disapproved O/C ....... ....... ...................... ....... ........... .......................... . ........ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building~ I nspector~ b. Plot plan showing location, of lot ond of buildings on premises, relationship to edioining premises or public streets or areas, ond giving o detailed description of layout ofpraperty must be drown on the diagram which is p~rt of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon opprovol of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of o 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, os herein described. The applicant agrees to comply with oil applicable laws, ordinances, building code, housing cede, and regulations. (Signature of applicant, or name, if a corporation) ............ (A~l~;;;s~iicont) .................. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................... ............................................................................................. Name of owner of premises ...~,d~.~.~,IA~.......~Z~IJ~...~./~.~.~.., ...~..1~:. .............................................................................. ~ is a corpprat..e, signature of duly authorized officer. (~ [ ! 'Z_-- ~ If applicant .... ~"*'-~l~-r~-c~nd ti~ of corporate officer) Street and Number ..... ../~.l.~l.&l~..'~'~[ ~ Ul'~)-~ ....... .'1~...~. ........................ ~r ....................................................................... Municipality ' 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ...... ~..~..~.~...'~.. .................................................................................................. b. Intended use and occupancy ........ ~.0.1~..: ........ .l...~..~rltt3. l.I;~.~..~. .................................................................. 3. Nature of work (check which applicable): New Building ~.....~.. Addition .... ~ ............. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost .......... ~.~7~.O.P...~..~ ........................... Fee ..... ,....~.~......~.~ ......................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ /. ................. Number of dwelling units on each floor ..... · ...................... If garage, number of cars ........................ /.. .................................................................................... 6. If business, commercial or mixed occupancy, speci~ nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ...... ~. .................. Rear ................................ Dej)th '. ................... 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 ~--~.~..T...O.. .......... Height ....~/J~e...'...~..... Number of Stories # Size of lot' Front /. O .~., Rear .~.~1 11. Zone or use district in which prem ~ ore s tuated . ~ ....................' ......... , ....................................... 12. Does proposed construction violate any zon ng Is~v, ordnanceorreau~;~> "~i~."" ' 13. Name of Owner of prem sesJ'~.-.~..~.,/'~ .~..~'~"~ '~lress/~J~h~.~..~.' l~"~.'~;~'-'"'"~i"~'~'~'"~'~;'~ Name of Architect ...................................................... Address ............................................ Phone No ....................... Name of Contractor ~..~....~r~..b....../~...~.~..~..~..-~.:-~...~,J....C,....Address ~w~.~.~...~..: ................... Phone N~7~b~.~ .~.~.~..~.,... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and Indicate whether interior or corner lot. '(Contractor, - ............. ~' ~,, ~c.) of said owner or owners, and is duly authorized to perform or have performed the said work and te make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that th~ work will be performed in the manner~se~forth in the application filed therewLth. Sworr~fo.b~ore me this /~ ~ ~ / . I ~ - ~, Noto- Pub,,c, .......