HomeMy WebLinkAbout7098-z]FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMI~,NT
Town Clerk's Ot~ice
Southold, N. Y.
Certificate Of Occupancy
No..Z.6~t~,,.. Date .............. Ja~..~ ...... , 19..?~
THIS CERTIFIES that the building located at ~y. Ave. &..~a~l~ .R~ .... Street
Map No.. X,~ ....... Block No .... ~l~X...Lot No...ZX,~ · .~at, t~.tuek.. N.,¥o .......
conforms substantially to the Application for Building Pemit heretofore filed in this office
dated ............ F®h.. ~'~.., 19. ~.~.. pursuant to which Building Permit No.. 709~.
dated ....... .~..r...~ ......... , 19...~., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is . bus~esi .bu:Lld~.. {ha~k) .........................................
The certificate is issued to .. Wt~.t. l~h~t~a~. Fedex&l-.Sev~J~ge .&. Loa~. kmll~, .... e~rner
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval .6/~1/'~ ..........................
UNDERWRITERS CERTIFICATE No.. ]I.~67~ .... Jttne. ~.~. ~ 97J~ ...............
HOUSE NUMBER... ~ 0900 ..... Street.. ~a~n..lte~d. ............................
........................ ? .............. ..............................
/'~Building Inspector ~
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)
No. 7098 Z
Permission is hereby granted to:
Geo, lla~em..&.~mL.J~.C..~a.t~t~lld, tmm..L~eaeza3. ~ & /,eem A~aa
..... .t~.....~...~,~e ................................................
............. ~..,..s...~ .......... ~.:~.:.......~.~;~. ...........
~t ~ ;ms~ms.s...~.~...~[..~,~-.,,~ ...................
at premises located at ..~.' ~..~III~...~J~I~Z..&I~t ..............................................................................
Y~att~tuek I~,!.
pursuant to application dated ......................... ~11).....2~. .............. , 1~....., and approved by the
Buildin~ Inr~ector.
Fee ~I~..O.R ...~.. .............
FORM NO. S
TOWN OF $OUTHOLD
, Building Department
Town Clerks Office
Southold, N. Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building
Inspector with the following; for new buildings or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, and
unusual natural or topographic features.
2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and
installations, a certificate of Code compliance from the Architect or Engineer responsible for
the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey.of property showing all property lines, streets, buildings and unusual natural
or topographic features.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in-
formation required to prepare a certificate.
C. Fe~s:
1. Certificate of occupancy $5.00
2, Certificate of occupancy on pre-existing dwelling or land use $5.00
3. Copy of certificate of occupancy $1.00
pete ......
New B~ilding ..~. ............. Addition ................ Old or Pre-existing Building ................ Vacant Land ..............
~./_W../.Corner of Bay. Avenue & Main oad tituck
Location Of Property .......................................................................... ~! ....... ,.....~. ..............................
Owner Or Owners Of Property ..W. alt Whitman Federal Savi.n.~s and Loan Association
Subdivision ................................................................ Lot No ............. Block No ............. House No .............
Permit No....O]~..~]~. Date Of Permit .................... Applicant ..................................................................
Hearth Dept. Approval ...... ..0.~....~.~..~..~. ..................... Labor Dept. Approval ................................................
Underwriters Approval ........ .9..~.....~..Z...~..~. ..................... Planning Board Approval ...O.~...~.~ .....................
Request For Temporary Certificate ........................................ FinaJ Certificate
Fee Submitted $ .~......0...0. .........................
Construction on above described building anq~errgi,,t meets all applicable codes and regulations.
· .............
5wom to before me th,s ~ ~ /~ ~,
2.1 day of ~ I I ~ (stamp or seol) ~
Notaw Public ...... )~.~... Coun~ NOTARY PUBLIC, STATE OF ~EW YORK
QuiliJ~ed i~ Nassau Coun~
Te~ E~pires MJrc~ ~, 197J
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
THIS CERTIFIES that the building located at ...M.a.l.~..R. qa.d. ~ .B.ay..~%~... Street
Map No..XX ......... Block No....xX ...... Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ........ F.eb....h~ ...... , 19...~. pursuant to which Building Permit No. ~.0.~.~.~..
dated ...... F~ar...1 ......... , 19..~., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is ...~. v.si.l~e. ~.s..B.u.i.l.d..i~g....(.b.a..n~. ). ......................................
The certificate is issued to . ~'{~1~;..',~i.~.~. F.e. clO~t~. $~Vi~.gs. &..L.o.$1~..~$~. .... .~ner
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval .(.~.e..~p.)..$./.2.].~...b.l~' .P.e~;.e?..A.~...
UNDERWRITERS CERTIFICATE No..~./.~0..~..~....b.y..J. :..E.u.b..a.c.k.l. .................
HOUSE NUMBER .... ].Qg.0~ .... Street ... ~.~,n.. ~.QaAt ............................
1~0 Bay A~
THE NEW YORK BOARD OF FIRE.UNDERWRITERS
BUREAU OF ELECTRICITY:
[~ ak 85 JOHN STREET. NEW YORK, NEW YORK 10038
THIS CEEIFIES THAT
Walt Whitman Bank, Main Rd., 3ay Ave. [ Main Rd., Mattttuck, L.I
in the followln8 location; [] Basement ~ Ist FI.
w..x. mtn~do. JUne 20, 1974
[] 2nd R. outside S~t~on Bto~
and found to be in compliance with the requirements of ~his Board.
RXTUBE RXTURES RANGES OVENS FANS
OUTLETS SWIT~ES ~UO~fSCENT
25 ql 17 7 18
DRYERS FURNACE MOTORS
SERVICE DISCONNECT S E R V I C
OTHER APPARATUS,,
Water heater: 1-~.5kw
Motor/s:l-lhp
Elec.room heaters: l-2.5kw,
1-? Ton A.C. Unit
l- 10kw Duct heater$
3/0
1
1-1.5kw, 3-1.25kw, 4-1.Okw, 4-.75kw
Of NEUTRAL
3/o
Commander Electric,
1716 Motor Pkway,
~auDpauge, L.I. 11787
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
$outhold Town Planning Board
=~I-lUTHnLD~ L. I., N. Y. 11971
PLANNING BOARD
MEMBERS
John Wlokham, Chairman
Henry Molea
Alfred Grebe
Henry Raynor
Prank Coy]a
June 19, 1974
Mr. Howard Terry, Building Inspector
Town Clerk's Office
Southold, New York 11971
Dear Mr. Terry:
Henry Raynor has inspected the property of the
Walt Whitman Federal Savings & Loan and finds that
most of the plantings are in, the remainder are on
the premises and it appears that the plantings exceed
those required by the site plan. He recommends approval
of the plantings and the entire site plan and I concur.
Yours truly,
~/~hn Wickham, Chairman
~Southold Town Planning Board
JW/mb
O$outhold Town Planning Board
-qCIUTHnLD, L. I., N. Y. 119T1
PLANNING BOARD
John Wlokho,m, Ohelfmen February O, 1974 , FEB ? i;7 /
Henry Moleo
Alfred Grebe
Henry Rllynor
Frank 0oyle
DeNigris & Haler,
120 Bethpage Road
Hicksville, New York 11801
Re: Walt Whitman Federal Savings
& Loan, Mattituck Branch
Gentlemen:
This is to in£orm you that the following action was
taken by the Southold Town Planning Board at its regular
meeting on January 30, 1974 on Site Plan 3095 dated November
8, 1973 and Site Location Plan for Sewage Disposal System
and Wells dated December 10, 1973.
On motion made by Mr. RaFnor, seconded by Mr. Moisa,
it was
RESOLVED that the site plan of Walt Whitman Federal
Savings and Loan be approved.
Vote of the Board: Ayes: Messrs. Grebe, Raynor, Moisa,
Wickham.
Yours truly,
Muriel Brush, Secretary
Southold Town Planning Board
cc.: General Engineering Services;~nit
Department of Health Services
PERM
33c
(12hQ)
STA'~E OF N~W YORK - DEPAR~TMENT ~F TRANSPORTATION
H)GHWAy WOrK PERM)T APPL)CAT)ON FOR NON-UT(L'ITY WORK
Application is hereby made for a highway work permit Highway permit No.
Effective Date
I~P~ l~)m) ~ AV~Ie : f ENTER NAME AND
JJ~JJ~t~ ~.'J~J3.~ JJ~ql~ '~ 1.1."~ / -~ MAILING ADDRESS
LIN THIS SPACE
L
1. Requested duration from 19
2. Protective Liability Insurance covered by Policy No.
3. Workmen*s Compensation Insurance Policy No.
4. Disability Benefits Coverage Policy No.
thru 19
expiring
PREPARE
3 COPIES
1242mrl im et.
, to apply to the operation(s) checked below:
expires on 19
Check Type Permit Show Ins. Fee in Total Amount Guarantee
of Operation Fee Amt. or PERM* of Fee and~ Deposit Amount
17 pr Under- or Insurance and/at Bond
taking on file
F~4. Single job. Permit issued for each job
[~a. Driveway or roadway
[~ Private N C
[] Commercial $ 50
[~] Subdivision Street $100
L~ Temporary access road or street $ 10
~]b. Improvement
E~ Private N C
~] Commercial $ 10
Check additional description below:
[~JnstaJJ sidewalk~ curb, paving,
stabiJized shoulder~drainage~ etc.
]Grade, seed, improve land contour, ~
clear land of bru'sh, etc.
[~ Resurface existing roadway
or driveway
[] MisceHaneous
T~c. Tree Work
[~ Private N C
[~] Commercial (not required for pruning if $ 10
utility has annual maintenance permit)
Check additional description below:
~ Remova~ or planting
[] Pruning, applying chemicals to__stumps, etc.
~". Miscellaneous Construction
~ Beautifying ROW -(for Civic Groups only) NC
~ Temporary signs, banners, Christmas decorations $ 10
~] Traffic control signals $100
~] Warning and entrance signs $ 10 ·
[] Miscellaneous
~]5. One permit issuance which rema~n~ in effect ~ndefinJtely and $ ~0
requires continuous insurance for encroachments caused by DoT
acquisition of property.
]6. Compulsory permit required when work performed
at the request of Department.
~a. Buildings (within State highway right-of-way)
on State lands when not covered by contract
specifications of the Department-
-- -- [] Demolition [] Moving N C
Tmpro--¥em--;nt m,--., st-- ndaCds ............ - -- ......
TOTAL PAID
Work may be described brlefly as roi Jaws:
To open the s/o o~ Jfatn Romd, Rt. 2~, weste~l~ eFA~z. ~0* f~ ~ i~.t
~ Additional work description is attached;
LOCATION ( ~ ~ ~ S~ydNo.,S~ between station ' ~
and station in the Town of C~nty of
known as
Acceptance of the ~equested perm ~cts the rmlttee to the restrictions, regulafions and obligations stated on this application and on the permit.
D of Appllcatlon 19
Appr . , ~/19 ~ By Regio:a?~g
PERM 32 & 33 (12/70) RESPONSIBILITIES OF PERMITTEE
REVERSE
1. PROTECTIVE LIABILITY INSURANCE COVERAGE
Permittee must have protective liability insurance coverage in accordance with Department requirements, (See Infor-
mation on Protective Liability Insurance Required for Highway Work Permits and/or Special Hauling Permits, Form
PERM- 27).
Expirafion of, or lack of, liability insurance automatically terminates the permit.
Insurance coverage may be provided by furnishing the Department with one of the following:
a. A Certificate of Protective Liability Insurance for Permits on State Highways (Form PERM 17, NYSDoT).
b. A $2.50 remittance (check drawn on a New York State Bank or Certified) for coverage under the Departmental Blanket
Policy.
c. An Undertaking may be furnished by Public Service Corporations and Government Units only and must include the
wording required by the Department.
2, COMPENSATION INSURANCE AND DISABILITY COVERAGE
The applicant is required to have compensation insurance and disability coverage as noted in the provisions of the
Workmen's Compensation Lawand Acts amendatorythereof for the entire period of the permit, or the permitis invalid.
3. NOTIFICATIONS
Notify Commissioner, through Regional Office, one week prior to commencing work, except emergency work by public
service utilities which should be reported the next work day.
Work must start within 30 days from date of permit.
Notify area gas distributors 72 hours prior to any blasting.
Notify Utility Companies with facilities in work area (permission must be obtained before doing work affecting utilities'
facilities) before starting work.
Notify land owners of abutting lands, before disturbing trees.
Notify Department of Transportation at conclusion of work and return original copy of permit to Regional Office.
Annual Maintenance Permit Notifications:
Notify by telephone the District or Resident Office, one week in advance, each time regular maintenance work
is to be performed. In emergencies, notification by telephone should be made the next work day.
4. SITE CARE AND RESTORATION ~
An Undertaking, a bond or certified check in an amount designated by the DepartmentofTransportation may berequired
bytheRegional Office, before a permit is issued, to guarantee restoration of the site to its original condition. If the
Department is obliged to restore the site of its original condition, the costs to the Department will be deducted from
the amount of the permittee's guarantee deposit at the conclusion of the work.
The permittee is responsible for traffic protection and maintenance, including adequate use of signs and barriers during
work and evening hours.
No unnecessary obstruction is to be left on the pavement or the right of way or in such a position as to block warning
signs during or between work hours.
No work shall be done to obstruct drainage or divert creeks, water courses or sluices onto the right of way.
All falsework must be removed and all e×cavations must be filled in and restored to the satisfaction of the Regional
Traffic Engineer.
5. COSTS INCURRED BY ISSUANCE OF THIS PERMIT
All costs beyond the limits of the protective liability insurance, surety deposits, etc., are tbe responsibility of the
permittee.
The State shall be held free of any costs incurred by the issuance of this permit, direct or indirect.
6. SUBMITTING WORK PLANS
The applicant will submit work plans and/or a map as required by the Department. This shall include such details as
measurements of driveways with relation to nearest corner, positions of guys supporting poles and a schedule of the
number of poles and feet of excavation necessary for completion of the work on the State right of way. A description
of the proposed method of construction will be included.
Plan work with future adjustments in mind, as any relocation, replacement or removal of the installation authorized by
this permit and made necessary by future highway maintenance, reconstruction or new construction, will be the respon-
sibility of the permittee.
The permittee must coordinate his work with any state construction being conducted.
7. TRAFFIC MAINTENANCE
Traffic shall be maintained by the permittee on the highway, in a safe manner, during work and evening hours until its
final completion. Suitable safeguards, to reduce conditions dangerous to [ife, limb and property to a minimum, must be
provided by the permittee (including flagman when requested by the Department).
8. COST OF INSPECTION AND SUPERVISION
If, in the accounts kept by the Department, costs of supervision are found to be exceedingly high, the Department re-
serves the right to bin the .permittee for actual expenses incurred by the supervision and inspection of the permittee's
project.
9. SCOPE
a. ~.reas Covered
P~rmits issued are for highways, bridges and culverts over which the New York State Department of Transportation
has jurisdiction. (Local governments issue permits for their own jurisdiction.)
b. legal
The privilege granted by the permit does not authorize any infringement of federal, state or local laws or regulations,
is limited to the extent of the authority of this Department in the premises and is transferable and assignable only
with the written consent of the Commissioner.of Transportation.
c. Commissioner's Reservations
TheCommissioner of Transportation reserves the right to modify fees and to revoke or annul the permit at any time,
at his discretion without a hearing or the necessity of showing cause.
d. Locations
Work locations must meet approval of the Department.
(Additional pages to this application vary according to the purpose and type of work to be permitted)
~ ,C~ .,.CAT 0,~ ....
I. ~.,...n...¢ pavement in :icl ~.o bo bro,(~n o:' undopmined.
2. Driveway paving shall b.~ of zoad quality (minimum requirement of 2" of
asphaltic concrete on k," of stone) & ¢,hall extend from the property line to
~hs main highway pavement. Stopping of driveway construction at existing bi-
~ .4~no~s shoulder will nbt be accepted. Driveway paving shall bo flared at
4~° onto highway in both directions to cover all wheel-track lines of moving
vehicles.
3.~ Curbing~ with 6" face showing shall be placod as shown on the attached
~ypiual $ectio~ sheet. Top of curb shall be 6" above final shoulder grade.
Curb shall be true to line & grade. The end of curb toward oncoming traffic
when not Joined to existing adjacent curb, shall be tapered down to shoulder
grade.
4- Side~,al~ sha~i be placed unless expressly waived in writing. It shall be
~" of cement concrete oxcepb a~ the driveway and ramp which shall be 6" re-
inforced concrete. Width of sidewalk shall conform with other sidewalk in
the area, but the minimum width shall be
~. Area between curb and property line, or curb & sidewalk, must be topsoiled
and seeded or asphalted.
6. Highway shoulder between driveways & between curb & highway pavement shall
be placed in a condition adequate to support all using traffic generated by
this development & one satisfactory to this office. Minimum requirement for
a residence is ~O#/sq. yard of stone chips & 3/4 gal./sq, yard of road oil,
properly applied on graded & rolled bass. Businesses shall place a minimum of
2" of
a~?~=~ic concrete on a drained, graded & rolled base° The determina-
tion of the least requirement pertaining shall be by this office. Partially
removed asphalt shouldo~ (as for installation of curb) shall be cut square
for its full depth & this edge painted with a suitable bituminous asphalt
before the new material shall be placed.
?. Drainage along'highway is not to be obstructed. Profile of driveways & the
cross-section of the finished shoulder shall be such as to follow the drain-
age cross-section of the highway shoulder. Initial slopes shall be away from
pavement of highway. Finished driveways which block shoulder drainage shall
be removed & replaced by the permittee to the proper grade, or otherwise, if
permitted in writing, the permittee shall construct the necessary leaching
basin to re!isys the adverse condition~ and to specifications by this office.
8. The psrmit~ee agrees, by acceptance of this ps,nit, to provide adequate
internal drainage interception within the private property, for roof drainage
& for run-off from all appreciable paved surfaces sloping toward the State
highway, & he further agrees that the cost of providing for a means of inter-
ception may be assessed against his bond if he fails to provide it.
9. Pedestrian & vehicle traffics is to be protected & maintained. There shall
be no unprotected or unlighted drop-offs or obstacles at any time. Open holes
shall be guarded or fenced. The permittee agrees to pay all costs involved
by the State, including mm% hours & equipment use, necessary to correct any
~- unsafe condiOion.
lo .... ~ ~'~.~o~ herewith agrees not to place or to leave in place any struc-
ture or appurtenance of private nature within or overhanging the State high-
way R.O.W., including coil~.ways, signs foundations, pull boxes, retaining
walls, etc. & further agrees that if such object placed by him ia found to
be within the State R.O.W. & iS is not removed immediately upon demand, that
the cost necessary to effect its removal may be assessed against his bond.
11,~. No trees may be cut or trimmed; either above or below ground~ without
permission in writing from this office. ~enever any work is done within th*
vicinity of a tree or treee~ this office will be given 72 hours notice, & s
~oin~ inspection arranged. The permittee agrees herewith to pay for or to
replace any trees damaged without permission & as directed by this office.
12. The permittee shall keep the 'Oraveled way free of foreign objects such as~
rocks, timber & other items that may fall from transporting vehicles.
Spillage of material carried by or dropped from the under-carriage of any
carrying vehicle resulting from' ~e permittee,s hauling.operations along or
across any public traveled way shall be removed immediately & such traveled
way~ both within & outside of the work limits shall be kept free of such
spillage of the permittse.
13. No official State Traffic Commission signs may be disturbed without approv-
al from ,ne Permit office. If it is necessary to relocate such signs the
District Traffic Office must be contacted for the new loeation.
I~. in State Contract areas the permittee must eonduc$ hie work in conformity
with the schedule of the State's contractor. All work mumB be done to the
· satisfaction of ~he State,s Engro-in-Oharge~
& /d /?' .-
...:. '" "t" ,~ U, ..""'"'' '
'"". ' ,1~ · ,"n,*',~. ," ~ """" ' ' · '
. .... .., ~q:?,~.~e/Y,:,' . ..
... z ~' ' o' ~.o/~ c~I~_' 'I" '
· ° '"¢""dj ~; ', ..0 .... o..,~-,,,-, .". ..
.. "~.,,~ ~"., ; I ~ : ,~ ' ..' -. ' : ." '~.~,. ' "' "'"'
......
· ':" I , .,.. .'
' ..... ..,, ~,1~ .-- . I...,...'...':
!..."; .,.,,~nO ~" ~, ~[ .,: , ... ,
,..... ~ , . ..~ .~: ~.,.,.,..
,,~ /~ . ,
... . : I ~.',,,......
-- ' " ~I '"'""'""""
.,,...,,~.~.,~,,,,,~,,, .... , .,..,,
'...,, - ..tx. . , ~ ~ , ~o'~-,-~ , . .....,~
~.~,,, b" c,.,,z.-~ · _L:. ' "' :'
· .::...l,.... " ' '~ ~'J .
~ I J '"'. : ·
,~.: · Z~ - __~ .. .
· .. C~,,,.Z ., "'
... ._ ",,. . -.. _----~? , .,,, .. f
· , . · . ;' ~"' .o .. . ~ . ",.**~ , .., ,o,* ,, '~ · , .... ,,._
.... · . .' . . ,~ . ~.,.,.... ~ . ..'...-- .., ....~,.,?..-,...,..-,...o .~- . ?,,--~..,,',-? "*;, ~ .... ,,,,,,~",-.., ,
~ · :. . . '.......~ ..... ~.'.; ,...~:..~,: .'~:.,.~,:~..':./.,..',.'~......,,,.,: ,,..~,,.,,.., .,
· ,. · ..' , .'", . _ ........ ".?: .,~..'* ..', ',, ,.',.t'~.:,-'?,,,,,~'.t.,'., ,' '* bw'., ,,,'t.; ,. ".'
· /; /.._*. '.. * ._,.'..o...t.; '~..."~~ "
J/z ' ' "': .... ' '~ ' ' ~. ............ ,,.:~:. ;~
&PPLICATION FOR IUILDIHG PERMIT~/_'~ % ~
..................... ................... ,
a. This al~licatJon mu~ be completely filled in by typewriter o~ in ir~ and submitted in triplicate to the B~ilcling
Inspector, with 3 set~ of peres, a~-u. mte~ plot plan to sca~. Fee according to schedule. /~ ~
b. Plot plan showing location ofiot and of buildings on premises, relationship to adjoining premises or public streets or~S~
areas, and giving a detailed descriptiOn of layout ofpe~party must be drown On the diagram which is part of this pppli~ation.
c. The work covered by this application may not be commenced before issuance of BUilding Permit.
d. Upon approval of this application, the Building laspector will issue a Building Permit to the applicant. Such permit
sha~l be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY/v~DE to the Building Department for the issuance of a Building Permit purauant to the
Building Zone Ordinance of the Town.of Southold, Suffolk County, New York, and other applicable Laws_, O~dinancas Or
Regulati,.ons, for the construction of buddings, additions or alterations, or for removal or. demolition, as heroin clescribed.
The apphCant agrees to comply w th all appl cable laws, ordinances, building cede, houseng code, and regulatJom, and to
admit authorized inspectors on pmmi~es and in buildings for
State whether applicant is owner, lessee, agent, architect, engineer, general cantractor, electrician, plumber or builder.
Name of owner of remises ....W...a..t.t ..W....h..f....t~....a..n.....F...~....e....r~..t.....S.&vt..r~.s....a....r~l.. L...o~....n.. Asso.d..atton
If applicant is a corporate, signature of duly authorized officer.
(Nam(( e and title of comomte officer)
Geor'gew° HoUcum, Sr';V.P. & S~c~et~r,y
Builder's License No ...... .n.~.t~..~.Y~'~.,L'~. ......................
not ,.a..w...a:~d .....................
Plumber's License No .................
Electrician's License No...r~...t...?...w~.......r~...e..d. ...................
Other Tmde's License No ...............................................
1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No .........................
s/w/coP, of' Route 25 and B~. Avenue~ Matt~,tuck~ N~ .~..
Street and Number .......................................
2. State existing use and occupancy of premises and intended use and occupancy of propo~ construction:
a. Exisiting use and occupancy Bustness (extsttng r'estdence to be r-emov_~l_)
b. Intended use and occupancy ..,,B...u,,s..t .n~...s..s.....-:......~...v~....~,...s...~..,,L.,,o,,a..n. ................................................................
3. Nature of work (check which applicable): New Building .........X.. ........ Addition .................. Alteration ........... : .....
Repair Removal .................. Demolition ............... ..... Other Work "
4. Estimated Cost $100s000. Fee ''~ ~O (DeSCription)
(to be paid on filing this application)
5. If dwelling, number of dwelling units ...... ..N.../..A.. ............. Number of dwelling units on each floor ..... .N.../..A.. ...............
If garage, number of cars . N/A
6. 'if business, commercial, or mixed occupancy, specify nature and ext&nt of each type of use ....B...a...n..~ ...............
7. Dimensions of existing structures, if any: Front ...'[Q..~.et..r~,,CO.~¥~[i~ar ................................ Depth ....................
Height ........................ Number of Stories .................................................................................................................
Dimensions of same structure with alterations or additions: Front .................................... Rear ............................
Depth ................................ Height ............................ Number of Stories ................................
8. Dimensions of entire new construction: Front .....5..4..~...'~...". .................... Rear ...... .~..~.'..'~..". ......... Depth .....3...7.!...-~...~! .......
Height .................... Number of Stories ......... .o...n..e. ......................................................................................................
9. Size of lot: Front ........ .1..3...~.-..0..Q.r. ................................. Rear . .. . .!. .2. .6. .-. .~..0. ~ ....................... Depth ...~.~2..4.4....'..5...0.r. .............
George _A.. McCarthy and
10. Date of Purchase ...~...u.g.~.u.s...t....1. z....1..9..7...~ ...................... Name of Former Owner .lq.e,[~.tl.~l~./9¥EC~lel~~ .............
11. Zone or use district in which premises are situated ...... .,B...u.~.t...r~...s.A ............................................................................
12. Does proposed construction violate any zoning law, ordinance .or regulation: ....N..~ ................................................
Yes
13. Will lot be regraded ............. :. .............Will excel_ fill be. removed frglLcL~re/~iS,~: (~.)_Yes ( ~ No
watt Whttman I-eaer~t ,~p~.~ ~le_T t~.v~ , ,~ .....
14. Nome of Owner of premises ^ddresS No.
· DtNt ~'ts & M ~ee ~35--2556
Name of Arch,tect ....~.~.~.P...t..s...... :. ....................................... Address. ~JLtP~.~,.' ~one No .......................
Name of Contractor ................. ~ ..~...~.~.....~.~.~.. ^ddre,~ .~...~....~.~....~...,~Noi~..~,~..T..~...~...~.,~..
PLOT .DIAGRAM //?~'5,
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.
:.':~TATE OF NEW YORK ~ ¢ c I~-~-O~ '
~COUNTY OF ...-.~.k~)~'Ql,~ ...............
G~e W. Hokum
................................................................................................ being duly sworn, d~s qd soys t~t he is the opplicont
(Name of 'i~ivid~l: Signing con~c~
~ove nOm~.
He is the ................. ~.~.~..~.~...;..~.t..~ ~...~..~~ ....................................
.. (Cont~tor~ ag~, co~rate officer, etc;~
of said owner or ~ners, and is duly authorized to perform or have perfo~e~the sa~d work end to ~ke ~nd file
this application; that all ~atements contained in this application are tree to the best ~-his k~°Wle~ge and belief; and
thm~e ~rk will ~ performed in the manner set fo~h in the applicati~ filed t~
Swam to ~fom me this
..... .......... of ........... ............... ,
Nota~ Public ~..: _...~...~~..~~~~~n~ ................. ~:'""7,, ,~ ,~ gna,u ......... re o,; ...... appm,can,,::"'"t': .............................
~ CA~Y I. PAS~K ~, ~ ~,
NOTARY PUBliC, S~te of N~ Y~ ' ,: ~ ' '
No. S2-~.Su~y~ /
Commission Expires Ma~h ~ ~ ,:~
'%,-
f
'1
er r
./--
.: _.. WALT', .WI-H I:"'MAb4 PED~---I~Al
DE NI~
ARCHITE(
12O BIETHI~GE
RtS MAIER. P.C.;
,INEERS, PL~NNIERS ,
HICKS¥1LLE, N,Y.
.t