The URL can be used to link to this page

Home My WebLink About9763-z ~OE.~I NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 9763 Z Permission is hereby granted to: .................. C.~.z...e.~...~......~..a~..z..~ ..................... to build Private. Oae Family. Dwellin~ at premises located at .......... ,.~g80..C~u~3r...Read...2.?. ................................................................. .............................................. S.o.~ .t.h.o..Z..4 ~...~w.. ~.e~.~ ...................................................................... pursuant to application dated ...~z~J..1. ....... -1,3. ............................ , 10..?.~., and approved by the Building Inspector. Fee $....~.'1..00 ........ lO00-69-/~-part of 8 Building Inspector FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall 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 Inspec- tor 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 installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5.Submit Planning Board approval of completed site plan requir, ements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing ali property lines, streets, buildings and unusual natural or topographic featu res. 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 inforqi~- tion required to prepare a certificate. 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 New Building .... X. ....... Old or Pre-existing Building ............ Vacant Land ............. House No. Street Hamlet County Tax Map No. 1000 Section.. ~d~, , ,~. ....... Block .... ~/~ ....... Lot. ~y.. Subdivision ........................... ,...v..IV~ap No .............. . Lot No ............... PermitNo. ~..~.~..~...~ateofPermit .~/~..7~.Applicant ...,. ....... ~.~>~.· ........... Health Dept. Approval .~.'~.~...'~.."~'.,~)'~ .... Labor Dept. Approval ...... /. ................. nde r,tersApprov , .... P,an ,ng oardApprova, ........ Request for Temporary Certifiqate ..................... Final Certificate ....................... Fee Submitted $ ~' Construction on above described building and permit meets all applicable codes and regulations. Applicant .... C-'~..~... ~"~ ............................. Rev. 10-10-78 TOWN I-IF SOUTHnLD I~FFI~E OF BUILDING INIGPE:0Tr-IF:'~ TOWN OLERK'~ OFFII'~.E: SOUTHGLD, N. Y. TEL. COUNTY OF SUFFOLK DEP~RTMENT OF' PUBLIC WORKS ~4~o ~harles Taplin P. Oo Box 336, North Road Peconic, New York 11958 Date__.Dece__m.~,28, 1978 Dear Sir: Permit No. 14782 County-Road 27 - ~iddle Road County Treas'urer has been authorized re ...... d _~o,~ s~cu+.~.ty in tho $ 00.00 ( ) Bond No. ' to cover work on t~{is p'ez~ni't" 'is herewith released and returned to the Bonding Company. This is to advise you that work under the hove-captioned perml,t has been inspected and found to be completed in a manner sstisfactory to this Department° ABC/ELB/er Very.~ruly yours, Building Department Town of Southold Main Road Southold,, New York 11971 Ao Barton Cass Chief Engineer O0 Z ;Z] m TOWN OF SOUTHOLD nFFICE DF BUILDING INSPI='I-:TOR TOWN CLERK'S OFFIOE Mr. k'A F~ M E~E~ Commissioner of Public Works Suffolk County Yaphank Ave., Yaphank, N. Ye Date ....................................... ~ Dear Sir: In accordance wlth Section 239K of the General Munlcipal Low 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 ...~..~..~.../7.~.~......./~.~.....7~..~ ........ ~"; ............................ 7 ...........................~ .......... '/ ................................. has applied to the Town of Southold for a permit to construct a building on "I" ......................................... 7 ................................................................. os shown on the attached plot plan, submitted in triplicate, da.ted .....~'...~..~'..... ........ .... a.dt t ed .... :9 .................. s,,~a~i'~'" ~b~,,~/f'"~'i. ~r' 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. ~0~,~ NO. 1 TOWN OF $OUTHOLD EUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. Examined ....... ~T. U4'g,~ ....... .~. .............. 19....~..~ Applicotlon No ..... 9.~.~ 3 ................... Approved ....... ~g~-'~e ........ .~ ............. , 19,7.8, Permit No...?.~.~.,~.Z. ......... ~ ............. (Building Inspector) APPLICATION FOR IBUILDING PERMIT Date ..J.~...A~ril .......................... , 19...?~ ..... INSTRUCTIONS o. This application must be completely filled in by typewriter or. in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accqrate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the 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 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 ar demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. C). ' ........ iP/i~nat~';e o~' ~li ~'~i"i~"~"~:'~';l~)';~'~i~'~ ........ · N~.t;]~...~ .....~. ~e o~,i,.e ......t .J .g 5~ ................................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...~f~.~,~.~..,~.,...~.~,D.~,,i,,~ ...................................................................................... applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No. ~' ~ E ectr cian's License No. & Other Trade's License No ............................................... 1. Lacatian of land on which proposed wark~will be done. Map No.: ,..,~ ............ ~. ..................... Lot No ......................... MunicipalJ~ 2. State existing use and occupancy of premises and in~ended use and occupancy of proposed construction: b. Intended use and occupancy 3. Nature of work (check which applicable): New Building' .....lC .......... Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ................................................... (Description) 35,ooo 4. Estimated Cost ............................................................ 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, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ..~.~. ................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ......... .80.? .................... Rear ...... ~0.~! ............... Depth .....32!! ............. Height ..1.f).'! ............ Number of Stories ...1 ................................................................................................................. 9. Size of lot: Front ....... 1..~O! .......................... Rear ..$~O1! ............................... Depth ..... 300~, .................. lO. Date of Purchase~....~.~.~.~t'..~..~....J.~..~..8. ....................... Name of Former Owner .~^...~.~.~,~,~',~ ......................... 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning Iow, ordinance or regulation: ................ ~) ................................... 13. Will lot be regraded ....~.~ ................. Will excess fill be removed fram premises: ( ) Yes ~ ) No 14. Name of Owner of premises ...q.~...~..r..];.~.~...~.:...?..~...~..]....J:.~.. ........ Addres~...~.~.~...~...a'.:..~..~.9.9..~...J:.°Phone No. ~.~..4..'T..~..4...~..0.... Name of Architect .......................... ~, .................................. Address ........... ~, ................... Phone No ..... ~ ................ Nome of Contractor " Address " Phone No. " PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions frorn 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 YQI'd~,#/ ~OUNTY OF (Nome of individual sigtl~ng eontracf) above n~med. He is the ......................................................................................................................................................... (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 file this application; that all statements contained in this application are true to the best of his knowledge and belief; and thru the work will be performed in the manner set fo~h in the application filed t~erewith. Sworn to b~fore me this ~ day o~..~ , 19 ............... Co.n ..................... ............... ........................... PERMIT UNDER SECTION 136 of ARTICLE VI of HIGHWAY LAW WHEREAS. a certain highway known as the F~DDL~E ~ has been improved and is on the Suffolk County Road System and %V~iE~EAS, C~R~S E. ~A~LIN, Po0. BOX 336, CRNo. 27 New York 11958 requests permission to build residential d=iveway as per revised plot plan & typical section, restoring County R.O.W.,t with ~opsoil and seed, to County Specs., on ~the s/s/o M/ddle Road, Hamle~ of Southold, Town NOW, THEREFORE, permission is hereby granted to said C'~AR.LES E, ~L~ to do said work upon the following conditions: CONDITIONS AND RESTEICTIONS 1. When concrete is remov~ cut concre~ ~th concrete ~w two feet outside the limits of the pro~ excavation and for the full ~nel ~dth. ~en the cut is ~e ~ p~vemen~ ~t~n 10 feet of ~e panel joint, the p~vement sh~l ~ removed for full p~el width from the cut on the fa~ side of tho excsv~tlon to the panel jolt. 2, B~IH ~d thoroughly comp~t fill using ~OWER TAMPER. pl~lng soils so that o~ su~ace. 3, ~pl~e p~vement, sid~alk or surf~o sa~ ~ e~ng; ff cone~te, repine u~g 1.1~,31/z ~ s~ne m~ concrete; ff bi~nous ~te~l, repIa~ using s~e ~ of Pavement. No undercutt~g ~owed ~ Pit. 6, Notify the Depar~ent ~t Yaph~k 4-~1 when the work h to ~On ~ that ~n ~cflon e~ ~ m~o of the o~r~tlo~ ~is ~it shall not be assigned or tra~f~r~ without the w~tten consent of tbe Commissioner of Public Works. The work authorized by this ~it shall be perfo~ed under the su~rvision and to the satisfac~on of the ~m- missioner of Public Works or his representative. Particular attention is call~ to the necessity of throughly ~pacting the bec~ fill, which will ~ requi~ by the C~ssioner o~ Public Works. ~e C~missioner of Pubic Works shall ~ given one w~k's notice by said applicant of the date when it in- tends to ~n the work au~ho~z~ by this pe~it, and prompt no,ice of its ~mpletion. ~e said applicant hereby agrees to hold the State, County and T~n ha~less on ac~unt of damag~ of ~ kind which may arise during ~he p~gress of the work authoriz~ by this ~it or by reason ther~f. Applicant cer~fi~ alt persons concerned with actuat work under this ~it are duly cover~ by Workmen's ~m- ~nsation Insuran~ ~d the State, County and Town shall be held ha~less on ac~unt ther~f. ~e ~m~ssioner ~ Public Works ~se~es the right to at any t~e revoke or annul this ~it should tbe said a~licant fail to ~ply with the te~s ~d conditions u~n which it is grant~. The applicant a~s to pay all n~essa~ e~nses in.dent to supe~ision and inspection by reason of the ~ting of such ~it ~ certified by the Com~ssioner of Public Works, such pa~ent to ~ made within ~n days from the rende~ng of the certified accent Work under this pe~it to ~ commenc~ within thirty days imm the date ~ ~it ~d ~ntinu~ in an ~e applicant shall submit a detailed pl~ of structure to ~ built, with a description ~ pm~ meth~ of It is unde~t~ that should future ch~aes in the ali~ent or ~rade of the highway require chan~es in the work ~ver~ by t~s application and permit, the a~licant shall on reasonable noti~ f~ ~e C~ssio~r of Public Works make such n~essa~ ~an~es at his o~ expense ~thin the time so s~cifl~ in noti~. ~c shE1 ~ maintained by the applicant on this section of the highway while the work is in pm~ss and until its ~al ~mpletion. A Certifl~ ~k in the sum of $~.~.~ .... payable to the ~unty ~easurer of Suffolk County Is ~ s~urity that the highway will ~ r~tor~ to its original ~ndition where distur~ at the e~nse of ~e appHc~t, ~ soon as tbe work h~ ~en complete, ~d the said ~m~s~oner ~ ~blic Works is he.by autho~z~ to e~nd all or as much of such de.sit ~ may be n~sary for that pu~e, should the said applicant n~l~t or ~use to ~o~ the ~rk. In consideration of ~ting t~is ~it the undersign~ accept~ it sub,ct ~ ~nditio~ des~i~. .......... ~ .... t., .......... ~ount7 ~om~s~ioner of ~bl~e Wo~k~. Dat~ ~ A~O~ S~O~S DA~AG~ TO V~AL H~GROH~ ~A~LITI~, PLEASE UALL LONG IS~D ~IG~- 2-O~L 25 BEFORE STARING ~E WOrK AUTHORI~D BY ~IS PE~. PERMIT REQU!RED UNDER SECTION 136' H'WAY LAW FOR ACCESS TO COUNTY RoAD ,/ .A '.! 0 60'= ~UFF. CO* DEPT. OF HEAL'TH SE*RVIC;E5 ~TATEMENT OF IN~NT FOR APPROVAL OF CON~'TRUC'T1ON ONI. Y~ DATE: H. B. RteF. ~D 1'tON 2, 3. 0 0 © Cl Ok¸