HomeMy WebLinkAbout14981-z ~ORM NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
14981 Z
Permission is hereby granted to:
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~o ~~.~~ L~ ~ ~;...~ ~
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ot premises ,oc' 'o,ed at...d.~..~.~.9.....~..........'t.'~....H.~.¢.'~....~.:..~.~.=:...~..~..
~/~. ~...,~,..~.~i~.~ ~ ...~.,...~..~.: ..........................
County Tax Map No. 1000 Section .... .~..C~...-]. ....... Block ...... ..~...~.. ........ Lot No ........ ~ ...........
pursuant to application dated ........ ,.~. ,~,~.,~ ................... , Jg,.~...q,, and approved by the
Building Inspector.
B~ilding Inspector
Rev. 6/30/80
S. &: 1E. RIB, LTY CO.
233 WEST MERRICK ROAD ,,, VALLEY STREAM, N. Y. 11580
Tolophone: (516) LOcusf I-%00
PLEASE NOTE NEW ADDRESS:
70 E. SUNRISE HWY ' SUITE 615
VALLEY STREAM, N.Y. 11582
June 6, 1986
Mr. Stanley Mitchell
King Kullen Supermarkets
3 Seabro Avenue
No. Amityville, N.Y. 11701
Re: King Kullen Supermarket
31525 Main Road
Cutchogue, N.Y.
Dear Mr. Mitchell:
Please be advised that you have our permission to
erect a King Kullen sign at the above location and to change
the name on the pylon sign in front of the Shopping Center.
i~rlieUc~oCr°ho~nReal Estate
JO:ids
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
gOUTHOLD, N.Y. 11971
TEL.: 765-1803
Examined.
Approved1~...~1.~,.., 19~. }~. Permit No../.
Disapproved a/c .....................................
Received ........... ,19...
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
June 13, 198.6.
Date ...................
INSTRUCTIONS
a. Tkis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets of plans, accurate 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
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
¢. 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 issued 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 g 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 or 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 building for necessary inspections.
KING KULLEN GROCERY COMPANY INC.
(Signature of applicant, or name, if a corporation)
.. 1] 74...p res..p.ec..t.a.v, u. e. .......................
Westbury, NY 11590 .........
(mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Lessee
Name or owner of premises ..... .S....fi..E....R.e.a.] .ty..Cp.. ...................................................
(as on the tax roll or latest deed)
If app~ant is a corporation, signature of duly authorized officer.
(Name arid title of corporate officer)
Builder's License No ..........................
Plumber's License No .........................
Electrician's License No...2.7.8.5.-.E ...............
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
......... 31 .-52.5..M.a j .n.B.o.a.d/B0u.te. 25 .......................... .cu.tcbogue ........................
House Number Street Hamlet
County Tax Map No. 1000 Section . . ~Tr~r.12 ......... Block .................. Lot ...................
Tax Code 125
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
2. State existing use and ~ccupancy ~f premises and intended use and ~ccupancy ~f pr~p~sed c~nstructi~n:
a. Existing use and occupancy . .Key..Foods. SuPerCord:et.; ...............................................
b. Intended use and occupancy ~I~G..KULLC~.$upermarket .............................................
3. Nature of work (check which ~pplicable): New Building .......... Addition. .......... Alteration ..: ........
Repair .............. Removal ............. Demolition . .!...y ........ Other Work..W.a! J..Sjg.n .....
! ~ (4' 9"x38'9") (Description)
i (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 m,xled occupancy, specify nature and exteng of each type of use ....................
7. Dimensions of existing structuies, if any: Front ............... .R.e. ar: .............. Depth.: .............
Height Number of Stories .............
Dimensions of same structure with alterations or addmons: Front .. 'i .............. Rear .................
Depth ' Height . Number of Stories
8. Dimensions of entire new cons.tructmn: Front ............... Rear ............... Depth ..............
Height ............... Nutnber. of Stories ................... : .....................................
9 Size of lot: Front ~ Rear ~ Depth
10. Date of Purchase ............................ Name of Former Ow ...........................
11. Zone or use district in which premises are situated ............. : .......
12. Does proposed construction violate any zoning law, ordinance or regulation: ................................
13. Will lot be regraded ....... ~ .................... Will excess fill be removed from premises: Yes No
14 Name of Owner of premises i ...... Address ' Phone No ..........
Name of Architect ........ ~ .................. Address ................... Phone No ................
Name of Contractor ....... ~ .................. Address ................... Phone No .......
15. Is this property locate~ withinl.00 feet of a tidal wetland? * Yes ..... No .....
· If yes, Southold Town Trustees Permit may be required.
· PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate ail 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.
STATE Oi NEW YORK, S.S
COUNTY OF ................
..... .~ .{-.(Nd~aam! ~'~}~jl~a'l~'s~i;t~'J'o('n't;dc'ti ..........
above named.
APPROVED A8 NOTED
765-1~2 9 AM TO 4 ~ ~R THE
FOLLOWING INS~C~ONS:
I ~ ~UNDATION ~ REQUIRED
FOR ~URED CONniE
2~ROUGH FRAMING & ~UMBING
SJ INSULATION
4. FINAL CONS~UCTION MU~
a~ COMPETE ~OR C.O.
ALL CONSTRUCTION ~ ME~
THE 8EQUIREMENTS Off ~E N.Y
~TE CONSTRUC~ON & ENER~
CODES~ NOT ~NS~E ~R
~ESIGN OR ~NSTRU~ON ~RORS,
being duly sworn, deposes and says that he is the applicant
He is the ...................... ....................... r .............. (Contractor, agent, corporate Officer, etc.)
of said owner or owners, and is dhly authorized to perform or have performed the said work and to make and file this
application; that all statements cor~tained in this application are true to the best of his knowledge and belief; and th'hr the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this i