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Home My WebLink About5381-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occu 3ancy No ...... .Z.'I. 0. J ?.'~ ..... Date ......... ~.o.p .~.ell~¢l?, 2. ........... 19 .~0 THIS CERTIFIES that the building ................. ............................... , . ~xs%. F~:~on.,..N.Y Location of Property ...... 3~0, ,~lO~.~.e~. P.'~...~O~I~ Street Ham/et House No. County Tax Map No. ]000 Section .... ~.~ ..... Block ... ' ~-. ........ Lot ....... ]~ ........ Subdi¥ision ..... ~8,~':[0~ .~B~QO.~. ........... Filed Map N~o... 20~.8 .Lot No ..... i ........ conforms substantially to the Application for Building Permi~ heretofore filed in this office dated ·., .... ~I~..! } ......... 19 .'?.J pursuant to Which Building Permit No ............ ~..~.'I.Z, .... dated ...... d'~rl.~,..28 .............. 19.7.1, was issued, a, nd conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ......................... One .l?~rally. ~el[~ng. ~ .............................. The certificate is issued to .......... Ro.y .Dll~.ye,~. i~ .S~¢~.l, ey. GllZStll~SS ............. I owner, li~;~)~ of the aforesaid building. Suffolk County Department of Health Approval ..... .~.0.-.~..2~ ..... .AI~.:i?..J,.1..'1.~. ~..'1.9.~. ~ ....... UNDERWRITERS CERTIFICATE NO ............. ~./~5 .~ ~·.Z[. ......... / .................. / Rev 4/79 FOP,~! NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMEN1 TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NV 5381 Z Permission is hereby granted to: ....Re~..~v, ee~..&..~..~ley..~-,~z~aske~ .... .......... · ~ .~.....~e,~a~ .~..~,ve. ........... ~ .................. ................ ~,~ ....... ~,,.!~.,.....-'!.~ ~.~ ............. "t ~ to ~a~a ~e~ e~e ~l.z.~ ~=...~..~:. ........... .(.~.r~.e..~J~..~...t,~.r~.a,tal ............. at premises located at ....... ~e~..~.....~.~,l~t~..~l~,~ ............ : .......................................................... ........................................ -~-,..-~t~..B~..~k'C~eave~.'~t;-'~4~ ............................................... .................................................. ]~i~-e t...~w~l.~ ............ ~'~'y'~--'. .......................................................... pursuan¢ to application dated ............................... ~$~.~....Jl.,~r..~.~'~ 19 ........ , and approved by the Building Inspector. Fee$.~..~ ........... ' BuiidinglnspecTor ~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 APPLICATION FOR CERTIFICATE OFiOCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the foUowing; for new buildings or new use: 1. Final survey of property with accurate location of all build!rigs, property lines, streets, and unusual natural or topographic featu res. 2. Final approval of Health Dept. of water supply and sewerage ~lisposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire UnderWriters, 4. Commercial buildings, Industrial buildings, Multiple Reside~nces and similar buildings and installa- tions, a certificate of Code compliance from the Architect ~r 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-conformin~g uses, or buildings and "pre-existing" land uses: I. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 2. Sworn statement of owner or previous owner as to use, occup~ancv and cendition of buildings, 3, Date of any housing code or safety inspection of buildings 0r premises, or other pertinent informa- tion required to prepare a certificate, Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 ?: .... New Building ............. Old or Pre-existing Building ...... ...... Vacant Land ............. House No, Stree't Hamlet County Tax Map No. 1000 Section ............... Block ............... Lot ..... /'. .......... Unde~riters Approval ~ m ,Planning Boar~ Approval Request for Temporary Certificate ..................... Final ~ertificate ~t"ZY. ~.a.C~/~,(~, Construction on -~ ~ above described building and permit meets all a~pli~able codes and regulations, ~ ~' ~[~/ 493 Baldwin Ave. FORM NO, ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, BI. Y. Certificnte Of Occupnncy No.Z~..~. 9. ...... Date ............. .,T..~l.e...~ ...... , 19.73. THIS CERTIFIES that the building located at . Map No..F~. ?.~..~1....M~I..t~lock No ........... Lot No... J .... .F~..#t....I~.F..~0.~...N:.Y? ..... · conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... .1~....~.$..., 19.7.1.. pursuant to which Building Permit No.. ,~8.~.Z. dated ........ .J..un.~....~.8. ..... , 197.~.., 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 ....P~..ya..t.e....o~...f...aJ~A~...Y...d.W.e.l.l..~. ...................................... The certificate is issued to ..Roy. ~ ..&..8..t~l...~. y...G.~...u~...k~..~ ...... . .~..e..l'.~ ....... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval , .k~..1'$.1.,, ~..?..~.?~..~., .b~'..R.;..~..~..1~.., UNDERWRITERS CERTIFICATE No.. p.~..1~..~..g ....................................... HOUSE NUMBER.. 360 ....... Street... C~..et&V~l~. lit. ~ .............................. S-9 SCHD SUFFOLK COUNTY DEPARTHENT OF HEALTH APR 1 9 1973 Dale Bld$o Permit No. TO WHOM IT MAY CONCERN: The sewase disposal facilities for a structure located - (Give deed location) / have been inspected by this department and found to be satisfactory. Chief of General Engineering Services APR 19 1973 NEW YORK BOARD OF F!iRE UNDERWRITERS ~te~ot~he above application number in the premlses of S~'tlon Block Lot enc¢ with the requirements of this Board. FIXlrURE OUTLETS EECEPTACLES SWITCHES DRYERS FURNACE MOTORS FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT $ E R v L C E OF NEUTRAL [his certificate must not be altered in an manner; return to the office of,t~( GENERAL MANAGER Per-- ',~ ~ moy be identified the;r c~'dentidls. EASTER~ DISTRICT Co~{ty C~,nter, Riv~rh~ad, ~ York PA 7-~7~ APPLICATION FOR APPROVAL OF XN~T~LED PRIVAT~ S~AGE D~;SPOSAL ~D ~ATER SUPPLY SYST~S ~ I~pec~ion for approva~ i~ requested, pertinent idStallation data her~tth. 1 .... Phon ~ ~ 5-~o~ 8-(a)Deed location of property ~. _~' fM a oM~C~ . (h)Backfill Mat ~riaI ll-W~t~ Supply: Public Sy~t~ ~ If P~ivate, t~ roll.lng questions are to be anmwer~d. ~ ~ to st. i li-Diamete~ of w.~l pip~ ~ in. ~/ il-Date ready for inapecLi~n .',~//~u The undersigned C~TIFIES: Able sys~s ~ave bee~ co~tru~ted and are in compliance wl~~ the Suffolk County H~lth De~r~m.nt?$ curren~ S~a~/rds, Bulleti,~ 19-Inse~t sketch of io~n of Water ~ ~e~age Faci~li~ies wl~h accurate Bas~-~ upo~ the' inforraatio~ S~[~d above, satisfactory functioning of the above systems can be expected with proper maintenance a,~d care. TO [,~oM IT MAY CONCIi~N: This apFroval for ~L ~/1, C}:iof cf G~nora3 =c~inecri. uF: Services of ~mrzon Manor, ¢/b Cleaves Point Ed., East Marion, is issued on the basis of receipt of letter ptlng high' chlorides ( DO.O J . ~, :: ~ July 31, 1980 TOWN OF SOUTH(ILD OFFICE OF BUILDING INS]iECTOR TOWN HALL SOUTHOLD, N. Y. 11~71 TEL. 765-1802 Roy W. Duryea 493 Baldwin Avenue Baldwin, N.Y. 11510 Dear Mr. Duryea: : ~ This is to advise you that the jo~ under Building Permit No~ 5381Z issued to Duryea,.il~oy on 6/~/71 for ~e family dwelling ~appears to be completed as of our last inspection. ~afore you can legally use or occup~ this structure a Certi£i~ate of Occupancy must be issued. Please fill out the enclosed form ~d return same to the above office. There is a fee of $5]~00 for a Certificate of Occupancy ~, Thank you for your prompt attention. Very truly yours, GEORGE H. FISHER Sr. Building Inspector encl. THE NEW YORK BOARD OF FIR UNDERWRITERS SS JOHN STREET, NEW YORK, NEW VpRn 1OO3S THIS CERTIFIES THAT ~ mdy the elec trlcal equipment as dezcrlbed be~w and ~ntroduced by t~ applicant ~m~d on the ab~ applicatlo~ nu tuber in t~ premises of in thefollowlng location; ~ Basement ~ 1st FI. ~ 2nd FL " Section Block Lot iL and found to be in compliance with the requirements of th s Board FIXTURE FIXTURES EXHAUST FANS OUTLETS ~ECEPTACLES SWITCHES ELUORESCENT DRYERS SYSTEMS NO. OF FEET E R NO, OF CC, COND PER ~ OTHER APPARATUS: I C E NO OF HI-LEG OFA Hi. LEGW' G, NO OF NEUTRALS AW.G OF NEUTRAL COPY FOR BUILDING DEPARTMENT. THIS COPY TOWN OF SOUTtt~ BUIIA)ING DEPAI{T~ ENT Town Clerk's Offic~ South~M, N, Y. Certificate Of Oc¢ ancy ~,g[219 Date June 2q 19 ~ THIS ES that the building located at ~eaves ; ..... .... ' CERTIFI Map No.l'i ' ~: .~-E.%Qz). ~,q~lockNo ......... LotNo, .i.~. ~.~l, {,az~.p~, i' ,~..... conforms substantially to the Application for Buildit~g [~cl'miL hereto[ore t'il(,d in this office dated ......... ik)k/...'[:}..., 19.7¢. pm'suant dated ........ (f}?}?...qf) ..... , 19~.., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occkpancy for which this certificate is issued is I-'r2vate one ['am-i ~,/ df.re [ ! ins The certificate is issued to .i~gY, ~u}-yp.q &. Sta,.~ley ~Guzauskas (bwner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval :'tpr~ q9 ~973 b>' :~. 7iZ]a UNDERWRITI~RS CI'~RTIF1CATI~ No. pending ItOUSU NUMBkR.. [~.fi0 ....... Street... 9~L~.g~¢~.>. ~¢.~. 2¢ . ................ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No ...... .Z.q. 0.1 ~fl ..... Date ........ THIS CERTIFIES that the building ................................................ · Eaat. M~.lorz,..N.Y. Location of Property ~/j,~ ~60..Clea.v. es. P.~...Road 's't/a~i ........ Hamlet County Tax Map No. 1000 Section .... ~.~ ..... Block ..... ~ ........ Lot ....... ~ ........ Subdivision ..... [~tt~.0rt .MSIIO~. ........... Filed Map No... 203.8 .Lot No ..... '} ........ conforms substantially to the Application for Building Permit heretofore f'ded in this office dated · -~ .... l~I~y..1. ~ ........ , 19.7. 1. pursuant to which Building Permit No ........... ~..~.1 ~. .... dated ...... d't2n.~ .28 .............. 19 .~.'1, was issued, and conforms to ali of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ......................... One. Family. 12~welling ................................ The certificate is issued to .......... ~ .Du~.ea. & .S~:anleY. ~uzallaks$ ............. (owner, of the aforesaid building· Suffolk County Department of Health Approval ..... .~.0.-.~ .~ .......Ai~.~..t..1..~.~,..~.9.~. ~ ....... UNDERWRITERS CERTIFICATE NO ............. N./455.~ 2A ........ .//. ................. / Rev 4/79 FORM NO. ~ 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) NV 5381 Z Permission is hereby granted to: at premises Iocoted at .......J~.'J'""JJ~l~eJJ"JJllllJ~ ...................................................................... ........................................ · J'~,"~"J'J"*& "JJ,~,"m~" I~t,"Jt .............................................. .................................................. thot.llmrAm ........... It~t~ .............................................................. pursuanrc to application doted ............................... Jl~.....~..J,~ 19 ........ , and approved by the Building Inspector. Buildi..... 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 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 peoperty 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 informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date ....... m. ?,. ~ .......... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property .~.~,~. House No. Street Ham/et Owner or Owners of Property ...................................................... CounW Tax Map No. 1000 Section ............... Block ............... Lot ..... /. .......... Subdivision .x~.~.~..o.~...~/~./.~..~...~.,~..~. ~.,_ ......... Filed Map No..~.O. ?.?....Lot No .... / ......... Permit No. 5-~/~ Date of Permit ~.~/..~..~./..Applicant ~.~. ~. Health Dept. Approval ~../~//~.3. ................. Labor Dept. Approval ........................ Underwriters Approval .~ .~.~./~.r? .Planning Board Approval Request for Temporary Certificate ..................... Final Certificate .......... ~..~ ....... Fee Submitted $.....-~.~. ?.~. .................. above described building and permit meets all a~lplicable codes and regulations. Construction on .... ~,~. Applicant ...~..~..'..~ . ...-v-~--~. ..................... R~v. 10-10-78 ~! ~)..~_j,~/~ Roy & Barbara Duryea 493 Baldwin Ave, ~- ~///j/¢~/ Baldwin, NY llSlO THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY October 17, l~ffOHN STREET. NEW YORK. N~i~/~_Y'J~f~ 10038 THIS CE~IFIES THAT DRYERS {RNACE MOTORS FUTURE A~ANCE FEEDERS }PEIAL REt'PT SERVi~E DIS~NN~T NO. OF S ~T. ~P. ~E ~. ,~2W ~ ~3W 3~,W ~.O~C~CONV. JTHEE A~AEATU$: OF CC. CO~D. TIMECLOCKS BELL UNIT HEATERS MULTI-OUTLET SYSTEMS AMps. TRANS. NO. OF FEET I C NO. OF HI.LEG oFA' Hi. LEGW' G. biO. O~ NEUTRALS EXHAUST FANS AMT. H.P. DIMMERS OF NEUTRAL 493 Baldwin Ave. Beldw[n,N.Y. 11510 ~ ; Per :; mo~ no~ be altered in ony m~nnzr:, re, om lo ~he office of ~he ~ard i~ incorrecL Inspectors may be iUPPOLK COUNTY DEPARTHENT OF HEALI~! EASTERN DISTRICT Co~ty Center, Riverhead, New York PA 7-1700 APPLICATION FOR APPROVAL OF IN~TAL!.En PRIVATE S~AGE DISPOSAL A3D WATER SUPPLY SYSTEN$ I~spection for approva~ is requested, pertinent installation data hero,th. Address ~(/¢~ .~/~;~,~ ~-~- --Phone " i-Section k. iddr~s m~,p~[~' ~ ~ ' //9~ 6-Bldg.Pemlt ~o.. 7-S~age Syst~ ~tafl~'by ~' ~ ' ~ -- Phone ~ 8-(a)Deed location of pro~erty ~.~. - leg oei P v : (b)H~let °r Villase ~/~ ~ ~ ~g~ - (c)T~ ~O~o/~ 9-Septic tank-Gal L~ft.~ ft.Liq~id D~th 10-Cesspools-(a)No.poolo (b)Bl~ bel~ lnlet-1)__2) (c)Block sisal ln.~ in.~ in.(d)Precast pool (f)~ ft. in; Di~ ft.__l~.(t)iinish~ srade to cover (h)Backfill Material Il-Water Supply: Public System ; Private We~l If Private, t~e following questions are to_be answered: , ,' ii-Private Water Supply Syst~n ira. tailed by-~,/ ~~/r~ ehone~ 3 ~ 13(a)-Total De~h of W.ll' ' /,~' (b)~e~t~to Static Water Level ~/ 1S-Name of ~horatory~C~..C ~ 16-Hethod of Disinfectio 17-Date ready for inspection ~he undersiSn~ C~YIFIES: Able cyst.s have been co~ru~ed and in c~pliance ~ith the Suffolk County H~lth D~rtm~t'8 current S[a~rds, Bull~ti~ 19-Insert sketch of location of Water & ~rage FaCilities with accurate bt Inspected by~__~ ~,~,,,~t~',~- ~-/ /'~ f.!~ Date~/]~ ~-~ Based upo~ the info.sCion stated above, satisfactory functioning of the above syst~s can be expected v~th proper maintenance and care. TO ~OM ~ }L&Y CONCERN: This approval for ~t #1, Chief of Oener'a~ E~gineering Services of ~rion M~or, S/S Cleaves Point Rd., East Marion, is issued on t~e basis of receipt of letter S-Se~om the o~er accepti~ high' chlorides (400.0). ....................... t l_Cu.e& ............. ........................... THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY . 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~.- .,~: ].s. ].~o '~""~"t'°"~°'°";i'"o8~9~ N 490281 THIS CE~IFIES THAT o~y t~ e~t~M ~u~nt ~ ~scd~ ~ a~ int~ by t~ applier ~m~ on the ~ ~p~tmn numar m t~ p~ of in the foll~ing location; ~ B~ement ~ Ist Fl. ~ 2nd Fl. S~tion B~k ~t ~ w~ exami~d on and found to be in ~mpliance with the requirements of th~ B~. FIXTURE OUTLETS DRYERS FURNACE MOTORS FUTURE AI~tlANC$ FEEDERS AMT. K,W. OIL H,P, GAS H.P. AMT. NO, A.W.G. RANGES 'ECIAL REC'P1 OVENS I DISH WASHERS UNIT HEATERS MULTI-OUTLET SYSTEMS · · · NO. OF SERVICE DISCONNECT NO. OF S E R V I C HI-LEG OTHER A~ARATUS: EXHAUST FANS DIMMERS NO, OF NEUTRAI~ A, W. O. OF NEUTRAt Balckdn,N.Y. 11.510 This certificate must not be altered in any manner;· return to the office of the Board if incorrect. Inspectors may be identified by the;t~redenti~als. COPY FOR BUILDING DEPARTMENT. THIS COPY .OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Cerlific&le Of OCCUl: ncy ..... Date ............. .J~:n~. -.- ~ (~]FI'IFII~ that the building located at . ~.~e. avg.~, .Pt. ~d. &. E. ~. Gl.!l~t Map No..1~..r.~0n. ~i.~r!Cl~lock No ........... Lot No .... 1 .... E!st. !Ta. rion. 51 ~¥.. ...... conforms substantially to the Application for Building Pernfit hereto£ore filed in this office dated ........... i.i~}y...1.~..., 19.7.1. pursuant to which Building Permit No...5.38~. dated ........ ~.uf~.e...~ ..... , 19~!.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for wbich this certificate is issued is ...P.r.~:¥.afc.e.. 9[1~..f.a~.~L.l.~(..d.~,(e.J..~ ~n.g ..................................... The certificate is issued to Roy Duryea & Stanley Ouzauskas O~.mers (owner, lessee or tenant) of the aforesaid building. Su~olk County Department of Health Approval .4P.~.i.1... !.9...~. UNDERWRITERS CERTIFICATE No. pending HOUSE NUMBER.. 3.60 ....... Street... (~..~.8,1i'~ ~..p,~. ~(J. ............................... FOI~M NO. 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD~ N. Y. ORDER TO REMEDY VIOLATION (ownxef or authorized agent o~/owner)~' (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violatio~,,o/f: ~ Zoning Ordinance ~'~ /..~...O. ................. i.~ Other Applicable Laws, Ordinances,~ Regulations at premises hereinafter described in that ..~...~.~~...~...~.~..~../......~.....~..~,) ~ (state character of violation) in violation of .6~.~..... ~/..~....~....~.-~./....~../.......~./......~...~.../...~..~.~.-.~-../...~....~...-~.. .~..~ ............. ...(.. ............ (State section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply wi._~.law and to remedy the conditions above mentioned forthwith on or before the day of ............... , 19...'~...~ 'The premises to which this ORDER T,Q REMEDY VIOLATION refers are situated et ~./.~.~...~..'~.....~.....~..~..~.....?.~.-,~:..County of Suffolk, New York. Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by fine or imprisonment or both. Building Inspector ,"~'"'~'-/~<~///~-~-~-~' APPLICATION FOR BUILDING PERMIt' (,~ ~ ~ /~/~ ~. ~ ~. This op~licofio~ must b~ com~letely fill~ in ~y ~wrifer or in ink un~ submilfed in In~r. PI~ ~lon show~ng I~ot~on of lot ~ o~ buddings on premises, mloflonshlp ~o odjolnl~ ;~il c. ~ ~ c~r~ ~ this ~pplic~ti~ moy not be commenc~ ~ore iuuoml of Bulldl~ ~. U~ ~1 o~ this ~pllcotion, fbi Buil~i~ Ini~cfor will I~ue ~ Buil~i~ Pemlf fo ~11 ~ ~t ~ the pmmi.s ~il~le ~or i~s~tio, t~rou~out the p~re. of the wor~. e. No ~uildin~ ~11 ~ occupi~ or u~d in whale or in part for ony pu~e wh~ft~ until shall h~l ~n g~f~ by the Building Inip~for. A~PLI~TION IS HEREBY ~E to the Buil~in~ Le~.ment for the is~uonce of ~ Bulldi~ Buildi~ Z~ O~inonc~ of the Tom of So~hol~, Suffolk Count, N~ York, ~nd ofhl~ ~llcGblt I ne o~pl~ fo'c~ly with ~11 ~pplicoble ~ws, ordi~o~ces, ~uil~in~ c~I, houl n~ c~l, ................................ ....... ......... .................. (Address o~ ~ppll¢ont) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder, If apELl~ant Is a CO~lorote, signature of duly authorized officer. ~/ (Name and~fltle 'of corporate officer) 1. Location of land on which proposed work will be done: Map No.: ~..0..~'..~.,..~.~...,g~...~.~Lot No.: ...../. .................. Street and Number ....~..~.~...~.....~..........~.?.{.~.....~.....~..~. .................. ...~......~....../~.,,~'~/..0....'~.. ............................... ..~ ~ ~ Municipality '" State existing use and occupancy of premises and j~tended use and occupancy of propaeed construction: · g na oc pa cy ...................... ~, .................................................................. ~ ..................................... b. Intended use and occupan? . .......................... ?~:...~.; ................ ~, .......................... ,,,~'..~-~.. ........... ~ .................... 3. Nature of wink (heck dicable): ew Building ~ ..... -- Alteration .~-' . ' .......... :': .......~ ........... ". ...... ~'~.... · ........................ L:.: ...... (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 busine~, commercial or mixed occupancy, specify nature .~.d extent of each type of use ........... ~ ............. 7. Dimensions of existing Structures, if ~ont ............................ Re~ ............................ Depth .................... Height ........................ Number of S~.ori~.'~ ....................................... ~ ............................................................ Dimensions of same structure with olterations~ditions: Front .............. ..~ ............... Rear ............................ Depth ................................ Height ......................... ...~l~umber of Stories ........... ~ ................. LeFT 8. Dimensions of enhm new construction: Front ..... .~..~. ........................ Rear .....~..~.. ................. Depth ..4'..~.~..r..~.~.~....-~'... H~ight ..~..q.../. ......... Number of Stories ................. ~ .................................................................................................. 9. Size of lot: Front ...........~..¢'..~ ........... Rear ......... ~.~. ..................... Depth ......./....7....~..../.....'~.F..~. 10. Date of Purchase ............... .7...~.. ........................... Nome of Former Owner ......,ff./..~..¢~......6~..F..U...&T.......C~..~..~.-. .......... ] 1. Zone or use district in which premises are ~ituated ~ ~../~ 12. Does'proposed construction violate any zoning law, ordinance or regulation? ........ .~..~'.-~. .......................................... 13. Name of Owner of premises ..~9...¢~...e~.~ .~...~ig..%~.....Address .~.~;..~.~..~..~.....~....~..v..~...~.~.,F... Phone No.S~.~?..;:~.~..-!~...9..~ Name of Architect .~.'.:~.~.~/~; ...... .~.:.~ ............... Address .~....'~....'~...~..u~...~.'~.. Phone No.=~..:'..~.Z.°.~.~,. Name of Contractor .~..'.K/~ .......... .'?. ......................... Address .~J~.....e~.. ......... .~..'~.~.~..... Phone N .o~..~..~..~'*~4~;- PLOT DIAGRAM .~ Locate clearly and d~st~nctly oll buddings, whether ex~st~ng or proposed, and indicate all set-lx~k dimensions from ~erty lines.. Give street and block number or description according ,to deed, and show street names and indicate e~ether interior or comer lot. I T ~ ~ ~os STA'I~E OF NE~ YORK,.. iS, j.~.~--- ~ .,.,o~ COUNTY OF .;~.., .......... ~ . ,.' . ......... i ....... ..~....~l.....~...'.....~....~....~.~..~.X~ ................................ i.....being duly ~orn, d~s and says t~t he is the applicant (Ndme of individua~ signing applicafi~) above named. He is the ...... ~.~.~...~..~.~.~.~ ............................... ~: ........................................................ (~ntmctor, ~t, co~omte officer, etc.) of .said ~ner or owners, and is duly authorized to p~or~ or have perfo~ed the said work ~ to ~e ~d file this a~lication; that ~11 statements contain~ in this~ati~ ~re tree to ~e ~t of his knowl~ge and ~llef; and that the work will ~ performed in the ~nner ~~ ~plicatim fil~ ~r~i~. ................ ........ ........... ....... ............................ AY //