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Home My WebLink About12070-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southoid, N.Y. Certificate Of Occupancy No...Z.1.1.4. ] ? ......... Date January 4 19 83 THIS CERTIFIES that the building ................................................ Location of Property 1670 Soundview /~venue Peconic House No. Street Hem/et County Tax Map No. 1000 Section 068 .Block 04 .Lot 015 . Subdivision .... X. .......................... Filed Map No.. X .Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .S.e.p. ~ .e.m.b.e..u..1.7. .. , 19 .8.2. pursuant to which Building Permit No...! .292.0...Z ........... dated ....D .e.c.m.e..b .e.p.. ] .3 ............19 .8 ~., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is .ad d£.t~ion ~.~..< .~.~. ~..~ r.~>.¢ .o.~..o.~.. ~>.~ z..~ f.y..~. ?.tAd. t..<~' ,(.~,: f,., !~ .~ ff.2. z. !. Ao...o?.~ .r.~.~.t.z. ¥..dy.? .Z Zing. The certificate is issued to ...... p.( ....B.a.u.p..y..S.....S .a.v.i.t.s. .............................. (owner,/es.~ee of the aforesaid building. Suffolk County Department of Health Approval . J.l.z .S.0.-.5.6. UNDERWRITERS CERTIFICATE NO. N 5869 1 3 ' 'Building Inspector Rev. 1/81 N°. ?OWN OF ~OUTHO[D7 BUILDING DEPARTMENT TOWN ~ H~LI. : SOUTHOLD~NoY. BUILDING PERMiT~ (THIS PERMIT MUsT BE KEPT ON THE PRE/~IStS UNTIL ~ULL COMPL~'ION OF THE WORK AUTHORIZED) 12070 Z o~, .... ...... , ......................... ................... , ~ ..... ..... ~'..~....~: ........ ~ ..... , ~~ . ..... ....... ..~..~... -~ ~ ~ · ~ ....... ................................................................................................ ~ .............. ....... ?"~'";'7 ...... ~: ................. 1000 Section ........................ Bilk ......: ............... ~L~ No. ........................ Building Irispector. ': Fee ~, ........ ~ ............... : Bull~ing Insl~ctor FORM NO. 6 TOWN OF SOUTHOLD : Buiiding Department Town Hall Southold, N.Y. 17971 APPLICATION FOR CI~RTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate to the Building tnspec- tot with [he 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 tol~ograohic 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 build[ng~ 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. For existing buildings (prior to April 1957}, Non-conforming uses, or buildings a~d "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topograph ic 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- t/on required to prepare a certificate. ./ Fees: 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 $1.00 Date .. New Building . . ~ Old or Pre-existing Building(Z) ..... =/Vacant Land ..... Location of Property . ... .......................... ! ................. ~ ,~ ¢. Hou~ No. Streec Ham/et County Tax Map No 1000 Section O~ O~ ............... Block ... Lot. Subdivision ...................... ' · ......... Filed Map'No...: ....... Lot No. .............. Date of Permit i~ I~ ......... ~phcan~ Health Dep,. Approval "~0 ¢~ --~'~$f~ , . ........................ La,or Dept. Approval ..... ~ ......... Request for Temporary Certificate ..................... Final Certificate ........ - ....... -.. Fee Submitted $ .... Construction on above described building and per~i[meets all apP~cabl~odes and regulations. Applicant ., .. .- . THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW ,YORK 1OO:98 THIS CERTIFIES THAT ~. ~::, ~ Ave. 5/~, ~c, ~.Y, in the following Iocotion; ~ Basetncnt ~ ls£ FI. .~asex..~i.edo. De~m~er 13, 1982 FIXTURE FIXTURES [~ 2nd Fl. Section Block Lot and found to be in compliance with the requirements of this Board. RANGES DISH WASHERS EXHAUST FANS DRYERS MOTORS ITHER APPARATUS: 1-$~ke De~ec~or E R I C E G & $ glmctric P.O. S~x215 Sour~old, N.Y., 11971 IAo. ~5 78 -E 'his certificate must not be altered in any manner; retur~ to the office of the Board if incorrect. COPY FOR~BUILO~ING DEPARTMENT, ,THIS COPY OF may be ~N~N¥ Edward J. Acker Soundview Avenue Peconio, New York CO. TAX #1000-O68-04-0t5, 016 Dwelling - B. P. #6852Z (Applied for Utility Shed) Permit Expired Submit Application for new permit, showing Greenhouse, addition and plan of Building as it is Now Require Health Department Approval - Compliance to Energy Code and Underwriters Certificate. CORRECT FOLLOWING: Living Room - Non Combustable Wall Behind Wood Stove~ Required. Dining Room - Non Combustable Base and Wall Covering for Wood Stove, Required. 3/4 Hr. Fire Separation between Garage and Dwelling, to Code. d. Correct Electrical in Furnace Room, Replace Cover on Furnace Control· e. Vent Furnace Room to Accepted Standards. Furnace and Wood Burning Stove Connected to Same Flue, N~t Fermltted. Ea~ch require separate flue. Hot Water Heating System, No inspection called for to check pipes for drainage. System will have to be filled with anti-freeze to protect pipes from freezing. Exhaust Pipe for generator runs thru combustable wall install insulated sleeve. Building Permit fee will be Barn and Fence B. F. #7464Z determined upon review of plans· 1. Require $5.00 fee for C. O. for Barn 2. Underwriters Certificate for Electrical work POOL B. P. #8553Z ~ ~ CORRECT FOLLOWING: ~___~./ 1. Pool enclosue, to 48" Height wall to right of gate must be r~ised 2. Up Dated Underwriters Certificate BLE B. F. 1. 2. ~equ±re fee for C. O. $5.00 #9744Z - Have been holding Not Issued. Require fee $10.00 for Building Yermit Applieation for C. O. B. Fee $5.00 for C. O. 4. Underwriter Certificate for electrical work. Building for fire wood and privy constructed without permit. Building permit is required for Structure. Privy is not permitted and will have to be removed. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 TEL. 765-1802 March 4, 1981 Mr. Butt G. Lewis, Jr. Country Reai Estate Main and Cox Roads Cutchogue, New York 11935 Re: Edward Acker Dear Burr: I am enclosing herewith a list of what is necessary to complete in order for Certificates of Occupancy to be issued for the buildings on premises owned by Mr. Acker on Soundview Avenue, Feconic, New York. A building permit for the dwelling was never applied for. Building Permit #6852Z was issued for a utility building. Therefore a complete set of plans must be submitted for the dwelling and it must comply with all the codes now in effect. Building & Housing Inspector EFH:jkd Enclosure FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL LocationofProperty .../..~'%'~.(~... ~.~.'~c'/,~/~c~7 7~.~..~. ~C~l~ ~'~ Street House No. ' .................................. / h3~/e~ County Tax Map No. 1000 Section . .~ ...... Block ...~ ....... ~t .~ ........ Subdivision ..... : ?~' 2 ....... Filed Map No ................. Lot No. ' " is returned herewith and disapproved on the following grounds .'~,.~..//.c~Q~7~.'../~ .~ ..... .~/. ~,~,~. ...... - e~.~, ~, .~/f ~ .~ ~ ~/. , ~.~.., ~o~,~ ~. .... ~.., ~ ~/.~..~..~~ ~ ~ Build~g Inspector RV 1/80 STEVE G. TSONTAKIS, F~.E. Drawer 1446, Middle Rd. Mattituck, N.Y. 11952 (516) 298-4533 December 15, 1982 Mr. E. HindezT~ann Building Inspector Town of Southold Town Hall Main Road Southold, N. Y. 11971 Building Permit #12070 Dear Mr. Hindermann: Enclosed please find the Health Depaz.~¥ent approval for the Sanitary System and Water Supply for the referenced project. Yours truly, Steve G. Tsontakis, P,E. SG~/d Enel. FORM NO, 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ To c~)~..~.~7.. ~.,..~.~.~..~.G~..~./~. ........... .. ~.x..7.~./. ...................... Date .................. ,19 . PLEASE TAKE NOTICE that your application dated .. · ....... , 19 . for permit to construct..?. ~ ...... °' "fiT' · · · ........... at Location ofProperty .../. 2~Z(~...,~..O'.~...dSp~..t'.~..6~... ~..~.~., ~ ~.~,~/~ House ~o. St~e~i ......... County Tax Map No. 1000 Section . .~(~ ...... Block ...~ ....... Lot .~E~ ........ Subdivision.. ' ~ Filed Map No. " ~t No. ' ' is re[urned herewith and disapproved on the following grounds .'~.~'. (~. ~ ~ ..... .~/. ~,~ ~...~ ~....~. ~.~..~ ~ ~~ ~/. . ~..~...~.~;. .... ~d...~Z~.d~..~c~..~~ ~ ~ Bulldog Inspector RV 1/80 FOI~M NO. 5 TOWN OF $OUTHOLD BUILDING DEFARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION (owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: ~_ O ,',,I t r, I d.--- A '~'T. ,,',',',',',',',',~ Zoning Ordinance ............................................ Other Applicable Laws, Ordinances'or Regulotions ............................................ et premises hereinafter described in that ...................................................................................... .~.... (state character of ¥iolation) of Z~N//~;C~..A. TeZ ~ tee- J~/. ... in violation (~;~i~"~"~ii;~ ';;;~¢;;'~;~;;¢';"of ';;~'~;ii;;;;~'i;"ig;;;'~;;'~i;;;;;;;;;"g'r ;;E;;i;ii;;;;i ...................... YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned forthwith on or before the day of ........................................ ?~.~...,~, ...., The premise~l~Which this ORDER TO REMEDY VIOLATION refers are situated at V ~ ..!..~...~...0.....~..?..~.J~....~?.!~/~ ........... '.-'-~..~....~.,..~.L..C2-.. ......... 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 FORM NO. 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD~, N. Y. ORDER TO REMEDY VIOLATION TO (owner or authorized agent at owner) (address of owner ~adthOrized'bgent of D~ PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance Other Applicable Laws, Ordinances or Regulations ............................................ at premises hereinafter described in that H A ~ 'E~ ! I_'T ,~ ~' ~ ~'01'-~ ~ (state character of violation) ........ ....... ....... ....... in violation of ~l¢"J' ~ ~. O0 '~ I~'t t ~ (State section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the Iow and to remedy the conditions above mentioned forthwith on or before the -~' day of ' J~E~ , 197~ The premises to which this ORDER TO REMEDY VIOLATION refers are situated at I~ £~ul~J) . ~'l~'~/ ArE ~ECON~e_ ................................................ ~. .............................. 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 FOI~M lgO. 5 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOL.D~, N. Y. ORDER TO REMEDY VIOLATION (owner or outhonz~a ag'ent o1' owner) (address of owner or aum~Fized agen~'of ~)~' PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance Other Applicable Laws, Ordinances or Regulations ............................................ at premises hereinafter described in that .....~...~...,,~. ....... ..'~,.,~.!..L....~. ........ ..~.......,~..~...~...0..~.!,..~. .................. (state character of violation) ........ ....... ..... ........ ............. in violation of J~I?'T ~[~ IOO--lU// (State section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned forthwith on or before the ,-~' day of F'~/1~ ] 9..?...~.. The premises to. which this ORDER TO REMEDY VIOLATION refers ore situated at ................................................ ~. .......... , ................... L. ounty or bu?ro K, INew 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 FO]gM NO. 5 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Date ................................. TO ................. Q ....................................... · ............ (owner or authorized agent of owner) 'D0 ~...~ ....... ~%/.!..~.~M~.~.,;.....!:...~: ...... ~..!!~.t.~.~ T~_r~c~' ~ ~'. "'i~'~l'ress of J~wner or authorized age~ of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance ....... ~,.~../~...!.( .~/.....~TT...: ....... ~.../~ 7 ~ Other Applicable Laws, Ordinances'or Regulations ............................................ at premises hereinafter described in that ...... i.~.U...t..I.m.~.'......~......:~.~...C. ClJT.!.b ...... (state character of violation) in violation of(Sto~ ....... ~'l~f'~'secti~n ~f''~or ......../pa~/~g~r ~ .................. ~licob~ ~'~)law, ..... ordlnance~"t' l ~/ .................... or regulation)" ........................... YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned forthwith on or before the ...................................................... ,~..1~. ........ day of .......................................... ~.x././~.~.., 19...~./.~ The premises to which this ORDER TO REMEDY VIOLATION refers are situated ot J.~/.~) ,.~)lJ^j./~. /~.I'..L~. ........ .~.../~ ~t~..k/...C~.. 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. FOI~M NO. 5 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION _ (owner or autho)'i~ecl agent of owner) (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance .... ' '~'~:7'(' · · ' · · '?'--~-" · 'Y' · · · · ........... Other Applicable Laws, Ordinances'or Regulations ............................................ at premises hereinafter described in that .~./:~.~tJ~!~.....~.~....b...~.~.~Z~`~.~:!f.~.~..~.!~:~`U`~.~/~.~.~!.:~.~.~!.~ (state character of violation) in vioJation ...............: ...................... 7 ................ : ...................... ~ ......................... : ........................... (State 8echon or paragraph of apphcable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned forthwith on or before the ~ 0 of .......................................... The premises to which this ORDER TO REMEDY VIOLATION refers ore situoted at SOU/,/} .... ........................ ; ................................. ? ............... t. oun~y at ~urroJK, 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 FORM NO. $ TOWN OF SOUTqqL~D./ BU".OI~G O~'~RT~Em' TOWN CLERK'S OFFICE SOUT"O~.D~ N. v. 'ORDER TO REMEDY VIOLATION (address of owner ¢~r eut~rlzc~ c.~.':.t _~f c'.;'_~er}, PLEASE TAKE NOTICE there exists o violation of: Zoning Ordinance /~...~.....~ ................ Other Applicable Laws, Ordinances or Regulations' . ................................. ~ ......... at premises hereinafter described in that ,?E,,.'~..~},~..~. ...... .,~.~..~...Z.,~..'...k.,~..~....~.......$..~.,b~..~.,.~.......O.~t ...... (state character of v,iolation) ................ ~'"~ ............ "'"Y'"' ............. '/'"'" .................. i ....... , .......... ~ ......... Y""~'"' ......... ,.~... ~.....~, .,.. ~.. r.~.~...'.cra'.... ..A...¥..g....:...o.F.~ ...V.. ~.:. ~. ~..L......W..,.~.~.,.....O.u...~......~:....~ ~:..T..L .C!..e...A..~..E. ...... .q. ff.....O.c.F...q.R.O .t¥.~.:(.., ~f ,A e"r ~ ~ oD- iq,i,. ^, 0x, ' in violation ..................... ~ ........... .~ ........................................... ~ ................................................... (State section or paragraph of appjicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned forthwith on or before the ................................... ..~... .............................. day of ......................... E~II~ ................. ' 19.~.-.~... The premises to which this ORDER TO REMEDY VIOLATION refers ore situated at I~'~) ~01)FID VIELt/ AVE, -I=~E ~ONl~.,Countv of Suffolk, New York. Failure to remedy the conditions aforesaid and to comply with the applicable provisions of Iow may constitute an offense punishable by fine or imprisonment or both. Building 'Inspector FOBM NO. 5 ~.~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY ViOLATiON (owner or authorized agent of owner) ~× 'B Z ,qo~--'~ 4A~v~~- ............... f...~/..~..¢.~ ....... .~...c~,.~...~,...~.:.~... ..... (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance .....~.....~....~.~...... ............ Other Applicable laws, Ordinances'or Regulations ............................................ /9ec¢/ (state character of violation) t~qG ~ 1~77~/ ~et~t~ ~u~ u~¢~ ~H OUr e~ Ft.F:~ ~ ................ ~: .... (Stoto ~oction or pom~mph of ~pplic~blo Iow, ordin*nce or reoulotionT YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the Iow and to remedy the conditions above mentioned forthwith on or before the ~ O day of ...................................... ~.~...., The premises to which this ORDER TO REMEDY VIOLATION refers are situated at .~v~/,~ ~/1~/ ~l/h/ "~E C¢ fft(~.. ('nuntv 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 FIELD .INSPECTION FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY QODE FINAL DATE COMMENTS __ ADDITIONAL COMMENTS: DEPAR~{E~ OF H~I2~H SERVIoEs " .... '"' ~h'~ water supply ~nd ~ewa~e disposal ~ sys,~m,,~for this re~idenoe will con- ~. form ~o ~he Stand~d of tho Suffolk FORM NO, 1 TOWN ~ SOUT,~OLD BUILDING DEPARTMENT ' / . TOWN HALL . // ~'~ - SOUTHOLD, N.Y. 11971 ~ ¢/ ¢~ TEL.: 765-180] APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled i~ by typewriter or in ink and submitteddn ...~ ..... *-to the Build Inspector; with 3 s~ts of plans, accurate plot plan to scale. Fee accordin§ to schedule. b. Plot plan ~ ' ' ~ sac,vino location of lot and of bail'lings on premises, relationship to adjoining premises or public sire or areas, and giving a detailed d¢scription of layout of property must be drawn on the dia~am which is part o~'this api cation. c, 'rile work covered by this application may not be commenced before issuance of Building Permit. d. Upou apprc.'al of this application, tile Building Inspector will issue a Building Permit to the applicant. Such pen shall be kept ou the promises available for inspection throughout fire work. e. No building shalI be occupied or used in whole or in part for any purpose whatever until a Certificate of Oecupar shall have been granted by tile Building Inspector. APPLICATION IS I-IEREBY MADE to the Building Department for th~ issuance cfa Building Permit pursuant to.L Building Zone Ordinance of the Town 'of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulatiot,s, ,and admit authorized inspectors on premises and in buildings for necessary inspections. , (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is oxvner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build ............. ........................................ , .................. . ...... Nane of owner of prc,uises . .'~.~.. '....t'~...1'53~..~.~ .~. ,~..,.f (as on the tax roll or latest deed) If applicant is a corporation, siguature of duly authorized officer. (Name and title of corporate officer) Bnilder's License No .......................... Plumber's Licens~ Ns....--~..~. ffff¢~. Electrician's License No.' ~ Other Trade's Licci~se No. ~' u 1. Location of land on which proposed work will be done....?.~.o..%. ?..'f'!. '~''...~.¢. ?."~. t'-'CC"~"~' '~' '~\ - -e'~'~ .... · ............................................ ............... House Number Street Hamlet County Tax Map No. 1000 Section Block .... .C> ..... Lot ......... Subdivision ..................................... Filed Map No ............... Lot ............. (Name) 2. State existing use and occupancy of premises and intended us~, and occnpancy of proposed construction: Z.,-, -_~ 2:'2 ....~ Y/ ""~, .................. ~ ' ' ; '?~t ': ti ' ' ' '~' '~ ' '1 .... ~ ...... tO. (4. property lines. Give street and block number or ',nterior or corner lot. Nature u~ work (check wmc;,i appiicaolc.~. New Bui.lding .......... Addition .......... Alteration ........ Repair .............. R0moval .............. Demolition .............. Other Work ............. , .._. Estimated Cost ........................... Fee . ] .W ......... ~. ..... .'g.~-...~. ......... ! (to be paid on filing this application) If dwelling number of dwelling units Number of dwelling units on each floor If garage number of cars If business, commercial o[ m/xed occupancy, specify ~atnre and extent of cacti type of use ....... Dimensions of existing stmcthres, if any: Front.. Rear Depth Height ' ' ' ............... Number ot Stones .......................................... Dimensions of same structure: with alterations or additions: Front ................. Rear .... Dcp}h ...................... Height ...................... Number of Stories ........ D'me ~s'ons ot entire new construction: Front Rear Depth Height Number of Stories ' · ~.. .. ' ' . ..... Re,ar ...................... Depth ..................... Size:of lot: Front .._ ,..,.~..~_._.:..... Datd df Purchase v' . a .{~'m-.~ I... ·... . .. . . ! ... Name of Fom~er Owner ...... /'~-.~.~.~..rT.- ............ Zone or use district 'n wh'cli pr¢lmses are situated ~',/~r ~ .~..~. { .O..~T'/.~..t-r. ":' Doe~ proposed constrnction V, iolate any zoning law, ordinance or regulation: ........ L,d..°. ................... W' otberegraded . .' . .. WPex .... m,~. ....... .~t. .......... Name of Owner of pre n ses 1.~.~..~.~. .l.~...~.tl~.~. Address .~.~.o~"~"tk'p'{..~ff..?~..PhoneNo .. Name of Architect Address Phone No Name of Contractor ................ Address ................ Phone No i PLOT DIAGRAM '" Locat.e clearly ~d distinctly iall ot tidings, whether existing or proposed, and. indicate all set-back dlmcnsJons fro: description according to deed, and show street names and indicate wheth, ~r,x'rz OF NEW.,YORK cou,-,n'¥ .*: ...... i S.S ............................................. being duly s~vorn, deposes and says that he is the applicm~ (Nanie or lndMdual signing contract) above named. ~e is the { (Contractor, agent, corporate officer, etc.) of said bwner or own'e~, m~d is dhly autliofized to perform or have performed thc said work and to m~e and file a/~plication; that all statcnmnts coat:fined in this application are true to the best of his knowledge and belief; and that tl~ W'ork will be performed in the manper set fortli h~ the application filed therewith. ~worn to before me this ....... . 9 .... c~ ........... , 19... , .... .............. b NOTIFY BI qLDI'i~FG ENT AT 765 1802 9 AM TO 4 PM FOR THE '-! S ~-~.or-3 .... J M, ~icc~qo -F[+I~ Insur~.c..e ~q L.,icen.~d Lo~d