HomeMy WebLinkAbout12074-z S14fMAC 41 Town of Southold 12/27/2022
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P.O.Box 1179
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53095 Main Rd
��rgj� rapt Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 12800 Date: 9/20/1984
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 230 Carole Road, Southold
SCTM#: 473889 Sec/Block/Lot: 52.-2-7.5
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
7/21/1982 pursuant to which Building Permit No. 12074 dated 12/15/1982
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:
addition to one family dwelling(add to livingroom).
oom).
12/27/2022 Corrected for house number only.
The certificate is issued to Ippolito,Joseph&Ippolito,William
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. N654233
PLUMBERS CERTIFICATION DATED
Auori d i ature
FORM NO. 4
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No...g.1.2.8.0..0 ......... Date .......... Sept..._.................20 ,.19.8.4.
THIS CERTIFIES that the building .. b.cl.d. 5: .'9.J-P.n...'99..O.n..e..F.a.m..J..].y..D..w.e.l.l:J:..n.g .........
Location of Property 2.35 ..... C~r.o.],...R.d... ................... Sour:hold
House No. Street Hamlet
County Tax Map No. 1000 Section . .0.5.~ ....... Block . .0.2. ........... Lot .... 0.0..7 ..........
Subdivision... X .Filed Map No. .Lot No.
conforms substantially to the Application for Bnilding Permit heretofore filed in this office dated
· .d'..u.iy....2.1 .......... , 19 .8.2, pursuant to which Building Permit No. 120747.
dated .... p.e.q:, .1,5, ............... 19...82 , 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 .........
...A.d.d.~ .t:.J_p.n..Tg..qn. 9..F.a.m. ~.~y..D..w.e.l.1. J: .n~r .... .( .a.d.d., .'99..1.~ .v.J..n.g...r.o.o.m. ! .............
The certificate is issued to ..... .I.P.P.Q .L.I.T.Q ~ IqlCHOLAS
(owner, I~ee
of the aforesaid building.
Suffolk County Department of Health Approval ........................................
UNDERWRITERS CERTIFICATE NO ............ 1x.1.6.5.4.2..3.3 ..............................
Rev. 1/81
Building Inspector
TOWN OF SOU*~OI~
TOWN HALL
SOUTHOLD, N. Y.
BUILDING FERMII~ :'
(THIS PEP. MIT MUST BE KEPT ON THE PRE~Is~s UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°, 12074 Z D~e ........................... ,. .......................... , ,9 .....
Permission is hereby granted to.'.
pu~oant to oppllc~hon dot~ ............... ~ ....... ; ...................... ..,.., i¢ ..... ond ~ppmv~ by the
Building Ifispector.
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z12800 Date .S.e~.t.:... 20
......................................... 19.$4..
THIS CERTIFIES that the building ...A.cl.d.i..t.ip.n...t9..O.n..e..F.a.m..i.ly..D..w.e.l.l.i..n.g .........
Location of Property 2.35 ..... C~r.o.~...R.d.... Southo id
House No. ' ....... 'S't/e~ [ .......................
County Tax Map No. 1000 Section . .0.5 ~ ....... Block . 9.2. ........... Lot 007
Subdivision... X .Filed Map No ..... Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
Ju~y. 21 .2. pursuant 12074g
.................... , 19 .8 to which Building Permit No ......................
dated .... pac.:..1.5. ............... 19 .8.2., 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 .........
Addition To One Family Dwelling (add to .living room)
The certificate is issued to IPPOLITO. NICHOLAS W.
(owner, leeeee
of the aforesaid building.
Suffolk County Department of Health Approval .... N.{.A ...................................
UNDERWRITERS CERTIFICATE NO ............ N. .6 .5.4~ 2. .3 .3 ..............................
Building Inspector
Rev. 1/81
FIELD INSPECT-iON COMMENTS
FOUNDATION (1st)
FOUNDATION
2.
ROUGH FRAME &
PLUMBING
(2nd)
INSULATION PER N. Y.
STATE ENERGY
C~,OD E
ADDITIONAL COMMENTS:
FINAL
FORM NO. 6
TOWN OF SOUTHOLD
Bu ilding Department
Town Hall
~outhold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted--i~=e~l;l[cctc 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.
For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
[and 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 arid 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/ land
3. Copy of certificate of occupancy $1.00
use --Pre-Existing C.O. $15.00
Vacant land C.O. $ 5.00
Date ..........................
New ~ilding ............. Old or Pre-existing Building ............ Vacant Land .............
Location~f Property ..........................................................
House No. Street Ham/et
~er or Owners of Property .....~. ~..c,~..o .~....~.....~, .~...[-. ,~ .~..%~.O. .........................
County Tax Map No, 1000 Section ............... Block ............... Lot ................
Subdivision ................................. Filed Map No ......... ~ .Lot No ..............
Perm,, No.' Date of,etm,t . ..^pp,,cant .q. ....
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval .................... Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ .............................
:[oooo9 . THE NEW YORK BOARD OF FIRE UNDERWRITERS
~ BUREAU OF ELECTRICITY
~- 85 JOHN STREET, NEW YORK, NEW YORK 1OO3~
THIS CERTIFIES THAT
in the following location; [] Basement ~[] 1st Fl.
.,,~e~a,,,i,,edo,, July 30, 1984
FIXTURE FIXTURES
OUTLETS SWITCHES
INCANDESCENT FLUORESCENT
4 4 4
DRYERS
[] 2nd Fl. Section Block Lot
and found to be in compliance with the r~quirements of this Board.
RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
SYSTEMS
NO. OF FEET
E
E R V I C
NO OF CC, COND A. W, G, NO, OF HI-LEG A.W. G*
PER ,~ OF CC, COND, OF HI4EO
OTHER APPARATUS=
2-Smoke Der ~¢tors
3/O
NO, OF N~TRAL!
OF NEUTRAL
~0
Peter Bog~)vic
Main
Southold, N.Y.
11971 [&c. I37 E
Pdt
This certificate must not be altered in any manner; return to the office of the Board f incorrect. Inspectors may be identified by their credent als. ,,, --
~NG DEPARTMENT. THIS COPY OF CER~'IFICATE ~U~T NOT IBE/~LTERED IN ANY MANNER I
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
File No ................................
.. ~ .... v~ ..........................
...~.?./~ ~. ~. . ~. : ~ ........
PLEASE TAKE NOTICE that your application dated .......
for pem~t to construct .... c~/ ~/7( /.~ : .~ ~. ~ . .~.~:V~(/ ~ ~ . ~. ~/~ i~ .... at
Location of Property ~
Ho.se
County Tax Map No. I000 Section .. ~.~ ..... Block .... ~d ...... Lot .~.~ .......
Subdivision ................. Filed Map No ................. Lot No ............. ~...
is returnea herewith and disapproved on the following
.
Building Inspector
RV1/80
II,
Southold Town Board of Appeals
MAIN ROAD- STATE RI]AD 25 SI:]UTHE3LD, L.I., N.Y. 11971
TELEPHONE (§16) 765-1809
ACTION OF THE ZONING BOARD O7 AP
Appeal No. 3044
Application Dated September 30, 1982
TO: Gary Flanner Olsen, Esq.
Attorney for Mr. Nicholas Ippolito
Main Road
Mattituck, NY 11952
P EIVED AND FILED BY
THE SOUTHOLD TOWN CLF. RK
Town Clerk, Town of g%uthold
At a Meeting of the Zoning Board of Appeals held on October 30, 1982
the above appeal was considered, and the action indicated below was taken
on your [ ] Request for Variance Due to Lack of Access to Property
New York Town Law, Section 280-a
[ ] Request for Special Exception under the Zoning Ordinance
Article , Section
IX] Request for Variance to the Zoning Ordinance
Article III , Section 100-31
[ ] Request for
The .public hearing on this application was held on October 21, 1982, at
which time the hearing was declared closed pending deliberations.
Upon application for NICHOLAS W. IPPOLITO, by Gary Flanner Olsen,
Esq., Main Road, Mattituck, NY for a Variance to the Zoning Ordinance.
Article III, Section 100-31 for permission to construct addition with
reduced rearyard setback at 235 Carol Road, Southold, NY; bounded north
by Stachtiaris; west by VIP Inns; south by Haas; east by Arshamomaque
Pond; County Tax Map Parcel No. 1000-52-2-7.
The board made the following findings and determination:
By this appeal, appellant seeks a 12' by 28' addition to the exist-
ing one-family dwelling for additional living area, leaving an insuffi-
cient rearyard setback at 28 feet at its nearest point from the rear
property line. The parcel in question appears to contain an area of
approximately 5,200 square feet, with 50' frontage along Carole Road.
The subject parcel is bulkheaded the entire length of its waterlying
edge, and the N.Y.S. Department of Environmental Conservation has
issued their "Notice" indicating no jurisdiction pursuant to Article
25 of the Environmental Conservation Law. There has been furnished
for the record that there will be a total square footage of 1,008
and that the 20% minimum lot coverage requirements of the code will
be complied with.
In considering this appeal, the board determines the variance
request will not cause detriment to adjoining properties; that the
circumstances herein are unique; that the difficulty cannot be
obviated by a method, feasible to appellants, other than a variance;
that no adverse effects will be produced on available governmental
facilities of any increased population; that the relief requested
will be in harmony with and promote the general purposes of zoning;
and that the interests of justice will be served by allowing the
variance as indicated below.
On motion by Mr. Sawicki, seconded by Mr. Grigonis, it was
RESOLVED, that Appeal No. 3044, application for NICHOLAS IPPOLITO
for permission to construct an addition to the existing dwelling, be
and hereby IS APPROVED, PROVIDED THAT ALL STRUCTURES ON THIS PARCEL
DO NOT EXCEED THE MAXIMUM-PERMITTED LOT COVERAGE REQUIREMENT OF TWENTY
PERCENT.
DATED: November 10, 1982.
Form ZB4 (rev. 12/81)
CHAIRMAN, SOUTHOLD TOWN ZONING BOARD
OF APPEALS
Page 2 ~ Appeal No. 3044
Matter of Nicholas Ippplito
Decision Rendered October 3'0, 1982
Location of Property:. 2.35 Carol Road, $outhold~..NY;. County
Tax Map Parcel No. 1000-52-2-7. ~
Vote of the Board: Ayes: Messrs. Goehringe~, Doyen, Grigonis,
Douglass and Sawicki. This resolution was unanimously adopted.
A?PRO'V 9 "'.,
--Chairman' Board of App~s J
TOWN OF SOUTHOLD, NEW YORK
ACTION OF THE ZONING BOARD OF APPEALS
Appeal~o. 2836 by application Dated May 18, 1981
ACTION OF THE ZONING BOARD OF APPEALS OF THE TOWN OF SOUTHOLD
To Nicholas W. Ippolito
36 Gehrig Street
CommackL NY 11725
Appellant
at a meeting of the Zoning Board of Appeals on June 11, 1981
was considered and the action indicated below was taken on your
( ) Request for variance due to lack of access to property
( ) l%equest for a special exception under the Zoning Ordinance
(X) Request for a variance to the Zoning Ordinance Art. TII, Sec o
( )
100-31.
the appeal
1, ]~lZJ~DI XK YZ~YJ~i~I~I X]YoK YeYg~D{~ [/~K i~ ~ XK XJ/~i Y~g&K~fav~[ X~ K ~~~XKX~
granted ( ) be denied pursuant to Article .................... Section .................... Subsection .................... paragraph
.................... of the Zoning Ordinance and the decision of the Building Inspector ( ) be reversed ( ) be
confirmed because Public Hearing: 6/11/81:, 8:45 P.M. Application of
Nicholas W. Ippolit~, 36 Gehrig Street, Commack,NY 11725 for a
Variance to the Zoning Ordinance, Art. III, Sec. 100-31 for per-
mission to construct addition to dwelling with insufficient front,
side and rear yard setbacks at 230 Carol Road, Southotd, NY; bound-
ed north by Stachtiaris; west by Carole Road; south by Hass; east
by Arshamomaque Pond; County Tax Map Item No. 1000-52-2-7.
(SEE REVERSE SIDE)
2. VARIANCE. By resolution of the Board it was determined that
(a) Strict application of the Ordinance (would) (would not) produce
hardship because
(SEE REVERSE SIDE)
practical
difficulties or unnecessary
(b) The hardship created (is) (is not) unique and (would) (would not) be shared by all properties
alike in the immediate vicinity of this property and in the same use district because
(SEE REVERSE SIDE)
(e) The variance' (does) (does not) observe the spirit of the Ordinance and (would)
change the character of the district because
(would not)
(SEE REVERSE SIDE)
and therefore, it was further determined that the requested variance ( ) be granted ( ) be denied and
that the previous decisions of the Building Inspector ( ) be confirmed ( ) be reversed.
CG:lk
FORM ZB4
ZONING BOARD OF APPEAL~
WHEREAS, on June 11, 1981 a public he~ring was held
by the Southold Town Board of Appeals eoncernin( the variance
application dated May 18, 1981 for permission tO construct an
addition to existing dwelling with insufficientlfront, side
and rear yard setbacks at 230 Carol Road, Southold, NY; and
WHEREAS, on June 11, 1981, the applicant requested
that his application be withdrawn without prejudice,
NOW, THEREFORE, on motion by Mr. Grig~nis, seconded
by Mr. Goehringer, it was
RESOLVED, that the application of Nicholas W. Ippolito
is hereby withdrawn without prejudice, i
vote of the Board: Ayes:
Goehringer, Sawicki and Grigonis.
Do ~en, Douglass,
APPROVED'
~Chairman Boa~'d of /~peals (/
RECEIVED AND FILED BY 1
.Application Received ; Disapproval Issued ~ Permit # !.
~oo~ ~oo~ ~o~ ~ ~oo~ ~o~
Typ~
Addition and/or Alteration~
Other (specify) ........
Elevation Data in relation to above mean sea level of:
(a) Lowest floor elevation, including basement feet
(b) In a V Zone, bottom of lowest structural me~ber
FIRM--Flood Insurance Rate Map, Zone designations
Owner of Premises ..~. ,C~40c.~e~ Ut L~_~-.9~..~ O
Location of Property:
inches
feet inches
.ss
Section ,~G, 7 Block ~'~_ Lot(s) 00'7
County Tax Map No.,
District, 1000,
Subdivision ,, , Filed Map # Lot(s)
I--IUnder Contraet]--~ Lessee I IC°ntract°r
7. Approval from other(s) before Pemnit is issued:
e
DEC /
HEALTH SERVICE
BUILDING PERMIT
WETLANDS (Town Board)
PLANNING BOARD
0wn%~_',' Ne~ OWner[ , Undg~ntract--~, Lesseel~, Agent-- ~.
p_~ r LTl, Und, I 1 __ _ . ,, Co_
tractor~-~, and agree to comply with all applicabie section~--of the Code
of the Town of Southold; County, and State and to admit authorized in-
spectors to premises authorized to perform or have performed the said
work and to make and file this application, that all statements contain-
ed in this application are true to the best of my knowledge' and belief
and that the work will be perfoEned in the mannerset forth in the
application filed therewith.
STATE OF NEW YORK
COUNTY OF
· Notary Public
Applicant,s mailing
address and phone #
if not given above:
4/80
LINDA F. KOWAI.SK[
NOTARY PUBLIC, Stgte of I~,)lv York
No. 52-4524771
Qualified in Suffolk Co[mty
_Commission Expires Marc~ SO, 198~
FORM NO. EO
TOWN 0F sOUTHOLD
BUILDING DEPARTMENT
(516) 765-1802
P.O. BOX ?28 TOWN HALL
SOUTHOLD, NY · MAIN ROAD
11971 i SOUTHOLD, NY
A~PL~CA~.ION FOR DEVELOPMENT ~ERMIT
Instructions: The application to the Building Inspector includes (each
~ duplicate) 1. FoEn No. l0 filled out in ink or typewritten, 2. Sur-
vey of premises with, elevations above mean sea level, 3. Drawings of pro-
iposed work. The application must give complete information to show that
the proposed can comply to the Local Law No. 1-1980, Chapter 46 of the
Code of the Town of $outhold known as "Flood Dsmage Prevention Law" of the
Town of Southold. The applicant must submit approvals that any.other
agency requires, i
~eneral Standards as!required tn Section 46-17 of the law to minimize flood
damage:
A. Anchoring oflstructures, including tanks and mobile homes
B. Use of construction material and methods
C. Design and lbcation of utilities
D. Subdivision proposal with drainage, public utilities design and
base flood elevations
~pecific Standards as required in Section 46-18: A. Residential Construction
B. Non-residential construction
C. Mobile homesI
The 'applicant must submit plans and specifications as well as any other
information requested by the Building Inspector to substantiate the facts
that the structure has or will have the lowest floor, including basement/
cellar, elevated above the base flood elevation or; if permitted by the
Federal Regulation, that: 1. such structure is flood proofed in such
mann.er that below the base flood level the structure is water tight with
walls substantially ~nd impermeable to the passage of water, 2. that
structural components are capable to resisting hydrostatic and hydrodynamic
loa~s and effects ofibuoyancy, 3. applicant must sub~it certification by
a registered professional engineer or architect that the standards set
forth in Section 46-18B (1) (2) (3) of the Southold Code are satisfied.
Coas~a~ High Ha~zard ~r~_~a (V Zone) 46-19. A~plicant shall submit plans,
~specmfmcat~onS mncludmn~ the required certifmcations and such other in-
formation as the Building Inspector may require in that ~he provisions of
46-1~ are complied with. Mobile homes a~e prohibited. The lowest portion
of the structural members of the lowest floo~ cannot be lower than the
base flood elevationlwith all space below open except breakaway walls.
~.and~ dunes. If sand!dunes exist on the premises and the applicant pro-
poses to alter same, iplans and specification must be shown in detailed
nature of any alteration submitted.
~$uildin8 Permit. A Buildin~ Permit is also required for any structure.
~oth a Development and a Bumlding Permit must be issued before any work
can Start in a special flood hazzard zone. A written disapproval or a
permit must be issued within ten (10) working days.
During constr~ction,.!the inspector Shall be notified in time so he may
make. the required inspections.
Upon completion, theirequired certification fo the final elevations and
work must be submitted before the approval to use or occupy can be
approved.
4./80~
(Fill Out the foEn on the back of ~his sheet)
FORM ~10, !
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
E×am,ned .................
,~pproved ~e~.,...r.~. ................ 19.~ Permit Mo, ..Z~.~.7.~ ....
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
.Application No ............ Z ................
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, 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 ofproperty must be drown 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 o Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described.
The applicant agrees to comply with all applicable lows, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and ir~ buildings for necessary inspections.
....
~ ~ [~~_ (Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ~CLt'~ X~ ~, , ?, ;t~L '~ /,
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No .....................................................
Plumber's License No .................................................
Electrician's License No .............................................
Other Trade's License No ................................................
Location of land on which proposed work will be done, Mop No.: ........................................ Lot No .........................
Street and Number .~OL~
Municipali~
State existing use and occupancy of premises~ and imended use and occup~cy of proposed construction:
a. Exisiting use and occupancy ....... ~}.~.'.~.,..~.~ ~:~).~.~< ...... ~.....~..¢ ..(~.,~ ......................................
b. Intended useandoccupancy .......
County Tax Hap No. Dist. 1000 Section
Block Lot
3. Nature of work (check which applicable): New Building.. ................. Addition..................~/' Alteration .................
Repair .................. Removal .................. Demolition .................... Other Work .....................................................
~Z~ , -- /Z~ Or__~ (Description)
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 on mixed occupancy, specify nature and extent of each type of use ............................
7. Dimensions of existing struciures, if any: Front .......?..~'. ............... Rear ......... ..~...9., ................ Depth .......~.;~. ........
Height ....[....%.?..o..~.~,. .... 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~ .............. ..gr..L? ................. Rear ........ :~..67 .............. Depth ....~.~:
Height ...~..:'~.C~j.z.,.,:[.. Number of Storie:; ......................................................................................................................
9. Size of lot: Front ........ ~.1~...~...~.....~..~..~.~..~. ................... Rear ....... ; .................................. Depth ..............................
10, Date of Purchase ............................ .~ ...................... Name of Former Owner ..... ..'~..C'L..~'.~..c...~.i~.~..~.. ...............
1 1. Zone or use district in which premises are situated '~,~.tO~'~A
12. Does proposed construction Violate any zoning law, ordinance or regulation: ..... ~. .............................................
13. Will, lot be regraded ..... ,.~.P..L ............... Will excess fill be removed from premises: ( ) Yes ( ) No
14. Name of Owner of premises. .t..c.~.0?6. .....................................' ,~?~eL ~"re Address ................................. Phone No .......................
Name of Architect ~p~.~F; Address Phone No.
Name of Contractor ........ ..?R....~ .... ~
[~. ·. · .~t. ~..tcJ.~. ~ ). ~;:..~) ............ Address ................................ Phon~ No .......................
PLOT DIAGRAM
Locate clearly and distinctly ~11 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
wh~ther nterior or corner lot.
STATE OF NErVe'RI(, , /. /,
~ (l'~ome of individual
above named.
~S.S
-- duly
................. being
sworn, deposes and soys that ha'is the applicam
that the wor~/will be performed in
Sw~o~.~/~re me this
....~;~,. ............. do¥ of ...........
He is the .................... ~ ................................................................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is d~ly authorized to perform or have performed the said work and to make and file
this application; that all stetemen}s contained in this application are true to the best of his knowledge and belief; and
'he manner set forth in the application filed therewith.
Caunty ......... ..............
~ ' b (Signature of dlSplicant)
~ ~I~, ~ of New ~
ID'
)
E Y-J S TIk]G WALL
NEW WALL
'd'
-- ~tEl,~ ADDffIO~
~E~DVED
' WALL ~EMDYEb
%;.
3' 2"X 3'
i¸ /
SOLAE E~/ALU A~I O N~
OCCU ^NCY OR
'
T{: eopp~r tuL bg is used
for Water c!iu[ributing
*Ymem~ U. lpL, g shall be
of'll~e* l( or l only.
(~ s F/
~+~F~+"LB+?.~. 1kB-= lOT-Ur 51%FT
lO'Lq-TbT~L Sll'r~ WALt_
· 2.urn" ,ALLD~AI~L'E- GLASS 5?~C~-
2. u,'z. TOTAL GLASS
JOISTS ' --
O.C.
~X. LI·
Ir.," O.C,
EELT -..
FtNIS~E]3 FLODF~
R. IDGE
E X ur SOLE
S/q- PLYWOOD
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