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Home My WebLink About12078-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Sol~thold, N.Y. Certificate Of Occupancy No..3. J?.q'? .6 ........ Date ..... N~.v.~ml~.e.r.. ~ ~3 ............... 19 .8..3. Tills CERTIFIES that tile building".':g'.a.r.~./$?..afl, fi. $.~.i. qn., .~.o..d¥?.l. lin~ .&. ac cessory Locatiou of Property . Y.kQ .... .~?a?.~.e, Road Southold House No. Street Ham/et County 'rax Map No. 1000 Section . 9.7.5. ....... Block 04 . .Lot. .0 13 Subdivision..South Nar'bop Homes ...... Filed Map No. .4 0.9 6. .LotNo. conforms substantially to the Application for Building Permit heretofore filed in this office dated December 6 t9~.2 pursuant to which Building Permit No 12078 Z dated .... D..e.c.e.m.b. 9?..'1.6. ........... 198..2:, was issued, and conforms to all of the requkements of the applicable provisions of the law. The occupancy for which tlfis certificate is issued is . .~.- ...... aqdSt±on to dwel~±nq.& .accessory storage bu±ld±ng. The certificate isissued to HERBERT H. SEAMA.N (owner, le~e-or of the aforesaid building. Suffolk County Department of Health Approval ~/.~ UNDERWRITERS CERTIFICATE NO .......... Iq.. ~ ~.6.5.~ .0 .............................. *THE ADDITION HAS SUMMER OCCUPANCY ONLY. Rev. 1/81 Building Inspector tOWN'O Sou'r.O / BUILDING DEPARTMENT TOWN HALL $OUTHOLD,. N. Y. BUILDING PERMI? (THIS PERMIT MUST BE KEPT ON THE PP, E/~I$~S UNTIL ~.ULL COMPLETION OF THE WORK AUTHORIZED) ~ Permissi°~ is hereby granted pu~gant to application aot¢ ........ ; ................................. ; ..~ , ...~., O ~pp y Building I~$pector. Fee $ ........ , ............... Building FORM NO. 6 TOWN OF $OUTHOLD Bu ildlng Department Town Hall $outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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. 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 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 informa- tion required to prepare a certificate, Co Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling/ land use 3. Copy of certificate of occupancy $1.00 --Fre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date . Oct,. 2/~/. 8~ ................ Construct a~dition to existing dwelling. New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property . ?.~.0 ...................... .~.~.e~. g.e..]~.; ............... .S.o.~.~.~9.~.d,. ,~: House No. Street Ham/et Owner or Owners of Property ,,, ~,eT~,,eT,~, ~[,., ,S,e,e~, ,e=,, .. ....................................... County Tax Map No. 1000 Sectio[~0.0p.-0?5 ......... Block 0~'008-13 Lot... Subdivision., ~o~t.th. ~[~'b0~'. Hp~9~ ............. Filed Map No. ~.09.~ ...... Lot No ...... .~ ....... Permit No. 1~0~. Z... Date of Permit . ,~.e.c. ,~.~,/.6.2-Applicant ....G,e.o.r~.e. ,S;. ~.~.e? ................ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. ng and peri a II ap p li~j~e~;:~a nd r_egu Construction on above described buildi t meets lations. Applican~~~ .......... FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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. Approva~ of e~ectrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and instatla- 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" land uses: I. 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. C. 'Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelring / land use 3. Copy of certificate of occupancy $1.00 / --Fre-Existing C.O. $15;00 Vacant land C.O, $ 5.00 Date .............. , ........... New~ding-; ..... ~ .... Old or Pre-existing Building .., ......... Vacant Land ............. Location of Property ....... ~ ............ ~ ............................... Hou~ No. Street Ham/et Owner or Owners of Property .......................................... ~ ..................... County Tax Map No, 1000 Section ,~,:2 m ¢~ :, 57: ~lock .:~ ~.-, ,~,~,~:, ,~Lot ................ /x .//' Subdivision.. ¢2Z/~.,~ ,~.~ ~ .... - ....e.~Hee Map No ........... Lot No .............. Per~it No. ~ Date of Permit ~ .... ~: '~: ....................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Applicant.../'-~,-~.~-,,-¢-'~-~L~/'. ,/~,~, .'~,.. ,~-,~ .~¢,~'?,'~..~ .......... Rev, 10-10-78 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Bo 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: I. 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- dons, 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"-_ 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/ land use 3, Copy of certificate of occupancy $1 --Pre-Existing C.O. $15~00 Vacant land C.O. $ 5.00 Date . ,~.?, .d~, ,~,~,. , , ~ ~,~ .~,¢/~..~. , , ·. ~ ........ Old or Pre-existing Building ............ Vacant Land ............. New Building ~ ~-~ Location of Property ................................................................. House No. Street Hamlet ..................... . Owner or Owners of Property ~-~-f'~.~.'~-~'~ ...~;~ ~ .............. : ................ County Tax Map No. 1000 Section .~.~97.~..--.. ~. Block ~. -~?.~ £~ Lot Subdivision...~.~.'~..~..~...~'..~. ~.'~..~'../~?..'~...~...'~ .~.~..Filed Map No ........... Lot No ...... ~. ....... Permit No .. Date of Permit Applicant ............................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Applicant ................................. ............... Rev. 10-10-78 ioooi~,i THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY THIS CERTIFIES THAT iiel-~ ~, 740 ~'~g~ i~, ~u~hold, N.Y. " in thefollowing location; ~ Basement ~ 1st FI. ~ 2nd Ft. ~t~i~ ~.. ~.,.~,,.d o. ~cn i4, i9~ ..ayo..~ to be ~n compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS SYSTEMS NO. OF FEET E R V I C E NO. O~E~¢OND. OF ~ C~gk D NO. OF HI-LEG oFA HI-LEGW' G. NO. OF NEUTRALS A, WG OF NEUTRAL l'own Iigt~'Doi' L.,~ne ~u~ld~ l~.Y. 11~]. This certificate must not be altered in any manner; return to the office of the Board f incorrect ....... ' ~ '~" .... ~ - - · ~~n'~n~n'~,~n-~n-~~~~ " i . .,~.urs may oe ~aentmea 0y the r creaenhals. ~J~ ~~M.~T. THIS COPY OF CER~IFIC~TEM~US~N,QT BE AE~'E~ED IN ANY MANNER. FIELD INSPEC'flON FOUNDATION FOUNDATION 2. ROUGH FRAME & ~L~MBING INSULATION PER N. STATE ENERGY FINAL (1st) (2nd) Y. DATE COMMENTS nDDITIONAL COMMENTS: iFO!M NO. 3 TO,~ O~O~T"OLD BUILDI~TG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No: ................ ~ ~.~ ~.~ . .~ . ~.¢. ........ Location of Property .... County Tax Map No. 1000 Sectio,, .... ~5 .... Block ...~5~ ...... LotCZ~.~.~... s~vis,o~n~.~,~d ~ ~o.. ~.~ ....... ~o, ~o...d ............ is returned herewith and disapproved on the following grounds~~J~. ~e.~ ~.~ ~.. ~.~z... cz: ..... ~ ............ /.. ...................... ............ ~T~... t ~ Bulldog Inspector RV 1/80 )'001 Southold Town Board of Appeals MAIN RI-lAD-STATE I~i'IAD 25 SOUTHr3LD, L,I., N.Y, llCJ?l ]:ELEPHONE (516) 765-1809 ACTION OF THE ZONING BOARD OF APPEALS Appeal No. 3022 Application Dated August 9, 1982 TO: Mr. and Mrs. Herbert H. Seaman P.O. Box 317 740 Grange Road Southold, NY 11971 [Appellant{s)] At a Meeting of the Zoning Board of Appeals held on September 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 , SectionS 100-31 and 100-36 [ ] Request for The public hearing on thi~ matter was held on September 30, 1982. Application~f HERBERT H. SEAMAN, 740 Grange Road, Box 317, South- old, NY for a Variance to the ZQning Ordinance, Article III, Sections 100-31, Bulk Schedule,'and t00-36 for permission to construct addition reducing the westerly sideyard setback and reducing the total sideyard area at premises known as 740 Grange Road, Southold, NY; South Harbor Homes Subdivision, Filed Map No. 4096, Lot 8; more particularly identi- fied as County Tax Map Parcel No. 1000-075-04-008.13. The board made the fo!lowing ifindings and determination: By this ~pp%'~l, app~liant seeks permission to construct a 12-foot addition at the westerly side of~the existing one-family dwelling with attached garage, thereby increasing the garage area for storage for two cars. The addition as proposed would leave a setback at its nearest point from the westerly side property line of 2.9 feet. The dwelling as exists is located 41.9 feet from Grange Road and 18.6 feet from the easterly side property line. Also existing is a blacktop driveway in front of the garage area. It is the opinion of this'~board 'that appli- cant's reasoning in extending the existing garage area is most feasible for the purposes it is intended under the circumstances. In considering this appeal, the board determines that the variance request is not substantial; that the circumstances her~i~ iar~ unique and practical difficulties have been shown; that by allowing the variance no substantial detriment to adjoining properties would be created; that the difficulty cannot be obviated by a method feasible to appellant 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. Grigonis, seconded by Mr. Sawicki, it was RESOLVED, that Appeal No. 3022, application of. be and hereby (CONTINUED ON PAGE TWO) ZONING BOARD CHAIRMAN, SOUTHOLD TOWN OF APPEALS DATED: October 5, 1982. Form ZB4 (rev. 12/81) Page 2 Appeal No. 3022 Matter of Herbert H. Seaman Decision Rendered September 30, 1982 That there shall be a minimum five-foot sideya~'d setback on the westerly side of this building. Location of Property: 740 Grange Road, Southold,NY,- County Tax Map Parcel No. 1000-75-4-8.13. Vote of the Board: Ayes: Messrs. Goehringer, ,Grigonis, Doyen, Douglass and Sawicki. This resolution was unanimousily adopted. RECEIVED AND FILED BY T~.~ souT~o~ Tow~ c~ ~ ~ ~ ~,.,~-,~ ~ ~ ..~ ~,/' ~,~, _ Town. Clerk, TO~ of Southold FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1803 Approved ................. 19 . . . Permit No ............ Application No .................. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ........ .7./~, ...... 19 ?..~. INSTRUCTIONS a. This 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 £o scheduie. 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. 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 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 buildings for necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nmne of owner of premises .~..,~...~..~, .'~...7~...,~...' .~...~..~ .,~..~.~...~. ~...~.. ~ .~.~...~-~...~.~ ............... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plmnber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. .... '~' '~"Q ...................... ~t~'/'~' '~'" ................ ~'°~"~L~'c*' '/(~' ............ House Number Hamlet County Tax Map No. t000 Section ..... O..'.~..~. ...... Block ..... L~D..~. ....... Lot ...... ~....~../~ .... Subdivision . .~...~..t~.'.~'..~/..,~t~.~.~'~.. ~.~.~'~..~. · Filed Map No. ~'..t?.~.~.~.~ . . Lot.. ~.. .......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ./.-~.~'./. ~. 2~-...~'.~:~.--. .... ..~....~--~..e?..~.~..~....~..~..~. ........................ b. Intended use and occupancy .............................. : . .0. . Nature of work (check which applicable): New Building ... Addition ... t'~ ..... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... : (Description) Estimated Cost...~..o...~....~.,q..~'..~..~'.~.~.....~.~q...e~..~..a~..~.... ;!?ee ...................................... (to be paid on filing this application) If dwelling, number o f dwelling iunits ............... Number of dwelling units on each floor ................ If garage, number of cars ..... .................................................................. If .... business, commercial or mixed. .°ccupancy' specify nature~nd~ extent of each type of, use ........... ~:~j ~ .... [hmenstons of ex~st~ng structures, ff any: Front....~-~..~.'..~'.~ .... Rear .. ~,~, ~'. .... Depth ....~.. ......... Height ............... Number of Stories...,~..~..,~..~..,~...~.~'..~.'~'..~'..~. ?~..-) ........................ Dimensions of same structure with alterations or additions: Fro~t ...~..~.,i .~. ...... Relr...~.~.'. ~..' ...... Depth'. ..... .'~.~F..~..~..r ..... J.. Height .~,~..,~..r_~...~.~.,~..~,.~.~. ~.. Number of Stories., .... ~. Z/..~./. Ihmensmns of entire new construction: Front ..... /.?:.: .~. .... Rear .. 'A~-~....,~..'.~. Depth ......~... ...... 10. Date of Purchase .... ,;~k . ,. ~ "~'~.. ~ .~. ........... Name of Former Owner ...(~. ~7.~4.----~ ----?-. ~ .~..~,~..g?.~?, .o..,~.. 1 I. Zone or use district in which pr6mises are situated ..................................................... 12. Does proposed construction vioiate any zoning law, ordinance or regulation: ........................... 13. Willlotberegraded .t~.~. ~...~.c~f~..~.~... .... Will ~xcess fill be removed from premises: .Yes 14, Name of Owner of premises t~A~.,.~'~".~..,~.,,~, ~ ;,~-~t..~,~/ ...... Address .2' .~. ~.~..~...~. ~:?Phone Name of Architect ' Address Phone No Name Of Contractor Address Phone No PLOT DIAGRAM Locate clearly and distinctly al~ buildings, whether existing or proposed, and, indicate all set-hack 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 OF NEW ~, COUNTY OF above named. ~dividual sig~ing contract) ,q being duly sworn, deposes and says that he is the applicant He is the ............... ~ ............................................................ (Contractor, agent, corporate officer, etc.) of said owner~ or owners, and is du!y 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 that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this : ':- i .,', , :, Nolca~ Pubiic, ......... ,~h..'... of apphcant) 'nov/ or formerly J. H. Lehr Lot B 'ARTMENT-DATA FOR APPROVAL. TO CONSTRUCT ~,TER I~IAIN MI, ~' NSOURCE OF WAT£R~ PRIVATE PUBLIC XMAP DIS¥-["000 SECTION 075, BLOCK 4 LOT"T~ NO DWELL~N(~S WITHIN I00 PEET OF THiS PROPERTY SURVEY FOR HERBERT H. SEAMAN& GRACE D. SEAMAN LOT 8 "SOUTH HARBOR HOMES" AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY~ NEW YORK JUNE DATE= MAR. 19~ $CALE~ 1"=40' NO, 79-114 ~UNAUTHORIZEO ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OFBECTfON 7209 OF THE NEW YORK STATE EDUCATION LAW ~OISTANCES SHOWN HEREON FROM PROPERTY LINES TOEXISTING STRUCTURES ARE EOR A SPECIFIC PURPOSE AND ARE NOT TO BE USED TO ESTABLISH ............... ~ ..... 7, --'t.~ ..... ~ --,~ .... FORM NO. 1 ' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, lfl,971 , TEL.: 765-1803 Disapproved a/c ............ i,,' ............. 4~ ....... / /9, f~ Date D. .eg. 6. ............. , 19B.2.. INSTRUCTIONS a. This 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. Pl~t 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. c. The wor¥ 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 promises available for inspection throughout the work. e. No building shall be occupied or used in whole or in l~art 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 issuahce o'f a Building Permit pursuant to the Building Zone Ordinance of the .Town of Southold, Suffolk County, New York, and other applicable Law~, 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 ~ode, and regulations, and to admit authorized inspectors on premises and in buildi~g~ for necessary inspections· ............ ¢~orge. ~. l~uer .................... '(Signature of applicant, or name, if a corporation) .... P, O,. ]8pX. 19~+.. $oughold.. New. York.. 11071 ·. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 3ut~der .......................... Name of owner of premises . .~I.~....a.n.6..~.r.a..H.e.r.b.e.r.t. JS...S. etaln~a ............................................ (as on the tax roll or latest deed) ' If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No... ~,5.8 .................... Plumber's License No ................. , ....... Other Trade's License No ...................... 1. Location of land on which proposed work will be done· .. 7¢9..Orgl~g~..~,. $o*ghold. Ne~.York ............... ·.. 7.~P ...................... .O.ro.ng.e..R.d.: .......................... Southold ..................... House Number Street Hamlet County Tax Map No. 1000 Section ....t~t.. 1..o99.-975....x:,~t~xg~.-.O9~,:l.3 ......... Lot ................... Subdivision ~o.u,~hkm~'~or. It.om.e~. ~. 8ubd~.~ri~.on ...... Filed Map No. t*096 · ......... Lot ...8 ........... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . .P.r.~y.a.~.e..It.o~.e... ...................................................... ix~'' b'Intel}deduseand°ccupanc9 .... ~ <~ ' ' .:' Z :~""' ..... 3. Nature of work (check which applicable): New Building .......... AdditionS..x.x ....... Alteration .......... Repair .............. RemOval .............. Demolition ...... ~ ....... Other Work .......... . ..... (to be paid on filing this application) 5. If dwelling, number of dwetlinglunits. A~[ ~3>.. ...... Number of dwelling units on each floor ................ If garage, number of cars .... r ................................................................... 6. If business, commercial or mixe,d occupancy, spec~y 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: ................... ~.. HeiSt ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... HeiSt ............... Number of Stories ........................................................ 9. Sizeoflot: Front .......... [ ........... Rear ................... :.. Depth ...................... 10. Date of Purchase .......... : .................. Name offerer Owner ............................. 11. Zone or use district in which pr~mises are situated ..................................................... 12. Does proposed construction vie!ate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ ~ ................... Will excess fill be removed from premises: Yes No 14. Nme of Owner of premises .. ~ .... , ............ Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Nme of Contractor .......................... Address ................... Phone No ................ PLOT DIAG~M Locate icleady ~d distinctly ~ buildMgs, whe~er existing or proposed, an& indicate ~1 set-back, d~ensions from property lines. Give street ~d block:number or description according to deed, and show street names and indicate whether interior or Corner lot. ~ See Map Survey, ~ S~mer ~om, 17'7"x20~ (~o ~eat) ~ . 3 8~x12~ Sterne shed,(Mobil) not attached to ~osga or foundation. Garde. Poured concrete f$~dation, reinforced concrete floor, buildi~ to match exi sting buildi~. S~me~ room to be built on poets, open underneath, mince glaze windows and door, (No Meat ~ully ~ineulated floor, wa~!e ~d ceilint. Oonet~ction to match existing buildi~. ~$tor~e ahem, to be met dn cement blocks. ~ ~o~ ~ ~~ STATE OF NEWc-Y~)RK~ ~,_/7/~' :S.S ....... '~in~ 'o~ d~vic~t~al sig~ni;lg contract' ~'; ........ being duly sworn, deposes and says that he is the applicant above named. He is the . 3 ~~ agent', corporate o~i~e;, et~.3 ...... of said owner or owners, ~d is duly auth~form or have perfomed the said work and to m~e ~d file this application; that all statements conthined.~ t~s applicati~ ar~tme to the best of his knowledge and belief; and that the work will be perfomed in the m~nqr set forth in the application filed therewith. Sworn to before me this - Notary Public, . ................. ~ ~ County., ~z ~ (Signature of applie~t) i NO~RY PUBLIC, State of New Yor~ ~o. S~-8125850, SuU0lk Co~ ~ Term ~pires March 30. 19