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HomeMy WebLinkAbout12492-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CeHi[icate O[ Occupancy No..g.I. 4.!.5.5 .......... Date ... January 15 1986 THIS CERTIFIES that tile building ^ d d 5_ t 5_ o n a n d a Z 'c e r a t i o n Location of Property 1085 Westview Dr. gattituck - h3~s'o hid ....................... 's't/~3i ....................... h3~,Ai County Tax Map No. 1000 Section .. 1. .3.9 ....... Block ....... 1. ....... Lot ......... ~ ....... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · . . .~.a.¥. ).3. .......... , 198.3. . pnrsuant to which Bnilding Permit No. ~ ~.4.~¢ .............. dated ...A.u.g ....1.8 .................. 198.3. ., was issued, and conforms to all of the requirements of tbe applicable provisions of the law. The occupancy for which tiffs certificate is issued is ......... Pj~.d,j.g. ~p.n..a..n.d..a. 1, .L.e,p.a. t ,~p.n...gg. a.n., .e,x.~s..g.5.n.g, .a.c.c.~ s..sp.~.y., g.a,p.a.~.e., .a.d..d. ,c.a..b.a.n.a The certificate is issued to Eus tace C. Eriksen & Gladys L. Eriksen ..................... ?o¥.'oh ~&~i~ 4&&i~(o~i~ ~ k ................... of the aforesaid building. Suffolk County Depart~nent of Health Approval ......... .lq/.~ ............................. UNDERWRITERS CERTIFICATE NO ......... .N:(.2.(/! [?.7 ......... & deck. Building Inspector Rev. 1/81 TOWN O~ $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJVIIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 12492 Z Permission is hereby granted to: ..... z./~.~.......ZY~..~Z./../~a.~ ....... ./ ...... ,__..__,~_.... .... ,~..: ............ ,o ...... ...~..~...,~,~r~....~..~.~..~./..~.~...~....~...z...~....~...~..~.~...``.~..~...~.....~...~....~..`~.~ .... ....... ~.~.=.. ....... ~zT..~.~.~.~ ...... ~:...~~=-~..¢~ ............................. County Tax Map No. 1000 Section .... ./.'~.....~... ...... Block ....(~..~. ....... ./.., Lot/No..~..~...~.. ......... pursuant to application dated ...,~..,~..~......./~.~... ........................... , 19..~....~.., ond approved by the Building Inspector. Building Inspector Rev. 6/30/80 NE~ YORK STATE DEPART~fPT OF EUVIRO~I~!P!TAL CO~SERVATIO~ Regulatory Affairs Unit Buildtn~ 40, SUNY Stony Brook, NY 11794 )I0 PER!'~IT ,,ECESSARY - TIDAL t~)ETLA~,)DS ACT HenKv G. t~illiams Commissioner A review has been made of your proposal to: Locat~ono ~ ' , k~ - It has'b~en determined~hat no permit is necessary un4er Arti~e z5 (Tidal ~etlands). Houever, any additional work or ~difications to the project may require a permit. It is you~ responsibility to notify this office in writing tf such additional ~ork or modifications are contemplated. Assuming you have obtained any other applicable permits, you may proceed ~ith your project. Very truly yours, ~/· Daniel J. Larkin Reginal Permit Administrator n~JL.R,,T.11 AUe ~ · ~ APPEALS BOARD MEMBERS GERARD P. GOEHRINGER, CHAIRMAN CHARLES GRtGONt$. JR, SERGE DOYEN, ,JR, ROBERT J, 0OUGLAS$ JOSEPH H. SAWICKI Sou hdd Toum Board o£ MAIN RI)AD-, BTATE ROAD 25 c~OUTHDLD, L.I., N.Y. 119'7'1 TELEPHONE (516) 765-1809 September lO, 1984 Rudolph H. Bruer, Esq. Main Road Southold, NY 11971 Re: Appeal No~ 3227 Eustace C. Eriksen Dear Sir or Madam: Attached herewith is a copy of the formal findings and deter- mination recently rendered and filed this date with the Office of the Town Clerk concerning your application, In the event your application has been approved, please be sure to return to the Building Department for approval of any new construc- tion in writing, or for other documents as may b~e appl~ca le~ If you have any questions, please do not hesitate to call either our office (765-1809) or that of the building inspector (765-1802). Yours very truly, Enclosure Copy of Decision to Building Department Mr. Eustace C.'Eriksen GERARD P. GOEHRINGER ~nda F. Kowalski Secretary FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ Date · .~.~..~a~:~.~. · ./. · -2'~' · -.,19 .~'~' ~ ~..~.~.....~..~..~~'.~ .... ~.~.~.,.~ ................ PLEASE TAKE NOTICE that your application dated ...~.~. I.~ .......... ,19. ~.~. ~o~ to ~o.~t..g ~....~.~ .... C~ ~~.: ........ a~ ~o~ o~o~ 2~ .... ~.~. ~.~'~.. :. ~ County Tax Map No. 1000 Section . ./. ~ ........ Block ...... ~ ........ ~t ...~ .......... Subdivisio~ - : Filed Map No ................. Lot No .................. is returned herewith and disapproved on the followMg ~ounds . ~ ~. ~ ............. Building Inspector RV 1/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG. OF. PT. . TOWN OF $OUTHOI.~ Instructions This application must be filled in typewriter OR ink, and submitted ia al~ 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 natura~ 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 Amhitect 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 survev of p~operty showing a{I 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 dwelling $ :[ 5.0 0 3, Copy of certificate of occupancv $1.00 4.Vacant Land C.O. $5.00 Date. M0. [/'.../~../.~..~.~.~. ......... New Building . ..~ ........ Old or Pre-existing Building ~ Vacant Land Location of Property ..................... ; ........ ~ .................... House No. Street Hamlet Owner or Owners of Property .~.'~ .,~,T,~, ,¢..~...(?...~.~.1 ]('..~.~. ....... .~. ~.~,~. ~/~, ........ ~ .~ .~..~.(./.~.~. ?.~./, County Tax Map No. 1000 Section .... /.%~, ? ....... 8lock .... /. .......... Lot..,~.. ............ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./.2.~ ?..~.-~.. Date of Permit .~.fi?j.f.~.. ~.Applicant Health Dept. Approval ........................ Labor Dept. Approval ........................ ~1~ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...~- .................. Fee Submitted $ ..-. ~ ....................... FIEL~ IN~°ECTION COMMENTS FOUNDATION ( 1st / FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY QODE FINAL ADDITIONAL COMMENTS: FOR~ I~10.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL County Tax Map No. 1000 Section ...[~. ....... Block .. ~/. ........ Lot ~..0...~. ....... Subdivision ................. Filed Map No. Lot No,.......,.,...'~-~ ,,., is returned herewith and disapproved on the £ollowing grounds Z'> .,~.. ~~¢~,~: h. . ,~w~. . o~ . o. . ~~ ..... ~ . . . ~-~~. . . ~ ....... .~~ .... ~. , .~. . .~ . , . ~. . ~.~:.- ' ~ .~ ~ ......... RV 1/80 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ ~ , ! PLEASE TAKE NOTICE that your application dated .. ~.~.../.~ ........ , 19 .~. for pe~it to construct. ~(~ ~7~..~.~ ........................... at ko~a,iono~o~,~. /~ ..... ~e~Z(~'~..~a, ........ -~~:... House ~o. Steer Hamlet County Tax Map No. 1000 Section ...~ ...... Block .... ~.g ....... ~t . ~.~ .~ ...... S Fit p N t N -'-' ubdivision .... --- ed Ma o. -~' Lo o .................. is returned herewith and disapproved on the following grounds .'~. ,~. ~'~4.t'.~..~.~.. (~..~o~. ~ ~/~...~o.~...~. ~.. ~d~. ~ ,T4.~ ~X.~. ~..~ z~..~ ..... ~, ,,~ ~ ~-~. ~.~,..~.~'~...~...~<~..~~ ~.~.. ~... l~.~ .......... Building nspector RV 1/80 765-180Z BUILDING DEPT, INSPECTION FOUNDATION 1ST FOUNDATION 2ND [~ INSULATION FRAMING [ ] FINAL ROUGH PLBG. REMARKS: -.-.-21'?/~'¢.-,~t' INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equipment ~ ~serlbed be~w and intmduc~ by t~ applicant named on the able application nu tuber in the premises of Section Block Lot w~exami~don ~)~b¢~~ ~ FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST OUTLETS IECEPTACLES SWITCHES DRYERS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C E NO O~ERCC~COND, OF A W, O. NO OF HI LEO a.w, O. NO OF NEUTRALS A W O, CC COND. OF HI-LEG OF NEUTRAL OTHER APPARATUS: 451 ' ~' , 108o W,.~at Vie~,, Drive This certificate must not be altered in any manner; return to the office of the Board if incoirect. Inspectors may be identified ~¥ their credenfiol$, ~ER. MAIN I~UAD TELEPHONE (516) 765-1809 Appeal No. 3227 Application 'Dated March 7, 1984 TO: Rudolph H. Bruer, Esq. as for EUSTACE C. ERIKSEN Ma~n Road Southold, NY l1971, (Public Hearing June 21, attorney 1984) [Appellant (s) ] At a Meeting of the Zoning Board of Appeals hold on Au~%~st 14, 19B4, the above appeal was considered, and ti%e 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 [ ] Request for Variance to the Zoning Ordinance Article ~ Section ~ I Request for .reversal of t~e December 12, !983 decis'rR~ of the building inspector ~n order to permit the con~ sion and renovation of a "guest, cottage", or second it,][Yq~,,,~3 dwelling (without .'cooking facilities). Upon application for EUSTACE C. ERIKSEN, 1085 Westvlew Drive, Ma~i~- tuck, NY for a Variance to t~'-~-6~ng~cTT~-~-~'e, appealing the Decembe~(~2, 1983 decision of the building inspector in order to permit the convers]~~ and renovation of a "guest cottage" or second dwelling structure at prem/~ses known as 1085 West View Drive, Mattituck; County Tax Map Parcel No~ lO~ 139-1-3. The board made the following findings and determination: By this appeal, a~plicant seeks to reverse the decision of the ~¥/ Building Inspector dated December 12, 1983 concerning an application for a building permit to construct guest cottage (conversion) dated May 13, 1983, which was disapproved on the following grounds, to wit: "Article III, Section lO0-30(A)[l], one-family dwelling no~ to exceed one dwelling on each lot..," and based on erroneous advice given in the 1970's by a prior building inspector. On O~ctobe~ 3, 1975,~ Certificate of Occupancy No. Z6726 was issu'ed by a buildin§ inspec'~or "~for a 'Iprivate one-family'dwelling with accessory building--can be gue~t' cottage with no cooking facilities," to Gildersleeve and Krebs,, predecessors in title. On the same date, a housing code inspection report was prepared by the building department, presumably prior to the issuance of the Certificate of Occupancy, indicating that the.former garage has been altered for four rooms and a bathroom, and that a sewage drainage system had been installed in ,the slab of foundation. :. The applicant purchased the subje'ct premises on July 22, 1977, On August 12, ]983, building permit No. '12492Z was issue, d for'an addition to the sub,lect detached garage structure, Applicant contends that no cooking facilities have been, nor do they exist on the premises, and accordingly does not understand the reason-, ing of the building inspector's decision. ~ . :~,. ] .~/ The boar~ members have visited and are familiar with the site in question as well as .the neighborhood. Upon inspecting the interior of the structure in question with the applicant, the board found that the building was being used for sleeping quarters, with kitchen cabinets, but without cooking facilities. Applicant contends that cooking facilities are not being requested and therefore compliance is made with Certificate of Occupancy issued October 3, 1975, ~ DATED: Sept, ember ~ 1984~ CHAIRMANt SOUTHOLD TOWN ZONING BOARD OF A~P. ALS ! ~;~ :~-i~,~:~..~?, ,~. :.~,:-~C~ ?~;. ~;:~: Matt~'~~'of'EEIST~ACE~-~-~- '-~ ..... C: ERIKSE~ Decision Ren--~-d-~,red August 14, 1984 No evidence has been presented indicating thatlthe building i'n'%question ts not in conformity with the Certificateiof Occupancy of October 3, 1975 sufficient to war.rant a denia! of ~the applicant's request. As of the date of this dec~sion, Build~ng Permit No. 12492Z' is pending and improvements to this structure as appli)ed for there!n have: been s~arted~,' i~, .. . ~' :, ,,. "' . , .... ., .~.,~ Accordingly, under the circumstances of this appeal and ue to lack of sufficient evidence to uphold the building inispector's . -.decision, the following resolution was adopted: ~..~. ' ~,;'..;! '. . . ~.,.ri.,.,~.. . On motion r, u ass, seconded by M Goe,'hringer, tt was I ' ']I ;~" i ~~' RESOLVED, that the relief requested in Appeal matter of EUSTACE C. ERIKSEN for permission to contin.;ue use of the. accessory ~~ing quarters without coo]king facilities,. BE AND HEREBY IS APPROVED SUBJECT TO THE FOLLOWI.~ ' l, Nb cooki)ng facilities~ ::,:.. 2', Not to be used as a one-family dwelling (Shall be for sleeping or residential storage purposes only); ' ~ ' : m '3. All new, future construction must not exceed 20%'of the, total (all buildinos) maximum-permitted lot coverage~ Location of Property: 1085 Water~lew Drive, ~attltuck, NY, County Tax Map Parcel No. 1000-139-1-3., ~ ~ Vote of the Beard' Ayes: 'MesJ"rJ'~"~Goehringer', Doyen, Qrigon~s of D°uglaSSall the and members.Sawicki~ This resolution was. ..... adopted by., unanimous..:v°te'~ ~~ ~O~HRINGER, C~IRMAN September 8, 1984) GG:lk 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ................ ,19... Approved ................. 19... Permit No ............ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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. Plot plan showing location of lot and of buildings on premises, relationship/:o 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 issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until 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 building for necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) l/90"0 State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. ............... v ii& ...................................... " '-' Nazneofownerofpremises 2zTl'qiKS£A/ ~OS?Ad~' C 4' ~/,[4~.$ J~, (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 ..... .L/. ?..o~. ............... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No..'~....~.z,( .~.:/c/.../ ..... I. Location of land on which proposed work will be done. }.~. f..~..l~..~5.,k, ,f, ,~,,ld,,, ~ ~t'.~. ................. House Number Street Hamlet County Tax Map No. 1000 Section .../..~..~ .......... Block ...... /. ........... Lot...~. ............... Subdivision ................................ Filed Map No ............... Lot ............... (iq'a~) 2. State existing use and occupancy of premises and intended use and occupancy of pr°p°sed constructi°n: a. Existing use and occupancy .~. ~.. f..~.~, b~.~-~. ~f~ (~/~ ~ £~ b. Intended use and occupancy ~./~ ~ .~fr~.. ~.. ~. I.'./? .0../f.~ .~.b{ .~.~.Q ~ :.~?..,~.. ~O...~./~ ~fi. ~-.U.~. .' .... 3. Nature of work (check which applicable): New Building ..... ' ..... Addition .......... Alteration .......... Repair .............. Rembval .............. Demolition .............. Other Work ............... >8) ~' - 6 5" (Description) 4. Estimated Cost .~..0. $ (5 0 O: . 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 or mixed occupancy, specify nature and extent of each type of use .................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............. tteight ......... ~ ...; '.. 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 ............... Rear ............... Depth ............. lteight ............... Number of Stories ...................................................... 9. Sizeoflot: Front .......... ~ ........... Rear ...................... Depth .................... 10. Dgte of Purchase .......... [ .................. Name of Former Owner ............................ 11. Zone or use district in which pr~mises are situated: ~ .................................................. 12. Does proposed construction vio!ate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ ; .................. Will excess fill~e removed from premises: Yes No 14. Name of Owner of premises ff'l~l ~ R t I<'S ~CN ,. Address/P.C.d', ~q~,r', ~/t.~,&. ~,¢'t, Phone No.c~../f. :~.~.~.. Name of Architect ...... ;. ·: ..... : ............ Address ................... Phone No ................ Name of Contractor .~/~.S..T'.~.t?P! .$..~d.t~!~. ........ Address/.q.-7.o. ~.~../{.7'.tq.~.t.¢.//..t0)'r Phone No~./g.~~..~.~./~.~..~.. PLOT DIAGRAM Locate clearly and distinctly all 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 whether interior or corner lot. STATE OF NEW YORK, . S.S COUNTY OF ................. ........ .' ....................................... being duly sworn, deposes and says that he is the applicant (Name of individual sigmng contract) above named. tte is the ..................... :~ .......... ...................................... ................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and ~e 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 b~fore me this ........... ...... day oi .......... , 19 Notary Public ...... ~...~.. ~.., .Coun 2 .~.~~'L. H[I.tN K, DE rOE .. ' '" ~' NOTARY POBLtC, State Of, New York ,-.~. ~ ..................... N0, 4'/ff~878, s~ltolk c0u,%~- .-- : . (Signature of applicant) Teml Ex'0 es t, tarch ~. 1~ .~ ~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a/c ,,~...~~l ..~~ .... .... . ...... ...... ~d ......... ~PPhIC~T]O~ FOR ~UILDI~G PERMIT INSTRUCTIONS Application No ................ 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. 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 issued aBuilding 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 m~d in building for necessar~]insp~e~ctions~. ~ ~ ~ --P ~ - ..... (Signature of appl~zant, o,r n2Cme, if a .co porati, on) (Mailing add,ss of ~6plicant) State whether applicant i~/~,w.~¢7~l~e~see, agent, architect, engineer, general contractor, electrician, plumber or builder. . Name of owner of premises .~./~ ! ,~.S..L-"..,~., ..... ~ .~.,~./. }.~ ~. ~-. ~.....Wy.....ly". ~z.~... (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 ....... ~..~ .' Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No..~... : ....... Location of land on which proposed work will be done...~.'.0. ~...~...~ .~... ~.~ ........... .. House Number Street Hamlet County r~x ~p ~o. ~000 Sectio~ . .t .~.g. .... ~...~ ~o~k ...... ~ ............ ~ot ..... ~ ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~1~... ~~.~.~ ~x.0d .~ZA~B~ ....... _/~ b.~l~ntended use and occup, ancy ..... ~C,....~ ...C~. 7.. ~. ~ ~_~....~.~. ~..~.O..~.,.~ 3. Nature Of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal ............. Demolition .............. Other Work ............... 4. Estimated Cost .IZ/.~..! .~.o. d)i Fee .,,~ ........ ~ ..... ~ (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ............... Number of dwelling units on each floor ................ If garage, number of cars ..... . ................ . ................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structure~, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure wRh alterations or additions: Front ................. Rear .................. Depth .................... ~.. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Sizeoflot: Front ........... : ........... Rear ...................... Depth ...................... 10. Date of Purchase ........... .................. Name of Former Owner ............................. 1 I. Zonc or use district in which pretnises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ......... · · .,, ........... Will excess fill beremoved, from premises' Yes No 14. Name of Owner of premises ...' .... ~... Address [.O.~..,~'..~..~..~.~.. Name of Architect ....... ,7:- 7): ................ Address ........... ~ ........ Phone No..67.~. ~3/°f...~ [.~.~.~'.. Name of Contractor~,~.~ ............... Address ./'4.°~.~,.... Phone NO ..... : ....... ;:; PLOT DIAGRAM Locate clearly and distinctly all i buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block humber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE~7~ ' O~ P'~K' '~ SS COUI~Y O~ .... i' .................. 5h ....... ~ ................... ~ , p ~d says that he is the applicant (Name of'individual signCng contract) above named. . He is the ................. ::' ::>~r; ' ' ....... ' ....~~ ' ' ': ............................ ; [ onr actor, agent, corporate officer, etc.) of saki owner or owners, ~d is d~l~ autho~zed to perform or have perfo~ed the said work and to m~e ~d file this application; that all statements conthined ~ this application are true to the best of his ~owledge and belief and that the work will be perfomed in the m~ne~ set forth in the application filed therewith. Sworn to before me this '"/Z'i[ ...... ' ' Nota~ Pubhc, . ~ ...................... Coun e,,+~,,~,~ ~,~,,~, ~,,~ ao, ~ , (Signature of applicant) o l' R OV TiOHL -,% -) / / i11 _/ ~ d-^~A~: :Loo~,- FOO-r_i~:, ~FI2ONt-r X/i~xx/ t ? APPROVED AS NOTED FEE:.¢ ¢'~>~7- BY: NOTi~ .UlLDING DEPA.TMENT 765-]802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - ~O REQUIRED FOR POURED CONCRETE 2. ROUGH - F~MING & PLUMBING 3. INSU~TION 4. FINAL - CONSTRUCTION MUST BE C~MPL~E FOR C.O. ALL CONSTRUCTION SHALL ME~ THE REOU~R~ME~S OF T~ N. ~A~ CON~RU~ION & ENERGY CODES. NOT RESPONSIBLE FOR D~IGN OR CON.RUCTION ERRORS. r~ .i 1 uot+k .................... ,-, ,cf K¢¢ ¢ -...... , : OCCUPAtlII¥ OR USE IS IINLAVIi:UL ffI DDT CERTII:ICUE El: OCCI)PlkNCY APPROVED AS NOTED DATE:, B.P. ~ FEE: BY: NOTIFY BUILDING DEPARTMENT AT 765-1B02 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: ,I. FOUNDATION - 'TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4,, FINAL - CONSTRUCTION MUST BE COMPL~ ~ ~ FOR C. O, ~ CONSTRUCTION SHALL MEET THE RE~U;REA~ENT*S OF TI-~ N, % ~FATE C~:}Nb, m~UCF~ & E~ T -t I I ._Lis."__ ...........