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HomeMy WebLinkAbout12211-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspei;tor Town Hail Southold, N.Y. Certificate Of Occupancy No. Z.ll.?. 56 .......... Date .............. .J.~.~.e.. THIS CERTIFIES that the building .. ~qQgfi~.a.~y ................................... Location of Property 2200..Q~'~ .~¥~... Hattituck House No. S'tre$i .... hJr~l'e:t County Tax Map No. 1000 Section . . .q 97 ...... Block .... Q.2 ......... Lot .... ! .0 ........... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Augus~ I 80 ..................... , 19... pursuant to which Building Permit No... ! ¢.2.fl.1 g. ............ dated ... Ha~..ah. 2~ ............... 19 ~., 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 ......... ............ T=gr. aumd..pool .and. £.ence ......................................... The certificate isissued to Beverly Andrews & Hark Rollins ..................... ?o¥.'o;, '~do',;/tbb;'o ...................... of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO. Pending Building Inspector Rev. 1/81 12211 Z (THIS PEP, MIT MUST BE KE~T oN ~ ' ' ~ is hereby granted to: i tO at, p~mlse~ located at ............... ~U~ T~x Map No. 1000 Sect[on .............. ¢~.~¢._.,~1~ , pur~Jont ~.o application dat~l. ................~ ......... :.,? ......... Bb~l~ing Ihspector. F~ 1.......,; ............... and approved by the - Iv. 'GRAND CO t~' FORM NO. 6 TOWN OF sOUTHOLD I~u i~d~ng Depa~'tmen~ Town Hall $outhoM, 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 topograohic 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 building~ 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 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 $500 / - ~. ~,/ 2. Certificate of occupancy on pre-existing dwelling e/r land use '~,/$~$5 00 3. Copy of certificate of occupancy $1.00 / ( ' ' Date .. New Building ............. Old or Pre-existing BuJldJng(X)/._/~_ --~ /Vacant Land -. ~ . . Hou~ No ..... S~ree~ ~ Ham/et or Owners of Property ~ *~r County Tax MapNo 1000SectJon .... ]-~.~... ' Block ....... Q~ .... Lot ..... :4~ ....... Subdivision ................... Filed Mag'No, .,; ....... LotNo...' ........... Permit No ......... Date of Permit ........... ~pphcan~ Health Dept. Approval ........................ Labor Dept. Approval ...................... ,.. Unde~ri[ers Approval ........................ Planning Board Approval Request for Tem~orary Certificate ........... Rev. 10-10,78 . FORM NO, TOWN OF SOUTHOLD J~u~ding Depar~mem: Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and subn~itted 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 ail buildings, property lines, streets, and unusual natural or tooogramhic features. 2. Final approval of Health Dept. of water supp y and seweraee disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, industrial buildings, Multiple Residences and similar buildings and installa. tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5, Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Nomconforming 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. / C. Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwe ing land use '~/ 5.00 3. Copy of certificate of occupancy $1.00 Date .. New Building ............. Old or Pre-existing I~u..ilding(:~)/-.f4. --=/Vacant Land -, ,, ........ Ham/et Owner or Owners of Property .... l o..'7 ' County Tax Map No..1000 Section ....... Block ..... .~)- .~- .... Lot SubOivis on .............................. Filed Map'No...: ....... LotNo. ' ......... Permit No ........... D ' ........... ~plluan~ .... . .............................. Health Dept. Approval ........................ Labor Dept. Approval ......................... Unde~riters Approval ........................ Planning Board Approval .................. Request for Temporary Certificate .......... )?<-;.] ..... Final Certificat~ ~ ....... - ......... ........................... / / / Constructlon on above described building Z~eets ~,/~( .... /~/ , ~ ~..~ ~ ~,.,z,,,, ~ ~caole~odes and reg~at ions. ' / ~- ~ ' ~ ,~ - 7/ , , :- v' ":~'..,~ ......... ~.~../ ......... . ..... 1 .7 FORM NO, 3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S O~FICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL File No ................................................................. Date ..... ¢/...~..~. .......~'.f.. ................. , 19. To~.,.~.~.~.7....~..../..~,z..~....~..c ...~.~..O....:....~. '~.....~...z:~.,~ ......................... .. ~..zz.~ z~r~.c_.z.zz...~. ........................ PLEASE TAKE NOTICE th, at your appticajagn dated ...... ~'.~'~.4~..~:'.~.. ....... ../. .......... , 19..~....¢~. / for permit to construct//~//~....~....~_/6~...~.~..at the pCemises located at..~'.~,..'~,~....~......~....~"4~..~ ~~...~r~ ....... ~ x/~ M a p ./. ~. ~'~.......-?.~. ~.f~... ........ Block ............. ~.....~.,. .................. Lot ............... O.~...C~.. ..................... is returned herewith and disapproved on the followlng ~.~ ....... ~,~,~. ~. r. :~. . ..~.. .,,~... .,.,~ ......... ,.~=.. . y ~ . . . . o,.~z,f .~ ... .~.~. . ... .~.~.~.. 7~. ~. . . . . z -~ ...... ~ ~ ~ ~. . . . ~. ~. ~ ~ ....... ~,~ . . . . ~ . .~_=,-~.~ . . . . ~ ~ ............. ....... :... ......... ........................... ...... Southold Town iBoard of Appeals . APPEALS BOARD MEMBERS CHARLES GRIGONIS, JR., CHAIRMAN SERGE DOYEN, JR, TERRY T UT'. ',: L~L ROBERT J. DOUGLASS ~ERARD P..GOE. HF~ING ER osepn ~.aWlCK1 September 25, 1980 Mr. David B. Cross Skinny Dip Pools, Inc. P.O. Box 108 Mattituck, NY 11952 Re' Variance for Pool in Sideyard Area Grand Avenue, Mattituck Property of Beverly Andrews Dear Mr. Cross: This date Mr. Fisher submitted the papers to be filed concerning the above project, requiring the variance, and same are returned to you herewith for the following reasons: Appeal Application front page). "Reason for Appeal" is not completed (bottom on 2. Reverse side not completed, signed or notarized. 3. Notice to Neighbors Form not.complete on front side, and signature on reverse not notarized. 4. Certified Receiptsk(to Neighbons) not submitted for Mr. O. Jemmitt.(please chec with assessors for address). 5. Three copies of surveys showing:yard setbacks required. Also, please show distance from ~deck (existing) to pool. [If deck is not existing, amend application, etc.] Please re-submit. Enclosures Sincerely !yours, Lifida Kowals:ki, Secretary $outhold Town Board of Appeals MAIN RE}AD- ~TATE RI'lAD ~5 SI:]UTHI~LD. L,I., N.Y. 11971 TELEPHONE (516) 765-1809 APPEALS BOARD MEMBERS CHARLES GRrGONIS, JR. SERGE DOYEN, JR. ROBERT J. DOUGLASS GERARD P, GOEHRINGERt JOSEPH H. SAWICKI February 8, 1982 Mr. Arthur F. Siemerling P.O. Box 108 Mattituck, NY 11952 Re: Appeaal No. 2937 - Beverly Andrews Dear Mr. Siemerling: Please be advised that the following action was taken at a Regular Meeting held February 4, 1982 concerning the recent application of Beverly Andrews: RESOLVED, to .approve as applied for. Appeal No. 2937, application of Beverly Andrews for the construction of an inground swimmingpool in the sideyard area on a corner lot. This resolution was unanimously adopted. An official determination and findings will be filed with the office of the Town Clerk as soon as possible and simultaneously forwarded to you for your records. If you have any questions, please do not hesitate to call our office. Yours very truly, GERARD P. GOEHRINGER CHAIRMAN By Linda Kowalski, Secretary BUILDING DEPT. COPY O1~ APPLICATION ~ OLD MOTO~ OFFICE OEFEOTS JLL A~O ~ A ~$EP~RATE ~f BE RETURNEO. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRIC~TYii es Jo.H STR£ET, .EW YORK..EV~ Y~RK ,OOZe THIS CERTIFIES THAT only the electrical equipment as ~scribed below and intr~uced by t~ applicant ~m~ o~ the above application number i~ the premises of ~ R~Ii~,2g00 ~d Ave. in the.following location; [] Basement [] 1st FI. wes examinedott ~[.~ 14, 1980 FIXTURE OUTLETS DRYERS EECEpTACLES 1 [] 2nd FI. 0[~ Section Block and found to be itt compliance with the requirements of this Board FIXTURES RANGES OVENS EXHAUST FANS SWITCHES 2 MULTI-OUTLET SYSTEMS NO. OF FEET Lot E R I C A, WG OF HI-LEG ~0 OF NEUTRAL~ A, WG OF NEUTRAL GIe~=L R, Bradley 169 ~or~o~ Ave. Mag=i~,N.Y0 11952 GENERAL MANAGER i; ' Pet' " This certificate must not be altered in any manner; return to the office of the Board if i~co~'ect. Inspector~ may be identified by their credentials. TO~ OF SOUTHOLD, ~E~' YOILK ACTION OF THE ZO~NIN~ BOAI~O OF APPEALS Appea/ No. 2937 by application Dated December 8, 1981 ACTION OF THE ZONING BOARD OF Al>PEALS OF TI~E TOVfN OF SOUTIiOLD To Mr. Arthur F. Siemerling as agent P.O. Box 108 ' Mattituck, NY 11952 DATE 2/19/82 Appellant at a meeting of the Zoning Board of Appeals on February 4, was considered and the action Ludieated below was taken on your ( ) Request for variance due to lack of access to property ( ) Request for a special exception under the Zoning Ordinance (X) Request for a variance %o the Zoning Ordinance Art. I II t ( ) 1982 the appeal Sections 100-32. and 100-34 1. ~P~L~~~XMK~~K~~X~~pt~n ( ) he ~anted ( ) be denied pursuant to Article .................... Sec~on .................... Subsection .................... para~aph .................... of the ~nMg ~d~anee and ~e dec.on of the Building Impector ( ) be reversed ( ) be Y~R~X Public Hearing 2/4/82: Application of Beverly Andrews, 145 Maple Lane, Mattituck, NY (by A. Siemerling as agent) for a Vari- ance to the Zoning Ordinance, Article Iii, Sections 100-32 and 100-34 for permission to construct inground Swimmingpool in sideyard area on a corner lot at premises located on the corner of Grand Avenue and Maple Lane, Mattituck, NY; bounded north by Jemmott; east by Young; south by Maple Avenue; west by Grand Avenue; County Tax Map Parcel No. 1000-107-02-part of 010. (SEE REVERSE SIDE) 2. VARIANCE. By resolution of the Board it ~vas 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) alike in the immediate vicinity of this property and in the same use district because (would not) be shared by' a~l properties (SEE REVERSE SIDE) (c) The variance (does) (does not) observe the apirit of th~ Ordinance and (would) change the character of the district because (SEE REVERSE SIDE) (would not) and therefo~ that the pre' FORM ZB4 ~ . .... a ....... ~c~e~mh~ed mar ,;ne requeste~ variance ( ) be granted ( ) be denied and ~E SOUTHOLD TOW~ '.aOUa IV. ~2 hrd p. Goehringor, Chairman ZONI 'G BO~D OF By this appeal, appellant seeks approval of th~ location of an inground swimmingpool, 16' by 32' and located north.erly of the exist- ing dwelling and approximately 40 feet of Grand Avenue. At the time of inspection, the board found that there is a deck! area at the northerly side of the house and stockade/chainlink ,!fencing surrounding the inground swimmingpool. The premises in questiqn is a corner lot with 126' frontage along Grand Avenue and 210' fronltage along Maple. Avenue, and containing an area of 29,448 square fe~t. The board agrees with the reasoning of applicant and feels t~at the requested location is the most practical and feasible under ~he circumstances. In considering this appeal, the board determines that the variance request is not substantial in relation to Ithe code require- ments; that the circumstances herein are unique; ~hat by allowing the variance no substantial detriment to adjoiningiproperties would be created; that the difficulty cannot be obviated by a method, feasible to appellant, other than a variance; that ino adverse effects will be produced on available governmental facilities of any in.creased population; that the relief requested will be in ~armony with and promote the general purposes of zoning; and that the interests of justice will be served by allowing the variance asl~applied for. On motion by Mr. Grigonis, seconded by Mr. Goehringer, it was RE~OLVED,~.to approve the application for BeVerly Andrews, Appeal No. 2937 as applied. ~ Location of Property: 145 Maple Lane (Aven~e), Mattituck, NY; County Tax Map Parcel No. 1000-107-2-10. : Vote of the Board: Ayes: Messrs. Goehring~r, Grigonis, Doyen and Douglass. (Member Sawicki was absent.) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 1~1971 TEL,: 765-180:3 Examined~ ................ , 19... Approved ................ ,19... Permit No ............ Disapproved a/c ..................................... Application No .................. (Building Inspector) . APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. 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, r~lationship to adjoining premises or public streets or areas, and giving a detailed descripti6n of layout of p~roperty must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced bef<~re 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 wo~k. e. No building shall be occupied or used in whole or in part for a!ty purpose whatever until a Certificate of Occupancy shall hav~ been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the is~suance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, N~w~F6rk, ~nd other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alteratio~tlS'~r for re, doral or d~emo~tion, as herein described. The applicant agrees to comply with all applicable laws, ordinances,~'uilding c~de, hous~ c~e, and regulations, and to admit authorized inspectors on premises and in buildings for necessa~ inspe~ls._ ~/ // i:Signature o_f applic~, or. name, if a corporation) /'/,,,~, . · ..~ '_, ~ .......... .............. (Mailing address of applicant) State whether applicant is owner, les chitect, engineer, g~neral contractor, electrician, plumber or builder. / \ t~ (as on the t~x roll or latest deed) I f applicat.ls_. ~ion, ,~.. n.a~t horized officer. 15~One and title of' cor156rate officer~l Builder's License No .......................... Plumber's License No ........................ Electncxan s License No Other Trade s License No ........ ~ (.J. ........ 1. Location of land on which proposed work will be done .... : .~.~{~..~. · .... ~ ....................... House Number Street Hamlet County Tax No. 1000 Section .../.O. 2 ........ Block .. ...... Lot.../..e ............ Subdivision ..................................... Filed Ma~ No ............... Lot ............... (Name) 2. State existing use and occupancy of pr~rn_ises~a~d~use and o0gupancy o~proposed construction: a. Existing use and occupancy ... ~'~//'/~'~:~(~' '~'~ ' *'--"-' .......... ~/~E ..... ~ ''"q2& ........................... b. Intended use and occupancy ..... ~ ...... .... ~ ...... ~ .......... 3. Nature of work (check which appficable): New Building .......... Addition .......... Altera/,ion .., .... ~.. Repmr ......... ~ .... Removal ......... ..... Demohtlon .............. Other Worl~'.~d~.~ 4. Estimated Cost:t../. ~'.o'..~.~ ........................ Fee ...................................... , (to be paid on filing this application) 5. I.f 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 natur_~ and extent of each tylte of use ........ ~ ......... 7. Dnnensmns of existing structures, if any: Front .... .d,~..~? ......Rear ...... ~.t~. .... Depth. O....~'~. ........ Height ............... Number of Stories .... ~ .................................................. Dimensions of same structure witfi alterations or additions: Front ................. Rear .................. Depth ..................... i. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ................ Rear,~ ............... Depth ............... Height ............... Number of Stories ..... .f~'. ~.~ c~...~.O'~../z. .~..'~-"~. ~ ',h ............. 10. Date of Purchase ............ ! .... /.O' .......... Name of Former Owner . .///~'..~. · · ~-. Gl. ~.'~: .~.... 11. Zone or.use district in which premises are situated ..................................................... 12. Does proposed c6nitructi%n~vi~a!e any zoning law, ordinance or regulation: .. .... /~..~. ..................... 13. Will lot be regraded ....j~/. (.j. ........... .,~. ,, .... ~.. Will excess fill be removed from premises: Y~es No 14. Name of Owner of premises ./~/~-t{~ ?~7/~,t~O/. Address ................... Phone No. a,?~..~.~..~.O. .,,,.".~... j ................ Address ................... Phone No ............... Name of Architect. .~}~ ~ Name of Contractor . . , ........... Address . .~ ...... Phone $o~..~ .~../.~.. 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 NE.~, ,O)~J/~/.~ 8.s COUNTY OF.............. , .............................. ................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named'. , He is the ..................... ;?. .................................................................. i" "~ "' (Contractor, agent, corporate officer, etc.) of s~d owner or owners, ~d is dul~ authorEed to perform or have perfo~ed the said work and to m~e ~d file this app~cation; that all statements conta~ed '~ this application are true to the best of his knowledge and belief; ~d that the work will be perfomed in the m~ner~ set f~rth ~ ~e application filed therewith. Sworn to before me t~is ........... Z ............ flay oI, ..... ~ .... -~., · · · ~ ~ .'1 ~ .'~. ~ -- f/ Nota~ Public,~ ~. (.~~.. County ' ~mmlsslon ~pires March 30~ 19~/ Examined..¢~'.~..~. ~.., 19Z~ / Disapproved a/c .... t~///~. FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ., 19~.ff. Permit No./. ~-.~.././'7 Application No. ~. ~. ~,~//..~.~ . . (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan sho~lk~7~.~ti2D o~[ot~bulldings on premises, relationship to adjoining premises or public streets or areas, and gi~t~g/_~:detailed ~l~scrip~fio~f~l~i~out of property must be drawn on the diagram which is part of this appli- cator? The wo~l~/ove~i~PPliCa-i~Gt-l~e commenced before issuance of Building Permit. d. Upon ap~ik~~~-lY'-0~¥~i~l~6gki~h~v[~;il~.ding Inspector will issued a Building Permit to the applicant. Such permit shall be kept on7t~[e ~8~ltlis~s~y~il~',{~s~c~F,~fi_ roughout the work. e. No buil.['(litgLgl4ttllFl~.e (~$,.~..~!~'~,¢~'~'~[%~w~oI¢ or in part for any purpose whatever until a Certificate of Occupancy shall have been lgraS~lxbTyAthl~?Bliild~Vl~)~e~tor, . - KK(.gUI R E j -' . . FOR ( c · ' E" ' ' APPLICAq~.O~c~¢~z~C~,~}i~he Building Department for the i~uance of a Build~ng Permit pursuant to the Building Zone30rl~,~¢,~,~,h'dt~/:~fi ~f t~ddtl~t~ld}CSuffolk County, N~w ¥6r1~, and otll'~r applicable Laws Ordinances or Regulations, foJc/;~ed~n~[r~i;)Ja__o£ ,b~.u. fldings additions or alterations, ¢~n~emoval/0r/denl~lition, as hj~rein described The apphcant agt~kesc~.C,~.~'L~{t~ a!T,a lidal le laws, ordmances, bu~J.~de, hq~ng ~Sde and r~at]ons, and to admit authori~in~/~se~.a~d ~ build~g for necessa, in~ ~-f ~ ' ~ ~.~1~ CONS'r~UCTION & ~'ff,) (Signature of~ ~me, if a~rporation) DESIGN OR CONSTR'UCTIoN ~p ~'~. (Maflmg address o pp State whether applicant is owner, lessee~rchitect, engineer, general contractor, electrician, plumber or builder. maine on the tax roll officer. deed) ......................... Builder's License No. Plumber's L~cense No ,' ..... .......... Electric/an s License No ",' ...... Other Trade s License No ....... house Number Street Hamlet ...... .... ........... ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premis~e~s~./and in,cna.ed us~e and q.ccugancy of proposed construction: a. Existing use and occupancy ...... ld.~.. 5 .... ~-~'_~.(.: ;L.-'..~/X~.../ .................................. b. Intended use and occupancy ..... ~..4.-'~'1~:~~ ...... ~.~.~..~...~.. ~7..~':~.~. ................... 3. Nature of work (check which applicable): Repair .............. RemOval ... 4. LstamatedCost . [...~.. New Building .... i '. .... Addition .......... Alter~J~ion/ . .:~ ...... ......... Demolition .............. Other Work6(.~.q/...o~..P~.~.~. (Description) (to be paid on Filing this application) 5. If dwelling, number of dwelling iunits ......... Number of dwelling units on each floor ................ If garage, number of cars ................. 6. If business, commercial or mixed occupancy, specif',~-n~ure and extent of ea~l~ tv.~e of use ......... ,~,~, .~. ....... Dimensions of existing structur6s, if any: Front...'.~._ .(-~. ....... Rear ...9. ~ ...... Depth...~'. ~ ....... 7. Height ............... 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 ............ ;.. Rea~ ............. Depth ............... 10. r)ate of Purchase ........... /.d ............... Name of Former Owner ............................. 11. Zone or use dastnct an whmh premases are s~tuated ......................................... 12. r)oes proposed construction violate an zonin law ordinance or remalation' 13. Will lot be regraded . ~.v. ~ ._ ......... /~ .~. · .,/.. Will excess fill be removed from premises: ~s . ~ No 14. Name of Owner of premises :~.(,.. ~. Address .......... Phone No. ,,~..~ .c~{.-.~.... Name of Contractor i ~,; ...... Address . Phone No..., ._,~ ....... PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block ~tumber or description according to deed, and show street names and indicate whether interior or corner lot. DA T~: NO 765-~02 9 At FOLLO~A/I NG ~. FOIJNrhA-i-i~ FOR P©UR[D 2. ROUGH_ 3. INSULATION 4. FINAL _ ALL CONsTR T/-JE STATE COD STATE OF NEW Y~K//,~ ~ ?S ................... . ........... ,i .................... being duly sworn, deposes and says that he is the applicant (Name of individual signlng contract) above named. ' ; ........ .............................. Heisthe ...................... ,: ....., ~ v ate officer,'e c.) of said owner or owners, ~d is dul,. authorized to perform or have perfo~ed ~e said work ~d to m~e ~d file this application; that all statements conta [ned ~ this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~ner set fo~h in the application filed therewith. Sworn to before me this No~a~ Public, ~ato of New go~ No. 52.0344963 iSuffok Count~ Oommisslon Expire~ March 30,