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Home My WebLink About10700-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z.I.O. 6. ~.0. ......... Date .... THIS CERTIFIES that the, building ' . ............... Location of Property .9. q..0.7.a.r.p.o.n...Dr~.v.e. ........... ~9.u.t;.h.o. 1..flJ..~9¥..I. qr..k ........... House No. Street Hamlet County Tax Map No. 1000 Section . .5.7 ........ Block ..... .1 ......... ~ot..1.q ............. Subdivision Sout. bo&d. ~so~.®8 ...... { ....... Fried Map No. 3~53. ~ · .Lot No.. 35. ......... conforms substantially to the Application for Building Permit heretofore fried in this office dated ........ ~la~..l~t ...... , 1 S8.0.. pursuant to which Building Permit No .... ~!0.7.Q0 ~: ........... dated .... J. une. 3 ................. 19 8lit, 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 ......... ......... G. ar. ag~..and. ~t;ora~e. Ac.cess~.r.¥. $.t~.u¢ ~;u.~.e ......................... The certificate is issued to ..... ttaae¥. ~.,. i~e~Lamann .&. Chaelo.t, tle. H....~elal~aol~ ..... r°wnarxgt~i~t.~x of~he aforesaid building. Suffolk County Department of Health Approval .... lt,t~t ................................... UNDERWRITERS CERTIFICATE NO ....... ~./.R .................................... ~ . . Rev. 1/81 Building Inspector FOP~ NO. ~ TOWN OF SOUTHOLD BUILDIHG DEPARTMENT TOWN CLERK'S OFFICE SOUTH*OLD, N, Y, N°. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLI:TION OF THE WORK AUTHORIZED) ~0700 Z Dar e . ....(.~'..(.~'./~.~..d ..... ~....~.~. ~..o...~.. ~.. ............. ..... ~.r~..~..~.~..~,. z ~.: ~: .. ........... ,... ........... ~'.:..z. .......... ,. .............. ~ ............................. .~ .........~ .... .?c..x.,r:~,~'.C~. ~..,'i~ ............................................................................. ~ ................................. / · ~- ~?~ - do. ~r~ ~ c,~'-~ oz o ~.&. ~ ~ ................................ ,.~. ........ ~.i ............. pursuant to application dated ....... ..~.....~....~.. .................. 19. and approved by the Building Inspector. Fee $.~...~,..~. ..... FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE SOUTH'OLD, N•. X. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N0 8262 Z Date ...........................Q c. ....�� ., 19 7.,�� P Permission is hereby granted to: ...��......4.. .......�......... v EA. .. .��. . ................................................................................ ................................................................................ to ...A. ?.......... .1Li 0........E . 15.!.J.JI-k6,7:........A.0 C...L.S.—Lo �. I. .......L�..U..............! .. .. ................................................................................................................................................................ at premises located at ............... ........... `7-A {R 1-1...........��.—I.N-/.�=..................................................... .............................`................................./... /�+.nT,..�.}��:..h'.:��'�^?�{..1.�....1.�................................................... I ..1.�^.. �UV ... V J 3('iof�.!....................... .. ............ pursuant. to application .dated ............................... C. ....l�.`.1.... , and approved by the Building Inspector. Fee �.u. ....... .............. Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTIHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 0 4343 Z Daae ............................. =0.....16......., 19...69 Permission is hereby granted to: , .............. .. a°€ ................................ d .......... . ............................................ 0 1 D O ..................8-0.t nftvid.......................................... to ............bxulld...aa.a00'II` t'a'n... ll..1?. -4". _.i ..:' t!y� ............................................................. �. ,.. ................................................................................................................................................................ atpremises located at ................Lot... . .... . .......................... :.......................sQ.. ......... N're,-1`x P 0T .......................... ................................................................................................................................................................ pursuant to application dated ................................ ........, 19..69., and approved by the Building Inspector. Fee $..5.cQ0........... 1-7 Building 6Inspector FOR~ NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Th~s 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. Fma~ survey of property with accurate ~ocation of a~ buildings, property ~ines, streets, and unusua~ 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 buddings, Industrial buddings, Multiple Residences and similar buildings and installa- tions, a cer[ihcate 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 buddings (pr~or to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, building~ 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. Certlhcate of occupancy on pre-ex~sting dwelling or land use 3. Copy of cert~hcate of occupancy $1.00 $5.00 New Budding .~ Old or Pre-existing Building . ...~. ....... Vacant Land ............. Looat,onofPr~i;t~ ~..'.~.~ ....... .~.././~.~"~{~~'V~,~'. Ho~se No. -- Street ' f I / Hamlet Own er or Owners of Pro perty ~ ~. ~ .~ .2~ ~" ~ ~.~.. ~ County Tax Map No. 1000 Section ............... Block ............... Lot ................ N o./~). ~'~).0 .~, 2:.. Permit Date of Permit ~/~/.~"~.. .... Health Dept. A~proval ........................ Labor Dept. Approval .................. .~..~ Unde~riters Approval ........................ Planning Board Approval ................ Request for Temporary Certlhcate' ..................... F[nal Certificate ' ..~ ....... ~.~.,~. 4 ~ ' ~./~ Fee Subm,tted $ .~ ......................... ~ Construction on above described building a~p~lt meets~l a~ica~e codes and regulations. ................ — FIELD T,NSPECTION DATE CON 'NfiS ,d y FOUNDATION (1st) • 1 � FOUNDATION (2nd) (D 2, ROUGH FRAME & PLUMBING c�- h c� CD INSULATION PER N.Y. STATE ENERGY CODE ,,r x • cn FINAL V ADDITIONAL COMMENTS: Al � kA 0 ' x C+- d FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ExaminedUM�i . '� . . . . ., 19 . (g, Application No. .,�Q.� . . . . . . . Approved J15WC . . . . . ., 19 OPermit No. Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . . . . . . . . . . ., 19 4 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, 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 necessa inspections. �. (Signatur of applicant, or name, if a corporation) IJ -Lq,&-71164-6 'ZI/f." (Mailing address of applicant) State whether ,applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (/ Name of owner of premises .Gh�r�q,�e. . . .Gt!��. . .��:�l.� . . . �l;S,/;�?,�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) j l I j G ` Builder's License No. :-3.ff. . . . .H :l. . .) Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. :� .3. 3 7 — E Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land'on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � o. . . . . . . . . . . . . . . . . . . . . . . .7�+ � �. . .��,. . . . . . . . . . .5 d u. �. . . .. . .i rl. . . .�.!9.7.1. . . . Hous u er , Street ' Hamlet ,/ / �� / County Tax Map No. 1000 Section . . . . . �. . . . . . . . Block . . . .( . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . Subdivision . . 3 S D V`? S Filed Map No. �. r . . . . Lot . . .�?. . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy S/�r g Lec� L� i�° ��. ./. .a . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy 3. Nature of work (check which applicable): New Building, Addition . . . Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . (Description) l 4. Estimated Cost . . . . . a00. . . 00. . . . . . . . . . . . . . . . . . . . . . . . . . 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 . . . . 77 We. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number ofStories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . ... . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . Rear . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height .��8' Number of Stories . . . . . . .oar .. . . . . . . . . . . . . . . 9. Size of lot: Front . . . . l. . . . . . . . . . . . . . Rear . . . . �.`f.°. . . . . . . . . . . . . . Depth . . . .. . . .. . . . . . . . . . . . 10. Date of Purchase . . . . . . . . l.q 7.3. . . . . . . . . . . . . . . Name of Former Owner . . . (r eo., , , .�7u�. . . . s . 11._ Zone or use district in which premises are situated . . . . . .y. A�_. . . R.es : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . ff1 . . . . . . . . . . . . . . . . 13:'-Will loot be regraded ak.�X . .Q . .�?Q u se �ou ti d0. r°"Will excess fill be removed from premises: Yes 1-4. Name of Owner of premises`? g(/:Heti yC: �'ei �a�hAddress . . . .. ` . . . . . . . Phone No. Name of Architect . . . . . . . . Address 3 h�" �� .St�"�! �Y��K. Phone No. . . . . . . . . . . . . . . . _ Name of Contractor . k�h. . .f� �.�.5.�`�p.hS�ti. . . . Address . .�.�. /Rt v.e� . . Phone No.. . . . . . . . . . . . . . . eALvepty m PLOT DIAGRAM 5 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 NEWWYOR ,, /. COUNTY OF4. . . ..-- S.S :Z7"' '. .'' ... . .`. . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. v Heis 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 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 �:�1 �: . . .day of. . . . . . . ! ? !''' 19rf�. �. . ., Notary,Public, . . . . r' - . . . . .. County FLIWETN ANN NEVILLE1B (Signature of applicant) NOTARY PUBLIC,State of Npw York A� No 52-8125850,Suffolk°C"o�unty �! Term Expires March 30, 19— FORM NO. 1 ` � � �GGr�tiy�`�'? LGG»o,�1-vr�� /gam`�`'✓ !�/1�� h TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE d7 /d SOUTHOLD, N. Y. // � 11 x-1 1 Examined ...... ..`.............................. 19........ Application No. ..... ...................... Approved ......... 19........ Permit No. 3 � Disapproved a/c .............................. ....................................'....:................... ? 9t- ........................................................... . ........... ............... ..... :............... ... .. ....... ...:.............. D.�-� . z c. �r .(Building�lnspec �r)� ,�-:--- �ow�-rte s APPLICATION FOR BUILDING PERMIT Date ..... ................. ..........................., 19.. .. INSTRUCTIONS o. a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. 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 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 progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy P 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, ordinanc s, building code, housing code, and regulations. ... .... . ........................................... . ...... ... . .. .. .. (Sig ture of app ' ant 0 name, if a corporation) ..................................................` ................. ... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber 'or builder. ....................... ............................................................................................................................................... Nameof owner of premises ...J4.-e-�. .....�Iir....... ....... . ... ..................................... If applicant is a corporate, signature of duly authorized officer. .............................................................................. (Name and title of corporate officer) 1. Location of land on which proposed work will be one. Map No. .A Lot No.: ... .. ..... treet an umber ............... ... ........ . i ....,. S d N .... .. . ... .. ............................ �/ , 9 � ��Municipa ity 2. State existing use and occupancy of premises and intended us and occupancy of proposed construction: a. Existing use and occupancy ....... r .. . ... .... .4............................................................... b. Intended use and occupancy ....X.X.J. .....� ...! . ..... . .......... .�...1 .Cn.. ....................... � 3. Nature of work (checkd�mck which applicable)- New Building ......---- - Addition .— ---/ ..�-. Alteration ..... ....... . .� � \ ,� Repair ----_. -'_--_— �em�|i��---.—_.-` Other \A�ork (Describe) ........................................ �+ - 4. Estimated Coot - ' . '�'4».��_-_',...— .' .�Fse -- - .------_------_----------------_—_.. (to be paid on filing this application) 5` If dwa |,ng, number of dwelling units --.-------mumbmr of dweUinQ.units on' each floor ' -4-'--------. Ifgarage, number ofcars ........................................................_-_----__�_,^-.---_-''-----.................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ Al �� nn �— �. Dimensions structures if Front —..v��.----_ -.,��m�r -_--'_-.. Depth --------- HeihMun�w� of 3tork� � --__---_--_-----' . _~~- --_.---'_--' --._— . �-'.-.^.--.-~..----'^---.'.---._-- �� A&�' Qinnansionoof ot nnvvh� o|tarotions ur additions: Front ---av=°=,----__-.- �oor -x!........................ Depth .......... ''- Hekght .........IF.................Number of Stories ....../...................... 8. Dimensions of entire new construction: Front' .................................... Rear ............................ Depth ........................ Number 3tur�o ------'.-'----.�--'------_________._________—.--. Height &� 9. Sizeof lot: Front ......... ....... Rear ................. Depth ..... .----- l0. Dote of Purchase .. - ��.re....................Name of Former Owner a..-C.......... � ' ~- ll� 'Zone or use district in ��icn pren��e�ona situated --.---------~-__-----'----------------------.. 12- ordinanceregulation? ---_------~— _ � 13. NomneofC�vnarofprenniseo . reas ' .��m�.---.- Phone No.�Q��'�"*��y� Name of Architect .--.--.--.-----------..Address ---------___--_--' Phone ��m. ----_--.— � � Womaof Contractor ....................................................Address ............................................ Phone No .................... PLOT DIAGRAM ' Locate clearly and distinctly all buildings, whethar, existing or proposed,,and indicate all set-bock dimensions from property lines. Give street and block number or description according to'demd, ond.ohmw street nonnos and indicate whether interior orcorner lot. . . � U � s Orr STATE OF NEV*-�Y t - eA- (Name roiin�dividua s-igni ica ion) above named. He is the v / L_- 7 . . ` . ' (Controctor, agent, corporate officer, etc.) � � � said of said owner or ownand /� du'� ou�oh��'to �om� or Mavework and to make and file this application; that all stoten�ontscontained 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 . � �� ...............&.. ~., .. _-- -- -� -'-'_----' ---------- Notary Public, '�~��3��-a4 IL. Cou :u;gnonmmm or��|�unt FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. �a Examined ................... / 19...� 5 � �� Application No. .. �:. ............ Approved ................... ... L�.., 19.L. Permit No. 6 a.Z...........` 42,C42,C... y Disapproved a/c ..........................J............. ............... r ............... I ...........r......................................................�....... ...................... ............................ .... ......... .. .. l ......... .. .......;.......... EBuiding Inspector) r • r APPLICATION FOR BUILDING PERMIT r r r r r . } Date 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, 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 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 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 alteratio s, or f removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinanc , buil in code, ho sing code, and regulations, and to admit authorized inspectors on premises and in buildings for n es ary i pections. 4name, .......... ........ . . ... ....... ..... ...�........... (Signature o applican , or if a corporation) 145 W. Main St. , Smithtown., N4Y.......Uq7......... .............................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................................Owne K...................................................•................................................................................................ Name of owner of premises .Henry .C. Weismann and i Charlotte H. Weismann ................................................ ....... ................................................. 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. .............................................. 1. Location of land on which proposed work will be done. Map No.: .Southold Shores Lot No. 26 Street and Number ....TA9?QA--DX VQ.........................................................:..........T iawn...of..S.outhmld........ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy ......vacant except for .utility shadk ................. ........................................ ............... ........... b. Intended use and occupancy ...Single family .dwelling and barn . 3. Nature of work (check which applicable): New Building• .....x.......... Addition .................. Alteration ............1. Repair .................. Removal .................. Demolitior.................... Other Work ................................................ ... f 5-- (Description) 4. Estimated Cost .$40.e.000.00...................................Fee .......�.U....v.v................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units .......One...............Number of dwelling units on each floor ............................ Ifgarage, number of cars ......two.............................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, of any: Front ......1.................... Rear ........2J,.................... Depth ....1.4............ Height .......1Q.I........... Number of Stories ........We.................................................................................................. Dimensions of same structure with alterations or additions: Front ............ ° 45 ° .4.................... Rear ........,...58............... Depth ........22.................... Height 19.°.... ........... Number of Stories Me............. 8. Dimensions of entire new construction: Front ........2a.°...................... Rear ....... ............... Depth .... ................ Height ....23 .6....... Number of Stories ....... ne„And..Ane.n alf......................................................................... 9. Size of lot: Front ...270.'....z...................................... Rear ..240.°....4......................... Depth ..�a,Q.....s................ 10. Date of Purchase .April..1.97.3...............................Name of Former Owner Geo3:ge..,T:Ur<je.nS ... ................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...........No........................................ 13. Will lot be regraded- .Prartia.11y...... Will excess fill be removed {, premises: ( ) Yes (x) No -•f 14m5 W. Main St. 14. Name of Owner of premises HeA4ZY.. ..... AddressSmi.tht.QW ...N.«Y.. Phone N0.265,-7575 Name of Architect N . �.an..F.,....Praul.Sen.................... AddressSmi'�i7.t:nran;�i548 Rte 1;1s:'Y'; OXPhone No.2.65:n9.150.... Name of Contractor Henry C. Weismann Address ................................ Phone No.2.6.5-.7.55..... 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, i COUNTY OF ..S.UF.FD.LK............fS.S ................. ..........lmmy..C.�_..WE.1s2aNx.......................... being duly sworn, deposes and says that he is the applicant (Name "of individual signing contract') above named. Owner He 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 file this application; that all statements contained in this application are true to the best of his knowledge and belief; and than the work will be performed in the manner set forth in the appli ati n filed therewith. Sworn to before me this :1 � .` .. day of ................. .......... 19 Notary P , .. Suff ....... County .. ... ................ . .... ... � .. ............ (Signature of applicant) JUDITH T BOKeN Nlofary Public S"”"of New York NO-52-0344963 Suffolk county °mmisss Expires March 30, I9 %_. Sc~ /~ i t L ~ SU~LDING DEPARTMENT AT 7~1~2 9 ~ TO 4 P~ FOR THE 1. FOU~AT[ON _ ~O REQUIRED FO~ peLl~=~ CONCR~E 2. RGU,?4 - F~AMING & PLUMBING 4. FIHJ~ - C~M~TRUCTION MUST ALL CONSTR~ CT~ON SHALL ~E REOUIRFM~b~S OP TH~ N.Y. 5TAT~ CONSTRUCTION & ENERG~ ~D~S. NOT RESPONSIBLE FOR ~IGN OR CONSTRU~ION -ZX~. T~ J,*t~T AT , k,oT