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Home My WebLink About10575-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-19927 Date MAY 23, 1991 THIS CERTIFIES that the building NEW DWELLING Location of Property 2435 PRIVATE RD. #8 (EDWARDS LANE) ORIENT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 18 Block 2 Lot 6.7 Subdivlsion Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 29, 1990 pursuant to which Buildlng Permit No. 10575-Z dated MARCH 4, 1980 was issued, and conforms to all of the requirements of the applicable provislons of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH ATTACHED GARAGE & WOOD DECK The certificate is issued to JOHN PUNG (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 10-S0-17- JULY 7, 1980 UNDERWRITERS CERTIFICATE NO. N-486623 - JULY 22, 1980 PLUMBERS CERTIFICATION DATED N/A "",, "" "'"'''' 00 ,-"", no", '/"/""~ ~~ ~l . Building Inspector Rev. 1/81 . ,",;oj, ,Ji H , .~ L ~ " , z, oo.~ , FORM NO. 2 TOWN OF SOU'fHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE pREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) JIi / ii/ / (h( N<J 10575 Z Dote .............,..,................Ntj.'R?,.."V., 19.fl.(). Permission is hereby granted to: l'.C.Bi. .1f.T...... ::.,( ~ /' N. $. Ji..f:\{ ...."...."...., .." ....~C,....~UU:f.....p..I1,N..tr.::......7'"...()W N~ 1<: .....H.3.~....$.tIIMtI..II.I.f.It!...tul.l:~.,...s.lJv,7.),jn L b N .y I ' totJl/J,I,..IL..A..lY1I:.....F./U'II.IJ.Y... !JW!t.U.WtJ,.... S.ue;.J.t.c.:r.....T.ll....A1?Nr:oV.I.j.L......(J.(;....", ,.. . 1M. (.I~.~.. ....(I:. fl/). A..~~!. ~f.'W)..~.f.9.r..J,';..... J.~.E....... USE... ..D1f:... ac .U:f?o'l....,C.y.. ,OF., .../:)W Il./J...\ }'16-;. at premises located at ......~.~.t3.5.......~J~~(.......12bJ.\,J)~...€?..::':':,..k.D.W.~.!':\D,S.... /..A />JIC' ......."................... ............. ..........,......,...,............. P. r. .f.. 1;. ,~J..................,...........,....,......,...... ........", .~.~..7.....~....~..~.~~.'.~.'f.......?,C!.!?..~f.V.f.~(,U,Io/.t~!.~.t!..':!.([.H:t"$...................... .... ... '.. ' . ,... .. .. pursuant to application dated ...........................F t..T:!>. "....3r!'], 1 BO.., and approved by the Building Inspector. lto 1. JJ.. Fee $............ ....,...... ~ In;r,;- -; f-\ J?1 e< f hU1"/t., . .....~..:2:.~~~...... foo(J - (<;- 3-T4.+i~' Y Building Inspector , " ! s,j, ~.~ FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No, , , . Z.1.0038 , , . . . ' Date. . . ' , , , , ..hJ.;', ,'18, , , , . . ' . , , , , , , ,.19, ao THIS CERTIFIES that the building . ' , ' , , . , , . , . , . , . . , , , , , , , , . , . ' , . , , , . . . ' . , , , . . . , ' . Location of Property ,," ,2435. . 2t'i:V,8.t~. hoed. #.8. ,:", y.;dw?;-'.c~,: ,Lnv;. ' . , .Jrt~nt. ,fl. Y. House No. Street Hamlet County Tax Map No. 1000 Section .' CJ.1.8 , , , . . .Block ",:.,...",., .Lot . , . . J ~ ,. ~ . . . . . . . ' , Minor Subdivision. , . . , .Beorb.ar.a. Hughes, . . . , ' , , ,IQIOO Map No. .1:'1.1. . , ,Lot No. /........... . conforms substantially to the Application for Building Permit heretofore filed in this office dated , , .F.ebraary, 2,9 ' . , , . . 198Q. pursuant to which Building Permit No. ." .1.G'';; :~. . . . . . . ' . , . . dated ..,.-VI: rch .4, , . , . , , , , , , . . , . . 192.0, . 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 ,. . . . . . . ' ..".',."""", ,Priv",t.e. .0Ilt, Eami~y. ,DwElling,.".".",.,.".".",....., The certificate is issued to ,..,...", J,QOO, Pung. . , , , . . , . . . . , . . , . . ' , . ' , . . . . ' . . . . . ' . . . . (owner~) of the aforesaid building. Suffolk County Department of Health Approval, , , .1P.-:~Q':"~7. , . ,JuJ.y. 7". .1960. . . . . . . . ,. ' UNDERWRITERS CERTIFICATE NO, . . , . , , , , . . . p.snding. . . , , . , . . ' , . , , . . . , . . . ' . . . . , , , . A /--' :) ~>> ",..".' ,~M?<' ./!,-(~",~~".",. Building Inspector Rev 4n9 FORM NO.6 TOWN OF SOUTHOLD Building Department Town Half Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; far 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 campleted site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey af peoperty showing all property lines, streets. buildings and unusual natural or topograph ic featu res. 2. Sworn statement of owner or previous awner as to use, accupancy and condition of buildings. 3. Date of any hausing code or safety inspectian of buildings ar premises, or ather pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of accu pancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 :;;'1 Date.... .c,.oo"f... ././f.. ./. 'l.f~ New Building. . . .~. . . Old ar Pre-existing Building ............ Vacant Land ............. Location of Property . :J.l1, .~ 5'. . . . . .f~.I.iJ. 9.'k. . .R. J. . . ~ ff. . . .5.<1 ~1.~e!.~ .l~ . Q;e.l.€: {1 T House No. Street Hamlet Owner or Owners of Property ... .L. h.t:\.... .P.U.I:\.~.. .. . ... . . .... .. .. .... ... . .. . ... ., .. . County Tax Map No. 1000 Section ... /? .1.8. . . . .. Black.... 3.. . . . . . . .. Lat... 6. . . . .. . . . . . Subdivision. . . . . . . . . . . . . ' . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . . . .Lot No. ...,........ . Permit No. .......... Date of Permit......... .Applicant . ./K.q~~.~T.. ..J;.h...":'.'\o.<?':'\...... Health Dept. Approval . . . .y.e: 5. . . . . . . . . . . . . . . . Labor Dept. Approval ... -:-:-:-:-. . . . . . . . . . . . . . . . . Underwriters Approval. . . y.e.5i. . . . . . . . . . . . . . . . .Planning Board Approval ~... . . . . . . . . . . . . . . . Request for Temporary Certificate. . . . . . . . . . . . . . . . . . . . .Final Certificate. .Yf'.3. . . . . . . . . . . . . . . . Fee Submitted $. . . . .J).'..~. ., . .... .. . .. . Construction on above described bu ilding and p mi Applicant. . . Rev. 10-10-78 (l.a "Z1tJ-d3tY u1<ff/tYc::> #--dJ.iJ 4~.#17-S1,::) i j .1.d: .<oJ:.:!! _~ l___k' ! L_ -,,,~ .y"".,..".".""~ Form No. 6 r[~@l~rUW]r~:r:\t! I ~r~-2";;-il~1 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL ! Ol___J J 765-1802 BI.DG, DBP.. ,__Ip\l'1'LQ~_~().l!ItiSlI2~".<, APPLICATION FOR CERTIFICATE OF OCCUPANCY .\. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn ststement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5, Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from archicect or engineer rE'sponsible fOl the building. 6. Submit Planning Board Approval of completed site plan requirements. 3. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant, If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. h Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 MAY 23, 1991 Date........................................ . lew Construction",.,...... Old Or Pre-existing Building...,.,.,.......,. . 2435 PRIVATE ROAD fl8 (EDWARDS LANE) ORIENT, N.Y. ,ocatlon of Property..............,............,..,........,.......,....,....,...,..,....,.., House No. Street Hamlet JOHN PUNG Jnwer or Owners of Property..,.....,......,..............",........,......................., 18 2 6.7 :ounty Tax Map No 1000, Section............. .Block............... .Lot.......,.............. ubdivision.,.,..................,.........,.. .Filed Map..,..,..... .Lot..............,....... 10575Z 2/29/80 JOHN PUNG ermit No............... .Date Of Permit..,.........,.. .Applicant............................. ealth Dept. ApprovaL..,.,..,.....,........... Underwriters ApprovaL.,.,..."....,...,...... 1anning Board Approval......................,. equest for: Temporary Certificate....,."... Final Certicate,...,...,.. oe Submitted: $.....~?:??.,?:?~:~?,~~:,.":.......~~.~~1:~"."......,.'...., G...~, Iff 751 VvLR~. ~()7:...}99J. 7 . ,AfPLICANT ; ""'~ "".\: ,.it , . THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY I' 85 JOHN STREET. NEW YORK. NEW VPRK 10038 Date July 2.2, 1980 Application No. onflle 081917 N 4!'H:.' <"\'~ rr) THIS CERTIFIES THAT " only the electrical equipment as described below and intTf.duced by th:r.~ant 7(m~'Mbove ~~on 8fufllber in the premises of Dr.. John Pong, end of Duaws 18;;1<0, . no.. . .. . in the following location; ~ Basement [$ ht n. o 2nd Fl. Section Block Lot 2. w", exomined on Ju.ly 17. 1980 andJound to be in camp'fiance with the requirements of this Board. FIXTURE FIXTURES RANGES COORING DECKS aVENS DISHWASHERS EXHAUST FANS OUTLETS ECE?T ACLES SWitCHES INCANDESCENT FLUORESCENT MERCURY AMT KW AMT KW AMT KW AMT KW AMT H P VAPOR 37 L() 1;2- 1 6.. 1 &.6 1 l' 4' .~ "- DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIMe C~OCKS BELL UNIT HEATERS MULTI-OUTlET DIMMERS kT tRANS < SYSTEMS - AMT KW OIL H P GAS H P AMT NO AWG AMT AMP, AMPS AMT H P NO OF FEET AMT WATTS 1 30 :.J t.OU SERVICE DISCONNECT NO.OF S E R V I C E METER NO OF CC COND A W C' AWG AWG AMT AMP TYPE EQUIP, 1,H2W Ijf3W 3Jf'3W 3ft4W PERir OF cc ceND NO OF HI-LEG OF HI-LEG NO Of NEUTRALS OF NEUTRAL OTHER APPARATUS' l'anelbof\1.'d/;;: 1..32cix. 200amp. lot>tor Is, 1.,P 3-G.c'.C.I. 2-Snoks Detectpr :t-4.5RW'lbt Water l'bat:ar 1-14.4RW,1-9.6m ~~t Puup ~ ~ ~"-- n ih;z~# riffV' 7, ' Joseph D. M8zv.oro. ~, ) 227 Waverly ;!we. . GENER IMA~L ~1edford, N.Y, 11763 L1c.4~2, 11 (',i-~ , Per This certificate must not be altered 1r1 any rpannef, return to the office of th~ Board if 'rCP~Iect. Inspecto(s may be identified bY'~_Jr C:!J!~:hfntJJ: ! COP~ !OR B~ILDING DfPA'Mf~T.. THI,S,~~~I Olj~i!'!'~i!'~'!1'SI:ti.~~~! alt~r~'i~~ IN ANY MANNER, FIELD INSPECTION . DATE COMMEN1<-3 j:. ...: ~""" 1. - ~...~ ..-J.--v1...4P1~, -~. JOUNDA'!~IOl'J _ -11.st) , - N ~..- b~ FOUNDATION (2nd) tJ) e CD 111 2. I~ ... II ROUGH FRAME & ~ . PLUMBING ~ tL1 3. - INSULATION PER N.Y. STATE ENERGY COJ;?E 4. - - FINAL , ~ &-\ t;:t ro < .ADDITIONAL COM1'llENTS: 'i ~ '(, / ~A.t/~ ~4~ t ...J) ~~ /-'............ - 'i*. P>", IT ~. '\'J .::> " f- , ::r: ""- CD C\ P> f--' , IT . :Y ~ :i I U " IT I . '-I 1 '-4 '.1 "L <, if \:,[, , L ~ 1",; ~:":::'::C'::'_':~:''- .'~=-:,:~::~~:":'::..:.~~:,:,.co"~""'-'-V-""",--,n_~~""...:...o..:""","~"~~,,~,..:~,:~::~~;;:,,,,,,~,i\i",'w~-",",<>~~.;~mk"~'t~~;"~""h;;';'~_~~=~~"~kL';;^,"\,, _'.' ~~ . . INSPECTION REPORT "10: Henry E. Raynor, Jr., Chairman .. No. 102 Southold 'Ibwn Planning Board DA TE: December 6, 1979 FROM: John \f. Davis . . . . Re: Hale and Hughes (l.liner subdivision at Orient) COMM~TS: A~ requested by Mr. T. Latham, contractor .for the owners, I made an ins~ction 'With him of' the completed road 'Work on the abave subdivision as f'olIO'Ii's: '. 1. Access to this project is made through a So ft. 'Width private R.O.W. on a one 'Way grave~ road 1.300 f"t. f"rom the State highway. ~is road is passable at present tJ.me. 2. Lilco and N. Y. Telephone Co. have instal1~d th:-ir trunk lines in the lef~ ...' . d shoulder o.f the raad.' s~ e 3. RoadwaY 'Width 24 f"t.,'soma sections at 28-30 ft. . 4. 'IbP 6" of road material is nd.xture of bankrun and sandy J,oam. Approximate1y 3000 C.Y. of other material brough~ in .from outside. . 5. According to contractor, .fill sections 'Were layered arrl compacted 'With constrl1C- tion equipment. ~e roadway appears stable, is being used by owners. . 6. ~e profile is satisf'actory, grades not over 5%:!:' . A lo'W point 'Was established at the pond opposite Lot No.3. Road grades are nd.nus from the South and North to this low point. . . . 7. 48 ft. of 18" C.N.P. is installed under the road at the low point" to'.permit drainage from the 'Wes,t side of the road to go to the pond area. - , 8. Some of large boulders .:from grading .operations have been left on the sides. According to c,ontractor no objections .:from owners. 9. '!his .type of road 'Will. require maintenance as most of the length is higher than existing ground. .. 10. No type of surface course for additional stabilization of the road is planned by the owners at this time. - Iofi:'. and loirs. Hale 'Were on the site, said they are satisfied 'With the road. 'Jhis type of' road constrnction 'With maintenance should be satisfactory for the subdivision and I recommend approval of the 'Work. d.,L d/:.dJ~ I . ." ~i.. .,1. ','U.l " t 'c .&< iif ~"". _ W~ ,,'.'~,"'. k .<-,,'f_ - , , ~ , , ~_~ __",>~.~_,""._,." _'_". ".' ',,-._, ~ _ ""._~-..^'"'o,_",."-""':..,,_.... Lk"'-:""'-11A~_;;i:,k~1M~~';~-"'~~~~f;~~~~'~~~'~"'~Y~";:-"",,,,~,,,,:;,\,..L;.~~~~~_ Southold, N. Y, 11971 HENRY E, RAYNOR. Jr.. Chairman TELEPHONE FREDERICK E, GORDON 765. 1938 JAMES WALL f BENNETT ORLOWSKI. Jr. December 18, 1979 c' GEORGE RITCHIE LATHAM. Jr. MrS. Barbara Hughes Solsville Road Madison, New York 13402 Dear Mrs. Hughes: The following action was taken by the Southold Town Planning Board at a regula~ meeting held December 17, 1979. RESOLVED to accept the report of JOhn W. Davis, Planning Board Inspector, for the right-of-way construction within the minor subdivisions of Hale and Hughes. number 102. Yours truly, HENRY E. RAYNOR, JR., CHAIRMAN SOUTHOLD TOWN PLANNING BOARD By Muriel Tolman, Secretary Copy to Mrs. Hale 'Building Inspector '..,,'-.. i '. i .;;. '._of ;bdL. .':.., ,-,;".~"i;~b ,i.;' .ctl.tk. ",' 'ii, 1 :',,, h-, , I FORM NO.1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL - SOUTHOLD, N.Y. 11971 ( 0 S'1 j TEL.: 765.180~ Examinedft9!if1J:. ~.., 19 fo lO 51 ~ Application No~7~ . . . . . . /.J/(.(' t./ (: ,.', ' Approved H.. .'.:N... . ., 19 .~~ernutNo./~~... - Disapproved a/c . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . , . . . . ... ....................... .....: ~~".~i'~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date. .Ee-.& . .;).. 1- . . . . ., 198.'9 INSTRUCTIONS a. This application must be completely filled in by typewriter or ill 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 applicatlOn may not be commenced before issuance of BUilding Permit. d. Upon approval of this application, the Building Inspector will issue a Building Pennit to the applicant. Such pennit 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 Pennit pursuant to the Building Zone Ordinanee of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the constructiOIl of buildings, additions or alterations, or for removal or demonion, as herein described. The applicant agrees to comply with all applicable laws, ordinances, buildin 0 , housing co e, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspe io (Sig ature of applica , or name, if a corporation) . 'f :3. .t?t?. .$Po4fJ.o!v,i'rw. AIr~. .'J~Th.<!4I. .. . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . /3v.i.ldefl.. . . , . . , . . . . , . . . . . . . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . Name of owner of premises .. ::r.;; hn . .P4.118 . . . . . , . . . . . . . . . . . . . . . , . : . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authonzed officer. . . . . . . . . . . . . . . . . ...................... .., .... (Name and title of corporate officer) Builder's License No. ". ),:;.,~. . . . . , . . . . . . . . . Plumber's License No. ...!(!. !i!p)dt'.":j.r;J:t. . Electrician's License No. .. .:rP.~. .Mq;z.'1-F':J:1/ , . Other Trade's License No. ...................,. I. Location of/and on which proposed work will be done. . ..D...........,............................... "if -;:/.?~... ./i:.t /?o.-::tp~~ .'#.~t.t-:~RJ: ,......".. .OIU f:.I1.r.. . . . . . ., . , . . . .. . . " House Number c~ "135 f'~ 7a"d.S~t8-": ~t\Aet... ~ I( Hamlet I County Tax Map No. 1000 Section. .Q /8.. . ., " . . ,. Block. .3. .. . . . . . .. . .,. Lot... b., ,.... . . . " .. Subdivision . B,,~.b.<!~.o., . . HY~b~:<;. . . . . ~\.~.~~!~. .Sv~iled Map No, ,............. Lot...,........... ( ame) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy. . . . . . . V4CI0.J.! (. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy ..... /P.E: S !bI.~ n?o~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 'J ^ ~ ;,,' L 3. Nature of work (eheck which applicable): New Building . .~. . Addition.. . . . . . . .. Alteration .......... Repair .............. Removal . . . . . . . . . . . . .. Demolition .............. Other Work. . . . . . . . . . . . . . . :, #': n (Description) 4. Estimated Cost. . . . . . . . '/Od.\.Gl60. . . . . . . . . . . . . . . . . . . . . Fee. . /,( if :f'1: . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on f1ling this application) 5. If dwelling, number of dwelling ~nits . . . ./. . . . . . . . ., Number of dwelling units on eaeh floor. . . . . . . . . . . . . . . . . ':L- It garage, number of cars ....., ................................................................. 6. If business, commercial or mixe4 occupancy, specify natUlwahd extent of each type of use. . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structure~, if any: Front. . . . . . . . . . . . . . . Rear .............. Depth. . . . . . . . . . . . . . . Height ............... Number of Stories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front ................. Rear.................. Depth. . . . . . . . . . . . . . . . . . . . : . Height. . . . . . . . . . . . . . . . . . . . . . Number of Stories. . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new constrl}ction: Front. . . .'1:5:. . . . .' .. Rear... 95". . . . . . . . . Depth .. . (I.<? . . . . . . . . Height '" I.'l. . . . . . . . Number of Stories. . . . ./. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size oflot: Front.. . . . oo P!i.q. . oo . oo oo' Rear...... J.I roo oo . . . . .oo Depth ....$?/.oo.oo.oooo... 10. Date of Purchase '" J. ...., . . 81i(. . . . . . . . . . . . . . . . . Name of Fonner Owner ... /lv:J). es. . . . . . . . . . . . . . . . . Ii. Zone or use district in which premises are situated. . . . /?'" '5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 2. Does proposed construction viola~e any zoning law, ordinance or regulation: .. A/9. . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded ..... Nil. . . i? . . . . . . . . . . . . . . . Will excess fill be removed fram premises: Yes @ 14. Name of Owner of premises .T.!.. v.~.9......... Address .Ow, .ld!fj~lj,,,,J(Y,, Phone No. .1.9'7:'.7.5".9..'2.-... Name of Architect .S:,c..c..o..J,.. /...Le-1C.5........ Address.. .S"'e;,r.he>L.I...... Phone No. ............... Name of Contractor . beR:1:. .q:o.b.l'I.s.I'.'1-..... . Address . .so"rJ..oJ.tI....... . Phone No. 7(5.-/.1.~S:.... PLOT DIAGRAM Locate clearly and distinctly all Duildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and shaw street names and indicate whether interior or corner lot. R,tj(' ~ Wily ql.f ' f~~J \ \ " JIB . \' ~ % iJS ~ - f['9/ ,\ " STATEOFNE~jj:;~s.si .': COUNTY . . ..' . . 1 ' . . . . . . . .~~f AT. " CI h 11 S.t:' 1111. . . . . . . . . . . . . . . .. being duly sworn, deposes and says that he is the applicant (Name of individual signing dontract) above named. He is the. . . . . . C (!>; ~T~T<A.R.. 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VAN TCJ`/L , PC. - z o04MfANO$ Acrt ern tlC u'� al<rr.�. /8, t960 Licensed Land SUrveyor5 { • •• i=s"6, z8, /96a Greers"tort -- New York Q• MAP O!- P.20PL=27-'' Oi3 Jfi 7 did { 6 30 surwF��e'n Foe JOH.,N/ PUNLa A7 Orzr�rJ�r' Tow'N of So TiaoLa, ra.', 94,690 sq.fi- r �� i rorr l'ihe { svrxoLx ootrxx^ -n'r crri Inr: - _ _ o = rrrorrunlent �ax;3 f1'1L01 - : Su�o(!c Counfcf Tax Ma�� Desi9nrltiorr: _ DIS(: lOOQ,Seth O(B,BLtr.3,p/o P_(. 6. � Chec, �ti rt ,S,-; , uir r dSe"_ou i 5.38"C�9'E S 37"�:3 _rI, C COLD W 1 �9 I-7$.O l4Qp0'C' o U,, _ Q - ( �y9, �' : rj 00 6.l r 6 2. 1(1 L > r I $ � � Americaer Tithe lnour tica Compamf -t z 1 �'a as survefed Der. (S,f9"7eJ. ty 1 tV. 39°IF:'W. -- 671 = 00r*FI2Ic/< VAN 7LrYL , PC C. t� aCJA:'vP(A NOS Licerrse:J Lnnd Sarver orb Alrrcndcr! Ju,re 6, 19,90 Oreeyr ;cr+ -- New Ybrk