Loading...
HomeMy WebLinkAbout11210-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No: Z-29558 Date: 07/03/03 T~IS CERTIFIES that the building NEW DWELLING Location of Property: 530 SCHOONER DRIVE SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 71 Block 2 Lot 8 Subdivision Filed Map No. -- Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 26, 2001 pursuant to which Building Pe~it No. l1210-Z dated OR/NE 26, 1981 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 ONE FAMILY DWELLING. THIS CERTIFICATE OF OCCUPANCY REPLe~CES C0#Z-10957. The certificate is issued to GEORGE L KOCH TRUSTEE (OWNER) of the aforesaid building. SUFFOLK COUN~fDEPARTMENT OF }~F~J~T}IAPPROVAL 10-S0-81 ELEC£K£CA~ CERTIFICATE NO. N 555411 PLU~BERS CERTIFICATION DATED N/A 04/09/82 03/30/82 AutHorized S/~e Rev. 1/81 (THIS PERMIT MUST COMPLETION OF THE WORK AUTHORIZED! i, FORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..g l .~ 9,5.'~. ......... Date ........ g.p.P.i. J...h3 ............... 19[i ¢. THIS CERTIFIES that the, building ................................................ Location of PropertyHouse' ~ .3,0No. S¢ h o.~.ne ~'. D,P. lVestreet ................ g°u't'h°ikdl:l~/e~ County Tax Map No. 1000 Section .. 0./.1 ....... Block ... 02 .......... Lot .... ~3.0.F1 ......... o .Filed Map No. 4362., .Lot No. .1 ......... ... Subdivision .Itarb.op. · Li.~h ~7~..(.oec£..., 1 ,)... . . conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ~,~ a~,..2.~; .........., 19 .t3 3pursuant to which Building Permit No.. J .1.,, l 0.2; ............ dated ..... d u n.~,'..E6 ............... 19 .,5 .1, 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 ......... · ,a .pr :~.v.~:~ ce. xm¢:~'.muil~..ci*,.~9.[.Tk~kag..~o..p.s.e, asonal uae only. · l- The certificate is issued to ...... .. .... 4t~ (t i.t.il, g p.c. l ................................... (owner, l_e~ ~ena~t) of the aforesaid building. Suffolk County Department of Health Approval . t O.z-&O-- ~.I .,. · ~ / .9./.82 ,. JLa t~ t ,. Jt.. k'.t.11 a .,..P · E. UNDERWRITER S CERTIFICATE NO ........... i~I..555 .~.1. l ............................. Rev, 1/81 Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate to the Bui[ding Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic featu res. 2. Final approval of Health Dept. of water supply and .sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable· For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. ; Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date ....... New Building ........... Old or Pre-existing Building(Z) ........ ,~/Vacant Land ..... Location of Property .... _.~_,~..0. ...... -.-:-~. ~ .~ ?.~ .c.~. .... ~ ./..//.~..; .z.... House No. ~ -- ~ /¢~ St)~et Ham/et Owner or Ownera of Prope,ty County Tax Map No. lO00Section ...7.~ ........ Block ..~ ........... Lot. Subdivision .ff~.. ~.~ (~-~...1.)., .Filed Map No.. ~ ~.Lot No. /'. .......... ~erm[t~o../.t.~t ~. Oateof~er~it ..... pplica~t .... ~ .. Bequest for Tem~rar~ Certificat~ ..................... Final Cordficate .............. Feo Submitted $~'~ ...................... Construction on above described building Applicant Rev. 10-10-7a 1ooo343 THE NEW YORK BOARD OF F[R UNDERWRITERS BUREAU OF ELECTRI~ITY~' 85 JOHN STREET, NEW YORK NEW ~ORK lo038 THIS CE~IFIES THAT only the e~trlcal equipment ~ described below and tntroduc~ by the apphcant na~ed on the able oppl[catlon number ~n the prem~ses of in the /ollowing location; [] Basement ,~.s ex.,ni,,ed on March 25, 1982 [] lstFI. 16 . 21 DRYERS [] 2nd Fl. Section Block Lot at,d found to be in cornl~lia~ce with the r~quirements of this Board. RANGES KING DECKS OVENS DISH WASHERS EXHAUST FANS SYSTEMS NO. OF FEET OTHER APPARATUS: 2-GoF, I, 2-Fmmke Detectors 1-4.5 K.W. F~t Water Heater E R ,V I C NO OF CC, COND, pER Coodale Elec. Cone, ~I Box tSaMainl%d. Mattituck, N.Y, 11952 A W.G. ~ NO, OF Hr-LEG OF CC C~ND _ A.W O, NO. OF HEUTRAL$ OF HI-LEG A, WG OF NEUTRAL 1 2/0 ~ i ~ Per~ This certificate must not be a feted n any manner; return to the office~pectocsof th Board if nco~ ecl ins eclats mayma bebe identidentifled by their cre~enf{als. COPY~FO~ BUIJDING DEPARTMENT, THiS CO~Y: OF P D HENRY E. RAYNOR. Jr., Chairman ~2ED22;C~'~. ~. CC,'I. JC.~] JAMES WALL BENNETT ORLOWSKI, Jr. GEORGE RITCHIE LATHAM, Jr. William F. Mullen, Jr. Southold, N.Y. 11971 TELEPHONE 765-1938 April 22, 1982 George ,H. Fisher Senior Building Inspector Southold Town Hall S0utkold, New York 11971 Re: Harbor Lights, I Dear Mr. Fisher: With reference to the above captioned subdivision, I have enclosed a copy of the Superintendent of Highways recommen- dation for a release of bond for the road improvements on this property. Also enclosed is a copy of our Board's rec- omendation to the Town Board requesting same; the Town Board released such bond December 8, 1981. The road improvements have been completed within this sub- division. Very truly yours, HENRY E. RAYNOR, JR., CHAIRMAN SOUTHOLD TOWN PLANNING BOARD Enc. By Susan E. Long, Secretary RAYMOND C. DEAN Superintendent NOV S Tel. 765-3140 734-5211 November 4, 1981 SoutholdTownPlanningBoard Main Road Southold, New York 11971 Gentlemen: Re: Harbor Lights Section I Schooner Dr. ~ot #1 The paving at the turnaround has been completed by the Corazzini & Sons, Inc. and I recon~end to the Town Board that the bend be released. Ve ly ~ yours, RAYMOND C. DEAN Sup't of Highways HENRY E. RAYNOI~, Jr.. Chairman JAMES WALL BENNETT ORLOWSEI. GEORGE RITCHIE LATHAM. William F, Mullen, Jr. Southold, N.Y. 11971 ~LD TELEPHONE 765-1938 November 25, 1981 Southold Town Board Southold Town Hall Southold, New York Gentlemen: The following action was taken at a regular meeting of the Southold Town Planning Board, Monday, November 23, 1981: RESOLVED that Southold Town Planning Board recommend, to the Town Board, a release of the bond on the subdivision Harbor Lightst Sec- tion I. Please note the attached letter from the Superintendent of Highways. Yours very truly, HENRY E. RAYNOR, JR., CHAIRMAN SOUTHOLD TOWN PLANNING BOARD By Susan E. Long, Secrefi~-rF Attch. FOUNDATION (Jst) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY f t/ C,ODE FINAL ADDITIONAL COMMENTS: New York State Department o! Environ~en[~.t Conservation En¥~ronmental A~alysis Unit Bldg. 40 - SUNY Stony Brook, N, Y, 11794 516 751-7900 Peter A. A. Berle, Commi~sio~le; March 7, 1978 }~r, Ernest Tarmin 474 Ocean Ave. Lynbrook, N, Y. 11563 Re: TW 15276-0265 Construction of a one-famfly dwelling on lot 1, Map of Harbo' Lights, property Owners Associa i Schooner Drive, Southold Dear Sir: As a result of your inquiry concerning the above referemced parcel, this Department has conducted an on-site inspection. We have foued the parcel to be above elevation 10' aad behind bulkhead. Therefore, pursuant to part 660, Title 6, Official Compilation of Codes, Rules and Regulations of the State of New York, Section 660.1 (c) (1), no per, mit under Article 25 (Tidal Wetlands) of the Environmental Conservation Law is required. llome is to be at least 50' west of bulkhead. least 100' from Mean High Water. Cesspool must be at DJL:cg Yours truly, Daniel J. Larkin Local Tidal Wetland Permit Administrator · ' FORM STOP ALL WORK TOWN OF' $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. STOP ALL WORK ORDER TO REMEDY VIOLATION Date ....... ~.u...Z.~...~.Z ................................. , 19....fL1 William J. Jacobs TO .J./..q...G.¢.q z'~ ~...L.,...K.ec h ........................... (owner or authorized agent of owner) B..~..x.....1...9..9..B.......D..e..p.~.~...t~...L...a.~n..e..z.....C..u...t..c-h...~..g.`.u..e..~ ..N..ew York 11935 (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance Ch. 100 Other Applicable Laws, Ordinances'or Regulations .S...t..a...t..e.....B..u..i...1..d...i..n..~....C...o..d..e at premises hereinafter described in that .~ft~.~....En.d....czf....Eo.~zn~La.t.£oz~ ........; ............................ (state character of violation) has developed two large cracks and wall has settled approx. 1½". in violation of ...... .,Z..o.g.~..~...C...h..:...J..0..0-T ] 0g- 1 ~3 ...~S...~.~..e....~..'u.A..~.~qJ~....C...~..d..e...~?.~a~.~.~3.~-~.~.~' 1 ( 630 ) a, b (State section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned forthwith on or before the ....... .2...8.~.,h. ..................................................... day of .....g..u...1.7. ........................................ , The premises to which this ORDER TO REMEDY VIOLATION refers are situated at .~..5..3...~.~.S...c..h...~..~..~...e~.D...~..J;'?'..e.~...H.'a.?'..b.~.~.~.~.~.~;C~unty of Suffolk, New York. Southold, New York 1197~(Co. Tax Map #1000-71-2-8) Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by fine or imprisonment or both. STOP ALL WORK Building Inspector Curtis W. Horton LAWRENCE M. TUTHILL PROIrEBBIO N&L. ENelINEER COUNCILMEN Henry W. Drum John J. Nickles Lawrence Murdock Jr. Francis J. Murphy TOWN SUFFOLK Southold, L. I., N. Y. 11971 TELEPHONE (516) 7654891 6/ll/81 Mr. Henry Raynor Chairman of The Planning Board Town of Southold Dear Henry: Mr. Harold Reese met with the Highway Superintendent, the Town Attorney and myself on June 9th relative to 6braining a building permit for lot#l, Sect. I of Harbor Lights. Mr. Dean and I recommend approval of a 15 wide a~ohalt access road from the easterly portion of the existing paved area of Schooner Drive to lotffi. ~r. Dean will confirm this by seperate letter. The Town Board has previously reviewed this road end area and was prepared to accept that road without the 100' turnaround. It is also suggested that if the above is agreeable with you that the owner of lot #1 be required to submit a letter to you and the Building Department that he~undersSands a cer~ifigate of occuppancy will n0t~be i~u~d untii, the access roa~d ia a~rove~. __~L __ ~es ~airman of The Highway ~ommittee cc: Town Clerk Building Dept. Town Attorney R. Dean JJN:jn KOCH-JOHNSTONE ASSOCIATES INC INTERIOR DESIGN AND PLANNING June 5, 1981 Mrs. Rain.s Southold Planning Board P.O. Box 728 Southold, New York 11971 Re: Proposed Koch"Residence Schooner Drive Southold, New York Dear Mr. Rainess: Mr. Fisher suggested that I write to you and outline my understanding with regard to the completion of Schooner Drive. On May 14, 1981 I spoke to Mrs. Terry, the town clerk and she advised me that Mr. Reese the former owner and subdivider of the above property had posted a bond several years ago to install Schooner Drive. She also told me that the Planning Board, on January 2, 198] voted to keep this bond in effect until Mr. Reese completed Schooner Drive. This bond is still in effect as of this date. I than called Mr. Reese Sr. and was advised by him that he was going to complete Schooner Drive as quickly as possible. He also told me that he had a meeting set up to see you on May 26, 1981 to discuss the completion of Schooner Drive and a new road in another section of Harbor Lights. On May 27, 1981 I called Mr. Reese Sr. and discussed with him his meeting with you. He advised me that he expected to start construction of Schooner Drive within thirty days. He also told me that you advised him to meet with the Highway Department and Mr. Fisher, the Building Inspector. I have subsequently filed my plans with the Building Department and have been turned down for a building permit because of lack of access to the property. Based on the fact that the town has a bond posted to complete Schooner Drive (and can enforce this bond with the Bonding Company) and the fact that Mr. Reese Sr. advised me that he is going to complete Schooner Drive in the very near future. I request you advise the Building Department to grant me the construction permit. I trust that you will not delay in granting permission to issue the required Building Department approval and permit. GLK:emf Very trj~y yours, George L. Koch cc: Mr. Bertram B. Daiker, Esquire Mr. Reese, Reese Brothers, Inc. ~ Mr. Fisher, Buildinff Inspector . -/ 10 [A.~T 44t~ STF~EI, NEB/YORK, Iq. Y. 10017 (212) 986-6170 HENRY E. RAYNOR, Jr., Chairman JAMES WALL BENNETT ORLOWSKI. Jr. GEORGE RITCHIE LATHAM, Nilliam F. Mullen, Jr. Southold, N.Y. 11971 TELEPHONE 765 - 1938 June 24, 1981 Mr. George Fisher S nlor Building Inspector Town Hall Southold, New York 11971 Dear Mr. Fisher: The following action was taken by the Southold Town Planning Board at a regular meeting held on June 22, 1981. RESOLVED to approve the recon~endations set from the Highway Committee on the subject of Harbor Lights, Section I, Lot #1. The Southold Town Planning Board concurs with all of their findings on amending the road turn-around. Yours truly, HENRY E. RAYNOR, JR., CHAIRMAN SOUTHOLD TOWN PLANNING BOARD By Linda Kimmins, Secretary GEORGE L. KOCH :::' " . /,~ C u, ._ From the Desk o]... GEORGEL. KOCH TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION -~o ~...~~.....~.IC~ ..... (owner or authored agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance .... .~ ~.....~'. '~.., · .~.' ............... at premises hereinafter described in that ...~~.~/~ ~~ (state char~er o~ol?ion) ~ ' ~"'"~~ ........ z'"'~'C ............ 5 .......................... ~ .................... :"'~-: - ~ (Stot~ so~]or p~r~roph.~ oppdcqble mw,. oroin*n~e ~r roOulot~nl ~ YOU ARE THEREFORE DIRECTED AND ORDE~ to co~ witch: ~w and ,o remed~ the conditions obove mentioned forthwith on or before the .... ~ ............ ~..~:..,,~],,,,~ ........ ~ ~ The pr~mis*s to which this ORD[R TO Rfi~[DY VIOLATIO~ re{ers ore situoted ot ~J~~ ~ ...... ~ ......... ~....Co~nty of Suffolk, New York. , Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by fine or imprisonment or both, Building Inspector FOI~M NO. 5 STOP ALL WORK TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. STOP ALL WORK ORDER TO REMEDY VIOLATION Date ....... ~.u...Z.~....~.Z ................................. , 19....~.1 William J. Jacobs TO ...~./..C..,H.~.~ ~.g fi,,.L..,.,K.o,n h ........................... (owner or authorized agent of owner) (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance C~ 1 O0 Other Applicable Laws, Ordinances'or ~,~, ~,~*~ State Buzldzng Code at premises hereinafter described in that .J~.~.~.k.,.En.d.,..o.P.....Eg.~n~a.t.J,a~ ....... :: ............................. (state character of violation) has developed two large cracks and wall has settled approx, 1½". in violation of Zoning Ch. 100-100-143~ State Buildin~ Code Part 3-AB01(630)a,b (State section or paragraph Of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned forthwith on or before the 28th day of .....(u..$.y. ........................................ , 19..a.].. The premises to which this ORDER TO REMEDY VIOLATION refers are situated at ....5..~...~..~..c~.`~.'~.?...e.~.~..D..C.~.¥..e.~...~.~...b'.~'~`~..~.~.'~.*C~unty of Suffolk, New York. Southold, New York 11971(Co. Tax Map ~1000-71-2-8) Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by fine or imprisonment or both. STOP ALL WORK Building Inspector -- Curtis W. Horton KOCH-JOHNSTONE ASSOCIATES INC. INTERIOR DESIGN AND PLANNING August 27, 1981 Mr. Fisher Building Department P.O. Box 728 Southold, New York 11971 Re: Koch Residence Schooner Drive Southold, New York ' :: / Dear Mr. Fisher: As you requested I have changed th~/circular stair to 5' ~ 0". ~ AS per our discussion you adviS'~d me you would from the 1st floor to the basement. I have ordered this stair f~d~m i~unva new home from 4' -10" a 5' - 0" diameter stair above. If you have any questions, please do not hesitate to cglil;~i {~Ve~y yours, L~/~_ GLK:emf f~ George L. Koch cc: Mr. B. Duiker, Esquire 10 EAST 44th STREET, NEW YORK, N. Y. 10017 (212) 986-6170 KOCH-JOHNSTONE ASSOCIATES INC. INTERIOR DESIGN AND PLANNING August 27, 1981 Mr. Fisher Department of Buildings P.O. Box 728 Southold, New York 11971 Re: Koch Residence Schooner Drive Southold, New York Dear Mr. Fisher: This is to confirm our tele~h0~ e0nve~,][~i!(~ on July 7, with requard to the Board of Heimlth approval sflbmi!ted- '"' to y~ with my residence on Schooner Drive. At your request I called for my well and s~ptil from approval I spoke to Mr~ Fazio and t01d her the Health Department required this approval translated She the file and spoke and that Mr. Brigham to Mr. Brigham and advised m~ that would perfer the applicatioil·t°i!,stay as I then called you back and advised you of my told me that if the Health Department did not requir Department did not require the change of thi telephone number and asked you to verify !ion. I was very surprised and disturbed when I was advised by Mr. ~Jacobs my Builder that Mr. Horton told him that I could not obtain a final approval and certificate of occupancy with out having this Board of Health approval change. the Health Department Inc. to my name. with Mrs. Fazio and you change the Building also gave you Mrs. Fazio's I trust that you will advise all parties concerned that this change is not required. If you GLK:emf cc: Mrs. Fazio Mr. B. Duiker, Esquire have any questions, please do not hesitate to call. Very z/r~y yours, eorge . oc 10 EAST 44th STREET, NEW YORK, N. Y. 10017 (212) 986-6170 TOWN OF SOUTHOLD BUILDING DEPARTMEN~ TOWN HALL SOUTHOLD, N,Y. 11971 TEL,: 765-1802 Examined ...... . .~..~....,27.., 19..~. Approved ..... ~..'~;'~ .~~ Permit No .... Disapproved a/c ............... j .................... (Building Inspector) APPLICATION FOR BUILDING PERMIT / Application No..t. ............... Date..~...~......~"...~. .... 19 .~. / INSTRUCTIONS a. This application must be completely filled in by typewriter or inlink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according t6 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 diaCam 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 fize 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 inspectors on premises and in buildings .... ~/~ ~/" ~ ~f~'~ a admit authorized for necessary i~spectio~. ( 'g pp ' (Mailing address of applicant) .... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................... ........................................................ Name of owner of premises.. ~..'~.~-~... ~'X: ..... 2~O..C:b.' ..................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of~)ate officer) Builder's License No ..........................~)~ Plumber s License No ......................... Other Trade's License No ...................... 1 Location ofland on which re osed work will be dona ~/~/~'~ ~'~1~' · . , P P ~ -' ../.-5 ........... ~... ........................... House Number Street Hamlet County Tax Map No. 1000 Section ....... .~../. ....... Block ........ ~ ....... Lot. Subdivision.~./~..~.~.~ Z[/f.~.7~..~~.~ .FiledMapNo..~.;;,~.~.~.~ Lot ]~"~'~ ./..~-.. · ' 2"' '(Name) ............... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction a. Existing use and occupancy [,//'~C ,q- M.7- b. Intended use and occupancy ' ~'~ ge~7./'~'~,~ ~ 3. Nature of work (check which applicable): New Building ......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... :! , (Description) 4. Estimated Cost .~.. / . ..d.e..,~..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 stmcture~, if any: Front ............... Rear .............. Depth ............... Height Number of Stories Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... ,Height ...................... Nun~ber of Stories ....... ; ........ ~ ..... 8. Dimensions of entire new construction: Front ...~'..~ ......... Rear . .(~.', ,C9.,. .......Depth Height .............. {~ ~umber of Stories ...... /~. O(o ~. ~. .- ~1-o~). 9. Size of:lot: Front ................... Rear ..................... Depth ................. 10. Date of Purchase ............................. Name of Former Owner ............................. 11. Zone or use district in which pr~mises are situated .... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................. 13. Will lot be regraded .... . .~..~?~" ~ ............ Will excess fill be removed fscom premises: ,Yes (~No) Name of Owner of rem.i~(s, .~.~.~.,~..lfi~ ~rlrl~3~'~e~ .~.t~., 14. P~ --~ ~n~.~- .. .... /.' ................................................................ Name of Architect /~{~..)., ~r~r.~q~-. J ~.~.. Address ................... Phone No ................ Name of Contractor ~.~,~'t~.~,~..~ J,~.~r~ ~.. Address .~.~.q.~. ~'~<. ?.-7... Phone No. 7. A.~r.5..~/.57.. PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block aumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW~RK~ t - ~ S.S COUNTY 01~.~',~ ~' ~ ~ . _ .... :~..~~..~i~~~.! .......... being duly sworn, deposes and says tha~he is the applicant (Name of i~idu~ ygning contract) above named. ~ ~ _ r of said owner or owne~, ~d is duly authorized to perform or have perfomed the ~a)~ work and to m~e ~d file ~is application; that all statements contained ~ this application are true to the best off--ledge and belief', and that the work will be perfomed ~n the m~nor se~ forth ~ the application filed therewith. ~womto before me this : .... ...... ....... ~ NOTtR? PUBLIC, 8tat~f New York ~, / (Signature of applic~t) N0. 52-8125850, Suffolk C0un~ ' ~erm Expkes March 30, LA-~J ~ N C; ~t4 0 I-~ /., :4 ~ SUFF. CO. HEALTH SEPT, APPROVAL ] H.$ NO. __ TEST hO~ SUFF. CO. DEPT. OF N~ALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY DATE: lO-So-F~ STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAr SYSTEMS FOR THIS ItESI. [~ENCE WILL (:ONPORM TO THE STANDARDS OF SUFFOLK CO. DEPT. OF HEALTH. SERVICES. APPLICANT APPROVED: T~TIJ~ rt. a;~,eeOvAt. I ~. s. ao.. SUPPLY AND 8TA~OA~O~OF SUFFOLK CO, ? me sewage disposel and water supplF facilities for this location have been inspected bT this department and fouz].d ~ef of Gem~ral ~gi~er~ ' ~~ ,~z~ ~. ~. . · s.~'~*'~. - ~.O :~ q I~0,0 bt ~J d , 1~-4 /4 _o.41 L =._9 ~d J J I- '-' I NO. J REVISIONS KOCH-JOHNSTONE INC. INTERIOR DESIGN & I0 EAST 44th ST. NEW YORK, N.Y. ASSOCIATES PLANNING 10017 212-986-6170 OAT,E :DRAWING NO. SCALE SOB NO. Kj --I NO. I REVISIONS KOCH-JOHNSTONE ASSOC IAT E S INC. INTERIOR DESIGN & PLANNING I0 EAST ,lath ST. NEW YORK, N.Y. 10017 212-986.6170 DATE BY DRAWING NO. /5,,7_ SCALE JOI NO.