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Home My WebLink About12869-z FOBM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL PULL COMPLETION OF THE WORK AUTHORIZED) 12869 Permission is hereby granted to: ...... !..i~.~A:.,'-.:......~ ............. !:../......~ ........................ ........... ~.....:.~.~. ............ ~: ........................... : ............ .~.~-~-~'~.~...~' ........ ~ ~...% ...... .~.\.~..%.A ............ ...... .~~d~. ~..×~ ~i~/~ ~....,...l~ ~.~ ~.~ b.~.~.~ ~ ,o ....................................................... ......... .... ~....~ .......... ~...~.~..~..~!~ .............................................................................................. at premises located ..................... ~,....,-...:~ ....... 'l ...................................................................... County Tax Map No. 1000 Section ........ [.~.,..'J,~, .~. ..... Block ...... :~ ............ Lot No.....?~.~'..~. .............. bL doted ..~..~,~.:~::=.~.~....L~ .................. , i~ ~. , and approv~ by t~e pursuant to application Building Inspector. Building In.~ector Rev. 6/30/80 FORM NO. 4 TOWN OF SOUTMOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z18614 Date DECEMBER 5, 1989 THIS CERTIFIES that the building ONE FAMILY DWELLING 435 CLEAVES PT. RD. & Location of Property 1945 EAST GILLETTE DR. F2tST MARION House No. Street Hamlet County Tax Map No. 1000 Section 038 Block 04 Lot 27 Subdivision MARION MANOR Filed Map No. 2038 Lot Mo. 83 conforms substantially to the Application for Building Permit heretofore filed in this office dated FEB. 15, 1984 ~ursuant to which Building Permit No. 12869Z dated FEB. 15~ 1984 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-UNHEATED SEASONAL ONLY. The certificate is issued to TOBALAJA ORRO (owner, X~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 11-S0-52 NOV. 16, UNDERWRITERS CERTIFICATE NO. N705375 AUG. 19, 1985 PLUMBERS CERTIFICATION DATED N/A REPLACES B.P.#11560Z Rev. 1/81 Feb. 22,1982 1989 Building Inspector BLDG, TOWN OF SOUTHOLD 'T~ Al oP- 3cu7~'~- n ~UIL. Pnw. YOU are here by granted a six month extention of Building Permit # 12869Z. This permit will expire Feb. 15,1986. VL:dsm Yours trulyt Victor Lessard Exec. Admin. Bldg. Dept. TOWN OF SOUTHOLD OFPlCE OF BUILDING INSPECTOR P.O, BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advise you that the job under building permit no. 12869Z issued to Toba O~ro on 2/22/84 for New DwelI-~9 is completed and a final inspection has ( ) has not ( x ) been done. An Underwriters is needed In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $25.00 payable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or nsc is unlawful without a Certificate of Occupancy. Please help ns to clear up this mstter so that lega! action does not have to be taken. Thank you for yo,r prompt attention. Very truly y~, Victor Leasard Executive Administrator VL:gar cncl. ToWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ To ,,, ,'77~. ¢. ~/'5.,., / .... O./q2 j,"~..O, ....... PLEASE TAKE NOTICE that your application dated ........... .5 h ~ 7 :i9 .~.}. for permit to construct... ]St.a.£ j&. ! .~..F.~.. .......................................... at Location of Property . ~.'(?..t.~q ~ . .~ ~ ~ .. [. ~.~, . . ~ ~/o~i Ham/et House No. "' ' , ....... County Tax Map No. 1000 Section ......... ~J. ~'.. Block ........ ~ [ ....Lot . ....... ~led Map No ................. Lot No .... is returned herewith and disapproved on the following ~ounds...........I N' ~ U (- .... F I FP.. .......... *~F ~,~c, .... N~ Form No. 6 APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. Commercial building, indnstrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. Submit Planning Board Approval of completed site plan requirements. 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. Ct Fees i. Certificate of Occnpancy - 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-existinR Buildin~ - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date New Construction ......... ,. ~Old Or Pre-_existing Building...~..~. ~. ....... Location of Property...i../~'.L.{.S ~ ~/~C.~'7-~-/~' ~ i~...-...~..~.~,0-~--~ ~ House No. Street Hamlet Onwer or Owners of Property ............. % ....... ............... County Tax Map No i000, Section ...... . ..... Block ............ Lot ................. ' Subdivision .................. Filed Map Lot ........... .................... . Of Pemit Applicant Health Dept. Approval. ~ ~ ~ ~ .Unde~riters Approval. ' ~ ............. .... ~.~ ............ Planning Board Approval ................... .. . .. ~ gCt c'j .......................... . ' / ' ........ ...... FORM NO. 6 TOW. N.OF $OUTHOLD It[~ ~. - ~ I.CJl~} ill Itl RulldlngDepartmont This ~pplication must be filled in Wpewriter OR ;nE, end submitted ~ ~ to the Building In' "" tor with the following; for new buildings or new use: 1. Final su~ey of property with accurate Jocetlon of ell buildings, prope~y lines, streets, and unumel n~tur=l 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 Unde~riters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and dons, a certificate of Code compliance from the Architect or Engineer responsible for the build/no. 5. Submit Planning Board approvat of completed site plan requirements where ~pplicabie. Bo For existing buildings (prior to April 1957). Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate ~Jrve¥ of property showing all property lines, streets, buildings and unusua~ 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 {nferma- tion required to prepare a certificate. C. Fees: 1. Certiticate of occupanCy [qew Dwellzm~.$25.00, Accousory '.$I0.00 Buaines:~ $50.00 2. Certificate o~ ~ccupancy on pre-existing dwelling ~ 50. 0 0 3. Copy of cerUflcate of occupancy $ q.o. o.oo ........ 6. ~lteratxon NewC on~ true ~t on...... Old or Pre-ex~sdn9 Bui[din~ ............ Vacont Land ............. Location of Property .............. ~._. ..... ~ .. -- ................... -o3e 4 County Tax Map No, 1000 8~cfion ............... Block .,,,,..,..,,.,. kot ............ Subdivision ¢* Filed Map No.~fl Z~'. .Lot No. , Permit No. . Date of Perml[.... ,. ,..f,,, pp .................... Health Dept Approval Labor Dept Approval · · A.. "' o ............. Undo~rlters rove Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $. 2.7. O0 ~ /~ 13o.~1~. ' d I- OI}/O ti Construction on above described building and permit meets alt applicable codes and regulations, TOCA OgRe A~li~nl .................................................. 765-1~02 BUILDING DEPT, INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~'INAL ]'65-1802 BUILDING DEPT, INSPECTION []FOUNDATION ~.ST []ROUGH PLBG. []FOUNDATION 2ND []INSULATION []FRAMING []FINAL REMARKS: / 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ZST [ ] ROUGH PI~BG,' FOUNDATION 2ND [~ INSULATION [ ] FRAMING REMARKS; FINAL DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [.-~r~.ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [~f_FRAMING [ ] FINAL DATE INSPECTOR FIELD INSPECTION 1. FOUNDATION ( 1st} FOUNDATION (2nd) COMMENTS OUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: N705375 I ~oe~c ~ ' Lot DISH WASHERS EXHAUST FANS DIMMERS '2/0 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 January 13, 1982 TEL. 765-1802 Mr. Orro 187 Berry Hill Road Syosset, NY 17791 Dear Mr. Orro: In regard to my letter of December 14, 1981: Your architect will need to submit how your cellar will' be flood proofed acoording to the Board of kppeals condition #1. A copy of those conditions is copied on the back of this letter. We need to know how this condition #1 is to be done so we may inspect the work before permitting you to back fill the foundation. This should be on a separate sheet and submitted in duplicate. I Am enclosing an extra letter with the conditions for your architect so he is aware of conditions (1), (2) and (3) that have to be met. Condition #4 will be complied with once I receive the information on how the basement-cellar is to be flood proofed. If you have any further questions please do not hesitate to contact me. Sincerely yours, George H. Fisher Senior Building Inspector GHF:ec Enclosure On motion by Mr. Goehringe.r, seconded by Mr. Douglass, it was RESOLVED, tha.~ Toba Laja Orro, applicant herein, be and hereby is granted a varia~c~ from the provisions'of the Flood Damage Prevention Law of ~he Town.of Southold to construct a one-family private dwelling o~ premises located at the easterly corner of Gillette Drive andlCleaves Point Road, East Marion, NY; further designated on the County Tax Map as District 1000, Section 38, Block 4, Lot 27, with the finished basement floor ~o be elevated not less than 3.75! feet above mean sea level as applied for and SUBJECT TO THE FOLLOWING CONDITIONS, to wit: (1) That the!basement be flood proofed ~o that below the base flood level t~e structure is watertight with wa.ils substan~ tially impermeablelto the passage of water; (2) That the!floodproofing requirements be certified by a registered professional engineer or registered professional architect as meeting the standards set forth in the preceding paragraph hereof; (3) That such certification be filed with the Building In- spector and with the Board of Appeals of the Town of Southold p~ior to the completion of the proposed structure and as early as possible; (4) That pri6r to the commencement of construction, the applicant apply fo~ and obtain a development permit from the Town Building Inspector, pursuant to the provisions of the Flood Damage'Prevention ~aw; (5) That there shall be no habitable, living area below the minimum 8-foot bas8 flood level; AND IT IS FURTHER RESOLVED, that pursuant to the provisions of Section 46-16F Of the Code, the applicant is hereby given notice that the structureifor which this variance is granted will be per- mitted to be builtlwith the lowest floor elevation below the base flood elevation and that the cost of flood ~nsurance will be com- mensurate with theiincreased risk resulting from the reduced lowest floor elevation; AND IT IS FURTHER RESOLVED, that the Secretary to this Board transmit copies oflthis determination% to the applicants and to the Town Building inspector. Vote of ~le B~ard: Ayes: Messrs. Doyen, Douglass, Goehringer, Sawicki and Grigonis. TOWN OF SOUTHOLD, NEW YORK Appeal No. 2 8 8 2 by ACTION OF THE ZONING BOARD OF APPEALS application Dated "September 18 , 1981 ACTION OF THE ZONING BOARD OF APPEALS OF THE TOWN OF SOUTHOLD To Mrs. Toba L. Orro 187 Berry Hill Road Syosset, NY 11791 AppeHant October 15~ 1981 at a meeting of the Zoning Board of Appeals on was considered and the action indicated below was taken or~ 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 to the Zoning Ordinance Art. III, Sec. 100-31 ( ) the appeal gra~ed ( ) be denied pursuant to ~ticle .................... ~eet~n .................... Subsection .................... paragraph .................... 0f Re Zoning Ordinance and Re decision of the Building Inspector ( ) be reversed ( ) be cF~K~y~xpkWause Public Hearing: 10/15/81: Application of,Toba Laja Orro, 187 Berry Hill Road, Syosset, NY 11791, for a Variance to the Zoning Ordinance, Article III, Section 100-31 for permission to build new house with insufficient front and rear yard area at 435 Cleaves Point Road (a/k/a 1945 East Gillette Drive), East Marion, NY; Marion Manor Subdivision, Filed Map No. 2038, Lot No. 83; fur- ther identified as County Tax Map Parcel Item No. 1000-38-4-27. (SEE REVERSE SIDE) 2. VARIANCE. By resolution of the Board it was determined that (a) Strict application of the Ordinance (would) (would not) produce hardship because practical difficulties (SEE REVERSE SIDE) (b) The hardship created (is) (is not) unique and (would) (would not) be shared by all properties alike in the immediate vicinity of this property and in the same use district because (SEE REVERSE SIDE) (c) The variance (does) (does not) observe the sp;rit of the Ordinance and (would) change the character of the district because (would not) (SEE REVERSE SIDE) and therefore, it was further determined that the requested variance ( ) be granted ( ) be denied and that the previous decisions o£ the Building Inspector ( ) be confirmed ( ) be reversed. CG:lk ZONING BOARD OF APPEALS FORM ZB4 By this appeal, appellant seeks permission to,construct a new one-family dwelling with a frontyard setback off C~eaves Point Road of approximately 36.5 feet, frontyard setbackioff East Gil- lette Drive of approximately 24.5 feet, and rearya~d setback of approximately 15 feet from the easterly property line. The premises in question is a corner lot as defined by Section 100-13 of the Code and lends itself to the practical difficulties in constructing any dwelling thereupon. The Boardll agrees with the reasoning of appellant, i In considering this appeal, the Board determines that the variance request is not substantial; that the circumstances herein are unique and the practical difficulties hlave been shown; that by allowing the variance no substantial detriment to adjoin- ing properties would be created; that the difficul.'ty cannot be obviated by a method, feasible to appellant, otherl than a variance; ~nat no adverse effectS will be produced on availa,ble governmental facilities of any increased population; that the :relief requested will be in harmony with and promote the general purposes of the zoning code; ~and that the interests of justice wiill be served by allowing the variance. ~ O~ motion by Mr. Sawicki, seconded by Mr. Grigonis, it was RESOLVED, that Toba. L. Or.ro, be allowed a variance to the zoning ordinance, Article III, Section 10'0-il as ~equested in Appeal No. 2882. It should be noted that a conditional variance under Appeal No. FL-7 has also been filed concerning this property. Location of Property: 435 Cleaves Point Road (a/k/a 1945 East Gillette Drive), East Marion, NY; County Ta~ Map Parcel No. 1000-38-4-27. Vote of the Board: Ayes: ringer, Sawicki and Grigonis. adopted. Messrs. Doyen, Douglass, Goeh- This resolution was unanimously , L _P_P_ROVED RECEIVED AND FILED BY THE SOUTItOLD TOWN CLEHK ~ Town Clerk, ~v~n ,o~ ~uthold FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 Permit No. 1 Disapproved a/c ..................................... Received. .......... ,19... ?~. ~?_:?..ctx.._: ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued 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 ~ Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessaw inspections. (Signature of aptJd4cant, or name, if a corporation) .. (.( (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ?. .................................................................... Name of owner of premises ...C.~fl.../.4-. .~..~...~. ~ .~..- .0 .................................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... .~..~. ~. ~ ............... Plumber's License No...~.~'..'~:,~{%. (~..~7. J. 2.~. ...... .... Electrician s Lzcense No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. Z- t9 ]- /t~ J~j') House Number I~4~ ~5'~'~lf~S~{~{g~ Hamlet County Tax Map No. 1000 Section ..... ~ .......... Block ....... ~ ......... Lot ..... ~ ~ .......... Subdivision .~./~. ............... ...... ......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~(~f~ .......................... ' .................... b. Intended use and occupancy ................................................... 4. F, stimated Cost ...... J ...... , .... 5. If dwelling, number of dwelling 9nits If garage number of cars ' Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. RemOval .............. Demolition .............. Other Work ............... .q~ (Description) (to be paid on filing this application) ·. [ ........... Number of dwelling units on each floor ................ 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 of Stories: ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Dept .................... ~.. Height ...................... Number pfStones ............... ~:. ~ ..... 8. Dimensions of e tire new constrUction' F ~- , 'q ~ 47 -g* De,~th ~ _ · font q] '~' Re ...... ~ ............ Height ....P~...~7~.1~ .... '~umbrer of Stories ..... ,~. ...... ~...~ ...................... r"~' ti .......... 9. Size of lot: Front .... l~ .C~f. ......... Rear ...... ~,/2.7',0,.~ ........ Depth .. [0.~..-7.°. ........... 10. Date of Purchase ../.~ ~'..m)...; ............. Name of Former Owner MA .,c//'t4~. ~..,'~ ./~.. . I 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed cohstruction violate any zoning law, ordinance or regulation: .............................. 13. Will lot be regmded ......... '. · .~ ............... Will excess fill be removed from premises: Yes 14. Name of Owner of pretnises .~...B ..... b-.:~.~.O Address /fT.~i(F..htt6c.4P .PhoneNo .~..&/ ~2_.~.. Name of Architect . ~ 19.N..~/, 0" io'" ~q'Opt~'~/'' Address ~]'}~..T'. ~. ~.¢F-C..//~. [. Phone No ................ Name of Contractor ......... I ................. Address ................... Phone No ................ PLOT DIAGRAM Locate iclearly and distinctly alli buildings, whether existing or proposed, and. indicate all set-back dimensions from property tines. Give street and blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW¥ORK, , COUNTY OF.. 3:~ .~/~..~.¢[.<~... iS'S ..... ~./~.~.../~.-...Oj.kj~. (~.. ~ .................... being drily sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the .............................................................................. ~ ........... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du!y 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 mannqr set forth in the application filed therewith. Sworn to before me this Nota~ Public ' ~. . . Count FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 '.~...,<~ ~ -... Examined ........_,~.~_i'~' .... ' ~9"7~'z--- //~0 '~ .... A~,~,~o,,~d ........ -/..~: :.., ,9... ~,-m~ ~o ............ ....................... ~ ................. ~x.. '~ /~ , _ ~.. ;~/~,. ~. ~ .... . ' ;. ~ (Building Inspector) i A?PLICATION FOR BUILDING PERMIT Application No./f5-5 ~ INSTRUCTIONS a. This application must be completely filled in 'by typewriter or in ink and submitted in triplicate to the Build: lnspeclor, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plm plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stre or ar=as, azd ~fivmg a detailed descriplion of layout of property must be drawn on the diagram which is part of this cai Jori. c. The work covered by tiffs application may not bo commenced b~fore issuance of Building Pe~it. d. Upon apprc,'al of this application, the Building Inspector will issue a Building Permit to th~ applicant. Such peri; s.,,.ll be kept on d~¢ promises available for inspection throughot~t the work. e. No building shall be occupied or used in v,,hol~ or in pan for any purpose whatever nntil a Certificat~ of Oceupan shall have been granted by the Building Inspector. APPLICATION IS I IEREBY MADE to the Building Department for t~g issuance of a Building Pe~it pursuant to t Bu ..... = Zone Ordinance of d~e Town of Southold, Suffolk County, New York, and other applicabl~ Laws, Ordinances Regulations, fm the construction of buildings, additions or alterations, or for removal or demolition, as herein descfib~ The applicant agrees to comply with all applicab}~ laws, ordinances, building code, housing code, and r~gu[ations, ~6 admit amhortzed inspectms on premises and in buildings for necessaw inspections. (Signat~ of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lesse% agent, architect, engineer, general contractor, electrician, plumber or build .~N.~.a ................................................................................... (as on the tax roll or latest deed) If applicant is a corporaiiou, m¢nature of duly authorized officer. (Name and title of corporate officer) Builder's License No ................. ........................ El:ctdcia ~'s License No.' ........ Other TraiN's License No ...................... 1. Locatibn of land on which proposed work will be done. ....... C L Eh v~5 f~t ............... u./~aae~ ............... ~ouse Number [~'~' ' k~L{-' d, ;-,Lk~ b' 'St&~t ~. Hamlet County Tax Map No. I000 Section .................. Block ................ Lot ................ SubdMsion ............................... Filed Map No .............. Lot ........... (Name) _ _ 2. State existin usg and occu >anc of rani' g I y p ~ses and intended use a ~d occunancy of proposed constrt etlon: ~xlstlng ~Se . . b. Intended use and occupancy . Nature of work (check whicl, ap'plicabl¢): Repair .............. Ren6va .. Estimated Cost '~"~'~,r */')~'~9" New Building Nlt..-'~IM· Addition .......... Alteration .......... ..... Demolition .............. OJ, h e r Work .............. ~ (D iptio ) escr n (to be paid on filing this application) ; Ifdwellin¢ numberofd~ellingiunitS, /. Numberofdw¢Ilingunitsoneachfloor If ,.:araee, m~m bcr of cars . .,,~ .i ................................................................. {. If bus/ness, commercial or mixc~I occupa~cy, specify nature and extent of each ~ype of use .................... ;. Di:nen~ions of existing structures, if any: Front ............... Rear ....... ....... Depth .............. Height . ............... Nun~berofStories. ...................................................... D/men~ions of same sm~cture Mtb alterations or additions: Front ................. Rear ................. Depth '. ................... ~.. Itei~t ...................... Number of Stories ................... . . , 't_ - ~'7~ ' ~f'-~' "' ~." Dim,msions. ot~,_ "eat're now construct,on:. ' , Front.; .... Rear.,. ~ ...... Depth ........ _ ,: Height ...... ~. .... Number of Stones .......... / ................. , ...... ........... 1, I t . ~,",· ,,,,, Rear ....... 7ff,.,' ....... Depth ,J, ~ ............. ). ., ' ' ....... '. .........;.. Name or Former Owner ~4 .~ ~. ~.).t~ .......... 1. Zone 0r use disr~ct in which pr~nfises are situated... ~ ............................... >. ................ roperty lines. Give street and block tcrior or corner lot. Does proposed construction violate any zoning law ord na~ce or regt a:ion , .... ~ ................... ~,\ fll lot be r o.a. t ...... ~ ................... Wfl, excess fill b,: ,emoved from premises. Yes · . ' ' '- ' ,'~,:,e or o,,',,=r of p~e:,z,,e$ ? ~'~A. t-,.. e.,fl~O.... Address . ,/~.K'. ~Jt,~, ,H//-~/IL) Ph o ne No, .~/'.2,..I. ,~,.g-l~. .... Nam~ of Archi[ect . . ./~O~/~i~.~)...~. , . -~'~7~)J~.. Address .~;~.~.../v'ff-g;N,l F~'Phone No ............. Name of Contractor ........ ~ ................ ~ Address .................. Phone No I PLOT DIAG RAM Locate clearly and distinctly al} buildings, whether existing or proposed, and, indicate all set-back dimensions fron- number or description according to deed, and show street names and indicate whethe: Lo'F,, (.L.~AV~5 pI2ltqT ~O^D TATE OF NEW YO...1}.~. OUN'r¥ OF..Sq.~..tSO..6tL..'...~' S.S · '... ~ ' being duly sworn, deposes and says that he is the applic?.n (Name of' ~dix idual s~ ~ ~g contract) e is the (Contractor, agent, corporate officer, etc.) f said ow)~er or ownem, and is d~fly authorized to perlbrm or have performed the said work and to make and file thi >plication; that all statemcats co~tained in this application are true to the best of his knowledge and belief; and that tt~ ~ork will be performed in :f~e manfler set forth in the application fi[ed therewith. worn to before me this ..... · : i ' [ J -~ // .~ q / x ~v eumo, ~.t~ ~ ~.~ jor~ ....... , ................. ..._, .... .... .......... ~ _