The URL can be used to link to this page

Home My WebLink About15085-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16529 Date December 22, 1987 Construct Addition & remodel existing one family THIS CERTIFIES that the building it~'e~2'ih'g ........................................ Location of Property 700 Koke Drive Southold, New York House No. Street Hamlet County Tax Map No. 1000 Section 87 ...Block 05 .Lot 06 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated December 18, 1985 pursuant to which Building Permit No. 15085 g dated July 11, 1986 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 ......... ADDITION & REMODEL EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to E L I & MAR JO R I E P E T RA S ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval . N / A UNDERWRITERS CERTIFICATE NO. N810872 - May 14, I987 PLUMBERS CERTIFICATION DATED: December 3, 1987 - Edward Schiller Rev. 1/81 FORM NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDiF4G PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 15085 Z I/ Permission is hereby granted to: .... ~.~....~.~.~....£......~ ...... ............. at premises I~oted at ...~.~ ....... ~..~..~.~ ................ ~ .......................................... County Tax Map No. 1000 Section ....... .~..~....~. .... Block ..... ..¢~....~.. ...... Lot No ..... ..~.....~. ........... pursuant to application dated '....~...L?. ............ , 19.~.~..'~, and approved by the Building Inspector. Built'lng Inspector Rev. 6/30/80 BLOG, DEPT. TOWNOF SOUTHOLD FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 )PLICATION FOR CERTIFICATE OF OCCUF Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or 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 instatla- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewC°nstruction ...... Old or Pre-existing Building ..._ ....... Vacant Land ..;¢ ......... House No. Owner or Owners of Property .... .~ ........................................ County Tax Map No. 1000 Section ......... Block ............ Lot ............... Subdivision ............................. ~...Filed Map No ........... Lot N,g..,. .......... Perm t No/~."~5, ~f'~-" ~, // r'~ ' ~ ......... Date of Permit./, ./!...Applicant . .'~','~.~'?-~ .... ~~ ....... Health Dept. Approval ........................ Labor Dept. Approval .................... Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and per[mit r~epts all a~9~licable c,odes add regu;lations, f, /~ ...... TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HAi,L SOUTItOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No._[5(~5 Owner ~ / /~~ (please print) Plumber (please print) I certify tha~ the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber s s~.nature) Sworn to before me ~his 19_~? . Notary Public,__~~-/County. Notary Public HELEN K,DE rOE Expires [~rch TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN ItALL SOUTItOLD, N.Y. 11971 December 4, 1987 TEL. 765-1802 Mr. Gregory Hunt 1455 Rambler Road SouthoJ. d, New York 11971 To Whom This May Concern, We are unable [o complete your Certificate of Occupancy because .of the following reasons. RE: ELI & MARJORIE PETRAS /~/ An application for Certificate of Occupancy is not on file. /-'~/ No Underwriters Certificate on file. ~ ~_/ 'The check is (outdated/~XO2XX~]~X) RETURNED HEREWITH SUBMIT NEW CHECK IN /[_~/ No Health Deph. Approval on file~25.00 /[]/ No final ins. pection has been made. PLEASk AMT Ob Please contact ()ur office on this matter. Thank you for your cooperation. Building Permit ~ _[_ ~ j~ ~ ~ Z Building Dept. ***/~/ No Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FIELD IN£FECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE COMMENTS'. 765-].802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~/~INAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING , '* ~L / // / / / DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH pLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [~FINAL DATE ~/~////~? INSPECTOR ~ 765-X~0Z BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING REMARKS: 76S-1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: ~ FORM NO. 3 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN CLERK'S OEFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL · _/occ~ ~.z.../~4-ZZ'~., .,s'...~... z r. ~'o PLEASE TAKE NOTICE that your application dated . .'~'(7~i-/(--t'~.../.~. .... 19 for permit to ~-otvar/,~(_2~..~..,e~/2,o./..~.O./M'..7.'.~. ~x'.y~/,~..~.~'L~. 16~ .... at Location of Property .~.Q .O. ,~ ~:~'.~..."~IV~ .... County Tax mp ~o. 1000 S~etion .. O.~ ~ ..... mock .. O ~ ...... Lot . .00 ~ ...... Subdivision ................. Filed Map No ................. Lot No .................. is returned herewith and disapproved on the following grounds .~C/~.-?O~5-~../7/2.~./..~./O./0 .... · .'FO.. ~..:.,'75.<,~... awz'./Z/,~ .... 15,~.:~.~ .>....~:O. r_.,.. ,,~..e':.,4. . .~. czz,.,e..:~.../.~... ,,Z.~. F..7... ~.~.:...'~...'....-... zaz/,c../,o:.7. ....... . .c-oe. ezc, a.~.. ;~e.~,. lT.,w~... ;c~./~.. r.z-/z~...'.60.7-...z.~ .... !.~d~4:.z.. · ~x~w. ~..,¢'~z:..co~.~'F~2~..o,? .... /.~/..o., g..,~g...r.T.... .... .,Fl {2o. . . ."~. :.c r).. z. s ¢ -. / >. . .Z& ca. z'--,~. . z. .,g. . FT/, o. o,o. . ,ffo ,,,reT. . ,Z]r .~ , .4zco. o . . . .o. .(. . . . FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ Date .... . .~.....m~...,h. '.&..~. ....~~&..~:2..,.././.~..7.t.. PLEASE TAKE NOTICE that ye,ur application dated . .~.~'~.. Location of Property ,,,~, ~ .... )'~',~..1.~, .~, ,, ............ ~..~, ~111~. ~-.................~.. ..... t*ouse tvo. ' ........... Street Hamlet County Tax Map No. 1000 Section . .(~..$..~ ...... Block .. · .~ .,,%'7. ..... Lot .. ~ .~..~. ..... Subdivision ................. Filed Map No ................. Lot No .................. is returned herewith and disapproved on the following grounds.....~...'.c~ .'".~-.. ,~.~ .)o7'.0..~ .......... .~ ~ =..o...~....q....~....~. ~....~...~...~&. ....... ~.~....~ .... .m~..q.. =..~.c. )....5.~,..(~. 2.~...~.~.. ...... Building Inspector RV 1/80 FORM NO. 3 TOI~N OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL PLEASE TAKE NOTICE that your application dated . .'-~..~<~7~7/~--/~C'~.... ,(.~..., 19 ~.~ for pe~it to ~O~ ,~V.g~..[O~ ~g~..~g~ .... at ........ ~o~7~¢~... Location of Propertyblouse'~9' ' 'No. '~ ~' ~I~E./ . . ~/e3i ' ' ' Hamlet co..fy T~ ~p ~o. ~o0o s~tio...0.~ 7. .. mo~k .. D. ~ ...... Lot . dO~ ...... Subdivision ................. Filed Map No ................. Lot No .................. is returned herewith and disapproved on the following grounds~.~Ot'~O,,5"~../q~..~.l..~.{~./,) .... . ~o.(~q... ~.. ~ ~.7... 0~,. ~...~.. ~7~.. zo.~ ....... .~~. ~ .... ~vz .~~v. .~m .... ........ ~¢. .~. . .... ~;~,...~..~...~ ~o .... ~¢~.~.~ .¢, ~c l~... t.~.. C~(-~.~ - ~~ (~ ~. ~'..~' ' '~' ~ ~wr;;:,:~o-~-; .... ,~90 DR~X/E 695.?.Z~ ill Southolcl Town Board of Appeals MAIN ROAD- STATE ROAD 25 ~[3UTHOLD, L.I., N.Y. 11c:)71 TELEPHONE (516) 765-1809 ACTION OF THE ZONING BOARD OF APPEALS Appeal No. 3497 Application gated April 25, ]986 (Public TO: Rudolph H. Bruer, Esq. as Attorney for MRS, MARJORIE D, PETRAS Main Road Southold, NY 11971 Hearing 5/22/86) [Appellant(s)] At a Meeting of the Zoning Board of Appeals held on June 25, 1986, the above appeal was considered, and the action indicated below was taken on your [ ] Request for Variance Due to Lack of Access to Property New York Town Law, Section 280-a [ ] Request for Special Exception under the Zoning Ordinance Article , Section IX] Request for Variance to the Zoning Ordinance Article IlI , Section ]0U-3] Bulk Schedule (Lot Coverage) ' [ ] Request for Application of MARJORIE D. PEIRAS for a Variance to the Zoning Ordinance, Article III~2~-i--~or permission to construct addition in excess of maximum-permitted 20 percent lot coverage requirement at 700 Koke Drive, Southold, NY; County Tax Map Parcet No. 1000~87-5-006, WHEREAS, a public hearing was held and concluded on May 22, 1986 in the Matter of the Application of MARJORIE D. PETRAS under Appeal No. 3497; and WHEREAS, the board members have personally viewed and are familiar with the premises in question~ its present zonin§, and the surrounding areas; and WHEREAS, at said hearing all those who desired to be heard were heard, and their testimony was recorded; and WHEREAS~ the board has ~arefully considered all testimony and documentation submitted concerning this application; and WHEREAS, the board made the fo]lowing findings of fact: 1. By this application, appellant requests permission to construct addition to an existing dwelling which will exceed the maximum lot coverage as provided by Article III, Section 100-31, Bulk and Parking Schedule of the Zoning Ordinance, from 20% to 26.7% as shown on survey prgpared by Howard W. Young revised May 1, 1986. 2. The addition proposed~ without the proposed deck area, has an area of 882 sq.. ft, The proposed deck would have an area of 141 sq. ft. The total percentage of tot coverage as exists is 17%, or 1469 sq. ft. The percentage of relief requested over the maximum 20%~ or 1728.2 feet~ is approximately 30% of a variance from the requirements, or 578.95 feet (over). 3. The premises in question is located along the {CONTINUED ON PAGE TWO) DATED: June 25, 1986. Form ZB4 (rev. 12/81) CHAIRMAN, SOUTHOLD TOWN ZONING BOARD OF APPEALS Page 2 - Appeal No. 3497 Matter of MARJORIE D. PETRAS Decision R~ June 25, 1986 southerly side of a private right-of-way referred to as "Koke Drive" containing an area of 8,641 sq. ft. [exclusive of the "Koke Drive" right-of-way] and frontage (lot width) of lO0 feet as depicted, on the May l, 1986 survey of Howard Young and deed at Liber 6605 cp 104 dated August 8, 1969. The subject premises is improved with a single-family one-story frame house set back 28.6 feet from the front property line (along the south side of the right-of-way), set back 27.6 feet from the bulkhead along Corey Creek~ and having sideyards of 8.4 feet on the west side and 19.8 feet on the east side. Also existing is an 8.2~ by 10.2'- framed accessory shed, which applicant has not 1n~cluded as part of the relief re- quested since the shed will be permanently removed. 4. Submitted in support of the application additionally is a revised survey of May 19, 1986 by Howard W. Young which includes one-half of the 30' right-of-way. Appellants claim that an additional 1,050 sq. ft., (lb' by 105') should be included in the total lot area for a total of 11,231 sq. ft., based on the subdivision map of the "Koke Estate" prepared by Otto VanTuyl, L.S. which shows a 50-foot wide,right-of-waY. However, in'further reviewing these documents, it appears the parcel in question as shown on the "Koke Estate" subdivision map is of a size 100' by lO0~ (exclusive of a 50~ right-of-way). This would give a total depth of 125 feet, rather than a total depth of 197 feet (127 + 10 feet) in appiicant's claim~ Although the ownership o~ this right-of-way appears undisputed, this board must view the total lot area as that ~escribed in, the applicant's deed and tit~e documents, exclusive of the area within the 50' right-of-way, which is unbuildable. ,5~.. For the record.it i~'noted there~is a conditional variance rendered under Appeal No. 2090 November 6, 1975, concerning the location of an accessory building in ~he front- yard area 25 feet from the front property line, which applicant has agreed to void and which structure has been eliminated from the relief requested by this application. In considering this appeal, the board also finds and determines: (a) that the relief requested is not unreason- able and is not substantial in relation to the zoning require- ments; (b) there will be no substantial change in the character of the area; (c) the circumstances of this parcel are unique; ~d) the practical difficulties are sufficient to warrant the granting of the relief requested~ (e) there is no other method feasible for appellant to pursue other. than a variance; (f} in ~iew of the manner in which the difficulties arose and in considering all the above ~actors, the interests of justice will best be served by allowing the variance, as noted below. Accordingly, on motion by Mr. Goehringer, seconded by Mr. Sawicki, it was RESOLVED, that a variance for permission to construct addition for a maximum of 26.7% lot coverage, or 2307.square feet, in the Matter of the Application of MARJORIE D. PETRAS under Appeal No. 3497, BE~A______N~D H_~R__EBY IS APPR~O~E__D_S~JECT TO THE ~OLLOWING'CONDITIONS: ~Pag~ 3 - Appeal No. 3497 Matter of MARJORIE D. PETRAS Decision Rendered June 25, T986 1. Permanent removal of the existing accessory shed in the frontyard area and automatic termination of the variance rendered November 6, 1975 under Appeal No. 2090; 2. Total lot coverage, including all structures, shall not exceed 26.7%, or 2307 square feet. Vote of the Board: Ayes: Messrs. Goehringer, Grigonis, Douglass and Sawicki. This resolution was duly adopted. 1 k ~ ~ -~-0-~-~ N--~-~-~ ~MAN July 3, 1986 SoutholdBoard Appeals Town ACTION OF THE ZONING BOARD OF APPEALS Appeal No. 35]8 Application 'Dated May 2~, ]986 (Public Hearin§ June ]9~ ]986) TO: Rudolph H. 8ruer, Esq. as Attorney [Appellant(s)] for MRS. MARJORIE D. PEYRA5 Main Road Southold, NY 11971 At a Meeting of the Zoning Board of Appeals held on June 25, ]986, the above appeal was considered, and the action indicated below was taken on your [ ] Request for Variance Due to Lack of Access to Property New York Town Law, Section 280-a [ ] Request for Special Exception under the Zoning Ordinance' Article , Section [X] Request for Variance.to the Zoning Ordinance Article XI , Section ]00-]]9.2 [ ] Request for Application of MARJORIE D. PETRAS for a Variance to the Zoning Ordinance, Article XI, Section 100-11~'.~ for insufficient setback of proposed additions from bulkhead along Corey Creek, at 700 Koke Drive, Southold, NY; County Tax Map Parcel No. 1000-87-5-006. WHEREAS, a public hearing was held and concluded on June ]9, 1986 in the Matter of the Application of MARJORIE D. 'PETRAS undq? Appeal No. 3518; and WHEREAS, the board members have personally viewed and are familiar with the premises in question,_its pr~sgnt zoning, and the surrounding areas; and WHEREAS, at said hearing all those who desired to be heard were heard, and their testimony was recorded; and WHEREAS, the board has carefully considered all testimony and documentation submitted concerning this applicatipn; and WHEREAS, the board made the following findings of fact: 1. By this application, appellant requests permission to construct two additions to an existing dwelling which are proposed to be located within 75 feet of the bulkhead along Corey Creek as restricted by Article XI, Section 100-119.2. 2. The additions proposed are: (a) to be attached along the (south) easterly section of the existing dwelling with a setback from the bulkhead along Corey Creek at its closest point of 37.7 feet (27.6' from the proposed deck), and (b) to be attached at the northwesterly corner of the existing dwelling with a setback from the bulkhead along Corey Creek at-its clos- est point of 67± feet, all as shown on survey amended May 19, 1986 prepared by Howard W. Young~ L.S. ~. ~ pcemise~ iD ques$!on.is located along the souther y s OT a private rign~-oT-way reTerred to as "Koke (CONTINUED ON PAGE T~O) DATED: Form ZB4 dune 25, 1986. (rev. 12/81) CHAIP/~AN, SOUTHOLD TOW~N ZONING BOARD OF APPEALS Page 2 Appeal No. 2518 Matter of MARJORIE D. PETRAS Decision Rendered June 25, 1986 Drive" containing an area o~ 8,641 sq. ft. [exclusiv of the "Koke Drive" right-of-way] and frontage (lot width) of 100 feet as depicted on the May 1, 1986 survey of HoWard Young and deed at Liber 6605 cp 104 dated August 8, 1969. I The subject premises is improved with a single-family on~-story frame house set back 28.6 feet from the front proper.ty line (along the south side of the right-of-way), set back~ 27.6 feet ~rom the bulkhead along Corey Creek, and having side~ards of 8.4 teet on the west side and 19.8 teet on the east iside. Also existing is an 8.2L by 10.2' framed accessory shed, which applicant has not included as part of the relief re- quested since the shed will be permanently removed. 4. Submitted 'for the record is a copy of Per'it No. 752 from the Southold Town Trustees which permitted the tonstruction o~ a "...bulkhead 65 feet across applicant's propert~ .... " 5. It is also noted for the record that a conditional variance was granted by this board same date hereof Under Appeal No. 3497 with conditions concerning limitations on lo~ coverage for all structures. In considering this appeal, the board finds a]nd deter- mines that by permitting new construction as noted b~low: Ia) the vari. ance will be minimal and not substantiall in rela- tion to the zoning requirement; (b) there will be no Substantial change in the character of the district; (c) the c!ircumstances are unique; (d) that the practical difficulties un~er these circumstances are sufficient to warrant the granting of a variance; (e) there is no other, method feasible for appellantl to pursue other than a variance; (f) in view of the manner in which~~ the difficulties arose and in considering all the above factors, the iinterests of justice wi I1 best be served by allowing a variance, ~s noted below. Acc'ordingly, on motion by Mr. Goehringer, seconded by Mr. Sawicki~ it was ~ RESOLVED, that a variance for permission to cbnstuct two additions within 75 feet of the e~isii~ng bulkhead albng Corey Creek, BE AND 'HEREBY 'IS APPROVED under Appeal No. 35!18' in the Matter o~ ~he Appli~ca't'ion "of MA~JORIE D. PETRAS, .SUBJECT TO THE FOLLOWING COND~I'~ON: ., ..... There be a setback from the existing bulkheadi along Corey Creek of the proposed new construction not closer th~n 37.6 feet (delete extention of deck). Vote of the Board: Ayes: Messrs. Goehringeri', Grigonis, Douglass and Sawicki. (Member Doyen was absent.) This resolution was duly adopted. ~ERARD P. ~'INGER, Ch~AIRMAN uuly 9, ~98~ Examined..~..I.I .... Approved FORM NO. 1 ': '' TO'~N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ., 19~.~Permit No..1.~----~. Disapproved a/c ..................................... .... (Building Inspector) APPLICATION FOR BUILDING PERMIT BLDG. DEPT. TOWN OF SOUTHOLD ,Received 19 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan 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 wk~ole 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 inspectors on premises and in building for necessary i spectior~. (Signatur~J.of applicant, or name, if a corporation) .L-...?...s. ............ ._. ~(Majlingta~tdress of apBliqa~t) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises'. .... ~'/~ '3'o'tr~ I.~,.. ..... .~ ...... · .~. ~/~.-~. ..................... (as on the tax roll or latest deed) If applicant is a corpo'ration, signature of duly authorized officer. (Name and title of corporate officer) ? Builder's License No ....... O..~. t?.O..~.N., .N.O?...~!~ .~ '(;~ Phnnber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done. ' .............................. .......... . ........ .,,5o .4g,.o. Ld ........................ House Number Street Hamlet County Tax Map No. 1000 Sectiou ...... .~.1 ......... Block 5 Lot Subdivision ..................................... 'Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended ose and occupancy of proposed construction: a. Existing use aud occupancy I Fth~,'rl L-f' ~l.U~t.l_~ ~._. . .................... b. Intended use and occupancy k( ppli bl ) ' ' ' Additi Alt ti 3. Natureofw0r check which a ca e: lng .......... on .... era on .......... Repair Removal Demolition ' Other Work 4. Estimated Cost.. ~f' .~ ~90 O O O .~ (Description) ................................... Fee .......... ,.. (to be ~aid on filing this application) 5. If dwelling., number of dwelling units ...... . ........ ~. Number of dwelling uni:s on each floor ....... ; ........ If garage number of cars i : 6. If business, commercial or mixed o cupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existingstmctures, ifany: Front ............... Rear ....... i........Depth ............... Height ............... Number of Stories ............................ i ............................ ' ~ Rear Dimensions of same structure With'alterations or additions: Front ...... , ..... , ....................... Depth Height Number of Stories . 8. Dimensions of entire new construction: Front ..... ~ ..... Rear ........ i ....... Depth .......... Height ............... Number of Stories ..... '2~_~' ' .... 10. r ....... :.l . .. Name of Former Owner .i ..... .~...~..~..?..~. ....... 11. Zone or use district in which premises are situated . . .t~.,~.--~.d.~...k-i~,.Xt&c..~..~..~,ret.?.o..t...-r,,u~,~t.. 12. Does proposed construction violate any zoning law, ordinance or regulation: .... [..~..O. ....................... 13. Will lot be regraded ...... : ..................... Will excess fill be remove~l from premises: ryes 14. Name of Owner of premises .~.....1).~ .~..1~?~.~.~. Address~.! I'~tc?tq~-~, ~'?r Ph,,-oNo Name of Architect .,...-7'y ..................... Address..~.~.~.o.~... ?.~.u.~. .... Phone No.. i.. i. i ..... .. Name of Contractor Address i Phone No 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, S.S COUNTY OF ................. ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ............................................................. i ............................ (Contractor, agent, corporate officer, etc.) af said owner or owners, and is duly authorized to perform or have performed the s~id work and to make and file this application; that all statements contained in this application are true to the best of hi~ knowledge and belief; and that the ~vork will be performed in the manner set forth in the application filed therewith. ~woru to before me this HKEN K. D£ /~.,, NOIAllY PUStl0, ~tl~ of New Yodl ............ '~ : (Signature of, applicanO , THE NEW YORK BOARD OF 'FIRE UNDERWRITERS Dat, Jpplicatlon No. on file N THIS CERTIFIE~ THAT o~y the ele~trJceJ equipment ~ ~scribed below and i~tr~ced ~ t~ appli~a~ t ~e~o~ th~ve epplication n~m6er i~ the prem~es of in the following hwation; ~ Basement ~v~sexa,llnedon ~E~y ~,~ ~.9~ DRYERS FUIINACE MOTORS [~ lst Fl. [-] 2~d El. Section Block Lot and found to be in co,tplia,ce [cit h the re t*~ire,~ents o.f tbls Board. FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS FUTURE APPLIANCE FEEDERS TiME CtOCRS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FS~T SERVICE DISCONNECT S E R V I C This certificofe must not ~e ~lter~ in ony monner; return fo the office o~ fAe 8o~r~ i~ incorrect, Inspe~fors moy be Jdenti~ed~by their COPY FORBU LD NG DEPARTMENT. THIS COPY OF CERTIFICATe, MUST NOT BE A~g. ED Iff ANY ~NNER.