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Home My WebLink About14503-zFORM NO. 4 TOWN OF SOUTBOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25686 Date: 04/28/98 THIS CERTIFIES that the building NEW DWELLING Location of Property: EAST END ROAD (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 5 Block 2 FISHERS ISLAND (HAMLET) Lot 10.4 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 10, 1985 pursuant to which Building Permit No. 14503-Z dated JANUARY 13, 1985 was issued, and conforms to all of the requirements of the applicable p~ovieions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH ATTACHED DECK, COVERED WALK, & GARAGE WITH ATTACBED SHED AS APPLIED FOR. The certificate is issued to BARBARA FOSHAY MILLER of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF BEALTH APPROVAL 85-SO-205 01/06/87 ELECTRICAL CERTIFICATE NO. N-452733 05/05/98 PLUMBERS CERTIFICATION DATED 04/09/98 GADA PROPERTIES LLC Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereb/granted to: ,~, ~ ~ ....... .g.,...c..... ................. .~,~......~~,....~..~, ....... ...... '- .................................................... Counly Tax Map No. 1000 Section .... ...~....~""~.. ........ Block .... ..~.......~.. ....... Lot No ...... I....~).:..d(. ....... pursuant ,o opplication dated ..~..~....L~l~.....)....~. ................. , 19..~...~...C and approved by the Building Inspector. Building Inspector Rev. 6/30/80 in the following location; [] Basement was examined on APRIL 27,1998 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE o75o 2 BU.E^U OF E.ECTR,C,Ty 40 FULTON STREET, NEW YORK, NY 10038 Date ~¥ 05,1998 Application No. on file 15936998/98 N 452733 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of FOSLAY/HILLER, EAST END ROAD, FISHERS ISLAND, NY [] 1st FI. [] 2nd El. GAR/OUT Section Block Lot SWITCHES INCANDE$CI FIXTURE OUTLETS RECEPTACLES and found to be in eomptiance with the National Electrical Code. RANGES SERVICE DISCONNECT NO. OFI S R AMT. AMP. TYPE ~ I 0 2W I ~ 3W 3 ~ 3W 3 ~ 4W NO O~OND A W. G O~CC. COND, OTHER APPARATUS. ENTIRE PRENISES-1 *NO VISUAL DEFECTS: "An electrical survey has been made of the exposed electrical equipment in the premises indicated." "No obvious unsatisfactory condition %las foun~. TIME CLOCKS / BELL UNIT HEATERS MULTI-OUTLE SYSTEMS AMI'. AMPS./ TRANS. NO. OF FEET V I NO, OF HI-/E~ DIMMERS C E I A, W. G, NO OF NEUTRALS OF HI-LEG OF NEUTRAL BD REMODELING AND RESTOR. PO BOX 477 FISHERS ISLAND, NY, 06390 GENERAL MANAGER This certificate must not be a tered n any manner return to the offl~ ~, ~k~. ....... . . )er 1[ · -,- ,~, ,,,~ ~uu~u I ncorrecn nspectors moy be Identified by the r credentials. RICHARD F. LARK MARY LOU FOLT$ LARK & FOLTS Attorneys at Law 28785 MAIN ROAD - P. O. BOX 973 CUTCHOGUE, NEW YORK 11935-0973 (516) 734-6807 July 31, 1998 Mrs. Georgia Rudder Southold Town Building Department Southold Town Hall 53095 Main Road Southold, NY 11971 RE: East End Road, Fishes Island, New York (SCTM ~1000-5-2-10.4) Dear Mrs. Rudder: Enclosed is Certificate of Occupancy No. Z-25686 dated 4/28/98 on premises owned by Barbara Foshay Miller. It is my understanding you will amend the C.O. to include the garage, shed and covered walk as shown on the survey of Chandler, Palmer & King dated April 27, 1998. Very truly yours, RFL/bd Enclosure BUILDING DEPARTMENT TOWN HALL APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 waker 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 soldsr 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 architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. ' 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. C. 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 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 April 9, ~ New Construction ..... ~ ..... Old Or Pre-existing Building ................. Location of Property ................ East End Road Fishers Island House No. Street ~amlet Dnwer or Owners of Property... Barbara Fosha¥ Miller County Tax Map No 1000, Section .... ~ ....... Block.. 2 L~ 10.4 Subdivision ................................... '.Filed Map ............ Lot ...................... Permit No .... 14503...........Z .Date Of Permit..~ ~/~. ...... Applicant,s, .~9~D. ~. ~.~ ...... Contracting Health Dept. Approval.'.. 1/6/8~ ~0/~5 ...................... Underwriters Approval ................. Planning Board Approval ........................ ~,equest for: Temporary Certificate ........... Final Certicate.. X Fee Submitted: $. ~.5.. ~ 0 ,..- ~J~ G ~ ~ Barbara Fo s h'a'y' h'i'i'l'e'r' ~ ~' ' ' · ................ Jul. Ol. lgg8 10:50 AM "~' BLDG DEpT £OT 7 P-ro~ -' P-ISHHR~ I~LAND I~RTH~ I~ORK$ 516 7887011 Jul.01.1998 10:50 AM P03 l~]O0~ .,! .I F'~'om : FISHllERS ISI_I~ND WATF-.R WORKS 51.6 788701.L STEpHEH L, I{~, III 1V~TTHE~,v'S ~ H~.M .~TTORI~IEYS AND 00UNSELLOR$ AT LAW 45 ~{AMPTON ROAD SOUTHAMPTON, N,Y. 11008 June 26,1998 Town of Southold Building Depadment Town Hall P.O. Box1179 Southold, NY 11971 Attn: Georgia Re: Certif cate of OccuPancy No. Z-25686 Dear Georgia: Further to our telephone conversation earlier today, [ have enclosed a copy of an excerpt from a survey of premises at Fishers Island (SCTM No. 1000-5-2-10.4) and a copy of Certificate of Occupancy No. Z-25686 relating to that property. Would you please confirm that this CO covers the covered walk, garage and shed, as well as the single-family dwelling and attached deck, as shown of the enclosed surgey. Thank you for your attention to this matter. Sincerely, Enclosures SO CONFIRMED Town of Southold Building Department By Stephen L. Ham, III Bldg. 40, SU~--P. oom 219 A review, has been ma_de of your proposal N~ ~or~ State Department of Environmental Conservation has found the ,, parcel .~< project to be: Greater than 300' from inventoried tidal wetlands. Landward of a substantial man-made structure. greater than I00' in length constructed pr~or to September ~_Landward o~ 10' contour elevation a~ove mean sea level ~..~9.gradual, na=ural slops. ~;F ~;~.~;A~,~ ~4/,~/'~F ~'~ ~ ,, Landx~ard of top~,raphieal crest ~fhluff, cliff or duna in excess of 10~ in elevation above mean sea level. Therefore, no permit under Article 25 (Tidal Wetlands of the Environmental Conservation Lmm) is required at this time since the current proposal is beyond State mandated Jurisdiction pursuant to this act. H~ever, any additional work or modifications to the project may require a permit. It is your responsibility to notify this office, in w. rriting, if such additional work or modifications are contemplated. Very truly yours, .- Alternate Pex~mit A~ninistratoT C~!:DDR:co~s JAMES V. RIGHTER ARCHITECTS 58 Winter Street BOSTON, MASSACHUSETTS 02108 TO (617) 451-5740 WE ARE SENDING YOU ~ Attached [] Under separate cover via [] Shop drawings [] Prints [] Plans *~ Copy of letter [] Change order [] [] Samples [] Specifications COPIES DATE NO, DESCRIPTION I ._ THESE ARE TRANSMITTED as checked below: [] For approval [] For your use ~i~ As requested [] For review and comment [] FOR BIDS DUE [] Approved as submitted ~ Approved as noted [] Returned for corrections 19 [] Resubmit [] Submit [] Return__ copies for approval copies for distribution corrected prints [] PRINTS RETURNED AFTER LOAN TO US REMARKS If enclosures are not as noted, COPY TO TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. Owner ~) ~ 0~..~ (please ~rint) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this · ~[ .day of' /(~)~.~' , l f7 Notar~ Public~ ~ County Notary Public NQ. 4707878. Te~m Expi~ M~h OF SOUTI OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date April 9~ 1998 Building Permit No. 14503 Z Owner Barbara Fosha¥ Miller (please print) Plumber Gada Properties LLC (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. By Sworn to before me this '~3./~ day of. April _, 19 98 '. Notary Public, Suffolk .... County GADA PROPERTIES LLC (p-lumber' s signature) A. John Gad,a, Jr. Notary RICHARD K Notary Public. Stole of New Ymk No. 743~500 - Suffolk ~nty Co~Issio. E×pires Aug. f ~" F'r6m : FISHERS ISLAND WATER WORKS 516 7887011 Apr. 03.1990 765-i802 IBUILDIN(~ DEPT. INSPECTION 03:52 PM FOUNDATION 1ST I J ROUGH PLBG. FOUNDATION 2ND [ .) INSULATION FRAMING ~ ~'~I~AL p01 Memorandum from... BUILDING INSPECTORS OFFICE TOWN OF SOUTHOLD TOWN HALL, BOX 728, $OUTHOLD, N.Y. 11971 765-1802 /ooo ROBERT YK DAN/EL~ UR* ond LINDA H, DANIEL BIo~# I tot8 I~ISH~R$ ISLAND, N£W ~'ORK N~'w~h~ Gonn. APR[{. ~7~ ~;olnCy Righter ,,h i t c c t s C t a i g i.J. G i FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall 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; 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 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- t~ons, a certificate of Code comphance from the Arch tact or Engineer responsible for the buildina. 5.Submit Planmng Board approval of completed s~te p an requirements where applicab B, 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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5,00 3. Copy of certificate of occupancy $1.00 Dat 12/10/,S6 New Building x. Old or Pre existing Building ' Vacant Land Fishers Island, NY Location of Property .P.a. ~'~../~,~- .e.a ........................................................ House No. Street ; Ham/et Owner or Owners of Property County Tax Map No 1000 Section 05 Block .2 · Lot ~..[.0 .4. Subdivision ................................. Filed Map No ........... Lot No ............. Permit No..~.4.5.(~3~... Date of Permit ~,/.1.3./. 8. .5. .Applicant Health Dept. Approval ........................ Labor Dept. Approval Underwriters Approval ........................ Planning Board Approval Request for Temporary Certificate , Final Certificate Fee Submitted $.. ~5...Q0 ...................... Construction onabove described' building' ' and perj;mt' meets all applicable codes and regulations. Annlln~nt A. John Gada General Cch~t'ractln Inc..... . ,,.,..,~ ............t .............................. .g.' ....... Rev. 10-10-78 No~ember 15, 1985 III. FOSHAY HOUSE Pr ellmi~am~ Specifications t. Concrete 1. Foundation walls reinforced concrete, as 2. 3. 4. II. Masonry 1. Concrete block chimney with clay-lined per coder see details. Basement slab wire mesh reinforced concrete on well- drained compacted base· Basement slab sloped to drains. Exterior foundation walls waterproofed below grade and par§ed above grade. flues, or equal. Chimney faces with brick (see elevation for bonding pattern). 2. Concrete block foundation piers as drawn. 6. 7. 8. Carpentry 1. Provide 2. Install 3. Kitchen lation). Bathroom vanities allow $1,700.00 lation). Blocking behind all towel racks. Pressure treated lumber on sill. Termite shield. hurricane clips. continuous ridge vents· Verify with architect· cabinets allow $10,000.00 (Cabinets and instal- (Cabinets and instal- Strapping on sheetrocked ceilings with outsized rafters and beams, and/or where rafters are adjacent to exterior. Fireplace mantel, surround, and flush hearth, allow $1,000. Garage: 22'x22' Use same mmterial finish, roof pitch, and eave detail as house. 3 windows by Marvin, same as number 8 in window scheduleR Reinforced concrete slab floor. 2 overhead doors. One 2~ x 6~ door by Morgan, M-lO0. Provide electrical service, 2 overhead lights, outlets to code, and 220 service for golf cart. No. IV. Doors and Windows 1. Doors Type Mnfg. Size Hdwr. Notes 1 Pine M-7984 Morgan iA Storm/Screen No.ll " 2 Pine M-5911 " 2A Storm/Screen No.ll " 3 Pine M-7984 " 3A Storm/Screen No. I1 " 4 Interior Fir/ Brosco 2 panel 10 " " 1 1 " " 12 " " 1 3 " " 1 4 " " 15 " 1 6 " " 17 " " 18 " " 19 " 2 0 " " 21 " 22 " " 23 " " 24 Pine M-2011 " 24A Storm/Screen No.lt " 0 3° 30 3o 28 28 30 28 26 26 26 26 26 26 24 24 28 3° 26 28 2--8 28 2° 2° 18 2° 26 26 x 68 x 6-8 x 6-8 x 6-8 x 6-8 x 6-8 X 68 x 6-8 x 6-8 x 68- x 6-8 x 6-8 x 68 x 6-8 x 6-8 x 68 x 6-8 x 68 x 68 x 6-8 x 68 x 6-8 x 68 x 68 x 6-8 x 6-8 X 68 x 6-8 pair A Weather B St r,i, pping B " A C D D C D E E E E E F G F F F F F F F F A Weather Stripping IV Doors and Windows iA. Hardware Type Function Mnfg. A Entrance Lock/ Schlage Deadbolt B Passage Latch Schlage C Spring Loaded Stanley Hinge D Passage Latch Renovator's Supply E Privacy Lock Renovator's Supply F Closet Latch Renovator's Supply G Dorm Motel Lock Schlage Model No. Finish H153 Al05 RD2068 50016 (vfy. w/ Archt.) 50016 50016 A73PD Plymouth 626 Plymouth 626 Brass Push Plate White Porcelain White Porcelain White Porcelain Plymouth 626 2. Windows No. Type Size Qty. Triple Track Storm/Screen i. Marvin 12/1 d.h. 36 x 32 2 2. " 8/1 d.h. 32 x 28 6 lO"x6' 8~'' 2 3. Brosco M-127 0'- - 4. Custom/Fixea 32 x 24 8 5. Marvin 6/1 d.h. 20 x 24 1 6. " 8/1 d.h. 32 x 16 7. " 8/1 d.h. 32 x 24 7 8. " 6/1 d.h. 28 x 24 3 9. " 1/1 d.h. 32 x 24 10. " 1/1 d.h. 32 x 30 4 11. Custom/Fixed 72 x 60 1 12. Marvin 6/1 d.h. 24 x 24 3 yes yes glass storm panel glass storm panel yes yes yes yes yes yes glass storm panel yes Note: Ail windows will have True Divided Lights, and single glazing. Finishes 1. Walls and ceilings ½" gyp. bd. painted 2 coats flat paint. Double sheetrock both sides of bedroom walls backing on baths. Wainscoting in foyer. Beaded board ceiling in big room, entry porches, and deck overhang. 2. Bathroom walls and ceilings greenboard painted 2 coats flat paint. 3. Ceramic tile around bathtubs as shown in interior elevations. Use wonder board behind all bath and shower surrounds. 4. Floors: Red oak throughout house, sanded, 2 coats polyurethane. Kitchen adnd bathroom floors of vinyl tile. 5. Interior trim painted 2 coats semi-gloss. asbestos 6. Exterior walls: red cedar shingles with 2 coats mix- ture Cabot's bleaching oil and Cabot's stain. 7. Exterior trim painted 2 coats enamel. Back prime all exterior trim. 8. Roof: red cedar shingles. VI. Equipment VII. Appliances: allow $5,000.00 Includes refrigerator, cook-top, double-wall oven, range hood, dishwasher, disposal, washer, dryer. (Appliances only-- not including installation) Heating 1. Oil-fired warm air heating. 2. 500 gallon fiberglas tank in ground. 3. Oil-fired 80 gallon hot water heater. 4. Provide low-setting thermostat. VIII. 1. 2. 3. 4. 5. 7. 8. 9. 10. 11. 12. -5- Plumbing Provide water service to house. Toilets: Am. Std. white elongated water saver cadet # 2109.405. Bathtubs: Am, Std. white spectra bath 5~ long # 2607.109. Master Bathroom shower ceramic tile 32 x 3~. Bathroom accessories allow $400.00 for both bathrooms: including medicine cabinets, towel racks, toilet paper holders. See interior elevations for placement. Master Bathroom lavato~e~Am. Std. Moen faucet # 4420. Guest Bathroom lavatory: Am. Std. Moen faucet #4420. Circlyn # 3201.035. Roxalyn # 0194.076. Kitchen Sink: Elkay LWR-3322-R. Moen kitchen deck faucet # 7310, Bar Sink: Elkay BCR-15. Am. Std. gooseneck faucet # 7516.172. Provide tempering valve for all toilets. Provide complete septic system. Bathtub and shower faucets: Simmons "Temptrol" single knob control. IX. 1. 2. 3. Electrical Provide underground electrical service to house. Provide lights and outlets tO code. kllow $2,500.00 for additional non-code light fixtures (fixtures only-- not including labor). Verify with Architect placement of electric meter. Electrical outlets 12" (center line) off finish floor, except where noted. Put down all bulbs for each fixture. X. Miscellaneous 1. Building Permit by Contractor. 2. Provide phone service to house. 3. Leave grounds clear and free of debris. grade as drawn. Back fill and ',TION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 40' S lO°l~'lO"E \~ 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined..~ O0~q, .... 19 !.2..., 19 ~.~/. Permit No. t ~.'~.'7~)..~..'~-'. 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 whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described· The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessar~ illzpectioF's~ /'~ /") · A, .4 .o~..~.'.m.. ~.~..~,~(..~..~?..~..0!~ ....... \ (Signature of applicant, or name, if a corporation) ..... ~;iliad aii;esi o~ appl'icant)' State whether a~nt is owner, le~ee,~gent, architect, engineer, general contractor, electrician, plumber or builder. ............ .... .................................... Nam~ of owner of premises ..... Zfi?.~. · .~f...~.///- .~. '.. · .~. ·: · · .~/.'. · .'~...J'/.'~?. -~. .............................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ~ .... ~~ .... ~~/ .............. /,'r~,~ =~(Name and title of corporat~officer) Builder's License No...~../.. Plumber's License No. [//~ Electrician's License No. Other Trade's License No../.~..~.~...~..~. ........ 1. Location of land on which psonosed work will be done ........................................ :..~ ...... House Number Street Hamlet .aT.. .,./e.g. . County Tax Map No. 1000 Section . ~ .......... Block ...... Lot ......... *.. . Subdivision .................................... ~ Filed Map No ............... Lot ........ ....... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed constrnction: a. Existing use and occupancy ~.~ b. Intended use and occupancy' . .... ~..~.A(.~ ............. ' ................................ 3. Nature of work (check which applicable): New Building .. ~ ..... Addition...;..~ ..... Alteration ....... ~... Repair .............. Removal .............. Demolition .......... .. Other Work ........ : ....;.. (Descnphon) 4 Estimated Cost . Fee .................................. * (to b~ p~id on filing this application) 5. If dwelling, number of dwelling units ..... / ......... Number of dwelling unit~ 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 structures, if ano: Front* ............... Rear ........ ; ...... Depth .............. i Height ............... Number of Stories ............................. ! ........................... Dimensions of same structure with alterations or additions: Front ............. i .... Rear .......... ; ....... Depth ...................... Height ...................... Number o$ Stories i ~e'p't~' i i '~i 3 ....... .~8. Dimensions orsrrentire new construction: Front .... 7~r. ./ ..... Rear ...*7/.' .'..{. ..... . .......... Height . .<~.. ........... Number of Stories .............. t~ ........... I ..... : ............ 9. Size of lot: Front ..... /./.7:.?7.......... Rear ..... 3. ? .............. t>epth .. 7.*. ........... 10. Date of Purchase ............................. I~e of Former Owner . -i ........................... 11. Zone or use district in which premises are situated ..... ~ .~'.t~./'.~.~t-t .~l'.a.I. ...... , ....................... 12. Does proposed constructiort vfiolate any zoning law, ordinance or regulation: .... ~f.O.' i .......i..i ............. 13. Will lot be regraded .... /V.,O..;. '.eP':. .............. Will e~c~ss fill b~ej~emoved! from premises: _ Yes , ~ 1 4. Name of Owner of p/~.mises/[dd,.d~ ~ .+~.~1~0¥ ........ Address~--~S.u.a~..~/~u.4 ~ ]('.tr/. · Phone No. ")~z-'Tf~.~.... . Name of Architect .~].A.~_.~ :~-~..,t~.. ~. ...... Address' ~.*.~W.~.t.. ~. · '.~. ~ il.. i Phone No ~/.7: ~?[.' S~r~ ' Name of Contractor .~., ~6..~..(~.~.h..A Address~.~.q~.. ,~/4~.~.~v ~...c], Phone No' ~'.'~}'~71~i i i i i 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. ............................. >~..~.'. ............. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. /'~ : ~e is the ...... (Contractor, agent, corporate of fleer, etc.)[ >f said owner or owners, ~d is duly author~ed to perform or have perfo~ed the s~id work and to m~e and file this ~pplication; that all statements contained ~ this application are true to the best of hi~ igc and belief; and that the ~ork w~l be perfomed in the m~ner set,forth in the application filed therewith. worn to befo~e~~ ~this ~ No. 4gOe650 ~ ] . (~at¢{e of appliqant) Term ~plre~ 3/~01~0 ~ ....... __ 300. I~ ~4~ 20 Io~otod 0~0¢1¢ I s $ ° 31 'PO "£ ~ ~1~' ? P.9 ol?'IO "£ from 0~ Ooost Ond GoodO'io ~urvoy , SINGLE ~A~Y ~WELLING oNLY ~HiS DEP4~T~ENT AND 9 I0~14'10"£ 7~ N OPo 4?~OOw [~! 8¥: NOTIFY,BUILD NG OF.-PAF~ME~T, AT ,, 766-1'1~02 9 AM-TO 4 PM POR THE ~,' ~OLLOWIN6 NSPECTIONS: FOR POURED C~ CRET~ r~4. FINAL CONSTRUCTION MUST AI~ CONSTRUCTION SHALL MEET TI~ REQUIREMENTSrOF THE N~Y STATE' CQNSTRUCTION CODES, NOT RESPON, SIBLE FOR '~r '1 !1 '1