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HomeMy WebLinkAbout26066-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27267 Date: 08/22/00 THIS CERTIFIES that the building ALTERATION Location of Property: 45395 MAIN RD (SOUSE NO.) (STREET) County Tax Map No. 473889 Section 75 Block 2 Subdivision Lot 11 SOUTHOLD Filed Map No. __ Lot No. __ (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 17, 1999 pursuant to which Building Perrait No. 26066-Z dated OCTOBER 21, 1999 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 & ALTERATION TO EXISTING STORAGE BUILDING AS kPPLIED FOR. The certificate is issued to JANET A DAVIS of the aforesaid building. (OWNER) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 26066 Z Date OCTOBER 21 99 Permission for : is hereby granted to: JANET A DAVIS 485 CARRINGTON RD CUTCHOGUE~NY 11935 ALTERATION TO ACCESSORY STORAGE BUILDING AS APPLIED FOR. at premises located at 45395 MAIN RD County Tax Map No. 473889 Section 075 pursuant to application dated AUGUST Building Inspector. SOUTHOLD Block 0002 Lot No. 011 17 99 and approved by the Fee $ 35.00 Auth~ed Signature ORIGINAL Rev. 2/19/98 JUN 2 8 2090 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: i. 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 i% 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" laud 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 w~iting to the applicant. C. ~ees 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~ - $i00.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construotiou ........... Old Or FreZ~isting Bui~dingt.~.t..~A~. ........ Location of Property..~.~.O..~.~...~&~..~f~..g~.. .......... ...~.S~-~.~.~.k..~ ...... House No. Street Hamlet ouwer or O ers. gCPT ...... ............................. couut~ ~ ~p No ~000, Section...O. 7..O--.. .... Block..~P..~ ...... ~ot...O./Z ............. S~bdivision .................................. . . ~iled Map .......... .. Lot .................... . Permit No.a~.O.~.~.~..Date Of Permit~/.~/./.~.~..Applicant...~..C~.-~-- ~.~-.~..,..~-~-~-~~- Health Dept. Approval .................. ........Underwriters Approval ........................ Planning Board Approval............ ........... . Request for: Temporary Certificate ........... Final Certicate. X ....... CANTILEVER DETAILS CANTILEVER, UNREINFORCED b~oek~.g pane,s {see detail F2i CANTILEVER, REINFORCED reqlJl[ed at Canll~VE~$ and ~ Single Sheathing (Option I) nm hoard, max ~nhlever length ,s 2' ' ~ CANTtL~E~, RE~NFORCEO DOUBLE RE[NFO~CEMEN~ NAILING PA~E~N Double Sheatt}ing (Option II) ~3~. ~A~ '~6,,X ~ CANTILEVER, REINFORCED ~ CANTILEVER. DROPPED I ~ Double Joi~ (Option Ill) v FLOOR DETAILS (~ FLOOR OPENING, TOP MOUNT HANGERS (regular lilier) Joist JoiSt Oepth M~teriat [~ FLOOR OPENING, FACE MOUNT HANGERS the backer w,tl fit. Clinch when possible, thstall STRINGER TO JOIST CONNECTION Double Woad I Beam' const r uclion per detail F11 full deplh Hangers for Nailing Requirement B Jail Davis Aiitiques Phone 631 ~765-2379 E-mail jadav~suffotk lib ny us PO 1604 45395 Main Rd. 8outhold, N.y. 11971 June 07, 2000 Mr. Doug Carey Georgia Pacific 4300 Wildwood Parkway Atlanta, Georgia 30339 Dear Mr. Carey, It was a pleasure speaking with you yesterday I sure hope you can help me. Enclosed are the plans for the barn you requested and a copy of the Building Dept. Inspection. The "I" beams used are Georgia Pacific. The barn has been completed for quite some time now and I was hoping to use it for storage for the tourist season. The inspector is questioning the items mentioned in the "remarks". He is requesting some type of documentation that the items addressed conform to your specs for proper support. Originally the contractor supplied specs for the "F' beams and followed directions for installation. He installed a line nf metal webbing across the width of the "I' beams. The inspector mentioned "squash blocks" but did not include anything about them in his report. The building is quite small and the overhang on each end is only 11" as you will see from the plan. If you have any questions regarding this matter please do not hesitate to call. I can reach my contractor if you have questions for him. Thanking you in advance for your kind attention in this matter. Sincerely yours, {/~anet A. Davis FLOOR DETAILS FLOOR OPENING, TOP MOUNT HANGERS [~] FLOOR OPENING, FACE MOUNT HANGERS Backer 91ocks * 40 and Backer block E) [~ STRINGER TO JOIST CONNECTION CANTILEVER DETAILS CANTILEVER. UNREINFORCED CANTILEVER REINFORCED Single Slleathing (Option I) For tiber conditions contact Georgia-Pacific, CANTILEVER, REiNFORCED Double Sheathmg(0ptionll) DOUBLE REI~'JFORCEMENT NAILING PATTERN IIIIII L ~ ~.-S ~/.'.~',× CANTILEVER, REINFORCED Double Joist (Option Ill) 23/32" AsheathlnPA 2 0" max [~ CANTILEVER. DROPPED GEORGIA-PACIFIC CORPORATION Doug Carey 22 Jun 2000 2:27 pm 4300 WILDWOOD PARKWAY, ATLANTA, GA. 30339- (770)221-2508 FASTBeam® En~lineednfJ Analysis © 1996-2000 Georgia-Pacific Corporation Version: 3.1(95/NTt Build: 3.1.0.0 Project: Information: Davis Job Mark #: Joist - Floor Desc: Usage: Joist(Floor) Repetitive: Yes Spacing (in.): t6.0 Max Deft: LL = 1_/480 TL = L/240 Composite Action: Yes (*See Note #8) II 3.5", 565 psi II 3.5", 565 psi il' o"] 48, 6- il, o,,I LOADS Project Design Loads: Floor: Live=40 pst, Dead=lO pst; ROO~' Live=30 pst, Dead=15 ps~ Live+Dead Ld(T) Live Ld(L) LDF Location* # Shape RStart REnd RStartREnd Span# Starts Ends Additional Info Spcg Sen Uniform(pst) 50 40 100% 0 0' 0" 20' 6" 16" o.c. Base Uniform Load (Spacing Sensitive) t Line(plO 465 310 115% 0 0'0" 16"o,c,- 2 Line(pit') 465 310 115% 0 20'6" 16"o.c.- *Dimensions measured from left end when span# is o, otherwise, from/eft end of the specified span. SUPPORTS(lbs) 1 2 Max R'n 1327 1327 Min R'n 321 321 DL R'n 343 343 Min Brg(in.) 3.50 3.50 Stiffener NO NO DESIGN Value Span X Group Allow LDF Ratio V(Ibs) 608 2 0' 2" 24 1710 100% 0.36 M(ff-lbs) 2639 2 9' 3" 23 8052 100% 0.33 IntRn(Ibs) 1327 0 1' 0" 64 3473 115% 0.38 LLDefl(in.) 0.18 2 9' 3" 23 0.46 IJ1211 TLDefl([n.I 0.21 2 9' 3" 63 0.93 1_/1047 See Note #4 USE: WI 80 14.00" ~16" o.c. [ APA-14"PRI-80] Wood I Beam is a trademark of Georgia-Pacific Corp. Grade, Depth selected by User NOTES: 1. Designed in accordance with National Design Specifications for Wood Construction and applicable Approvals or Research Reports. 2. Provide lateral support at the bearing location nearest each end of the member. Continuous lateral support required for compression 3. Design valid for dry use only. 4. This reaction is based on the combination of loads & duration factors that produces the highest stress ratio and may be less than maximum reaction. Therefore, when reaction values are required, use Max R'n from 'Supports' section above. 5. Bearing length based on design material; support material capacity shall be verified (by others). 6. When required by the building code, a registered design professional or building official should verify the input loads and product aapplicailon. 7. This engineered lumber product has been sized for residential use. A concentrated load check, per the building code, must be performed 8. Floor sheathing of 3/4' nominal APA rated OSB or Plywood must be glued.nailed to joists and spacing must not exceed 24" o.c. L~ve defi'n exceeding U480 not recommended(i.e. L/500 is OK). 9. Company, product or brand names referenced ara trademarks or registered trademarks of their respective owners. 10. Allowable upward deflection for cantilever is the greater of 0.20" or the cantilever span (inches) multiplied by 2 and divided by the ~acthr shown In Max Deft (located above beam drawing), 1t, For explanation Of GROUP, change to expanded pdntout. 12. See De~ati Cl for cantilever installation. Page I of I Jan Davis Antiques Phone 631-765-2379 E-mail jadav~suffolk.lib.ny,us / Dougtas P. Carey ~ ~ Georgia. Pacific Colorlon 4300 Witdwood P~, 2nd Fi. AtJanta, GA 30339 TeL 770-221-2508 Fax 770-221-8109 DPCarey@gapac, corn PO ~ 604 45395 Ma~n Rd. 5outhold, N.Y. 11971 U.S.A~ June 07, 2000 Mr. Doug Carey Georgia Pacific 4300 Wildwood Parkway Atlanta, Georgia 30339 Dear Mr. Carey, It was a pleasure speaking with you yesterday. I sure hope you can help me. Enclosed are the plans for the barn you requested and a copy of the Building Dept. Inspection. The 'T' beams used are Georgia Pacific. The barn has been completed for quite some time now and I was hoping to use it for storage for the tourist season. The Lnspector is questioning the items mentioned in the "remarks". He is requesting some type of documentation that the items addressed conform to your specs for proper support. Originally the contractor supplied specs for the 'T' beams and followed dh'ecfions for installation. He installed a line of metal webbing across the width of the 'T' beams. The inspector mentioned "squash blocks" but did not include anything about them in his report. The building is quite small and the overhang on each end is only 11" as you wi~ see from the plan. If you have any questions regarding this matter please do not hesitate to call. I can reach my contractor if you have questions for him. Thanking you in advance for your kind attention in this matter. Sincerely yours, (/~anet A, Davis GEORGIA-PACIFIC CORPORATION Doug Carey 22 Jun 2000 2;27 pm 4300 WILDWOOD PARKWAY, ATLANTA, GA. 30339- (770)221-2508 FASTBeam® Enc, lineerfnc, I Analysis © 1996-2000 Georgia-Pacific Corporation Version: 3.1(95/NT/ Build: 3.1.0.0 Project: Information: Davis Job Mark #: Joist - Floor Desc: Usage: Joist(Floor) Repetitive: Yes Spacing (in.): 16.0 Max Deft: LL = I-/480 TL = 1_/240 Composite Action: Yes (*See Note #8) I 3.5", 565 psi II 3.5", 565 psi LOADS Project Design Loads: Floor:. Live=40 pst, Dead=lO pst; Roof: L~e=30 pst, Dead=15 pst. Live+Dead Ld(T) Live Ld(L) LDF Location* # Shape (~Start ~End ~Start~[~End Span# 0S, t~.?s Ends A.d,~iflonallnfo Spcg Sen Uniform(ps0 50 40 100% 0 20' 6" 16 o.c. Base Uniform Load (Spacing Sensitive) · 1 Line(pi0 465 310 115% 0 0' 0" 16" o.c.- 2 Line(pi0 465 310 115% 0 20'6" 16" o.c. - · Dimensions measured from left end when span# is O, othe~vise, from left end of the specified span. SUPPORTS(tbs) t 2 Max R'n 1327 1327 MIn R'n 321 321 DL R'n 343 343 Min Brg(in.) 3.50 3.50 Stiffener NO NO DESIGN Value Span X Group Allow LDF Ratio V(Ibs) 608 2 0' 2" 24 1710 100% 0.36 9'3" M(ff-lbs) 2639 2 23 8052 100% 0.33 IntRn(Ibs) 1327 0 1' 0" 64 3473 115% 0.38 LLDefl(in.) 0.18 2 9' 3" 23 0.46 I-/1211 TLDefl{in.) 0.21 2 9' 3" 63 0.93 I./1047 See Note #4 USE: WI 80 14.00" ~16" o.c. [ APA~I4"PRI-80] Wood I Beam is a trademarl( of Georgia-Pacific Corp. Grade, Depth seiected by User NOTES: 1. Designed in accordance with National Design Specifications for Wood Construction and applicable Approvals or Research Reports. 2. Provide lateral support at the bearing location nearest each end of the member. Continuous lateral support required for compression 3. Design valid for dry use only. 4, This reaction is based on the combination of loads & duration tacfora that produces the highest stress ratio and may be less than maximum reaction. Therefore, when reaction values ara required, use Max R'n from 'Supports'section above. 5. Bearing length based on design material; support material capacity shall be verified (by others). 6. When required by the building code, a rsglsterad design professional or building official should verify the input loads and product aap,pllcation. 7. This engineered lumber product has been sized for residential use. A concentrated load cheek, per the building code, must be performed 8. Ploor sheathing of 3/4" nominal APA rated OSB or Plywood must be glued-nailed to joists and spacing must not exceed 24" o.c. Live defl'~l exceeding U480 not recommended(i.e. U500 is OK). 9. Company, product or brand names referenced are trademarks or registered trademarks of their respective owners. 10. Allowable upward deflection for cantilever Is the greater of 0.20' or the cantilever span (inches) multiplied by 2 and divided by the tacfor shown in Max Deft (Iocated above beam drawing). 11. For explanation of GROUP, change to expanded printout. 12. See Detail Cl for cantilever Installation. Page 1 of 1 1. PRODUCT NAME Wood I BeamTM WI Series Prefabricated Wooden I Joists and Headers 2. MANUFACTURER Georgia-Pacific Corporation Engineered Lumber Division 133 Peachtree Street, NE Atlanta, GA 30303 Phone: (800) 423-2408 (In the East) (800) 765-5402 (In the West) 3. PRODUCT DESCRIPTION Beam series and sizes are shown in Table 1. Basic Uses:WI Series Wood I Beam joists are used in commercial, indus- trial, institutional, and residential struc- tures as floor joists, roof rafters~ and headers. In many cases, Wood l Beam joists permit longer clear spans and increased spacing between joists as compared to conventional lumber. Made from dry material, they resist shrinking, twisting, splitting, and warp- ing so squeaky floars are minimized. The wide flanges of the Wood I Beam provide more nailing and giuin§ sur- face, and the plywood web allows easy drilling of holes for duct work, electrical, or plumbing requirements. Wood I Beam joists can be cut to lea§th on the job-site. Composition and Materials: Wood I Beam joists are made by bonding lumber flea§es to plywood webs with an exposure 1 rated glue. The flanges are fabricated from 4" x 2" or 3" x 2" nominal size lumber. Lumber used in the lion§es is kiln-dried Southern Pine graded either No.1 Dense or 2400F- 2.0E machine stress rated. The webs are fabricated %" or '9/3~' structural 1 plywood with exterior §lue. The plywood face grain is oriented in a vertical direction. Finger joints are used to fabricate the flanges with appropriate testing to ensure full tension capacity of the mated lumber grades. limitations: Strictly adhere to Geor- gia-Pacific's published installation guide. Please contact Georgia-Pacific for a copy of the guide. Wood I Beam joists should be pro- tected from the weather until in- stallation. Exterior application or any use of the Wood I Beam joists in other than dry conditions is not recom- mended. All loads applied to Wood l Beam joists should be parallel with the web and bear on the top chord. Concentrated toads should not be applied to the bottom chord or to the web. Except for cutting to length, top and bottom flanges of Wood I Beam joists should not be cut, drilled, or notched. 4. TECHNICAL DATA Appflcahle Standards: Ail adhesives meet the requirements of ASTM D 2SS9. Plywood used as web material is made in accordance with U.S. Prod- uct Standard PS 1-83. Maximum Span Capacities: For PEO0 .. pec-Data sheet conforms ~ to editorial style prescribed by~-~ The Construction Specifications Institute. The manufacturer is responsible for technical ac- ~ curacy. literature describing loading con- ditions other than those shown, Please contact (georgia-Pacific. FASTBeam® and FASTPlanTM product selection and inventory software is also available from Georgia-Pacific. 5. INSTALLATION Methods: Wood I Beam joists will not support workers or other loads until properly installed and braced to pre- vent dominoing of the system or buck- ling of the top chord. To minimize the risks of injury, follow the procedures below before allowing workers or other loads on the joists. Each Wood I Beam must be prop- erly fastened as it is erected. Continu- ous closure and/or blocking panels may be installed during or after erec- tion of the joists, but must be com- pleted and compIetely attached before continuing. Rows of temporary con- tinuous lateral bracing (CLB) at right angles to the I beams must then be fast- ened to the upper surface of each par- ariel joists in the bay with a minimum of two 8d nails at each bearing sur- face. The CLB should be 1 x 4 mini- mum and at least 8' Ion§ with o.c. TABLE 1--WOOD I BEAM RESIDENTIAL FLOOR SPAN CHART Simple Span Only (clear spans) Multiple Span (clear spans) Joist Spacing Joist Spacing 06170 APPRAISALS ESTATES, INSURANCE P.O. BOX 1604 SOUTHOLD, N.Y. 11971 Bus. (516) 765-2379 Res. (516) 734-5527 ANTIQUE DOLL RESTORATION Oc ~. eel 765-1802 BUILDING DEPT. [~FOUNDATION 1ST [ ] PLBG. [ ] FOUNDATION2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~ DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FO.~UNDATION 2ND [ ~"' FRAMING [ ~IJLATION [ ~ FINAL [ ] FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] F/O~NDATION 2ND [ ] INSULATION [ ~/'FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ]INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROU~: [ ] FOUNDATION2ND [ !~JLATION [ ] FRAMING [ ~FINAL [ ] FIREPLACE & CHIMNEY .EJ.A.KS= ~ DATE ~'/,.~/~'~ I NSPECTOR~_ ~ULATION PER N. Y. STATE ENERGY CODE FOR~ NO. ! TOWN OF SOUTHOLD BUILDING DEPARTNENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL: 765-1802 ~ued ................. , 19 ........ , ,93. Disapproved a/e .................................. SRTS OF PLANS ............... SURVEY ........................ /CtmCK ......................... NOTIFY.' Z~'c~._..---~'- -~'~' ~ CALL 7.~.~7~ ? 0 ~ ...... ~ ~-~ ~ ~IL TO: .................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ................ ,19... a. This application must be coupletely filled in by typewriter or in ink and sdmuitted to the P~dlding Inspecto~ 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on pr~nises, relationship to adjoining pr~nises or public streets or areas, and giving a detailed description of layout of property rmst be drawa on the diagram daich is part this application. c. l~e ~ork covered by this application vny not be ecmmnced before issuance of Building Permit. d. UlXm approval of this application, the Building Inspector will issue a Building Pemit to the applicant. S~ pemit shall be kept on F_he premises available for inspection threc~ho~t the ~ork. e. No building shall be occupied or used in ~nole or in part for anF Imrpose daatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATIC~I IS I~¥ NAEE to the Building Uepart~nt for the issuance of a Buildiug Permit poranant to the Bui¥ing Zone Ordinance of the Tomu of Sc~thold, Suffolk County, Ne~ York, and other applicable Laus, Ordln~ses or P~gulatioas, for the construction of buildings, additions or alterations, or for removal or demvlitian, as herein described. Tse applicant agrees to c~ply wlth all applicable la~s, ordinances, building cede, housing code, and in build'ug for necessary in ions. ~gt~a~ture of applicant, or nane, if a corporation (millng ~re,~ ot ~Ueant) State ~aether applicant is c~ser, lessee, agent, architect, engineer, g~eeral contractor, electrician, plurber or .... ~ IZ;.a.~.C. ................................................................................................. ~ o~ ~= o~ ~se~ .... .-~7. z~e_~...~.:.~ .~. L S ................................................... (as on the tax roll or latest deed) If applicant is a corporation, $ignatm-e of duly anthoriz~d officer. (Name and title of corporate officer) Builders License No .......................... Plumbers License No .......................... Electricians License No ...................... Other Trade ' s License No ..................... ~. ~tiono~l~aan~i~.orkwilibe~..~.~...~..~..~..... oc ~. . ............ .................. ~.~ ~ ........................................ [klme lq~er Street Itmulet C~ T~ M~ ~lo~1000 Section .0..~..k~'~.. ..... Block ...O.~,~ ...... Lot .... /./. ........ Subdivision ...................................... Filed Map No ................ lot ............... 2. State existing use and occupancy of premises and intended use and cccopancy ~?onStruction: a. .... ..C.4-'4-'-="c' ................... .................... b. Intended use and occupancy .... .~.../..,O..~..C~.C.~..~ ......................... "'.. .................. Repair ........ R~auval ............. L~I ilion ............ Other ~ork .................................. '6~ (Description) 4. Esti,,t~a ~ost ~2J.v.~.~. ........ loc .............................................. (to be paid on filing this application) 5. If dt~lling, nt~r of d~elling traits ............ l~r of d~elling onits on earl: floor ................ If garage, nmt~er of cars ...................................... 6. If business, ccmnercial or mixed occupancy, specify nature and extent of eadt tv~e of use ...................... ..... %-~ ~ ~', ~ ~f4-t,' 7.,,~ns,~s of ex, y_klZ st~res, ,f ~: ~ont.../...~. ........ ~r /a° ...... ~ .... Depth ~Z.~. ........ Ileight .... IL-~ ............. D,~r of S~ories ...... .J. .............. Dhnensions of sam structure mith alterations or additions: Front ../. ~... fl.. :t.... Rear .[.~...b...~. ..... Depth oTk.q../~..~. ~ Beight $.7...~..~. l~r of Stories ..¢7~... 8. Dimensions of entire oc~ construction: Front ................ Rear ............... Depth .............. lteight ......................... Nu~uer of Stories ..'~,,-~-~...--~;;.-'~ ' S. Size of lot: Fro~t /../~...~..~..~..~... Rear ..~...~.,..~..m~.... Depth ..d~..~...?.:...~....~ ~0. ~te o~ ~a=se ..~../g.O../.~..~..~ of~o~r O~r ..t~e--tL..~.. .... .'.~...,.ff.;...~. I I. Zone or use district in which premises are sltt~ated .... ~..C- ................................................... 12. Does proposed construction violate any zoning l~a, ordinance or regulation: ..~0. ................. 13. Will lot be regcaded ...... ~k/.~ ......... Will em=ess fill be reurrvnd [~-on preutiscs: YES ND [5. Is this property '~ithin 300 feet of a tidal ~etland? ~ YES .......... HO j~ ........ PLOT DIAGRAI~ Ii,cate clearly and distinctly ail l~itdings, ~hether existing or proposed, and indicate ail set-hack dimensions from property liocs. Give street and block nt~ber or description aocording to deed, and sho~ street nares and indicate ~netlmr interior or eorocr lot. (l~..-r~ of i~llvidual sigaing contract) above namd, lie is the ................................................................................................... (Contractor, ngent, corporate officer, etc.) of said owner or owners, and is duly sathorlzed to perform or have performed the said ~rk m~.l to make and fife this application; that all statements contained in this application are true to the best of his kon~ledge and belief~ and that the ~ork wilt be performed in the maoner set forth in Lite application flied therewith. /(Signature of Applicant) / L 4-5.0 HAP ix, 'i ,) i ¸il V O ~iA L '4 d V ex~ C,d, 6) " Jl~l,~'~·. io:g ',/.DUTL //~. / J" II[' Y 'l 6