HomeMy WebLinkAbout24987-zFORM NO. 4
TOWN OF SOUTROLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25988
Date: 09/28/98
THIS CERTIFIES that the building ACCESSORY
Location of Property: 1800 VILLAGE LA ORIENT
(ROUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 24 Block 2 Lot 22
Subdivision Filed Map No. __Lot No. --
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 30, 1998 pursuant to which
Building Permit No. 24987-Z dated JUNE 30, 1998
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 ACCESSORY GARAGE IN REAR YARD AS APPLIED FOR & AS PER ZBA #4571
The certificate is issued to WALTER & ALISON M MILLIS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF REALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. PENDING 09/18/98
PLUMBERS CERTIFICATION DATED N/A
Bui~ing Insp~tor
Rev. 1/81
FORM NO. 3
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)
PERMIT NO.
24987 Z Date JUNE 30, 1998
Permission is
hereby granted to:
WALTER & ALISON M MILLIS
1800 VILLAGE LANE
ORIENT~NY 11957
for :
CONSTRUCTION OF AN ACCESSORY GARAGE IN THE REAR YARD OF A SINGLE
FAMILY DWELLING & TO THE CONDITIONS OF ZBA APP & CHPT 46 OF TOWN OF SOUTHOLD.
at premises located at
County Tax Map No. 473889 Section 024
pursuant to application dated MARCH
Building Inspector.
1800 VILLAGE LA ORIENT
Block 0002 Lot No. 022
30 1998 and approved by the
Fee $ 135.00
uilding I ns~c~t or
ORIGINAL
Rev. 2/19/98
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF
OCCUP~~
This application must be filled in by typewriter OR ink and submitted
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 i% lead.
5. Commercial building, industrial building, multiple residences and similar buildir
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.
For existing buildings (prior to April 9, 1957) non-conforming uses, o~ ~uildings an
Vpre-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 - ~ .25~.
4.Updated .Certificate of Occupancy - $50.00
5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $1'5.O0
Date ...................... .... . . . .
New Construction... ~ ..... Old Or Pre-existing Buildin~ ........
l'.ocation of Property...t ?. ................ ..~'..'.LI..~?..t~...~..~?...' ......
House No. Street
County T~ ~p No i000, Section .............. Block ............ Lot ...... ',. .......
S~bdivisfon .............................. Filed Map ............ Lo t ........... ~ .......
~oalth Dopt. ~pproval .... ~/~ ...... Hnde~rSeors ~pprovah~ 7~.~~. ....
..............................
........
WALTER MILLIS
PO Box 183, 1800 Village Lane
Orient, NY 11957
September 21, 1998
Building Department
Town of Southold
PO Box 1179
Southold
New York 11971
Dear Building Department:
Please issue me a C. O. for my new garage, building permit number 24987-Z.
I enclose a completed application for the C. O. a check for $25.00 and the
certificate indicating the New York Board of Fire Underwriters Certificate is in the
process of being issued.
Thanks for taking care of this.
Sincerel~~
Walter Millis
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
September 18, 1998
Walter & Alice Millis
1800 Village Lane
Orient, New York 11957
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
XX An application for Certificate of Occupancy is
not on file. (Enclosed)
XX No Underwriters Certificate on file.
XX The check is (not on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 24987-Z
Thank you for
Please contact our office on this matter.
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
FOUNDATION (1st)
FOUNDATION ( 2nd )
ROUGH FRAME &
.PLUMBING
COMM£NT$
INSULATION PER N. Y.
STATE ENERGY
CODE
ADDITIONAL COMMENTS:
FINAL
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAG .i
llT s .U.EAU oF L CTR,C,TY
~- 40 FULTON STREET, NEW YORK, NY 10038
Date SEPTEMBER 28,1998 Application No. on file 16836098/98 N 466532
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
WALTER MXLLIS, 180~ VILLAGE LANE, ORIENT, NY
in the following location; [] Basement [] 1st FI. [] 2nd FI. GAR Section Block Lot
was examined on SEPT~IMBER 1.8, i998 and found to be in compliance with the National Electrical Code..
FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
FIXTURE RECEPTACLES
OUTLETS FLUORESCENT OTHER
2 i
DRYERS
S E R V I C
NO. OF CC COND A, W, G. NO OF HI-LEG A.W. G, A W G,
PER 0 O[~ CC. COND. OF ~[I- LEG NO. OF NEUTRALS OF NEUTRAL
)THER APPARATUS:
PARELBOARDS~ 1-2 CIR. 39
G.F.C.I~-i
Q.C. ELECTRIC INC.
P.0.BOX 518
Ia%UREL, NY, 11948-O518
LIC. #3823E
GENERAL MANAGER
11
rhis certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT, THIS DOPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
765-~.802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] FIREPLACE & CHIMNEY
REMARKS:
[ ] ROUGH PLBG.
[ ] IN~,ATION
[ ~-'F'i'NAL
Olj-DITH T. TERRY
TOWN CLIgRi~
REGISTRAR OF V1TAL STA'I]STICS
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Town Hall. 53095 Mare Road
P.0. l~ox I
Southold, New York 11971
Fax (5[6) 765-1823
Tclepilonc (516) 765- 1801
THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE
SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24, 1993:
RESOLVED that the Town Board of the Town of Southold hereby adopts
two (2) new forms to be used under the Flood Damage Prevent regulations
of the Code of the Town of Southold: "Floodplain Development Permit
Application" [FDP(93)], and "Certificate of Compliance for Development in
Special Flood Hazard Area [C/C(93)].
BLDG, D£P'T. ~
TOWN OF, SOUTHOLD,~D....~
Southold Town Clerk
August 25, 1993
TOWN OF SOUTHOLD
APPLICATION #
PAGE 1 of 4
FLOODPLAIN DEVELOPMENT PERMIT APPLICATION
This form is to be filled out in duplicate.
SECTION 1: GENERAL PROVISIONS (APPLICANT tO read and si~n):
1. No work may start until a permit is issued.
2. The permit may be revoked if any false statements are made herein.
3. If revoked, all work must cease until permit is re-issued.
4. Development shall not be used or occupied until a Certificate of Compliance is issued.
5. The permit will expire if no work is commenced within six montl~ of issuance.
6. Applicant is hereby informed that other permits may be required to fult'fll local, state and federal regulatory
requirements.
7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable
inspections required to verify compliance. ~.~.
8. I, THE APPLICANT, CERTIFY THAT~-~~~ALL STATEM~ENTS~H.~v~c~Z~.¢aNT) IN ATTACHMENTS TO
(APPLICANT'S SIGNATURE)~-'~,~r'2~'/~'ff ~L~.~ ,/~ DATE.~.~'O/4 ~ O j q t~
SECTION 2: PROPOSED DEVELOPMENT (To be completed bv APPLICANT)
NAME ADDRF_~S TELEPHONE
APPLICANT
BUILDER
ENGINEER
PROJECT LOCATION:
To avoid delay in processing the application, please provide enough information to easily identify the project
location. Provide the street address, lot number or legal description (attach) and, outside urban areas, the
distance to the nearest intersecting road or well-known landmark. A sketch attached to this application showing
the project location would be helpful.
FDP(93)
APPLICATION #
PAGE 2 OF d
DESCRIPTION OF WORK (Check all applicable boxes):
A. STRUCTURAL DEVELOPMENT
ACTIVITY
STRUCTURE TYPE
[] New Structure
[] Addition
[] Alteration
[] Relocation
[] Demolition
[] Replacement
[] Residential (I-4 Family)
[] Residential (More t~an 4 Family)
ID Non-residential (FioodprooFmg7 [] Yes)
[] Combined Use (Residential & Commercial)
[] Manufactured (Mobile) Home (In Manu-
factured Home Park? FI Yes)
ESTIMATED COST OF PROJECT $
B. OTHER DEVELOPMENT ACTIVITIES:
[] Fill [] Mining [] Drilling [] Grading
[] Excavation (Except for Structural Development Checked Above)
[] Watercourse Alteration (Including Dredging and Channel Modifications)
[] Drainage Improvements (Including Culvert Work)
[] Road, Street or Bridge Construction
[] Subdivision (New or Expansion)
[] Individual Water or Sewer System
[] Other (Please Specify).
After completing SECTION 2, APPLICANT should submit form to Local Administrator for review.
SECTION 3: FLOODPLAIN DETERMINATION (To be completed by LOCAL ADMINISTRATOR)
The proposed development is located on FIRM Panel No. , Dated
The Proposed Development:
El Is NOT located in a Special Flood H~2ard Area (Notify the applicant that the application
review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED).
[] Is located in a Special Flood Hazard Area.
FIRM zone designation is
100.Year flood elevation at the site is: Ft. NGVD (MSL)
[] Unavailable
[] The proposed development is located in a floodway.
FBFM Panel No. Dated
[] See Section 4 for additional instructions.
SIGNED
DATE
APPLICATION #
PAGE 3 OF 4
SECTION 4: ADDITIONAL INFOILMATION REQUIRED (To be completed by LOCAL ADMINISTRATOR)
The applicant must submit the documents checked below before the application can be processed:
[] A site plan showing the location of all existing structures, water bodies, adjocent roads, lot
dimensions and proposed development.
[] Development plans, drawn to scale, and specifications, including where applicable: details for
anchoring structures, proposed elevation of lowest floor (including basement), types of water
resistant materials used below the Fa'st floor, details of floodproofmg of utilities located below
the Fa'st floor and details of enclosures below the f'LrSt floor.
Also,
[] Subdivision or other development plans (If the subdivision or other development exceeds 50
lots or 5 acres, whichever is the lesser, the applicant ~nusA provide 100-year flood elevations
if they are not otherwise available).
[] Plans showing the extent of watercourse relocation and/or landform alterations.
[] Top of new fill elevation
Ft. NGVD (MSL).
[] Floodproofing protection level (non-residential only) Ft. NGVD (MSL). For
floodproofed structures, applicant must attach certification from registered engineer or
architect.
[] Certification from a registered engineer that the proposed activity in a regulatory floodway
will not result in any increase in the height of the 100-year flood. A copy of all data and
calculations supporting this £mding must also be submitted.
[] Other:
SECTION 5: PERMIT DETERMINATION (To be completed bY LOCAL ADMINISTRATOR)
I have determined that the proposed activity:. A. [] Is
B, [] Is not
in conformance with provisions of Local Law # , 19
attached to and made part of this permit.
__. The permit is issued subject to the conditions
SIGNED , D~,TE
If BOX A is checked, the Local Administrator may issue a Development Permit upon payment of designated
fee.
If BOX B is checked, the Local Administrator will provide a written summary of deficiencies. Applicant may
revise and resubmit an application to the Local Administrator or may request a hearing from the Board of
Appeals.
APPEALS: Appealed to Board of Appeals? [] Yes [] No
Hearing date:
Appeals Board Decision --- Approved? [] Yes
Conditions
Ul No
APPLICATION
PAGE 4 OF 4
SECTION 6: AS-BUILT ELEVATIONS (To be submitted bv APPLICANT ¢efore Certificate of Compliance
is issued)
The following information must be provided for project structures. This section must be completed by a
reg/stered professional engineer or a licensed laud surveyor (or attach a certification to this application).
Complete I or 2 below.
Acthal (As-Built) Elevation of the top of the lowest floor, including basement (in Coastal High Hazard
Areas. bottom of lowest structural member of the lowest floor, excluding piling and columns) is:
FI' NGVD (MSL)
2. Actual (As-Built) Elevation of floodproo£mg protection is
FY. NGVD (MSL).
NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant.
SECTION ?: COMPLIANCE ACTION (To be comoleted bv LOCAL ADMINISTRATOR~
The LOCAL ADMINISTRATOR will complete this section as applicable based on inspection of the project to
ensure compliance with the community's local law for flood damage prevention.
INSPECTIONS: DATE BY DEFICIENCIES? [] YES [] NO
DATE BY DEFICIENCIES? [2 YES [] NO
DATE BY DEFICIENCIES? [] YES [] NO
SECTION 8: CERTIFICATE OF COMPLIANCE(To be completed by LOCAL ADMINISTRATOR)
Certificate of Compliance issued: DATE: BY
for
Attachment B
SAMPLE
CERTIFICATE OF COMPLIANCE
Development in a Special Flood Hazard Area
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA
(OWNER MUST RETAIN THIS CERTIFICATE)
PREMISES LOCATED ' AT:
PERMIT NO.
PERMIT DATE
OWNERS NAME AND ADDRESS:
CHECK ONE:
[] NEW BUILDING
[] EXISTING BUILDING
[] VACANT LAND
THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW:
COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS
LOCAL LAW # ,19
SIGNED: DATED:
OF
COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF
LOCAL LAW # .~, 19__, AS MODIFIED BY VARIANCE #
DATED '
SIGNED: DATED:
C/C(93)
765-1802
BUILDING DEPT.
, ~~~;PECTION
[ ] OUNDATI 1ST [ ] ROUGHPLBG.
[ N 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
FORHNO. 3
TO~ OF SOu'£HOLD
BUILDING DEPARTHEWr
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
DATE: .................. .4/i.4.]98 ..
Walter Hillis
P 0 Box 183
Orient NY 11957
PLEASE TAKE NOTICE that your application dated .~.}~ .......... 197~ ....
remove ~y~?~l?~
for permit to ....... shed and re ace with accessory garage
1800 Will
Location of Property .................... age Lane Or ent
House No. Street Hamlet
County TaXHap No. 1000- Section .24 ........ BLOCK 2 LOT 22
Subdivision ............................... Filed Nap No .......... Lot No ........
is returned herewith and disapproved on the following grounds ..~9~.~[~.~ .....
Section 100-30A.3 of the Bulk & Parking Schedule of the R 40 Zone- The removal of
existing accessory shed of 64 Sq. Ft. with existing lot coverage of 23l and the
construction of accessory garage at 320 Sq. Ft. will no~ become 26l + or - lot
coverage which is ~y~ ~? ~p~d ~
..................... ~ .the Bulk Schedule.
Action required }LY~? ~JP~ }?~Y9 of Appeals.
RV 1/80
APPEALS BOARD MEMBERS
Gerard E Goehringer, Chairman
James Dinizio, Jr.
Lydia A. Tortora
Lora S. Collins
George Horning
BOARD OF APPEALS
TOWN OF SOUTHOLD
Southold Town Hall
53095 Main Road
EO. Box 1179
Southold, New York 11971
ZBA Fax (516) 765-9064
Telephone (516) 765-1809
June 29, 1998
BY HAND 6/29/98 a.m.
Mr. and Mrs. Walter Millis
Orient, NY 11957
Re: Appl. No. 4571 - Variance for Accessory Building
Dear Mr. and Mrs. Millis:
Enclosed please find a copy of the Appeals Board's determination
adopted at our June 23, 1998 Meeting (at which Mr. Millis was
present). We are today furnishing the Building Department with a
copy for their open permit application file.
Please do not commence construction activities until a building
permit has been issued. You may wish to contact the Building
Department directly at 765-1802 as a follow-up in this project for
issuance of the pending building permit application.
Very truly yours,
GERARD P. GOEHRINGER
CHAIRMAN
Attachment (ZBA Decision)
Original Decision filed with Town Clerk's Office
Copy transmitted to:
Building Inspectors' Office
Gerard P. Goehringer, Chairman
James Diniz[o, Jr.
A. Tortora
Lydia
Lora S. Collins
George Homing
BOARD OF APPEALS
TOWN OF SOUTHOLD
Southold Town Hall
53095 Main Road
P.O. Box 1179
Southold, New York 11971
ZBA Fax (516) 765-9064
Telephone (516) 765-1809
FINDINGS, DELIBERATIONS AND DETERMINATION
REGULAR MEETING OF JUNE 23, 1998
Appl. No. 4571 - WALTER MILLIS PARCEL 1000-24-2-22
STREET & LOCALITY: 1800 Village Lane, Orient.
DATE OF PUBLIC HEARING: June ll, 1998
PROPERTY FACTS/DESCRIPTION:
The subject property is located on the westerly side of Village Lane,
Orient, and contains a total lot area of 8,346 sq. ft. The survey map
submitted under this application shows that the subject premises is
improved with a one-story frame dwelling and 8' x 8' accessory shed
located in the rear yard not closer than 3' from the rear property Hne
and 7' from the southerly side property line. The existing lot coverage
for the dwelling is confirmed to be 1,847 sq. ft. for the house and 64
sq. ft. for the shed, for a total of 1,911 sq. ft. (23%).
BASIS OF APPEAL: Building Inspector's April 14, 1998 Notice of
Disapproval, disapproving a building permit application to remove
existing shed and replace with accessory garage, which will exceed
allowable lot coverage of 20%.
AREA VARIANCE RELIEF REQUESTED BY APPLICANT: The applicant's
request is to replace the existing 8' x 8' accessory shed with a new 16'
x 20' garage at not closer than 3 ft. from the rear property line and not
closer than 7' from the side property line, as presently exists for the
shed. The new lot coverage as requested is an overall increase of 256
sq. ft. for a total lot coverage of 2,167 sq. ft (26+- %). The height of
the garage is prOposed to conform with the Code at less than 18 feet.
REASONS FOR BOARD ACTION~ DESCRIBED BELOW:
On the basis of testimony presented and personal inspection, the Board
makes the following findings:
(1) Applicant has extensively remodeled an existing house located on a
lot whose small size is typical of the neighborhood. The remodeling did
not change the size of the house, which covers 22.1% of the lot.
(2) the house has little usable basement space. There is an 8-by-8
foot shed at the rear of the property but no garage. In order to obtain
adequate protection for an automobile, tools and beat equipment,
applicant wishes to demolish the shed and build a one-car garage in the
same rear-yard area.
Page 2 - June 23, 1598
Appl. #4571:1000-24-2-22 (Millis)
Southold Town Board of Appeals
(3) The house al~ne covers 22.1% of the lot, and with the shed total
coverage is 22.9%.~ thus, the only way that applicant can obtain the
benefit of a garage! is by a variance a. llow~.'ng .lot coverage in excess of
20%. The propose~ garage is modest rn size but nevertheless increases
the coverage (after Iremoval of the shed) to 26.0%.
(4) Lot coverage o~f 25% is significantly greater than the 20% allowed by
the Code. However, the lot coverage is already at nearly 23%, and the
neighborhood is d~nsely built on small lots, with numerous accessory
buildings. Thus, granting of the requested variance will not pro. duce an
undesirable change in the character of the neighborhood or detriment to
neighboring proper~es.
(5) The reque.ste~variance w~ll not hay an adverse effect or impact on
physical or environmental conditions in the neighborhood.
The Board concludes that the following action is the minimum necessary
and adequate to e~ble applicant to obtain the benefit of a garage w..hile
also preserving al~d protecting the character , and at the same time
preserves and protects the character of the neighborhood, and the
health, safety, welfare of the community.
RESOLUTION/ACTION: On motion by Member Collins, seconded by
Chairman Goehringdr, it was
RESOLVED, to GR~NT the variance as applied for.
VOTE OF THE BOARD: AYES: M_..~RS GOEH_~I~NGER, DINIZIO,
24-2-22 (Millls) ~proved for Filing
AI~EA = 8,346 sqft.
SURVEY OF
PROPERTY
,4 T ORIENT
TOWN OF SOUTHOLD
SUFFOLK 'COUNTY, N Y.
1000 - 24 - 02 - 22
Scale: 1' = 30'
Oct. 10, 1996
Mar. 10, 1997 (Elevollons Added)
CERTIFIED TO:
WALTER MILLIS
ALISON M. MILLIS
CHICAGO TITLE INSURANCE COMPANY
~ 9608
C.
1230
SOUTHOLD~ N.Y, 11971
NO. 49618
BOARD OF HEALTtl ...............
3 SETS OF PL~,~S ~ .............
SURVEY ........................
CIIECK . .~ .....................
SEPTIC FOR~ ...................
NOTIFY: ~r~ ~t;
........................ //
Dar ................. , ~ · -
a. 'Ibis application n~st be conpletely filled in by typewriter or in ink atw] zad~mitted to the P~tilding 1espector wi.
3 sets of plans, accurate plot plan to acale. Fee according to sd*edule.
b. Plot plan ~hcr~ing location of lot and of buildings on pr~nises, relationship to adjoining pr~i~ee or ix,bllc
streets or areas, and giving a detailed deserlption of layont of property mJat be drama ~ the d|agr~n ~lcb ia I~rf of
thia nppl icat ico.
c. 'lhe ~rk co, red by this nt~plication ~ay ~ot t~ cc~cenc~l before ia~oce o[ I~dlding Penuit.
d. Upee approval of ~is a~licat{~, tl~ lhdldi~ lns~ctor ~il~ i$~ a ~ilding Pemlt to the applicant.
~mit d~all ~.bept on tim ~a avail~le for ins~ti~ thro~t tl~ x~rk.
e. ~ ~ildi~ droll ~ ~pted or ~ in d~le or in ~rt for a~ ~ ~at~er mtil a C~rtlflcate of
~y dmH hme I~n ~ant~ by ~m ~dldi~ Ins~tor.
~,I~TI~ IS t~ ~ ~o tbe lhH]diog ~rt~nt for the ia~e of a ~ildi~ Pemit ~rmmnt to the
I~ildi~ ~ ~i~ of fl~ T~ of ~tl~ld, ~ffolk ~n~, ~ York, ~ otlmr a~ltcable I~s, ~h~es nr
~lati~s, for tim ~t~ti~ of hdldi~, ~iti~a or alteratt~s, or for ~al or ~ltti~, as I~reln
~h~cril~. ~m applier ~s to c~ly w~th all a~hcable 1~, ord~t~es, ~ld~ng c~-x~,
..,: ..... ~ ............
', (~ilh~ ~ress of n~ltcant)
State v~tber applicant is o, mer, lea~e, agent, architect, e~stseer,' geeeral c~tractor, electrician, ph~r or I~ihle~
If applicant is a co. ratio, ~i~re of duly ~tl~>riz~l o[ficar.
and ri~le o[ corporate officer)
l~ilder~ License I~o ......................... ·
Pl~bers License fro ..........................
Elecrriciana l.leeru~ ~
O[l~r ~ Licen~ ~ .....................
I. l~ari~ of la~ ~ ~dd~ p~l ~rk will ~ ~ ...................................................... *' ~';' ....
~nt~Tox~p~. I~ ~ti~ ~ Bl~k O ~ lot ..~.~. .......
~Mivisi~ .......... ~ ................... Fil~ ~p ~ ................ lot ...............
(~
2. grace exlsti~ u~ a~ ~y o~ i~i~s a~ i~te~ tree ~ ~ of p~ c~stn~tJon~
. ~-S/p ~c~~ , . . ~ . . ......
a. F~sti~ ~ a~ ~y .................................. ~ ................. ................
... ..... ........ ,.. .........................................
(to ~ ~id ~m filing thta al~licaci~)
6. If Inmi~aa, ~mrctal or ~i~l ~qm~, a~ai~ ~t.ura a~ extant o~ ~a~ tylm of u~ ......................
I~pth .................... I~i~t .................... ~t~Imr og 8torlaa ...............
............................ ~l)th .........
...... lu .... ..............
15. Ia thia pm~rt~ ~lthln ~ f~:,of a tight ~tlaM~ * W~q .......... ~ ..........
I)I.OT DIAORAH-
frm~ proimr~y ll~a, Gt~ at~t m~l~bl~ ~mimr or t~aarlpti~ according to ~, a~ ~ atreet m~s ar~l tmlieaea
~dmtlmr interior or corer lot. I
(C~ltrnct()r, ngei)~ ~ o ~r~)rate Offl(.eE, etc.)
()~ said (~mr or ~ra, a[Kl in duly ~thorJ~l to i~rfonn or I.~e l~rfim~l Lhe ~i(l ~[k taxi ~o rake a~xl fil. e Lhia
a q)l 'caLtoli; Lhn{: all ~Lata~nt8 c(~)Lail~l il) tide n ~)J.t(:att(~l are tn~ to the I~et
~am~r ~t forth In the