The URL can be used to link to this page

Home My WebLink About23991-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25578 Date: 03/06/98 THIS CERTIFIES that the building ACCESSORY Location of Property: 5745 ALVAHS LA MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 101 Block 2 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 12, 1997 pursuant to which Building Permit No. 23991-Z dated MARCH 18, 1997 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 10' X 16' CHICKEN COOP AS APPLIED FOR 'AS BUILT' The certificate is issued to DENISE M ANTIGNANO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A i ing Spector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25577 Date: 03/06/98 THIS CERTIFIES that the building ACCESSORY Location of Property: 5745 ALVAHS LA MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 101 Block 2 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 12, 1997 pursuant to which Building Permit No. 23991-Z dated MARCH 18, 1997 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 14' X 32 ' GREENHOUSE AS APPLIED FOR "AS BUILT" The certificate is issued to DENISE M ANTIGNANO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A i1 ng In ector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25576 Date: 03/06/98 THIS CERTIFIES that the building ACCESSORY Location of Property: 5745 ALVAHS LA MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 101 Block 2 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 12, 1997 pursuant to which Building Permit No. 23991-Z dated MARCH 18, 1997 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 ALTERATION TO AN EXISTING NON-HABITABLE ACCESSORY BUILDING AS APPLIED FOR "AS BUILT". The certificate is issued to DENISE M ANTIGNANO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. H054809 04/15/97 PLUMBERS CERTIFICATION DATED 02/04/98 DENISE A. MARKUT B it ng Inspector Rev. 1/81 PORM NO. f 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) N° 23991 Z Date .................3�1.....:........................., 1927 Permission is hereby granted to: ................... S?fG ....... ...1:.. �.. ... ....�f1X:.l..(r.. cYic.(gr✓:... .a..�...../�...../.. .&J ....,. Df t -rlr42rlr. ✓....! ......./z`�✓...Yif�7�v �4 ✓ , �/d: .. 'r�.....r9tl.......�� ,>lJ.......%r ....�x�f� atpremises located at...................................................................��.......................................................... County Tax Mop No. 1000 Section ....lal......... Block ........ Lot No. ....1'S pursuant to application dated ....1ff.� ... ..S......��................... 1911. , and approved by the Building Inspector. Fee S...f.. '......... ' ....... ... .. ` ... 1............................ ui ding Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OF, ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form) . 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 17 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 L. 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 Building - $100.00 3. Copy of Certificate of Occupancy - .25v. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . .� . . .Jr...!.�J. . . . . . . . . . . . . . . . . . . . . . New Construction. . .✓/.. . .. .. Old Or Pre-existing Building. . . . . . . .�rvt Location of Property. . . . . . . . . . . . 5 .li . . . . . . . . . . . . House No. �yStreet 4amlet Onwer or Owners of Property . . . . � . . . . /.LC . . .. . ,4 County Tax Map No 1000, Section. . . . l.4 . . . .Block. . . . . . . . . . .Lot. . . . . . l 5. . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . 22 0 Permit No—,,_1.7.1 . . .Date Of Permit. Z. . .App1icant� �. . .8 !.(bS . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . ..Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . / Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . Y . . . . . . . Fee Submitted: . . . . . . . . . . . . . . . . . ,&W .... . . . .Q. . . . �� . . . . . . . . . . . . . . . . - S'N) APPLICANT 0tl �-57 ?� Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 prcperty 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 17 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 Building - $100.00 3. Copy of Certificate of Occupancy - .25V, 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . �.: .5 . . � . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . .l, . . . . . . Old Or Pre-existing Building. . . . . . . . . . Location of Property.:7.Y.S. . .R. �1JCt ?. . kY1. . . . . . . . . . . . . . . . .(....t 4-T.44C�'`� House No.7� Street y� t Haml� Onwer or Owners of Property.. .S 1 Y 1`�e. . .� 5 ��! . . .: . .1 Jf1 Ctr- a-K-6 . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . .1.0.1 . . . .Block. . . . .O : . . . . . .Lot. . . .(V5 . . . . . . . . . . . . . Subdivision. . . . .ppn. . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filqled Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. .�3.0-` a . .Date Of Permit. ;3I/ ?#7 . . .ApolicantQe__" HealthDept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . / Request for: Temporary$. . Certificate. . . . . . . . . . . Final Certicate. .V . . . . . . Fee Submitted: $. . . .cam . . .. . . . . �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICANT Form No. 6 '''`Til-tiL TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 water supply and sewerage-disposal(S-9 form) . 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 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 Building - $100.00 3. Copy of Certificate of Occupancy - .25v 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . .� . . .5.V.4. . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . /r !77--. . . Old Or {Pre-existing Building. . . . . . . . . . . . . .. . Location of Property. .J .q�. . . f.0 ?.Y��1. . 'Y R . . . . . . . . . . . . . . . . . . . . .(n�Z-T?�Oy�/.��.Q.� . . . . . . House No. Street � HamleL� Onwer or Owners of Property. . . ZZI L, J .4 l ftr. l F::-++. . .... . . A�n. 1 Cr:1.4/yL.0. . . . . . . . . . County Tax Map No 1000, Section. . . /.�)J. . . . . . .Block. . . . . G c� . . . . . .Lot. . . . . Subdivision. . . . . . . . ...g. . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit Nos�.3� .A. 1.� , . .Date Of Permit. -V/A/g .7. . .Applicant�� -Q . . /J. [!�!? . • . . . HealthDept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . f Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . .. . . . . . Fee Submitted: $. . . `. . .�... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f�Q�C • S y13 0 APPLICANT CCI-2-L- 2SS ?� �sufFoi . Sf{BOO Town Hall, 53095 Main Road tC= x Fax (516) 765-1823 P. O. Box 1179 +r m Telephone (516) 765-1802 Southold, New York 11971 N Off. Ul . OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE : - ILI -499 Building,Permit No . Owner: )'Se /} — please print) Plumber: (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ILey Lcciz . l 9 900 - a O OqZ) t1� (Plumbers Signature) Sworn to before me this day of / 19 qr Notary Public, i ( County lkwr4 Febru=ry 24 , 1997 Southold Town Assessors Departmentj�. Southold, N.Y. 11971 Dear Southold Town Assessors Department, Please be advised that my neighbor has been doing major renovations on her garage and property. Owner Denise Narkut- Antignano, Tax map Nc . 1000-101-02-015, Alvah' s Lane, Cutchogue . eF She does what ever she wants to her lot and never gets a Building Dept . permit. The neighbors have already complained to the Building Dept. She has :already put un two greenhouses with electric and plumbing. A new bathroom above her garage. There is talk of zin apartment. She has been running an illegal business out of her residential zoned land for two years now. See enclosed article. This property needs to be reassessed. Please take care of this matter for all the neighbors want an honest assessment . She should follow, all the Town Codes like all of us. Thank ,you, An Upset Neighbor. 1 1r Joe i i Q /7P 1SS G.r°A o7;73 o 0-2 TT �Sr5� n aLl r -- wi; r sr i�Ti.�l� za 7 w n S I n n LIT N 1 OCCUPANCY OR it ? USE IS UKILAWFUL - ---- ,�s WITHOUT CERTIFICATE X\ oA Lane, OF OCCUPANCY W ' tisji ^ f P II Se.CJ+"�O k-i:aa� { i � I � i � + Sh ce \ C^x`rC \i•Sa�aa�,i^.r'. J a 3(o r r Y ! shed � I ? 1 4 I � � 1 , f Y zk�z,k Ll 1 m` _ 3 u ' CesS�ool Inc t f 7r 3rr wCk s+o� S, , [ b T ! qI& � 0 0 I I � 15 I , i i • • • • • • � I 40 n FIEI.b**lNSI ECT ION REPORT DATE COMMENTS ii ii b ' FOUNDATION ( IST) II I� tel. FOUNDATION_– (2ND)====__�^--��-- ; ___– --_ _ ______ _____=__=__________=_____________________ II ROUGH FRAME S PLUMBINGif __- n l � n INSULATION PER N. Y. STATE ENERGY —n CODE n` n n n —a n FINAL ADDITIONAL COMMENTS: t� H H H x m r� r r� ro — — N THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE i 8065474 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NY 10038 Date APRIL 15,1997 ,application No.on file 13682897/97 H 054809 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of DENISE HARKUT-ANTIGNANO, 5745 ALVAHS LANE, CUTCHOGUE, N.Y. in the following location; ❑ Basement ❑ 1st Fl. ❑ 2nd Fl. OUT Section Block Lot was examined on APRIL 08,1997 and found to be in compliance with the National Electrical Code. NXTUNACLM �� R RANGES COOKING DECKS O DISH WASHERS EXHAUST FANS OUTLETS WANINSCINTt FLUORESCENT I GTHEW AMT. K.W. AMT. K.W. AMT, K.W. AMT. K.W. AMT. H.P. DRYERS FURNACE MOTORS MTUN AMUANO 116111RS SMAL REC'►T TUNE CLOCKS NU UNIT NEATRRS MULT40UTLET 0111"ERS OIL N.P. am H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT: H.R SYSTEMS NO.Of MTAMT. WATTS SRRVXX 06CO M M No.OP S E R V 1 C E AMT. AMP. TSE low. 10 2W/ 10 SW S AI SW S,ff 4W I WO-OF R kCOND. AC.CG. NO.OP NIAEG A�.� NO.CSP NEUTRALS OF W.* . AL OTHER APPARATUS: *NO VISUAL DEFECTS: "An electrical survey has been made of the exposed electrical equipment in the premises indicated. " "No obvious unsatisfactory condition was found. DENISE HARKUT ( L L 5745 ALVAHS LANE CUTCHOGUE, NY, 11935 ODOM MANAGER 11 Per This cortifkate two not be altered in any manner; return to the office of the Board if incorrect. Inspadlo s way be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ 'FINAL [ ] FIREPLACE & &CHIMNEY REMARKS: 2& �b dal V=� DATE INSPECTO CONSENT TO �p�, /-INSPECTION the undersigned, Owner(s) Name(s) do(es) hereby state: That the undersigned (is) (are) the owner(s) of the premises in the Town of Southold located at �5_72L51 which is shown and designated on the Suffolk County tax map as District 1000, Section Block Lot That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold/ Town Building Inspector's Office four the following: That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws, ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulations of the Town of Southold. Dacca: (signature) (print name) (signature) (print name) A v" ff-o( mut • a , m 0 M nd m 0 N/ 0/F N/O /F N/0./f WILLIAM H . MASTON °o IROBERT L. HUBBARD IaLOUVINI,JOHN FORD & ALVANIA MASTON °o & JOIDA HUBBARD FORD W sQt. ' 517. 50. ' " . fp� slory 69.L3 N pteN;a_oNw_M 6 o hous LJ CCeryrp opvi cd 1 0.1'w. si S. 56128'20"W. fie 528.22' W v Q loa N/ O/F VILLAGE OF GREENPORT 'Ewy SURVEY FOR "aEa�flP DOMINIC AND DENISE ANTIGNA ~O AT CUTCHOGUE TOWN OF SOUTHOLD bbs SUFFOLK COUNTY , N. Y. •SJYf N.Y. S- UC. NO. 49668 Prepared in accordance with the minimum 1000 — 101 02 015 ',.. _... standards for title surveys as established by I'4VEYORS 8c ENGINEERS , p. C- the L.I,A.L•S. and approved and adoptstd SCALE IN = 60 ' 15020 for such use by The New York State Land NOV. 15 , 1965 BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . .. BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . .. . TOWN HALL SEPTIC FORM . . . . . . .. . . . . . . . . . .. SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: p9 CALL . . . . . . . . . . . . . . . . . . Examined...... I .. .....I 19.G:J�? G� MAIL TO: . . . . . . . . . . . . . / . . . . . . Approved...... /./�----, 19,/..7 Permit No.,a N/.e... .................................. Disapproveda/c .................................. .................................. ...................................................... BdCI :, . .. . ,z (Huila•. n- tor) WQ ( 2 p� APPLICATION FOR BUILDING PERMIT !w� e L , Date. .. . .� PZ. '. . . . . , 19�.? T BLDG.H� _O INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector 3 sets of plans, accurate plot plan to scale. Fee according to sciedule. b. Plot plan slowing location of lot and of buildings an premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of Property mist be drawn on the diagram which is part of this application. c. The work covered by this application vary not be crmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue 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. APPLICATICN IS BERM MALE to the Building Department for the issuance of a Building Permit pursuant to the Building 7.one Ordinance of the Tam of Southold, Suffolk Canty, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or derolition, as herein described. The applicant agrees to amply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) t.CC<'fr��o�f< 4 (Mailing address of applicant) V State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build .........Q.�t(J. ..�r. ................................................................................................ nC Ci .tel Name of owner of premises lJ t:sE ....1.1:.... a.1'KLL7L 1�1n12....Q................. x �:.} (as on the taroll or latest deed) A7'PROVED AS NOTED If applicant is a corporation, signature of duly authorized officer. DAT B.P.# FE11 . V0. ......................................................... NOTIFY BUILDING DEPAR ENT AT (Name and title of corporate officer) 765-9802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: Builders License No. ......................... ONDEMITERSCERTIFICATE 1. FOR POUnED -CONCTWORETE REQUIRED REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING Plnaapers License Nn. ........... 3. INSULATION Electricians License No. 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. Other Trade's License No. .................... ALL CONSTRUCTION SHALL MEET 1. Location of land on which proposed work will be done.........................THE REQI,IREN gNX$•,QF.ZHE..N.Y. ��// rn• / g STATE CONSTRUCTION & ENERGY ,• 77 5-.....1LVa.�:1.`,?,,,,,Lame - ............lQC f ES. �yNOT RESPONSIBLE FOR (4� T ... House Nuaber Street OE /r�.e�-L'6NSiFiUCT10N EiiRORS Canty Tax Map No. 1000 Section ....t�. ....... Block .....�. :.... Lot .....41.1.5.... Subdivision ...................................... riled Map No. ............... lot ............... (Name) 2. State existing use and occupancy of premises and intendeduseand occupancy ofproposed construction: a. Existing use and occupancy ...pK-.,: ....A.0 .......................... b. Intended use and occupancy ............................................................................. t �- Gv�snhoLcSz Ar 'rna ( s ecL fRenovc,-4-7 crn G G e- 3. Nworc of work (clec:k which applicable): flow lirildinq; ... .... ... fxklition .......... Alteration ... .. Repair ............ Itenmal ............. Demolition ......:..... Other Work .B.(I...F.*hri "iA. (Description) 4. ESLimaled Cost ......................... fee ............................................. (lo he paid on filing this application) 5. If dhwelliug, n,tdner of dewellinp units ............ limber of dhaelling units on each floor ................ Ifgarage, number of cars ...................................... 6. If business, emnercial or mixed occupancy, specify nature aril extent of each. type of use...................... 7. Dimensions of existing stnrcLures, if any: Front.. .............. Rear .. ... .......... Depth ................. leii;Ait ......................... Narber of Stories ........ ........ Dimensions of same structure with alterations or acklitions: Front ............... Rear ............... Wplh .......... leignt ................ .... Amber of Stories ........ ............... 8. Dimensions of entire new construction- Front Rear ..... Depth leiOnt ......................... Nunlner of Stories ..................... se e 9. Size of lot: Front .................... Rear ............... ... .. Depth -. i row ................... 10. lime of Purchase ..................... Name of Former Goer - _s .,-.. R3"�•`. _:. :�7 I1. Tcxe or use district in wluidn prem ses are situated ................................................=........... 12. Ries proposed construction violate any zoning law, ordinance or regulation: ........................ 13. Will lot lie regraded .................... Will excess fill be remmed from premises: YES NO 14. flares of Owner of premises ........................... Address .............................. Phone No. ......... Nine of Architect ....................... ...... ....... Address ......... ..................... Phone No. ......... Name of Contractor ................................... Ivhlress ...............................I'fnone No. ......... 15. Is this property within 300 feet of a tidal wetland? * Yt:S .......... ND .. ..,, *IF YES, SODNC%D 1114N 1RUSIlxS PI:1441T MAY 116 REQ Jlllll . PLOT DIAGRAM Locate clearly and distinctly all buildings, uiuether existing or proposed, and indicate all set-back dimensions Fran property lines. Give street and block number or description according to deed, and alive street nares and inrlicat: wi.etber interior or corner lot. SUNIE, t1F l4;W Y(MSS 1L ...... K ( � 4��V �`�'I -�!:C��7�-f, .r7.,.ix!ing duly :corn, deposes and says that he is the applicant (Mane of iuxlividual signing contract) J alxrve named, Ileis the ................cz.u) .....,.._.....,...........,.............___...........,,...._.._.. (CouLraclor, agent, corporate officer, etc.) of said owner or wners, and is July anhori7ed to perforin or have lierforned the said work arxl Lo make and file this application; that: all staLeneuts contained in this application are true to [lie hest of his krxrwledge and lielief; and thatthe weak will be performed in the nnnner set forth in the application filed therewith. Stworn Lo I/ �f77o a ne Ihis ......... .4! day ...... `.... 19.22.. Notary Prtl)"' —' "„""c CJ,AIRE L. GLEW (Signature of Applicant) Notary Public, State o.New York No, 4979?aO!5 Qualified in Suftnik County Commission Expires December 8,19q