HomeMy WebLinkAbout23781-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-25236 Date SEPTEMBER 4, 1997
THIS CERTIFIES that the building ADDITION & ALTERATION
Location of Property 1170 HIGHLAND ROAD CUTCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 102 Block 8 Lot 32
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 3, 1996 pursuant to which
Building Permit No. 23781-Z dated OCTOBER 28, 1996
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 ONE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to THOMAS & ANN SLEDJESKI
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-419283 - MAY 8, 1997
PLUMBERS CERTIFICATION DATED AUGUST 21, 1997- PECONNIAC PLUMBING & HEAT.
x-)44 r
BuilAing Inaptfor
Rev. 1/81
FORM NO. $
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)
M 23781 Z Date ................A�--
.....................
Permission is hereby granted to:
......................
!/.ZQ.... z.GGr�z,!.?........ '..........................
.................
to ..f�llL ... ../G1.... ... ........C�Ll .........G��..... 1. r� ! .....
atpremises located at ................................5si..............................................................
..................................................
..�� 49.....1.�,..Ctt::.4r.'?..'.t.�l�....... ............................................
............................................................... // 1`lJ.. Z1Y .............................................................
County Tax Map No. 1000 Section ..... ....... Block .....4e......... /Lot No. .......3.�........
pursuant to application dated ...........�JC.. ......� .................. 1949 , and approved by the
Building�rInspector.
Fee 5....1").....x........
uil g Inspector
Rev. 6130180
Form No. 6
t r 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 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 Buildine - $100.00
3. Copy of Certificate of Occupancy - _ -25,4�.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . . . . . . . .7/`3� f� . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . . . . . //Old Or Pre-existing Building. . .,l�. . . . . . . . .n. .
Location of Property. . . . . ./1 �- 0. . . . . .. . x1 . . . . . . . . . . . . . . . .4 u. @. . . . . . . . . . . . . .
House No. Street / Hamlet
Onwer or Owners of Property.. . .�� tn'ad. . G P . . Al. . . :.(Icdjkfxi. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. . . . . . . . . . . . . .Block. . . . . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .FFiled Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit No. . . 23 7P. .Z .Date Of Permit. . �d#01(. . . . .Applicant. . . . . . . . Pneef&
Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . X
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . : .` . . . . .
Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . ?
i
. . . . . . . . . . . .
�. s 3 3 y 9 ICANT
K,li 3
"oma
C.
C,
3
R.
36.922/38; �A `91 •-+y, � yym
L-
o
� �AWti y tY �r
CiY /~X W
S
.v
, 4 5
ci
o '�
=j a
M=MONUMENT
o: STAKE
, S�#
SURVEY FOR "
CHARLES L. MOSER B ELEANOR MOSER
LOT NES. 35, "HIGHLAND;E55A74S wrs.i
AT CUTCHOGUE DATE MAY /9,/98/
TOWN OF,SOUTHOLO SCALE: I " = 50'
SUFFOLK COUNTY, NEW YORK"gT �'�"` xo. 8/-289
xuMDmMTuo µttnnnox on ADDITION TD M1;, GUARANTEED TO,
SUMMIT M A v1OLAVOx Ol NOTION MOA OI ONARia L MOSER B ELEANOR MO5ER
NEW Y%A STATE EDUCATION LAW
A
COFl[f A THISW
is MvIY MOi S[AAWS~TXR[LAxO'�-a s(SRGAW9 j/1LE/NS(NIANCE LD.
funVfYONf XEO AL OM[MIOaIA. µMALL
Ix !F
NOT!I CONSIDERED TO M A YALIO TRU[C
XOVARAAM[a INOICITED HEnEOM!HALL AN MLY A �
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE MRAON MM wxox ME SUMIY lA MEMn[O -'-'; �pT! W}
AND ON xH BY M TxE TRu LOMMNY,eOVMN `ru
NN[AM[lT WA1q NAIX—NI.!NSOURCE M WATER-PIVATE ECFlMLIC_'` NENTAL AOLMCY AHD LENDIXB IA T.
X NII CO.TMXM PIST1006lLCTIOx 109 NOCK_LOLEfi_ REASON,AND TO M[ARMS [{OI m[L[ADIM[ aPo, D
X THERE AM NO MELLOWER WITHIN 100 F[[1 OF THIS PROPERTY INfTIt."N DUMA IT![S AR[
OTHER THAN THOS! SHOWN HEALON. lO MOITIONAL WeTNUTMNa OR NLKWExi '• yt �2�`
M THE WATER aUMY AID)A[WLL DISPOSAL SYSTEM FOR MIS RESIDENCE OWNERS
W ILL WATCH
M TO rM STANWOOD ESI THE SUFFOLK COUNTY DEPARTMENT H DIa %.. AIW C HEREON IMOM MGLRt YX[!
OF HEALTH SERVICES, - tO FSISTIN, liRUCNRLS ML MA A!P[CII,
A,PLICMi, PURYOS[ AND ARE NOT TO BE W[0 10[STAELISX # -
PROPERTY LINES OA FOR Mt ERtCTAOM p F[XCE3 " Y' 'YO,4509
ADMEN T
TEL. , ''' . D99TAA DER AVENUE
__ ._--. . ....._.__ Ill �:,YOUN-G-a,�01JNG-.`?„'R1 RMAD,NEW YORK
NOTE `
SO80/VIS/pYMAPR4F0IN TNEA'F]CEOFA6ClERd(N[';n, ALDENW.YOUNO,PROFESSIONALENGINEER
SUFFOLNCOUNTYpYAPR.E6,1977ASF/LEA'0.6537 AND UND SURVEYOR N.Y.S.UCENSE N0.12845
HOWARD W.YOUNG,`LAND SURVEYOR,:"'- "
MM LOCATIONOI WnL1W1MPncuMpTlec[bMOOLSILWIMOWx MMaft RIMS LICENSE NO 45893 -i,jp``�•'.
ME FROM FIELD PoMRWTIOW1 WON DATA OSTAAGOIRM OTHERS
tri, Y„\1 iu,r,
Y
`f l5ifi) Irl:;l'8 GI 1 O r 1 1w I, It I. DA I'1'' ('OPIF11iN'1'S
-----------------------
- - -
rouNnn'rinN ( u;'r)
FODNDATI.ON (2ND)
unur.n run)n+,
----------------
if
rLuwnlNc I
IFISIILn'I')ON PI(It N. Y .
s'I'nl'ii I�,NI:Il I.Y
-------- - — i .. __.._._ _.......... . . .. .
ADDI'r'IONA1. cvFRn;N'rs:
y
N III
�c
0
i
t
r ''
1,J-P'-Z'
Town Hall, 53095 Main Road
Fax (516) 765-1823
Telephone (516) 765-1802
P, O. Box 1179 4;z�
Southold, New Yofk 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T 1 0 N
DATE 17
Building Permit No .
owner: lklorvj S t /-U)') Ve4(' CS
(please print ) d
Plumber: ^A I0, ;9Z&ln hYA;& )41-110,47-1,Al
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead .
Zug,
(PliMlYers SiVnature)
Sworn to before me this
9/ day of 19 J>7
Notary Public , ff
County
9A4'-'A,7A
MWY pt"'�flc'��Iz'la 0?tzow York
'county
o�OgUFFO(�-C
O
Town Hall, 53095 Main Road y Z Fax(516)765-1823
P. O. Box 1179 v- Telephone(516) 765-1802
Southold, New York 11971
X01 � dao
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
July 29, 1997
Thomas & Ann Sledjeski
1170 Highland Rd.
Cutchogue N.Y. 11935
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)
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.
XX No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984) .
BUILDING PERMIT # 23781-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE; i
1195099 BUREAU OF ELECTRICITY
F85 JOHN STREET, NEW YORK, NY 10038
Date 14AY 08, 1997 Application No.on file IS756497/97 11 419283
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
TI1014AS ,9LF.DJLSK1., 11701 HIGHLAND ROAD, CUTCHOMIF4, N.Y
in thefollowing location; ❑ Basement ❑ lst Fl. N 2nd Fl. Section Block Lot
ova examined on RAY Or 5 r 199/ and found to be in compliance with the National Electrical Code.
FIXTURE ECEPTACLRS SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT I OTHER MIT. I K.W. AMT. I K W AMT K.W. AMT K.W.
£3 17 17 8
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'PTI TIMECLOCKS I BILI JUNITHEATERS I MULTI.OUTUT DIMMERS
SYSTEMS
AMT. K.W. OIL H.P. GAS M.P. AMT. I NO, A.W.G. AMT. MIP. AMT. AMPS. TRANS.I AMT, I H.P I NO.OF FEET AMi. WARS
SERVICE DISCONNECT NO.OF S E R V I C E
METER NO.OF CC COND. A.W.G. A.W.G. A.W G.
AMi. AMP, TYPE EQUIP. 1 p tW IW RW 3.e'3W 3.e AW PER's OF CC. OND. NO.OF HbIEG OF HEIEG NO.OF NEUTRALS OF NEUTRAL
OTHER APPARATUS:
PADDLE PANS--3
HOr1'OM 3-P H.P.
C,.P.C.Ia -1
MGM, DETZCTOIda-4
J114 SAGE ELEC. INC. - l_.. L
PO BOX 38
GnENPORT, NY, 11944-0035 GENERAL MANAGER
1.1
Per
This 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 COPY OF CERTIFICATE MUST. NOT BE ALTERED IN ANY MANNER.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [VrFINAL�/ ,. �
[ ] FIREPLACE//S CHIMNEY
REMARKS:
w
DATE 7j/eh7 INSPECTOR
2� IN
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE A CHIMNEY
REMARKS: �..�`G�✓� C '
DATE INSPECTOR
p
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] R GH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING ( ] FINAL
REMARKS:
DATE I Im IqLINSPECIOR
M-1802
BUILDING DEPT.
1 NSPECTI N
[ ] FOUNDATION 1ST [ ROUG,H PLBG.
[ J FOUNDATION 2ND [ ] INSULATION
[ ]' FRAMING [ I FINAL
REMARKS:
DATE J INSPECTOR
),3 ??/z�
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
] FOUNDATION 2ND [ ] INSULATION
[ FRAMING [ l FINAL
REMARKS: __ -
DATE INSPECTOR
ROARP Ufa IUiA1,111 . . . . . . . . . . . . . . .
FORM NO. 1 ,-3 SGT'S OF PIANS
N
TOWN Or SO '1'1101D SIIRVI?Y _ .
- - - - -
� " I—,0 BUIIAI,NG, DEPAIUMF.NT /CIIRCK . . . . . . . . . . . . . . . . . . . . . . . . .
'IIOWN IIALL SGPTI(1 F0 lift . . . . . . . . . . .
i,iAJ,
OfpVr:.":.i!'x11013 u:101 :1...,., a� >0T17I.: 7 N.y. I I I7 1 n S
- .� 'I'E1.: 765- 1802 NOTIFY:
/y CALL
GK:nii!x•<1...--�'/t?,..., 19./Q,/Y �J MA If, •3'0: . . ;-.7 .� 12"'
App ov[KL...101,41...., - -
// - .... ... .. ..... . .... ...... . ... . . . . . ..
Uisar4n tied a/c. ......... ........ .................
......... . ....... ... ... ... . . .. .. .. . .
...... ......... . . .................. ... ... . ..... .... ... AA/
o
OW U
APPLICATION rOlf 1311II,DINC I'lilfMl'1•
DaIe. . . . . . . . . . . . . . . . . 19 . . . .
1 NS'rRUCT I ONS
If. 'Illi!; 111)P1 icat inn nuslbe coaq)Icl cly filled in by Iylxaa iter or in inlc mol rulrni(Ipd to (he fktf Wing lnstx=vt or with
T rets of plans, accurate plot, plan to reale. Fee according to schedule.
b. Not dao skmin. localA m of lot aril of loildin.s
I U !, om 1)l t7nf ser, relal ioaship to a<l joining prc-nirer or in )Ifo
!:l mels or nrear, aril )living n def ailed rlprcript icxl of Irryoxol, or properly must Iro dr-maa ext fire dingrmn mdrit is row of
Illis all)] ical ion.
c. '11e txtrle emmed by this atp)licnthnr nrty Intl be. compoo'ed Ixfore irsuw!wo or Ituilding Permit.
d. Ilfxxl atgm>val or this m(>I)licafion, trip IWldfng ln<rlx,c.lor trill irm)e n fkaflding Permit- to Ibe nppl icnnl . itirh
Ix'roit shall be kepi On t1M pr"xires available fol Inspection throglxmf the ra)rlc.
e. W Imi Wing slialI be. occopital or ored in whole or fn fart for any Iforrlose wba(ever until a (:erfi ricafe of
Oo-vulnnxy shall brrve Imes granted by fire Building lonlx•ctor,
AI'I'LICNI'lOtl I!i IIGREItY F1AIE.to lite Ik)flding 1)e0rinnul- for Ibe issuance of n Isolildiog Permit. Inrsuant. to the
Iklilding 7xnxe Ordilvince of the 'front of Foothold, Suffolk Connly, Nc:w Yolk, mol other allAicablp I;aas, Orclfnmteer. Of
14•gulat ionft, for IIKQ coustr(Aicxl of lotildings, mldifirnis of alletatious, of for rtrrc)val or [icnnlif ion, as heloiu
descr ilwil. 'Ih(• nppl icnnl- agrees to conq)ly with all allAicable Irma,, ordinancen, loflding took, IKxo:iog pools, mol
tryulnti[os, :all to rxhil, auOK)rfred inrtx:elors Ise prtolires mxi fu Imildfr 3 r r rtece.^,anr iorliecl.ions.
".421 urp"('),
a applican , or nrnr, if n coflxtrfit fon))
(FLni I iryl nolo rerr of alyl ioant )
Sl01e cubether/•tlry)I i�calntt,Qin oxmter , lessee, agew , archilect, engfix-er, general contractor, electrician, phxdxnr or loildel .
. 1.. . .. . . .. ..lO v"/V'Gt`........ .... ... . ... .
M;*Iv of ommx•r of premises .... ..7Nnt>`»5.....,KA.J . ...!1!'IYI. . .-�.. . ....SIE'��GS �I
... ... ... . ....... .. .... ... ... ..
(a^, (Al the lax roll or latest decd)
If applicant it a colllioratiom, signature of duly awlhorived officer.
.... ....... .. . .. ..
arxf I it le of coriornie oFri vvee/r) (�
Ikrilders Liceur,e Na. . ......../. // ,V, .. ... ..
I'I(rdKIrs i.frenre No. ...... .. l.D. . . !. .. ..
Electricians License A). . .....13 3ls.. .
Other 'axle's l.fcense Ila. ....... . . . . .........
I. Irx-af.ioo of latxl on which prolosed won lc will Ise dol to" .. ... .44
/.�. . . ...... ......... .. i 6i.�rcnP�. .. ./4. .. ? lP.-
e........ . ...... . ......
..Ikmn:o tdntx'r ,i(reef ILnil _
0xo1y T'.Ix FLIP R). 10110 Secticm ....1.6.a..... Iliox•k . ..D... ......... Lo)1 .� S�..t......
.`;ulxlivirian .... . .... .......... ...... ..... ... . .... riled Rap Fb. . I,oc
(Kme) ..... ..........
2. Slate existing use mol occurgloy of ptonirer roll'inlerxletl use nrol cxturmfwyy of prolx>,red coosUuction!
a. Exist ing u!u: mol occulx1my ....C)AI45- .,�../t'/j??( Y. ... .(Rf�.[m.lN ./i',�•:f.0 �...:.". ... ....
b. Inleuokxl fire alnl oectirwaxy ...... !7C!QG... ..... .... ... .......... ...... ...�..'.'_.
1. H.'u tilt! uI 1Aa1( (heck %Ali(h a I�'
l9 l icuhle): i•k+J Ito lll(Iinl; . . . .. ... . . Al ldit loll .. . . . . . . . . Allcl nl ion . . . .
IWlulll . . ... . '. . .. . . 16alrrvul . . .'',. .. . .. . .. . Ikurll it lou Other Ika k . . . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . .
'Coal .. . . • • (Ik:elcripl Ifni) . . . . .
4 hal iurll ell �30,, ort 0•. . . . . . . . . fee .. . . . . . . .. .
I!, 0(r Iie lurid on lir int; This uppl War ion)
'l. 111 11,AdI inn, 1xrllwr of Ikx!II ina unlln . ,t;7/Y.C'.. . .. Ikrllu:l of IMolI lull unita on each floor . . . . . ... . . . . . . . .
H' t. I.. . . . . . . . . . . . . . .. . . . . . . . . . . .. . . . . . 'I
II aa,e, unbcr of cola ill (x:(:I fill Iq xacl Iy nal til n. III NI ee/xleul n oc'a'h II YIN!(o�f uae. .. . .lV/�. . . . . . . . . .
fI. l)larxlmll1IU loll txiul llnl;l alnrtu'Inl Ica, if any: Iflonl . . .�o, JF�d`1' (p.z•p J"t�
:!. . ... .....SII. fkrlber of filar lea . . . . .. . . . . .. . . . . . . .
Ilinrmailnls of or allluaure w0h alleral Inou or ;Motif Iona: hong . . .zyq-.,FKe . . . . . Item .YA^.,[. . . . . . , .
IAga 11 . . . . . . . . . .J•Ft. .. .. .. I L.i1)if .. . ..01,1c... . . .f. . . . lk ober of fir or ion .. .+rte¢.. . . .. .
Cal INa ioe; H•I' !!! -. . . . .. . , hear Ikpih
11. Illur:uallxla UI` 111 I11! IN1J anmll�'i . . . . . . . .. . . . . .
Ikeiltlll . ... . . .. . . . . . . . ... . . . .../. U111wr of Hiorica . . . . . . . . .p. .".'... . . . . . . .
'J, fill( of: lot : Films ..�dO.�t^ta(� J'(� IL_ar . .. f�P�f.�O.Z.7Gi!/.. I)!plll
III. Win of IUlchuae. . ..1.?-`!y/,r,ol . .. . . 11,11ot: of Folar!r 0,41we.1' .. .C�R.4t.V, �i-'.$. . .[!`•.!�,SP/!. .avJ�p�.{�%� �/F
11. 7rnul or title diel llcf 1ti Jlirh dreeaiaea ate Hilualed . . . .. . .. .. . . . .. . . . . . . .. . ... . . . ..,.A. . . . . . . . . . . . .. . . . . . . . . . . . . . .
I ). line lot Ill! d,on ll !/late any unlinn law, oldlnance or iegolal.lun: . . . . . . .'V,o . .. . .. . . ... .
12. INx!:: nn umcd rinlal nNa ilxl viol
Wil
legra
.. .... . . . .. . . ... Flfll exccea fill Iw lortwed ffnn ptoldra 1% WS 1X14
Ilk. IJ.ru:n of (kn N!r of pr eenl cea /1VAL . . . Alklrr.aa 111o+N! it, W7. '.�0.
N . . . . . . . ..*.jeJ..
N;ra! til` Arrllflecl .. . I,. . .. . . ... . . . . . . . &hit can . .. . .. . . . . . . . .. . . . . . . . .. ..�.. ./. Mono Ikn.
Haa! til 0ollraC11117 . . C7,as`?`q. . . .. ... ... . ... t4ldrnes . . .l ery,e t!. ,{�;Gt... /!!rP .11 u>I tie I•kr. �.t�.t '•2/,J�JI.
h. In [Ilia plulx:r(y within W) fell 11 oV it tidal wt lmul'! A YI'..'1 IvCI . . .!/. . . . .
All+ YIiS, fifXfil►N1) 'IC7,JH '114l, wifi 17i1C•11'1' IIAY im I Ail Ilwl).
PLOT IIIAORM
Immle r.leal ly alxl dial ilx:l ly tell Inliltlinl,a, OafTher exist inn or ploposed, mal ilxlicala all nel-back 11111conions
Irbil plulx!Ily liluen. Give (heel mo ItImAt Ixrduer or derrrfpl iron ncroldint; I(1 deed, arid NIHAJ atICel' name and iollilaue
010I1141 ila Uli01 01 Carmel 101'.
'i SEC S�t�UGY
1,1
51'A'I l( IM' 19-4 Y(WK,
(I)IIIfIY 01, .. _10A 'syne. . . . . . . .Il�l
.
. . . . . . . . . , /y(. OmQ:'s. . . . ...�/Gld;�'E'.•$�'/. . . . . . . . . . . Lc inf, duly :,an n, dclxlHen alar tiny(; dull he in (I,, nppl Irani
(11;ar: til ilnlividual Itignitig runt ulrl )
alxrvc u;ra!d,
II.! in Ila: D. . . . . . . . . . . . . .W�. .(�. . . . . . . ..nnle ullicol. . . . . . . . . . . . . . . . . . .. . . . . . . .. . . . . . . . . . . . . .. . . . . . . . . . . . ... . . .. . . . . . .- p
(Coal lad til , agent , I,Irurlx , (!l c.)
of mill[ olawl or 'Aakeia, noel for duly Mothnl lzed In IN!Ilallll (Ie IIOVe lxll forined Ille aaid will, e11N1 to IIGII(e IIIxI fill! Illln
nplll lu"tion; that al ut"Immmou I:UIIIyllx!d ill thin MIT! !lot 11111 all! Ilou to Ille Iuml of hill lailml •Illte Iaxl Intl ivf; alxl
Owl, 1111: N.Mt will 1N, lx!1loowd In Ili( 111,11111er flet for(ll In the Ilpplilall for) filed (llelemilll.
!Xmall lu In!lolrnJm! Ihla JJ
. . . . .rl . fl,4. . . .dn of _ 0.06.&K, . . . I'). . .1'. �a. .
Ikn any 111h1 ir.
. . ..�. . . . . . . . Gy �.
ROSE E. HUSE (:ill; altilc of Ali ranl )
NOTARY PUBLIC,State of Ne l���uuu York
No.52-7003475,S�iffIk C¢ 11W
Term Expires 9 j 3 0 i
�pF NFW Y
]P�a J63,o PLUBER CERTIFICATION
ON L ADCO"TENIBEFORE
CERTIFICATE Oen (ICCUi6AFTCY—
SOLDER USFry D WATER I axa �/�-i; 's a•I I°r<, �o ten" �4
SUPPLY SY,`TEL: C/�NPd(aT �� +<"' ' ` ' ` PAOFESSID
EXCISED 2110 cl 7% LEAD.
M.s4,er -&,l f<,M, 13' -1
IT4" r Iv S" ih.G , A..o-
uJ
'c
K'S4+ .,5 CL'�P< . 'T� PROVIDE OPENINGS FOR
E 41,,1 el �'o" '�.. ,.ry EMERGENCY EAS
--- CY ESCAP
�r•< kla o-, la+mss c REQUIRED BY PART. 714 OFZ -
\ PLLAOSING N.Y. STATE BUILDING C99E.-n- Z-p �
. -` - —_— - - u
/h.�l. �....h ALL PLUMPING WASTE �' 'a••^'•
&WATER LINES NEED
I ,Ilse
�
11
I
resn,vG COVERING X
If copper tubing is used
for water distributing
system: P i m shall be 5 I I o' x
P
of types K or
L only
UNDERWRITERS CERT TE -' '�'_ _ -'w
REQUIRED
rT W� ..u3t c✓c Ak drt ES �,,•cc
APPROVED AS
NOTED rel s I rT _ R-Aq
NOTIFY BUILDING DEPARTMENT T
ALR 0- /0'1"S
765-1602 9 AM TO 4 PM FOR E � ; � 0 (�
_-- FOLLOWING INSPECTIONS: iC+(Isftic l,�,n2ao�I J
1. FOUNDATION - TWO REOUIR D
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBIP GI 000
3. INSUI-AnON 1
4. FINAL - CONSTRUCTION MU T
OCCUPANCY OR
BE COMPLETE FOR 0.0
USE IS UNLAWFUL ALL CONSTRUCTION SHALL ME T —
THE REQUIRE
CODES.
CONSTRUCTION S ENERGY
WITHOUT CERTIFICATE
CODES. NOT RESPONSIBLE BOR
OF OCCUPANCY DESIGN OR CONSTRUCTION ERRORS �p 0 M �J'C
].IOW tjr-wr U
1176
/ dAstii�� � foal
tEOF NEW Y09
4-
_
]P.m p43m IfCV C•
.L ].us pAOFES510N�y
-/ � .
=lr..rtpn r �u:(� C-r:rc{f'✓"
12
�l Eli
n.
LC
Vp .,
i
S
_ rl
e of
3i.rr��r- .,rr>i 4✓� �—Akm at4 ES rs`oc Q-!4
..and ydNOL ) (A- 1V l.S
i
- ' I
Oew t+rmer !-
�.� — flew a*•1 w•II
Q.T��'17Z77—Z3Z4 — EKisi�,r5 'J. ! Wcll �io L`.e R<M.dc•I
.,:, q Sear�nd 'Fbnl' `Fo Be PnrirFr.i K� KjC 1 17orm¢(eGl
frisk
t a'
_ ut31a 3tNe 7<co r ..j 1'n+l ��r�tS
- `�o'1x8 `^)/J'�/aM 7•S�1[I lid fl
Au.
J •
1 . �� � _ _ �.:.' � �� , Q<'d � I Iu_ h �i Ird e✓ Ih�G I I I��„- 1.0 '
,��,, t F�<ra Kayo As<<✓F 54..hlra
IL I• / /�- Wen+l«w•fd.V••A er4y.�•
--YY
p-kId
/a ¢a r• oc
pa.l>9.W
u
. . .. r u. *,�. .'s",.0 — � 13'�'`'Sr+F4sk fiW'N•' !n FNrR :7.%WAnI LS Y3.F.li a<tc5 lr'P<�”
.yk.ef. ' aei fl1:.As
µ ,�,;q";'`..:.�•�e"t^_'.t'_:?>^'� .v . . "r I / ToG< er..a.�� . ,f,
✓pr1
tjl 4er.C:•Y 7ej6 I / -I(' �1,,A m.ete�
R.19
- _ -- - sr4.litc L✓c.. . A,k.KAtt F3 IVOC
QP
l 1 fi Q/cF4._. } y{ �• I� �rc 5rcN dT.�ts..a.:�a.�ci n:,r.
I
4 s'G+uo/P 4V/- 2.c� G;rlei
I
I Frrc
e
C oss pec+ a„ - rlew T roar
SIT
-- - -- —
- - —