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FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25011 Date MAY 6, 1997 THIS CERTIFIES that the building NEW DWELLING Location of Property 3120 SOUNDVIEW AVE. PECONIC, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 68 Block 4 Lot 9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 24, 1970 pursuant to which Building Permit No. 23316-Z dated MARCH 19, 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 ONE FAMILY DWELLING WITH ATTACHED DECK AS APPLIED FOR. The certificate is issued to ALFRED & MARY KNAPP (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 6-SO-169-MARCH 17, 1989 UNDERWRITERS CERTIFICATE NO. N391513-7/17/96 & N394844-8/22/96 PLUMBERS CERTIFICATION DATED APRIL 3, 1997-HENRY SMITH PLUMB.&HEAT. B lding Inspector 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) �j NP 23316 Z Q Date..................31�.1 ..F. .............................., 19 . .. Permission Is hereby granted to; ................................. /..��. ��....�s :....�-�... ................ ..-4 .1 :C4.: ...mal/elv...... . //..79/ ta ..,1c. 1��....f3......... f ......s ......./C !... ........... ... . /za........... . .. ..`?�-�5.... ... if......., .../"w. .......... ` /!t. .......1 /.. °6..7 .................................... .................................................................................................................................................................. ................................................................ ...x, ; .... pp ...... at premises located at.... J -�. f�� '00 .'` .................................................................. ff!�� 49t{�P.lr..........��....9......................................................... County Tax Map No. 1000 Section ....��d.Q............. Block.....4s .....�..1. Lot No. ....6757 .......... pursuant to application dated ...........7`,1.0` ............................ 19..`�(�P .., and approved by the Building Inspector. 6a Fee$........!2/r�r . ... " /•••....................................... 7/.. Building Inspector Rev. 6/30/80 I \ "an NO. a 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° 20067 Z Date ....-�/7........................................ Permissi n is hereby grants , ....s, .. . ....... ..................... ............. �7 to1... ...0 ..-y4..... . ........... ..... ....................... at premises located at ... 1/ ..... .... ................................................ r� ...................................................................... ................................................................................................................................................................. County Tax Map No. 1000 Section .... .1?..0......... Block ......... ..(;. . ........ Lot No ...... ............. pursuant to application dated ......119-5,0-1.24....................... 19........, and approved by the Building Inspector. Fee S•••42 .. . . .,0. ........................ B ing I for Rev. 6/30/80 ' FORM 130.2 _ - : *64,14W SOUTHOLD:;' . BUILDING DEPARTMENT 'TOW-CLERK'S OFFICE SOUTHOLD. N._Y. BUILDING PERMIT= (THIS PERMIT MUST BE KEPtON-THE,PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO 4711 Z Date ................... � ., ........., 19 ... . Permission is hereby,granted to - *jI*d 1. ......... ................ ...... ... to ....... ti1Q„RdW D f11i x' . +� . .... atpremises located-at ..... ........ :..................... r ............::". Bq.44k7 ..::,.. .r ::.. . ......:............................ ....... ..... pursuant4c, application-dated .. ..... SS .: ,.,..., 19., „ and approve4,by the,. Building Inspector. Fee $t10 , C"c�r Buildinganspector a.m Sept. �1 Foem No. o /,�6L4 1j /(') 6 TOWN OF SOUTHOLD L.. ,t /jo (ow /"y BUILDING DEPARTMENT w7q 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 Building - $100.00 3. Copy of Certificate of Occupancy - . •25C. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.;700, Commercial $15.00 Date . . . . � • '( . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . � Location of Property. ^J. .1.w . . . . . . . .. . . S�U, �.�:Q . . . . . . . . . . .1 : . . ... . . . .. . . . . House No. �4 Street Hamlet yyn�� Hamlet Onwer or Owners of Property. . ��� e. • • • • V r� • •'•WJ � • • • • • • • • • • • ' " ' " " " " " " County Tax Map No 1000, Section. .. .. . . . .Block. . . .V . . . . . . . . .Lot. . . 9• . • • • • • • • • • • • • • • Subdivision. . . N . . . . . .. . . . . . . . . . . . . . . . . . . .. .Filed Map. . . . . . . . . . . .Lot. . . . . . .. . . . . . . . . . . . . . . Permit No. . Jv�,�6• , . . .Date Of Permit. . . . . . .. . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . .. . . . . . . . . .. . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . .. . . . . . . .. . . . . . f Request for: Temporary Certificate. . . . . . .. . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . o\kc,s),Opp .AP CANT C O �, SSG it o��SOFF01/rea, a c� G� N x Town Hall, 53095 Main Road p • Fax (516)765-1823 9y�Q� �aO� Telephone(516) 765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD April 11, 1997 Alfred Knapp 1616 Stewart Lane Laurel Hollow, N.Y. 11791 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. ) $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 23316-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. Town Hall, 53095 Main Road z : Fax (516) 765-1823 P. O. BOX 1179 y Telephone 516 765-1802 Southold, New York 11971 P ( ) OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE• '7 '3 Building Permit No. p Owner: 'Al— did� P/Z) Su y al r/rU� C (please print) Plumber: y1P�t/AY X54?/ 711 (please print) I certify that the solder used in the water- supply system contains less than 2/10 of 1% lead. (Piumbext Signature) Sworn to before me this BERNADETTE L.TAPLIN NOTARY PUBLIC#4844893 3r& day of �,Z Cyt Q_ 19il State of New York Residing in Suffolk County Commission Expires Sept.30. 19_q Notary Public, County N U �� FORM I6B EL The Xrw Vork Trva�� 0, ����r lubtrwrittkIV` Il � gj{ BUREAU OF ELECTRICITY � N814216 _' 85 JOHN_ STREET, NEW YOLK;NEWYORK 1603,8 '< < AateJu e 22, 1970 ApplivationNo.on�letE29422 N814263. { (l�rrttties, �4 that the electrical equipment as described below and introduced by the applicant named-on the above,application number in the premises of " Jos. Sarrantanl«, .30iXndv:kev7 Atre. , ;e ,%6 14117: Ted, , in thefollowing location; ❑ Basement ❑ 1strl. ❑ 2nd Fl. Gftl'�51tT.f' Section Block Lot q; was examined on, June 1El L 1970 mid found to be in compliance with the requirements of this Board - 5� is t FIXTURE FIXTURES RANGES COOKING DECK$ OVENS DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLE$ SWITCHES INCANDESCENTI FLUORESCENT I 'VAPORY AMT. K W AMT K W I AMT. I KW I MT K.W. AMT H P 2 ` DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS i i SYSTEMS ' AMT K.W. OIL H P GAS H,P. AMT. NO A W.G. AMT AMP AMT AMPS. TRANS. AMT. H.P. NO.OF FEET AMT, WATTS. i VICEtVISCONNECT--""Ntr:OP- AMT AMP TYPE METER I R,ZW I A 3W 3 6 3W 3�4W NO OF CC COND A.W.G. NO OF HiLEGA W G NO OF NEUTRALS A W G EQUIP. PER,O" OF CC GOND OF HI-LEG OF NEUTRAL t b 1 '30 Slr x 7 2 X. 2 OTHER APPARATUS: i x AMOUNT N. K PLEASE REMIT BY CHECK OR MONEY j .S.00 ORDER TO THE ORDER OF THE NEW YORK BOARD OF FIRE UNDERWRITERS, AS CASH SENT BY MAIL WILL BE AT s Joseph Sarrant Oni 0, RISK OF SENDER. , 1$-165 -- 26tt1 I{d. , d` Per " . I$Y¢SUBILl;F9R$"$RY1,CFRENDERFt,Q ANpIS NOTACERTIFIC!>rE OFACOMPLIANCE�THI$BUL P,gYl18L€AT THE I�FiV�YUR�OFF,IGE�85 JO HN SKEET,'�JEV�YORK,N Y�`1003Q '4 'B # ct THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGEI 1 2001071 BREU OF ELECTRICITY F 85'JOHNi$T ET, NEW YORK, NY 10038 Date JULY 17,1996 J'A1i lico {on No.onfile 54281994/94 N 391513 THIS CERTIFIES THAT I only the electrical equipment as described 6ebto armijittAdvIl by the applicant named on the above application number in the premises of AL KNAPP, SOUNDVIEW AVENUE, P%4-29CONIC, N.Y. f�11 k in thefollolcinq location; ❑ LtK Basement !a%Fl. nd Fl. GAR Section Block Lot was examined on JULY 12,1996 +'J an ,found to be in compliance with the National Electrical Code. y 1A FIXTURE FIXTURE.; RANGES- COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUT LETS ECEPTACLES SWITCHES INCANDESCENT fIVORESCE T 1p; 1H' NAT. I K.W. I AMT. I C AMT. K.W. PMT. K.W T. H P. 5 12 5 5 DRYERS FURNACE MOTORS I FUTURE APPLIANCE FEEDERS ISPECIALREC'PTI TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL H.P. GAS H.P. AMT. NO:` " W:G. AMi, AMP. M1T. AMPS, TRANS. AMT. H.fl NSYSTEMS AMT. WAiiS NO.Of FEET I. 2 600 SERVICE DISCONNECT NO.OF 3 '* 'S'�` E R V I C E AMi. PMP. TYPE METER 1ptW 1,a'SW S,9'3W 3pL NO40F CC GOND. A.`W.O. t�� Of HbLFG A.W.G. NO.OF NEUTRALS A.W G. FOUIP. PERA, OF CC.GOND. OF HI-LEG OF NEUTRAL 1 100 CB 1 X 1 4 1 4 OTHER APPARATUS; PADDLE FAN-1 MOTORS11-F H.P. G.F.C.II-1 TRACK LIGHTINGI-20 G & S CONTRACTOR LIC"; 7 .• w F� L L BOX 215 SOUTHOLD, NY, 11971 et i GENERAL MANAGER it; 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. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1001071 BUREAU OF ELECTRICITY F 85 JOHN STREET, NEW YORK, NY 10038 Date AUGUST 22„1996 Application No.on file 12058496/96 N 394844 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 AL KNAPP, SOUNDVIEW AVENUE, PECONIC, N.Y. in the following location; © Basement ER lst Fl. IX 2nd Ff. OUT Section Block Lot was examined on AUGUST 19,199'6 and found to be in compliance with the National Electrical Code. FIXTURE ECEPTAGLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER NAT. K.W. AMT. K W AMT. K.W. AMT. K.W. AMT. H.P. 20 28 20 20 3 r DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS I BELL I UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AML K.W. OIL N.P. GAS H.P. MIT. NO. A.W G. AMT. AMP. AMT. AMPS TRANS. AMT, H.P. NO.OF FEET AMi. I WATTS 3 P 2 — 3600 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. AMT. MIP. TYPE EQUIP. 1ptW 1,e'SW 363W 3,e AW PERE OF .W.G. D NO OF Hb LEG OF HLLEG NO OF NEUTRALS OF NEUTRAL OTHER APPARATUS: G.E'.C.It-6 SMOKE DETECTOR:-•4 >f G & S CONTRACTOR LIC.#578—E BOX 215 ANN SOUTHOLD, NY, 13.971 GENERAL MANAGER 11 aS 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. 00 E 4�� •,ri=rv�E1.,3r�?b6TT5 Ar 4�:?2iiii} ! - - t7tion of f, •`x3= tar -:,.'.`?of the N,,pork$tOW - v:! c '&of this$� � � ��►���" Urvlw man not arFng vWK<;n�� 1 . 277. 1E &�'oi�nidi,bO nsMem{'( l_ .s *, ».. - n trus,crpy. 1 l f int 'ta :! ti isaf4 in N z .the stervoj: 44 �y i and Al • t am' ± �`i ,�11V sJ� a `� � gyp 9. t"i STY. ACID 4.7 15$. eta { i (�tLT lo AiJ P' Chief o+,Burt�ae nt �d2 ;�..�; r . 3-ager�ent � 5PWT�� kkco . J09PU J . A[ - 5, . r �: tr, PIPE LE E8 ; , � � ' f M ErAX A S rac'�not bo.,.r•;tn \,� Nk • M W _ �1 4'7 ` OV T0 " W, — 254. 20 ,• , nYi h ` l�\ �/ q [� } S`ai�r i..V al>• '; + »e..L...�-�_ .moi tf is -1, •.:wsi1'/'• :y f—� c iLT t 1 St` i a C, � F l A n �ntand/or .7 0 tys 0/1 �' � Cl1iEf`Ote(ji:fcdii 'J( .12;,1-vi:•',t'f y a,:Ak�f�B{lt ` opl 5IV) j ar � PEE 0 11C TowN cysoUp rluttlAuTEgo io T:;,g GUARAIN W 71p1; Div. - Amtiz,1 4tj IiTCE W4�L,r AKGI� $ VIVAyE,)7 SEPT. -1 197, # VA N T 6, y r �• 1969 P1r- ! ITL W 4— 4978 Ggj&NPa#- , kt-1Y Ua¢ 1ELD I;:S:'ECiiU;J �IU 'AT E UUhfMLNTS FOUNDATION ( 13t ) FOUNDATION ( 2nd ) 2 . z 0 ROUGH FRAME & PLUMBING ti H 3 . x' m m I14SULATION PER N . Y. STATE ENERGY CODE 4 . l/lam y FINAL ADDITIONAL COMMENTS : P U x � H y� O `.Y m�9 ' - x• Q m � ro `^ M a i -s R , J r .gLrq.ytYdi`2�y l b VICTOR LESSARD ft` Town Hall, 53095 Main Road PRINCIPAL BUILDING INSPECTOR E k M7 P.O. Box 1 179 (516)765-1802 1 < ' Southold, New York 11971 FAX(516)765.1823 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD April 19, 1990 Mr Joseph Sarrantonio, Jr. 918 Oak Street Bellmore, New York 11710 Re: Building Permit #47112 (1970 ) Suff. Co. Tax Map #1000-68-4-9 Premises: Sound View Ave. Southold, N.Y. Dear Mr. Sarrantonio: The above building permit has expired and a Certificate of occupancy has never been issued. You are in violation of the Code of the Town of Southold as this building permit has now been voided. Please contact this office immediately to avoid legal action. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Victor Lessard, Principal Building Inspector VL:gar i COUNTY OF SUFFOLK CO DEPARTMENT DEPARTMENT OF HEALTH SERVICES N Varch 5, 1979 CAVID HARMS.M.D., M.P.H. COMM15510MER Joseph Sarrantonio, jr: 918 Oak Street Bellnore, New York 11/10 RE: 6 SO 169 s/s Sound .View li anue•, 30001 e/o Mill Lane . Dear D:r- Sarrantonio: A recent check of our files indicates that this office has never issued a final approval for the above referenced job. Please be advised that it is illegal to occupy the building until the fol- lowing paperwork is submitted to this office and/or the following inspec- tion(s) are completed: DE—Well Drillers Certificate :;Jl4Pater Analysis jam` jCesspool Certification Final Surveys Other ',fe wast do an ins-rection on the well, !lease uncover andPI] r_ us- for an inspection ✓2C 3 6 Should you have any questions, please feel free to contact this office. Very truly yours, ���� — • � �— 'moi— 9 ` . p Y`7 !J y/ /76 cc: Town Building Department �j/,�1e tooxv CCHTCR • Piv ERN¢Y(p, MAW VQRN 11901 • I5I0I 7..7•47d0 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 111SULATION [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: . \r �y DATE ���/�-�-INSPECTOR < r M-1002 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ) FOUNDATION 2ND [ ] INSULA N ( ] FRAMING [ ~ INAL REMARKS: / GL DATE /� S INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ I ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE U �� INSPECTOR � / FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT -f TOWN CLERK'S ICE g i' �'`[s — c.°. o.,., l -e Y SOUTHOLD, Y' -13'73P�arlu `d 6n„� S > l/a6� �cn f"Z .� a� � U �1 herdr� /vt / .!j[dc.o o Examined Approved ........... .:......................... 1 9........ Permit ( 0-&17plication No. .. 7 �.....�..........�_ 70 ............ ..........`... ! // "�� aI' /mac e�uwp�P No. ................... 1ylTs a Disapproved a/c ...... ........... ...... ad L j ....... y/rs y� �Co w 4J ...................................................... .. .. ... .. ��' �) ..... . .. . .................. ..... . .... 0..�.�......... ..... c$ � '`_ ye (Building Insp etor) � �/ 01 APPLICATION FOR BUILDING PERM17 0.9 Date ............ `.:...... ��. ............. 19 9.... c INSTRUCTIONS C a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building G Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets'or < areas,and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. m, c. The work covered by this application may not be commenced before issuance of Building Permit. .� d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. pp agrees to comply with all applicable laws, ordinances, building code housing code, and regulations. The applicant a �. G .................... ?n of applicant, or name, if a rporation) ................................................................................................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Q cv-i,.s,.. - 03 c,,Pte.. ...............................................`....I.................,..,.........................................l...r.................................................................................. Name of owner of premises ...Ug:.: a �6. � �..� 'v r �..N.... D .. >� ................................ ....... .. .............................................. If applicant is a corporate, signature of duly authorized officer. ................................................................................................ (Name and title of corporate officer) y k 1. Street on of land on and Numberwhich proposed work II be done. Map�No�:��........'\.............. Lot No .:�../\........... CM...�� /,;z Q Municipality lc 2. State existing use and occupancy of premise— s and intended use and occupancy of proposed construction: . ..... .. . . 17*�w ............................................................. a. Existing use and occupancy .............Vb. Intended use and occupancy ...................... .. .. `".....................i........................................................... 'per 0 3` Nature of work (check which applicable): New Building ........Y. ..:. Addition .................. Alteration i...`...�:.�,: Repair ... .............. R c� va .................. Demolition........4C....... Other Work (Describe) ...r...:.....::......................... 4. Estimated Cost .......C. 6, O0 D.. ...........................Fee ...��................................................................................ . (to be paid on.filing this application) 5. If dwelling, number of dwelling units ..... .........Number of dwelling units on each floor ............................ Ifgarage, number of cars .... 0:................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height .... ................... Number of Stories ......................,.......................................................................................... Dimension of some structure with alterations or additions: Front .................................... Rear ............................ Depth ..... .......................... Height ............................Number of Stories ................................ Dimens 8. Height ion of entire new co Numb�elr5f�toriesFront .,y.....:.....Rear ai.�l; ...:";..:. Depth .....Y.o....:,.:::.. 9. Size of lot Front .......... ................. Rear ,...�.............................. Depth .. ..... .. 10. Date of P rchase ........ 74 .......................................Name of Forter 0 ner ...V... 5 .�'r......................... ... 11. Zone or c 4 r in which premises are situated ......... . ........ .1..............I—.......... ... 12.13. Name of caner oftprem ses ' °te any zoning law, a ii-nance or regulation? (.. .... ...................................... Does prop sed construction.vG . m�."..^.^.:Addresss ......... ............. Phone No. .................... Name of rchitect ..............:.......................................Address ............................................ Phone No. .................... Name of ontractor SS ` .................Address ............................................ Phone No. .................... PLOT DIAGRAM Locate clear y and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. G ve street and block numl _or_description according to deed and show street names and indicate whether interior o corner lot. pPcfc.� i to I `) u �ttn� —,qvt> L121—t AVC,7" STATE OF N5W 1 S COUNTY O ........ .. ....... ...... me individual signing application;* """".•••.being duly sworn, deposes and says that he is the applicant t above named. He is the ............................ ............. ................................................................................................................ (Contractor, agent, corporate officer, etc,) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; t iat all statementsl contained in this application are true to the,best of his knowledge and belief; and ti-,or the work will De performed in the manner set forth in the application filed therewith. Sworn to b��jjfore m this ...............6L.: dcy of ........... `�'/ `„' `............. 19. 0 //\ y //" .... . b ...........9.. ...... .. /. n.........r........ Notary Public,�.�s�/!RIU..:./ .. County (Signature of applicant) (/ -YAKAS A-1 ME S. *7 09 40 6.11-4 {t�,r �4ff__�; � +� h, ' •eta . M� ��'' � �' ! .i ��D� - A(AU `Q VDUCATIOm RD ALTERATION ae ADO,,O Y . 4 RVEY IS A VICEATRDEF D9 OF Ti�'E N[W VORR:STATE LAW lp. + / .IS SURVEY WAP NOT TRAY,,a{ .Y 1 P� U:L SH L!,:;T SC O OR f('_' j(�, { EAL SfiAtt AJi CE CONS@EY:'v1LID TRUE CCPV. 1�C 4{ Yi ) �` FT� GUARANiE^ 'MICATED Y.LREON SHALL RUN - is J1�'//J�(� F .7 jVjjw¢�7Gr1 F [vim»l I�{)/jd{/L(\� �(/nj�� �)Jp/(/�} (.�! /j/'t{'1 ./(E/'/�� y(/.}}i[ p /`Jq F�1 (///j')� ONLY TO TH :E:SO:I FCC CA,t.t THE SUF.k Y y P'NY / V •/ V ( t ' V I[.e 1 ($ I.I (✓ t Y i f V 34 J !I Fr 2 f i P i 1 V TO TITLE Af SSIGN.SOVC Ti'E LENDINGOINSTI.A D 4 IENCING INSTiTUT! N USTEC h-A2ON,AND .p TUIION.GUARANTECS RE NOT TRANSFFU _- {fes` S TO ADDITIONAL INSTETU ON5 OR SURS=QU . � Y � �F� � � _ _ QWNER� � �I�rvN SDU ttoc� N. }�, f:U& tLkut c0 TO TUE GUA2AINT60 TITLE =s ' DIV. - AMMC44 -f ITLE 1,u5712ANC6 CO. VASN 2 , I IF ' 1 � 14 �Ic��psEA �u PIPE 1 C � �� �� �4-J 78 pops G26E1J,�Id2T , 1l�Ct' �(02t!