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HomeMy WebLinkAbout18593-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 220128 Date AUGUST 2 1991 THIS CERTIFIES that the building ADDITIONS & ALTERATIONS Location of Property 762 GREAT PECONIC BAY BLVD LAUREL House No. Street Hamlet County Tax Map No. 1000 Section 145 Block 002 Lot 007 Subdivision DUDLEY PARK Filed Map No. 212 Lot No. 3 conforms substantially to the Application for Building Permit heretofore filed in this office dated OCT. 17, 1989 pursuant to which Building Permit No. 1S593Z dated OCT. 24 1989 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 ADDITIONS AND ALTERATIONS TO EXISTING ONE FAMILY DWELLING. The certificate is issued to JOSEPH & EILEEN FARRELL it (owners) of the aforesaid building. i SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N{A UNDERWRITERS CERTIFICATE NO. N 193041 2 page JUNE 21, 1991 PLUMBERS CERTIFICATION DATED BERTSAND PLUMBING & HEATING AUG. 1 1991 uildinq Inspector Rev. 1/81 xosas xo. s 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 o 8 5 9 3 2 Date .~c/ ~T ..............ee,.o..............., a ~~y Permission ~ he~ y grpnted to: w ~~:........%...~...........~...e . e..~ ct premises located at .~:~i..a.....~~/'~iQr.~,L~~GCd.,..k~'~<Eel,.,.~~..,,~~.f County Tox Map No. 1000 Section .l3`"~....... Block ......Q.A~..~' Lot No........c'1..~?.,~... pursuant to application dated .........~Q./..~:.~ 19. and approved by the Building Inspector. / ~ Fee $..7. ~ ............r.....~: uil ng I ctar Rev. 6/30/80 p C't Forin No. 1i f ~ ~~IU b U \l1AL`, TOSJN OP SOUTIIOLD ~ !~~',,~r ~ ~ / IlJ1 BUILDING DEPARTPILNT ~V~ " 2 {991 TOWN HALL 765-1802 fhd_,Js.~.~t>2:W t. YCPNf~ Cy4=.%s?'.~it4i7+, APPLICATION FOR CERTIPICAT)r OF OCCUPANCY 1. This application must be filled in by typewriter OR pink and submitted to the building inspector with the Following: for new building or new use: 1. Final survey of property caith 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. Scaorn 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 C~;mpliance from archi_ect 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, or buildings and j "pre-e:isting" land uses; 1. Accurate survey of property shocain; 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 Luilding Inspector shall state the reasons therefor in writing to the applicant. Fees ' 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25•D0, Alterations to dwelling $25.00, Swimming pool 525.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Build9ng - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50,00 5. Temporary Certificate of Occupancy - Residential $15.001j, Commercial $15.00 Date Y/~ t ew Construction.........pp~~., Old Or Pre-existing Buildirn~g..,,,.LC...... ocation of Property...7ttt'~'.....~G~CY7:d~;.. ~.../c':~/~~.r...~.......~!~'u''~......... tiousc No. Street Hamlet c ewer or Owners of Property....~1~34a'.y~`:1...~..~. ~:~-~~~.'L ,unty Tax hiap N-o~ 10~0~0, Section....~T~.....,Bluclc... ~ ~:.......Lot....~ :bdivision......~:~~!~!~-.~....~~~:~:.......Piled Map...~1r~.-. ...Lot............. rmit No..~~`7~r.~~...Date Of Pcrmi.t...:~~~T...~..Applicant.,~(~.'~6r~..~~...~~`Z~~"~-: / ~,F17GG6} ~ ~£C''7', alth Dept, Approval..... N/! .................Underwriters Approval.(Sa~t.~f4~s................ inning Board Approval... Nk~" guest for: Temporary Certificate........... Final Certicate.,.~.... Submitted: i, C~, 2. ~o l a ~ ~ c-CC9~c°_ `tj~,~~~`rY1 ~-~'It~' TEL. 765.1802 oS~FFO~~o Town ors souTSOr~n ~:c OFFICE OF BUILDING INSPECTOR P.O. BOX 728 y~r TOWN HALL `'per,. ` ~a0~ SOUTHOLD, IV.Y. 11971 , 1 ,x. C E R T I F I C A T I O N ~lr I~, Date Building Permit No. owner . ~ 9 sb~i~'.1=.~=LL ' (please print) Plumber~E2TSn.?~ ~~u~,~,ti~ °/~~~~~~s,~-~~'. ' (please print) I certify that the solder used in the water supply system ~ contains less than 2/10 of 1$ lead. +-~x,u/ ( lumber's signature) Sworn to before me this /,s.F:~,day of u ~ ~.,~s 19~. Notary Public Notary Public,SuFr--~~~~ County EILEEN M. ROHCHE ' Notary Pu61k, State of NawYork' No.482t3842 QuelMletl trrSUffolk County Commleaion Expires January 31,182s~ -----r- ~ ~ . ~ ~ T - THE NEW YORK BOARD OF FIRE UNDERWRITERS PAt;k:' 1093.071 BUREAU OF ELECTRICITY s BS JOHN STREET. NEW YORK. NEW YORK 10038 Q- - Daty ITITPIT'' 1.) , 1491 APPlication No. on file 73 44 l 140/91) N s, 9.f047 E' _ - THIS CERTIFIES THAT only the electrka! equipment as described 6ebto and introduced by the applicant named on the eboce applicstion number in the premises of E.FARREL, P&C.ONTC NAY BI,VU.?N~~yyA77Y S:OR?, 1,A.URRi1, N.Y. in thefdlolring location• 0 ment L`J tat FL ~ Ynd FT. Oll'I' Section Block Lot ]eaa examined on JUN~~ 7. 3 ° "'"1 and ound to 6e in com J pliance with the reyuiretnenta of thia Board. BXTUlE RXTURES ~ RANOES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ' TACIES SWITCHES INUNDESCEM FIVORESCENT OTHER AMT. K. W. MAT. K.W. AMi. K.W. Mni. K. W. AMi. N. P. - 74 F: 65 ? 7.2 7 e DRYERS FURNACE MOTORS NTWE AEFUANCE REDERS SKCIAL REC'Pi TIA1E CLOCKS RNt UNIT HEATERS MULTI.OUIIET DIMMERS AMT. K. W. pl N. P. GAS N. P. AMT. NO. A. W. G. AMT. AMP. AMT. AMPS, TMNS. AMT. N. P. SYSTEMS AMT. WATTS NO.Of FIST _ 4 P 1 4 ]7 7 SERVICE DISCONNECT NO.Of S E R V 1 C E 'tl` AMT. AMP, TYPE ~ 1 / ]W 1 / ]N' ] B TV ] / AW aER dCOND. Of CC. COND. ~ N41EG OP ~N NO. a NEUTRALS OP NEUTNAI 1 200 CN 1 X 3 4/I) i ?./U £ OTNEE AMAl1A7U5: E 'T. TON A.C UNI'i"S-"t = 3'PON A!C F3NITS-"1 FRAC'!' ATR HAN"lY1~k,RS°~i g 5RM uF,NERATOR-3. S.OOAMP. AUTO TRANSFF;R SiI'[TGR-7. MOTORi:I.-t.5 H.}`.,1-0.75 H.P, o i [i1tNN;LBOARIJS:1'8 C~Ck. 100 ~ SMOKE bFTF;CTOR : --'l. - ~4~.E%u-~~ P . i<•: i'ontnnen nn Pa~c. C: OBA@AE MANAGH Per This certificaro must not be Dlrored in any mantror; return to the office of the Board if incorrect. Inspectors moy be ideMffie eir crodentiGls. fs COPY FOR BINLDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. _ ~ _ _ T _ ~ ? z ~ ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS "a~an £ 1.001.077 BUREAU OF ELECTRICITY _ ~ 83 JOHN STREET. NEW YORK, NEW YORK 10038 T7UNR i1 "?~7i "1799759(1!90 ti 793Cia3 Dote Applicotian No. on file = 'r; THIS CERTIFIES THAT ti only the electrical equipment as described 6ebw and introduced by the applicant named on the oboDe application number in the premises of 3 S.1?AF.RFL, PECOH[C. AAY ALVO. (AAV S:~:i)F.1 , LAUREL, [Y.'Y. in the following location; ©Basement ~ Ixt Fl. ®End FI. OUP Section Block Lot was examined on JUHF' ~ r 1.991. ondfound W 6e in compliance with [he reyairementx of this Bwrd. HXTUR! ECEttAC1E5 SWI7CNE5 RXTURES RANGES COOKING DECKS OVENS DISH WASNlRS EXNAUST FANS__ OUTLLRS INCANDESCENT RUDIIESCENT OTNER AMT. K. W. AMT. K. W. AMT. K.W. AMi. K. W. AMT. N. P. DRYERS FURNACE MOTORS NITURE APPDANt1 FllDERS SPECIAL R[C'?T 71ME CLOCKS REII llNIi NEATEK MUITI-0UTIET DIMMERS AMi. K. W. pl N. P. GY5 M. I. AMT. NO. A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT. N. P. SYSTEMS AMT. WAT15 - NO.OF FEET SlRVICE DISCONNECT NO.OF S E R V 1 C E _ 1 AMT. AW. TYPE MlWgP. t,e TV/ 1PJW 3,e 3W 3X AW ~k gCOND. aCC COND. ~~~NFIFG a'HI'~ ND.OE NEUTRALS pj ~NEUTRAI c- ? C OTIER AMARATUS: 'a _ G & S tYkl'dTRACTUR 6[C,#578Et - AOX ?.15 SOfiTHOLD; NV, 1197'i EiRTEBAt MANAOM = 77 Per This aniW[aM must not be altered in any manner; roturn to the office of the Board if incorrect. Inspectors may be idenfifiad by 'r crsdentiDls.:~ COPY FOR BUILDING DEPARTMBIT. THIS COPY OF CERTIFIGTE RUST NOT BE ALTERED IN ANY MAINER. '1G~.~ 1.~u.L ~V.. `Ill?`. II li l.':K~~C. /`~1... OUt1DATI0G (1st) ~I . ?oUtJDATIO'J (2nd) _ ,q~ ~ SOUGH FRAhfE & a ~ - , A PLUMBING ~•~J-- /J ~ -tiN.v? c-- 4ti ' H 3, a 3 m IJJSULATIOM PER N. Y, I STAT° EPJERGX CODE I x Jr~ m H i I FI;IAL ( . m pDDITIOfIAL COMMEIITS: ~`~j . m H Y~ • ~ O \ • ! O • m ~v .-7 MEMO FROM PECONIC DEVELOPMENT CORP. r0 ~ P.O. BOX. /r~ia M N~ !l~i3l custom homes Derrick Doubrava & alterations President SUBJECT DAT ~ .P ..frs~ ,~e~p~e~u_.e. ,e~7~ilxc i~ ~ /~~`9..~ SIGNED REPLY DATE SIGNED RETAIN WHITE COPY FOR OUR FILE. SEND ? YELLOW, ? PINK COPY TO CUSTOMER. ~ ? NO REPLY NECESSARY ? PLEASE REPLY ? TELEPHONE ? RETURN ENCLOSED MEMO WITH REPLY I ' S U T E R and S U T E R P A R T N E R S H I P 6 AtlanticAve. PO Box 389 East Moriches New York 11940 January 29, 1991 TOWN OF SOUTHOLD BUILDING DEPARTMENT Main Road Southold, NY 11971 Attn: Mr. Gary Fish Re: Dr. and Mrs. Farrell, Peconic Bay BLVd., Laurel, NY. Permit # 185932. TJI floor ioists. Dear Mr. Fish, The Contractor Derrick Dubrava requested that I send you current plans for your records showing the upgraded floor joists. We have designed 14" T.J.I's to clear span the living areas. If you should have any questions, please do not hesitate to call. Yours truly, ~ ~ _ d~e to Suer BS:rq ec: Derrick Dubrava Dr. and Mrs. Farrell ~ FEB - 4 i~~! ~~Lz;%, p . Encl: TO~.~;~ c`~.....:.r;r~~~.~a 516 8 7 8 4602 fax 51 6 878 6485 , PT.L'~•1 YOFI: STATE DEPA=°.T: ~.EP'T Or Ft•'VIl•OIII:'EI4TAL COP?SERVATIOi1 F,egulatory P,ffsirs Unit ~ Eldg. 40, 5Uf?Y--poom 219 • Stony Brook. KY 11794 (5161 751-7900 VesiCY"N ~ fr/~/Y'/t~t L L V''G='f'i, / ~j•~~~ ~w,?r,~?~ro,J,,t?.y /i~¢..3 Dear ; / ff/"r~ A review has been made of your proposal to: ~~,,~~~yq~y. C_%Yi~~~?.~.~'rAs~C~i 'v ~!/J!/ ~/!J~j ~E~~- 7~/irYJ~?1 rl'!~~la'N/7C, L.. t>~!E? e: /z.Je-•r 7e: ~~~Ce,~7,L C~~/~r~,a5frur>~ s~ /rc «/~~</~Jl~'~~ %G~ t cc~ yls r~~ J lo'l~dlJl~~t~Tir7JLf-e/`~ C> ~ /71i ~!5+~=- yC"d r'7/>F, i 'r../?~/f'.~ //J~'~GfT/~,~~~ Location: fi/1 'f/1 E~ .5"<~/"r/! • h.,. ~ ~ar^ J~/~~~J~;, ~ dliJlj/x~';i ~y c3. s~f~,- ,U,t/ mar= ~i~ ~,1-~ //-~C~[ir/J~l,- /~'~yy ~/G~l~ ~liC//"~'~ ~a^<!f ~a'~%~~=>°,-~%/~~ ~vGO ~/.~~_':~'~1~,"E~~T . Kew YSrk State Denarfinent of Flnvironmental Conservation has found the parcel project to be: Greater than 300° from inventoried tidal wetlands. i Landward of a aubatantial man-made atructure• ,~~~//,t ~r~~~~ greater than 100' in length constructed prior to September 20, 1977: Landc~:ard of 10' contour elevation above mean sea level on a gradual, natural elope. Landward of topographical crest of bluff, cliff or dune in excess of 10° in elevation above mean sea level. Therefore, no permit under Article 25 (Tidal wetlands of the Environmental Conservation Law) ie required .at this time since the current proposal is beyond State mandated jurisdiction pursuant to this aCt. `3.oeoever, any additional trork or modifications to the project may require a permit. It is your responsibility Co notify this office. in writing, if such additional work or modifications are contemplated. Very truly yours, ~l~?/t~ Lt,~rL~Q~~ Alternate Permit Administrator CTIi: DDR: co ° a •'S" U T E R and S U T E R P A R T N E R S H I P 6 AtlanticAve. PO Sox 389 East Moriches New York 11940 ~ GW ~.,4J lr .w~, + .x,,, October ~ ~ OCT 2 01989 ~ TOWN OF SOU'I'HOLD BUILDING DEPARTMENT TOWN HALL 70WN OF SO TFtO~p Main Road Southold, NY 11971 Dear Bldg. Dept., Per our telephone conversation with Lynn at the Building Dept., please find enclosed a blank check for the Application fee for Dr. and Mrs. Farrell Building Permit. As soon as we find out the numbers of the plumbers, builders, and electricians we will submitt them to your offices. Please call if you have any questions. Also, please call or mail to our office the Building Permit and the amount of the fee you wrote on our check. - - - - Sincer , J e~=~~ "v Rose Quintas Encl: Check. i 516 8 7 8 4602 fax 51 6 878 6485 < , S U T E R and S U T E R P A R T N E R S H I P 6 AtlanticAve. PO Box 389 East Moriches New York 11940 October 17, 1989 TOWN OF SOUTHOLD BUILDING DEPARTNENT TOWN HALL Main Road r 5outholdr New York 11971 f l J Re: Dr. and Mrs. Joseph Farrell fit,`/ / ,a { Peconic Bay Blvd. D Laurel, New York ~ , >nwN 0 SouiT Mph Dear Building Department, ~ s Enclosed are the Construction plans for a renovation/ addition to an existing residence. I spoke with a building inspector several months ago and I think I have enclosed all of the needed documents. Please do not hesitate to call if you need additional information. Yours truly, ~f"`p' • _ ette Suter BS:rq Encl: 6 8 7 8 4602 fax 51 6 878 6485 ~ T65-1862 BUILD{NG DEPT. INSPECTION [FOUNDATION 1ST f ] ROUGH PLBG. , [FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL r._, REMA S: .~°~r Lz~ Gtr r DATE ! ~ G ~ INSPECTOR ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ INSULATION [ ] FRAMING_ ~J [ ]FINAL REMARKS: `'~G~'C~~~° C~ i DATE l ~J INSPECTOR ~'~j x. rss-iso2 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST -{~J ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL %n REMARKS: i ~ ~^-z-~° V~ DATE ~ ~ INSPECTOR 765.1802 BUILDING DEPT. 1 NSPECTI4N [ J FOUNDATION 1ST ROUGH PLBG. ]FOUNDATION 2ND [)INSULATION MIND [ ]FINAL REMARKS: ~i~-~.~-e_ o'~--~ a,~.,~-~.) ~ DATE~~~-' ti ~ b INSPECTOR y waAUTEwRUED uieRArwa oR AownU, • ~4g ro 7X15 SURVEY Is A VIOUTION or \O ~V S[CEION 7209 Or AIF NEW YORK STgiI `V fOVCAT1pN uW. O~ COPIES OF THIS SURVEY MAP NOi SEAUIN~ Q ENE unD SURVEYOR'S INKED SEAL OR ( eMBOSSED sul SHALL NOi SE CONSIDEev P \ ~0~0-J t0 N A VALID TRUE C09Y. \ \ a `J0 3UARANTEFS INDICATED HEREON SHAD eur , ~ ONEY i0 SHE PERSON FOR WHOrs tee Alktr ~l IS PREPARED, AND ON HF. BEEUdl rt Ir^ O ` EITLE COMPANY, GOVkRNmENIAI ~ AN9 G (ENDING IN9TINYION ll>?L P AND G , v N [O THE ASFIGNt6 Ui iHf IIHUnvG MSTI- Q a~ ~ NtlOrv GUARAPIIIE$ ARE NOl fknNSfERABL'F \ \ 0 'O pDUINONgL WSi1TUTwaS OR SUBBEOIN9P \ \ \ Q ` Q~ 1 \ o- /0 _ r 2 t, , o o e ~ S~ '065 ~ \ w ~ Q \ l.o 'o Q N \ o g2.r w Q \ A V O D. 'N C' ~ 1}'..J \ \ \ \ v \ ~ Y \ H \ 1 ~l y \ 14~ E e D J dw \ d i\ N Z N r h: \ \ ` N \ \ \ ~ `vaw / N N ~ O ~vv 1 \ i ` W ` A./ /V \ \ e ` \ ,w Q \ ue~~ \ < \ lm ' ~ ` i \ \ \ \ \ ` N \ 6*~ x-00` GN FFs`g21 OR \ ~ 13'7' P C^\y,`A' .0 F~agE1FENt F~51?9 ` li` N mW poaGµ FFs\5:53 M NOTES ~ cMONUMENT 13-'~" SUBDIVISION MAP FILED IN THE OFFICE ~p ev 3 \.?p~~ Q, OF THE CLERK OF SUFFOLK COUNTY ES ;_s° T \ k ON SEPT. 17, 1928 ,AS MAP N0. 212. ~ ~ 0e` SUFFOLK CO. TAX MAP \ \ DIST.I~SECT.I~BL.QQgLOT.gQ~ \ \ 1 N\ ~ SURVEY FOR , JOSEPH E. FARRELL r,;;• M~;'` LOT N0. 3 ` n° '(DUDLEY PARK° tio~ wew rod'°~ LAUREL ~,~r'~~N w. vOVk* ~s• >°t~ : TOWN OF SOUTHOLD oUA AEI % s e°" SUFF. CO., N.Y. MEAOOwe ~vsl c W~\\ °~Py HOME TIT SCALE ~ 111 = 401 TITLE INS m CE o y0. O / FEB. 9, 1966 ~,f A gab ao*,; ~oQeJa ~ ~~G FEB. 21, 1984 z ~ / ~ PROFESSIO L ~ 45 / `C/G MAR. ~30, 1985 LAND 3URVEYO , / . Q RIVERHEAD N.Y. . N6.84-121,2 ~ ~ a ' ' FORM NO. 1 ' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765.1802 Examined .1~~ T.. , 19 ~ Received , "1 Approved 19 lf. Permit No... . Disapproved a/e ( ildin nspector) APPLICATION FOR BUILDING PERMIT Date 19 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. 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 appli- cation. - - 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 issued 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. 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. The applicant agrees to comply 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) P.-.4 : ~i.O.oc.~ ~iq . (mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . h.9J.. l1(tV4! . V .~~P.t"1.... ~7-t~GXs.~r~ ~r:~-.- . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) - Builder's License No . . . f . Plumber's License No. U Electrician's License No. . Other Trade's License No. C'~O.` ~(e~ ~¢nn~,,-~4y- QQ f . Location of land on which proposed work will be done. C Q.N ~i'*:.1.. ,T,~ ~,,,.V ~t. , , , , , , , , , , , Flouse Number l ,GS~trGe~et /)Hamlet County "Tax Ma'Nto. 11000 Sectio(~np~./n.~.'./!..`, f........ Block ...~U~.!....... Lot...r'-~..~~. Subdivision ..~W~.G~ / •~fYCn~ Filed Map No. ~ Lot . • . • • . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a.F.xietin~llSPA11d(1CClln~n(`V ~DC1~iTt?•{~~ PrzIMAt2~ ~fnlrtl F FA~Mt(k 1~-~'~1t1~?.i~r.=' o2~e1 ~ ~•a ~Mnww,~ " (;uea?idde 3o aan;eu8[$) I A~ w wue~ ?1019f? `oN • IM?A .wMl Net4 '9176nd ANiOy Itt021 'W ~N31tlV`0l I`I/"~ ~(;uno~ ~ ~L.,'~'~~,.~ `o?Ignd Sze;oH ` bs6l • ....~•a~ 30 ,tep..~~.C . - I s?q; our azo;aq o; utomS •q;imaaaq; pair3 uoi;eoiidde aql u? q;zo3;as.rauueu[ ar{; ur pauuo3.rad aq 1IIm xaom ar{;;eq; pue :3atiaq pue aBpalmou~[ s?r13o;sag aq) 03 an.r} aae uoi}eotidde s?q; ui pause;uoa s;uaura;e;s lie }eq; `uor;eo??dde s?4} ai!3 pue axeut o; pue xizom p?Bs aq; pauuo3zad aneq .ro uuo3aad o; pazuor{;ne rCinp s? pus `sraumo to aaumo pees 30 (•a;a `aaa?33o a;erodaoo `}ua8e `.ro}aea;uoa) ..........`........................._.1..7~1I1-J7til~f •aq;slaH •pauzeu anoge I (1aEz}uoo Suiu~ts tenpin?pu?3o aureri) 3 43 4 3 ul P odap `u.roms .Crop Su?aq • ~ . ~ uear dde a sr a e s,ies ue sas' Z1~..J.(tiS• ~ ZJtd}~ ~1 •~1 U 30 A.LPIf1O~ ~ S S `}igO.L MdN 30 d.LV•LS `"A~p,~~l o`er+.~'1~'--~y- ",r+c~z,_ I'`~oJ.11~n~"~~, ~,oru"`~~ . ! » s ~Uis+ ~21~awJV+d ~b?.'~ZS'1 = ~ °lsZ -Na~y)QU~ d~ bZ'o~Z'1 ~ asNo~ av`„aa , ~gn~ ~ rt1y~ NOtl~(1611~NU~,OOd3S30 ?r ~ ' ~°1 QN H1. 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