HomeMy WebLinkAbout18227-z : 6 .
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23840 Date AIIGUST 31, 1995
THIS CERTIFIES that the building NEW DWELLING
Location of Property 265 BRIGANTINE DRIVE SOUTHOLD NY
House No. Street Hamlet
County Tax Map No. 1000 Section 79 Block 4 Lot 45
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 20, 1983 pursuant to which
Building Permit No. 18227-Z dated JUNE 16, 1989
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
ieaued is A TWO STORY SINGLE FAMILY DWELLING WITH FIRST FLOOR SCREENED
IN PORCH, SECOND STORY DECK AND ATTACHBD TWO CAR GARAGE AS
APPLIED FOR.
The certificate ie ieaued to FRANK & VIRGINIA MBMOLI
(owner's)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTFI APPROVAL 12-SO-02 AUGUST 30, 1995
UNDERWRITERS CERTIFICATE NO. H045751 JUNE 6, 1995
PLUMBERS CERTIFICATION DATED MAY 8, 1995 EDWARD F. SCHILLER
uilding Inspector
Rev. 1/81
F08ai NO. 8
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 ~ g ~ G. I Z Date ....!~1.1.~~ 19.~S..g.
Permission is hereby granted to:
.............~(~GZ......~.Gr.~tt~...........
..Yl. ir.~~ o
• r '
G%y~.z~.~.4rr-r~......... -~~I
.....................v......~ ..........U....................................v.................................
at premises located at ...<!1.t~...~4.I
...........................................................................QQ....................................................................................
County Tax Map No. 1000 Section ..........7(......... Block Lot No.......7...5......
pursuant to application dated .........ld/~ 19.~s.3, and approved by the
Building Inspector.
Fee $.~..l.Q./...
pp i/~~
yi~,y,.~,ua ~~`i3~s9
uildin Inspector
~
Rev. 6/30/80
r~osns xo. 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°- 13759 Z Date .......~~:.~..~......~sl 19.p.7
Permission is hereby granted to:
....~-,~-.4-~:~.......~j,.,,~.e::~:............
,
of
prem~te~t..~..W..r~~.....JJ.... .......'..::...3.:.{~4c......A.?:t~::`:4~f.1r~!Y,
\Y
p LL~~,, ~
County Tax Map No. 1000 Section S~OQ.~1...1...... Block Lot No.......7[.~:...........
pursuant to application dated ..~~.~~-!`.!":'.!`.~'-....s~~ 19.~.w~., and approved by the
Building Inspector.
Fee 5...4?~..~.°1..` I D
.t~
1 _ , _ ` ,j, 0.C~~ 1 l , I ~ Building Inspector
Rev. 6/30/80
F08M 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)
NS` 12 714 Z Date . ~`?..4~!`~`~:.....n~..1 19. A.
Permission is hereby granted to:
.ls~..~....~`l~se.uatc~ IJ~'.~
,
..~.~.rf?
:4 J..~.............U........::....t~:........................... ...........U...V..............
f ~
of premises located at ..~..w.:~..... ~..Ga::"`~`.:.:~ u.,...!:4?c~ :...............!:~::4:4:L!~?::aQ~r.~.........
County Tax Map No. 1000 Section q ~
Block Lot No......!~~::~...........
pursuant to application dated ~...~..~.~.``.Q`.~a::....~-.~~ 19~..a~., and approved by the
Building Inspector.
Fee
....I....l..C~3?-:.
Building Inspector
Rev. 6/30/80
~c~s
Form No. 6
APR 18 1995 BuOILDINC DGP~RTNGNT
_ TO[JN 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 [tie following: for new building or new use:
1• Final survey of property with accurate location o£ all buildings, property lines,
streets, and unusual natural or topographic features.
r 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-° form).
3. Approval of electrical installation from Board of Fire Underwriters.
t 4: Sworn statement fromfplumber 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 325.00,
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 - $20.00
4. Updated Certificate of Occupancy - 350.00
5. Temporary Certificate of Occupancy - Residential $/15.00., Com//mercial $15q.0y0~-
Date .J•,'•~~~...f•~. / :>J _
1Jew Construction....Y Old Or Pre-existin Buildin
~ ~ .
Location of Property.,Z~?,'J~„•;k!K`~,~~~/J~~ D~r~~' ~~~,C.,~
House No. " • • Y •'•®C".~~. , , _
Q~S ~ Street Hamlet ~ ~ ~ ~ •
Onwer or Owners ~~f Property ~!\.!-a!Vr~
County Tax Map No 1000, Section..../.~ „
....B1ock.....~........Lot... T
Subdivision... ~ • ~ • " "
~j .Filed M;~p............Lot..
?ermit No.IC!L 27 : z .,Date Of Permit.. ~
.Applicant.~~..~~iC ~1~~ J
health Dept. Approval....,. F f
" '••••••••••••••••.Underwriters Approval..
?lanning Board Approval
2equest for; Temporary Certificate........ ~
Final Certicate...1~...,,
'ee Submitted• U~ •
THE NEW YORK BOARD OF FIRE UNDERWRITERS a?A~~
8054423 BUREAU OF ELECTRICITY
65 JOHN STREET, NEW YORK, NEW YORK 10038
Date JIINP 06 r 199gi Application No. on file 07257395/5 H 045751
THIS CERTIFIES THAT
only the electrical equipment m described below and introduced by the applicant Homed on the above application number in the premises of
FRANK MF,MGLI, 265 f3RIf;ANTINE nRIVk:, .SOUTHOLD, N.S".
in thefollawinq location> ®Basement ® 1st Fl. ®2nd F7, ~-"AR/ATTZ(". /f)UT Seetian7~ Blocky Lat 45
u~as examined on ~UNk: ~2 r 1995 and found to be in compliance with the National Electrical Code.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS ECEPTACLES SWITCHES INCANDESCENT fWORESCENT pTHER AMT. K.W. AMT K.W qMT. K.W, pmt K.W AMT. M. P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS FELL UNIT HEATERS MULTI.OUTLET DIMMERS
AMT N. W Oll H. P. GAS H P AMT. NO A. W. G. AMT AMP. AMT, AMPS. TRANS. AMT H, p SYSTEMS AMT. WAiiS
NO.OF FEET
SERVICE DISCONNECT NO.OF S E R V I C E
AMT. AMP. ttPE METER 1 p tW 1 ,9' 3W ~ 9 3W 3,e' 4W NO.OF CC COND. p. W. G.
EQUIP. PER9 Of CC. COND. NO OF HI~IEG OF~H lqG NO OF NEUiRAlS Oj NEUTRAL
OiNER APPARA7U5:
*NO V7SUAL bEF1;C7°S: "An elec'hr:i.ca:f.
survey has Aeon made of the exposed
electrical. equipment in the
premises indicat.ed." "No obvious
unsatistanY,nry condit.i.nn was found.
FRANK MEMOLI G!/~~
J
7.G5 DRIGAN:PINE DRSVE
SOUTH07aD, NY, 7.19'71 OENERAI MANAGlR
1 S.
Per ~
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspetlors may be identified by their credentials.
COPY FUR 3UILDIRIG DF.PARTI'U'dFiil'7. THlS COPY ®F CERTIFICATE iiR49S'T NL97 BE ALTER[D IN AF9iY MAlVfilER.
iL -
Town Hall, 53095 Main Road ' ~ Y
_ ~ Fax (516) 765-1823
P. O. Box 1179 ~ cr-~'-',~j Telephone (516) 765-7802
Southold, New York 11971 ' '
.,~-.-r•-~~--i,~-~ OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
z 1. { z°.
~ MAY 9 ~q~~l ~ C E R T I F I C A T I O N
. ~ , ' DATE : l'l ~ ~J~
Building Permit No. ~~`zz! - ~
owner: _ ~YG7hs~~ 6~~.~~iGrle'~
(please print)
Plumber: ~~iil//Q~4p /
i ~C/-yIGG('7~
(please print)
• I certify that the solder used in the water supply system
contains less than 2/10 of 1~ lead.
(Plumbers S gnature)
Sworn to before me 's
'/7/ day o f 19 nt:S~
v i ~
Notary Public, my
R08ER713 . JR.
NOTARY PUBtdC fate of N.Y.
No. 1725088. uNoBt
Term E><p~rea May 31.18
FRRNK R. MEMOLI
RRCHITECT
265 BRIGRNTINE DRIUE
SOUTHOLD, NEW YORK 11971
516-7655937
August 25, 1995
Mr. Uictor G. Lessard
Principal Building Inspector
Office of Building Inspector, Town of Southold
Southold Town Hall AUG 3 0 IQ°5
P.O. Box 1179, 53095 Main Road
Southold, New York 11971
RE: Building Permit # 18227-Z
265 Brigantine Driue, Southold, N.Y.
Suff. Co. Tax Map # 1000 - 79-4-45
Dear Mr. Lessard,
hereby request the issuance of a CERTIFICATE of OCCUPRNCY for the
aboue referenced premises. ~
Rs per requirements I am enclosing the documents listed below.
1. Final Board of Health Rpproual (as indicated on the final
survey)
2. Underwriters Certificate
1 believe that the aboue were the only documents outstanding and
that their submission will allow the issuance of a CERTIFICRTE of
OCCUPRNCY.
Sincerely,
Frank R. Memoli, RR
INSPECTORS
Victor Lessard ODgpFFOt:~
Principal Building Inspector CQ
Curtis Horton h~ GZ~ SCOTT L. HARRIS, Supervisor
Senior Building Inspector o ~
Thomas Fisher W ~ Southold Town Hall
Building Inspector O ~ ~ P.O. Box 1179, 53095 Main Road
Gar Fish y?~ O~ Southold, New York 11971
Building Inspector ~ Fax (516) 765-1823
Vincent R. Wieczorek Telephone (516) 765-1800
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTHOLD
February 25, 1992
Mr. Frank Memoli
120 Riverside Drive
Rockville Centre, N.Y. 11570
Re: Building Permit # 18227-Z
Premises: 265 Brigantine Drive, Southold, N.Y.
Suff. Co. Tax Map #1000- 79-4-45
Dear Mr. Memoli:
During a review of our files it was noted that the above
building permit has expired, and a Certificate of Occupancy has
never been issued.
According to the Code of the Town of Southold, Article
XXVIII 100-281 and 100-284 a building permit is needed for any
construction of additions, accessory structures or new
dwellings, and it is unlawful to occupy or use said structure
until a Certificate of Occupancy has been issued.
The final inspection was made an Aug. 10th, 1990, but you
did not apply for the CO. Please submit the following papers to
this office so that the Certificate of Occupancy can be issued.
1. Application for CO and Check in the amount of $25.00.
2. Final Board of Health Approval
3. Underwriters Certificate
4. Plumbers Certifioation,,s
As soon as we .receive these papers, we will issue the
Certificate of Occupancy.
Thank you for your cooperation in this matter.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
Victor G. Lessard,
~ ~?emb1J Q-t'~~ ~ <~G~j Principal Building Inspector
o~.l,~ ~r,,,~p/v,JOl« .
J
FILLD INSPECTION DATE COMMENTS f '
1.
FOUNDATION (1st) ~
• c
FOUNDATION (2nd) ~
I
2. z
o ~'
6
V
ROUGH FRAME & a
t
PLUMBING
~
.
'- ~
H
b
3. ~'
INSULATION PER N. Y. H
STATE ENERGY
- CtODE a
3
- r
ra
~# . H
a
FINAL
r ~
o
z
DDITIONAL COMMENTS: x
.~
m
x
^o
H
H
f -'
~ e.-
~ N
a ~
r
' H G
~ C
b
t+l
'9
H
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING )FINAL
REMARKS:
DATE ~ ~ ~ INSPECTOR
ass-180Y ~ v
BUILDING DEPT.
INSI~ECTI®N ~
[ ]FOUNDATION 1ST [~G] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
FRAMING [ ]FINAL
REM KS: ~ y~
v c~~ • ~
~ c~ N~
DATE t ~`S ~ INSPECTOR C~~~S
t
I
765-1802 ~ ,
BUILDING DEPT. /y('~J'~A'`'`"'"~-
INSPECTION
[ ]FOUNDATION 1ST ( ] ROUGH PLB
[ ] FOUNDATION 2ND [ ] IN CATION
[ ]FRAMING ~ FINAL ~.O
s ~
REMARKS: ~
~ ~~a ~
a
q
ATE ~ /
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ )FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN TION
[ ]FRAMING [ FINAL
REMARKS:
DATE ~ Q C~ INSPECTOR
nrmj'~~ TEL. 7G5-1802
S~~F°~kc
0~0 , Opy Z'OWN.OI' SOUTIIOLD
~ OFFICE OP BUILDING INSPECTOR
u, ..~r 9` ~ P.O. BOX 728
~ ~ L~ ~ TONN BALL
O~Ol ~ ~a0!' SOUT[iOLp, N.Y. 11971
August 14, 1990
FRANK MEMOLI
120 RIVERSIDE DRIVE
ROCKVILLE CENTRE, N.Y. 11570
To P7hom This.May Concern,
We are unable to complete your Certificate
oL- Occupancy because of the following reasons.
/ An application for Certificate of Occupancy ,
s not on file. ENCLOSED)
/_//IGo Underwriters Certificate on file.
/-.~~Ire check is ( ,not on file.) $25.00
% No ?calth Dept. r:pproval on file.
No final inspc:cL•ion has been made.
L'leaae contact our office on this matter.
Thank. you L-or your cooperation.
Building Permit 1 8 2 2 7_ Z '
Buildincy Dopt.
/ No Plumber Solcler Certificate on file.
( all pcrtnits involving plumbing being
.iasucd after npril 1,19B4 )
J
t
i
oS~FFO~~o
VICTOR LESSARD ~ ~ Town Hall, 53095 Main Road
PRINCIPAL BUILDING INSPECTOR ~ P.O. Box 1179
(516) 765-1802 0 ~ ~ Southold, New York 11971
FAX (516) 765-1823 ~01 ~ _`~0
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
April 12, 1989
Mr. Frank Memoli
120 Riverside Drive
Rockville Centre, N.Y. 11570
RE: BUILDING PERMIT #12714-Z
SUFF. COL T.M. #79-4-45
265 Brigantine Dr.,Southold, N.Y.
Dear Mr. Memoli:
During a review of our files, it was noted that the above
Building Permit has expired and a Certificate of Occupancy has
not been issued.
According to the Code of the Town of Southold Article
XXVIII 100-281 and 100-284, a Building Permit is needed for
construction of a new dwelling and it is unlawful to occupy a
dwelling until a Certificate of Occupancy has been issued.
Please submit to this office your check in the amount of
$581.30 to renew the Building Permit.
In order to avoid any legal action you must correct this
violation immediately.
Thank you for your cooperation in this matter.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
Gary Fish,
Building Inspector
GF:gar
c,QFFO(¢ TEL. 765.1802
~ CpG TOWN OI' SOUT3:IOI~b
OF~FICI? OE IIUILUING INSPECTOR
I'.O. IIOX 728
TOWN HAIL
~ ~ SOUTHOLU, N.Y. 11971
'this is to ndvi.zc you that the job under building
perrni.t no.12714Z issued to Frank Memoli
on 10/31/83_ for Ne_w_ Dwelling is completed and
n final inr;p-erti.on has ( ) has not ( x ) been done.
An Underwriters Certificate is needed
[n order to complete this file, it is necessary that
n Certificate of Occupancy be issued. Please fill out [he
enclosed form, return same to the above office with a check
for $25.00 PaYah)c r.o the Town of Southold. Piease indicate
to Whom the Certificate of Occupancy is to be mailed, and
' arrange with this office for nn inspection date .
Occupancy or use is unl.nwful without n Certificate of
Occupancy. I'Iease help us to clear up this matter so that
legal action does not have to be Caken. ;
'Thank you for your prompt attention.
Very truly yo~u~r ,
Victor Lessard
fsxecutive Administrator
Vi.:gnr
encl.
VICTOR LESSARD ~
Town Hall, 53095 Main Road
PRINCIPAL BUILDING INSPECTOR t -:`w "J•' _ ~
y; 7~~'-'~ P.O. Box 1179
(516) 765-1802 r SOUthold, New York 11971
FAX (516) 765-1823 ' "a'
~
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
DATE: a Iabl M1r1
NAME: F26lNIL {MEWto~~
ADDRESS: a(o$ IJ2~GWn~TInLE DRS SaUT~ao~~
RE: BUILDING PERMIT g 1a~IN ~
SEC. '~9 BLOCK I-~ LOT L~s
This Building Permit has expired. You are now in
violation of the Town of Southold Zoning Code.
Please contact our office, this matter must be
corrected.
Yours truly,
Victor G. Le__ssard
Principal I `-~-nor
~~~~~~..~~~~0
1/~~0
A
Frank R. Memoli
Arohttect And Interior Designer
236 W. 27th Street, 13th Floor • New York, NY f 0001 • (212) 242-7846
~x,~e ~~s~~ ~ ~ c ~s ~ ~ ~
r~s~~'~
r'?,~/~ ~S~dGC ~ _ ~ JUN 1 31989
s~oc. o~Pr.
TpWN OF SOUTHOLD
/c~Dk' `l 7 ~
~ cow , ~ ~ ~ - ~ _
~~~~r ~
~~~s~ ~ ~
~ ~ ~Cfl~~~~'L/~~
y>
-
@'IELD dINSI'LCTION llATE COMMENTS
1.
FOUNDATION (1st)
. ~ ~
ti
FOUNDATION (2nd) m V
2.
0 9J
R H FRAME & v ® U~
n ~ S `~~C~1 ~r ~Q'2
PLUMHIN -nom
S'/C ~L ~ T .p~~v/~ l r
f ~ ~~1V .~'iv S~ Gr~J~.~ i
H
3. r~
C+7 .i
ter-.- / ~ 7 r H
IIJSULATION PER N. Y, Z?.~ = .y.k~s4~Q9 /v~~
STATE ENERGY ~'~~'Q~`"~
CtODE ~
a
3
4 . .3
Gr/
FINAL
o'
z
ADDIT NAL COMMENTS:
s...
r`-'
e~,,~ .S' . 3® "
x
:u
a
o
z
1
x
a N
y Gi
w. O
d ~
~U
H i
..t
~ ~ ~ FORM NO. 1 ~ ~ ° ,
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined .P.C-{~-~!r~. 19$.~ Received.......'... , 19...
Approved O. Car.? ~ 19I'~ .Permit No. j x-1.1 .
Disapproved a/c
..'l .h . ~.tp!.1.'.u~a.~..~
(Buiiding inspector)
APPLICATION FOR BUILDING PERMIT I
Date . ~ I.. 2~J.... ! 19~~,
INSTRUCTIONS 1 1
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 demol' ion, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, build' ode, housin e, and regulat~ s, and to
adn;it authorized inspector on premises and in building for necessary i~ ectio s.
('nature of app ~c t, or name, if a corporation)
/ Zv... ~/aS/E?~... ~i2:......... .
~~~~Ia~gaddress dap licant)
/r o ~ ~i~a-~~ leL, y,
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
,~6.PPLIGAIJ~.I~a o1~9dEF~.~..?~~G:J.I~~G~
Name of owner of premises .~~{4NI<.~.~!i(''`,C1,I.N,IF~..M~~e'J,L~
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of\c/orporate officer)
Builder's License No. . .
Plumber's License No. . .
Electrician's License No. .
Other Trade's License No . .
1. Location of land on which proposed work will be done . .
2~5 .............P~,~,I.ra,a~.NT.fr-~>=...!?12'........~?uTN~~.t~..... r-1~t`e. `(~ai2,,K....
House Number Street Hamlet
County Tax Map No. 1000 Section G.~~........ Block .....4:........... Lot .
Nb,(Cf'iO~ LIGI-IT~ E`.~TA.ZEc~`J- ~2
Subdivision SJr,G"r1oN, ei1~lE , , . I~A~~!I1=\~r'... , , , , Filed Map No. '~:3.~? .rL....... Lot . .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....~~'G'a'~T L-ANI~
b. Intended use and occupancy ...~E~fDE(-1tI~.L.. ~~itJCtle~ 1=AMILe.~ p1V~lf,(.si1~1~
/ r.'
3. NatuPe of work (check which ap'plicable): New Building ? Addition Alteration .
Repair Removal , Demolition ..............Other Work .
(Description)
4. Estimated Cost ~~-,rJ,
a0®O Fee .
(to be paid on filing this application)
I i
5. If dwelling, number of dwelling units Number of dwelling units on each floor .
If garage, number of cars J~ . •
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use , N o N k • • • • • • • • • •
7. Dimensions of existing structures, if any: Front ...............Rear Depth .
Height ...............Nun{berofStories........................................................
Dimensions of same structure with alterations or additions: Front Rear .
Depth ~ ..Height Number of Ssrories .
8. Dimensions of entire~~new construction: Front ...59: T~l,l, , , Rear ...r~.'~`.t -.~.t..... Depth ~'.7 ~~~t... .
Height ~.8.°0...... Number of Stories .
1 t t' V
9. Size of lot: Front 1.3C?° 00 Real ~Q~.~~.. , De th a,? ~e 7~. . .
10. Date of Purchase I .'L2 82 Name of Former Owner .
11. Zone or use district in which premises are situated /4.~~. REvlDE.IJ~IAL,, ~~121,G U L.TUP.AL.. , , , • , • • • • •
12• Does proposed construction vio}ate any zoning ]aw, ordinance or regulation :
13. Will lot be regraded Y~`,~....... ......Will excess fill be removed from premises: Yes No
14. Name of Owner of premises F~V, M EMOLI • , • Address . ! ~1~~~51 uE ~RPhone No.Z~.Lt3R~1.... .
Name of Architect . FLANK fL. ,M Ej•%1 oLl, , , ,Address , f~oe~vrr?c.r?• GYRt phone No.....'~ .
~~ANK ~d.ME.MC~L.I....Address . NE~V YoKK 11~•7aPhoneNo.
Name o ontractor
PLOT DIAGRAM
Locate clearly and distinctly all buIIdings, whether existing or proposed, and indicate all set-back dimensions from
property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether
interior or corner lot. pp, C'~iQ,IVA.-t~~
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nRIVE l3R'ICtANTINE. 4~~
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STATE OF NE R S.S
COUNTY
RANK I'C. M- ~~.-:I
r ~ ' being duly sworn, deposes and says that he is the applicant
(Name of individual stgr~ing contract)
above named.
He is the O \V N ~ If./• CO h-~ T 2 A C~"i'O.r'~
. .
(Contractor, agent, corporate officer, etc.) -
of said owner or owners, and is du)y authorized to perform or have performed the said work and to make and file this
application; that all statements cont~~ained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
...............day of 19
~p~~~~
Not Publjc, C-~/rc,v'- . County .
luZA9BdH FINN NEV1glw (Signature of applicant)
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