Loading...
HomeMy WebLinkAbout17789-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219153 Date JUNE- 18, 1990 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 595 GREENFIELDS LANE & 95 BARLEY LANE SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 59 Block 04 Lot 5.013 Subdivision GREENFIELDS Filed Map No. 6313 Lot No. 13 conforms substantially to the Application for Building Permit heretofore Piled in this office dated DECEMBER 19, 1985 pursuant to which Building Permit No. 177892 dated JANUARY 30, 5989 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 AND GARAGE. The certificate is issued to ROBERT BRASLOW ~ JOHN BRASLOW (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-163 JUNE 8, 1990 UNDERWRITERS CERTIFICATE N0. N135809 JUNE 14, 1990 PLUMBERS CERTIFICATION DATED PERFECTION PLUMBING June 14, 1990 ~i~ Building Inspector Rev. 1/81 n~osas xo. s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N° 017789 Z Date 19 Permission is hereby granted o: 3 4~ ........l~.l.~.... ..r....... ct premises located at c.! ~.`~?.J....~. G~r~G.1.~~~.....!f..~~ ....................................................o~.a~~ r~..~~ .f~ QQ . County Tox Map No. 1000 Section ........,.lr.,r........ Block Lot No......: ~-3.. pursuant to application dated 19.......,, and approved by the Bui lding,,(~/Inspector. Fee x...7`.3/. 4~J ng Inspector Rev. 6/30/80 Form No. 6 , gyp, L r~?-•~ TOWN OF SOUTAOLD jy~~o~~(0 9~ BUILDING DEPARTMENT uW i7 TOWN HALL l~ 765-1802 BLDG.~O~µplt) YgWN OF PLICATION 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. o£ 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 - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ' Date . ~ New Construction. Old Or Pre-existing Buildin//~g t~~ Location of Property. .Sqs G{~eeN~'-ieLS~ LF}N~....... S't7.tic::a~-7,,,,..,,,,,. House No. 1 Street Hamlet Onwer or Owners of Property ~~.`..~~.~-'~.~~~'"J.... a: ~O~N .~~`.'P`.c~`c~c~J County Tax Map No 1000, Section.:~.~: ~~...Block.. 6 7•~©~....Lot f?C?S :O ~ ~ Subdivision ..Filfe~dgMap........~...~L~ot..........I............ permit No.Q~. ~.~~.~....Date Of Permit.. ~~~v./.4./...Applicant.!`.~~. ~.~~.~~.~5~~....... Health Dept. Approval ..........................U/Underwriters Approval....................... Planning Board Approval / Request for: Temporary Certificate........... Final Certicate... 2S e~® . Fee Submitted: $ ~ -2,-.'~i~`W ~ y pia C o z / y-~s'3 . ..APPLICANT ~ ' ~/~d TEL. 7G5-1802 Q~o5~FF4U, c~> TO'G°JN 4F SO'UTHOd,D L;~!Y;}! < OFFICE OF BUILDII~IG INSPECTOR o • ~ P.O. f30X 728 u' ~ TOWN HALL .,0~~0~ ~ SOUTHULD, N.Y. 11971 • C E R T I F I C A T I O N Date ~7'~!`~~7 Huildirq `/Pezmit,/~NO. //~7 J~9 Owner J~O L'k'{'-7 i34~r5/OW (please print/) , Plus ;er e2/=~cfcn~ f ~Um f~,~,~ <c ~/N,gntiq (please print) •l I certify that the solder used in the water supply system contains less than 2J10 of lg lead. „ " (plumber's signature) Sworn to before me this ,day of Notary Public notary Public, County ' ~ yj/ ¢ HELEN K DE YQE ~ 1 , ~ ~ t ~R47078r8 S Noik P~untyY~aM~ farm Ex{rires March 30,19.71 C 2 ~ N N W LL p( 3 O ~ U'J ~ ~ JJ N W ~ ~O 32 ~ W M O < Ot ~ F W d W W .y Q ~i O U' V 4 O X j O 2 N ~ r O •ki b W; N ~ N W rJ ~ ~ •l .J = j W u. Z t S13 u' .°0 3 s a" q oo ~ LU z r m ~ ~ v i F- o ° r O~ W t)w y r.~ N 3 t d ~ P Q r ~ o 0 do u~,' 'S, p Y ~ ~ £ ? ` W V O ~ ~ N ~ Ol p( a Y o c '"y ~Y ~ ~ - v M i ? ~ ~ > a ~ ~ , § ~ $ p a ~ uo U Y c, ~ ~ N u~ o. o~ O W C w ~e ~ M N N' m O W~ ~ ryn ~ rc~ ~ W~ i M •C 6 W O g U O ~ Z ~ } ~ ~ ~ m ~ un U m ~I a W C a ro a I Q <Z ° ~ ° ~ ~ 0 3 p' ~ o w ro w w W I- tl ~ C k x ~ a H Z ~ d O K W ~ .i® ° O W m F ~C C s_ ~ a i R ~ c N 'p J W w ~ ~ C OC V a m z O p n > w w U M I N et $ ti p Q '9 ® x~ r N d O , .D W LL LL m U O ~ z w q W E J l~' ~ ~ ry w ~ J- C L.1 .L L Z S W Z O W O` w C a T ~ p N ~ z> m w ~ e~ z_ M ~ _ ¢ ¢ .y C G V w~ ¢ U J FW p Z N } T F- d w ~ w 2~ gi ~ .-i ~ N o ..Ir w Q~ w w ; rn V i m o a y G. ~ Q K C z ~n N i ° O 4~ .O U• O~ Z x K O r, ~ r, ~ rc u. v W o ¢ c~ z a N ~i v u ~ W Z m F- .E c v ~9 W S W O ~ LL s[~ u°U~ ~ M O a i t- ~ ~ z E O ro U ~ ~ W •D d~~ J 0 C C 'S O ~ ti p o W y v' 3 d .may s ~ O V y Q p E WN ~ x ~ 0.d U W O~ O N ?i m ~ ~ K OC K 41 £ V ~ F O o r pa' u 0 r C~ H~ Y F fD ~ _ :c rc O i" y ~ .~~Q~ ~ ~ ~~a d`w y.. ~ ~ 1i~ T i f .n • ,;;t ~~1 ~(V ;.l3yWrll~r~ ui?ici~---- , Pi; ~ ~~~'F are measured ur ~ ~ aa' 9.ndungrkste.ttnwlarodDaanot(.r "CHOICEOFxHREEFRAMESTYLES • , wparkrlMUlatinaperformanc+fa'new ! i,.»~~,..«~. homuorremodelGtg, a ComeNlorwldwrkprlm.tlwoodfrom.wlthrobbgtrodpm6rof ~ w:4' •~•.fcckfunaFnhanceSv,lemrfi,aturo , l 0 lrrondordacvrtomwldlhyondpoftemeaBrltkMouldtoa~•dwilh 1 J' omcnmaarqulouq al.u entrgna mapnpHt W.allwrrlrlpp + Doorswllh PP~O , d" t. ~ maynetlcw.ath.nrrt Door'Frame Threshol ?otall~Veolherseali +';)t ~r.i 4 IhafwghltkrianGtperafardaoyod• ,4 r, r r n9• " {uPkbte bottom sweep, om! Boss•fre. , You i „ w you re Beth the best insole and out. i~-I tlwshdd5erxhmorksovermongoq rx v f;:p~;'s„#.~, ~ ~ F! healin¢,eoolkgandmohdenonu. r• - ri4r [nWnNrededua . , CMckrheufoaluws: YidnwoendwjJ~~ MUrnowoodwNS, ~ ~ eomPnNlon snd NlNNtlCeuid, ~ ~ ~!".w • RFaabrl4.$ l~ wNwenolP ~ ` i wwDrndrxe4 J t, : • plSlFaatal,5 IorpluwMwpthn• saDP~PeaccdvrMSS. ' ~ t~t ~ ' • Heovlest Gauge olary Slack Red• • Nipb denciry ~1~;`' ' . p denHol Inwlahd Steel Dootprovides ~ ~ r InwleUon .w.r. !Agra SowlbY BcrwhmsmYcycram •NIFIushOoorwndhlon•UteFm• f••'~~ ~ eapwpbrfxVmas 7 ~ based Door an raMd for 1 h Hour ci , . merrywood doaa . i FVaandHaeStwomTiaandwrr ~ { « ma aBlabel." r f~rypa of hemp ~ e,;; i:•t. AskyourDealerabouNdander8eneh• ,t „ pConwnuonNPdmewoodaeme'`-' markspectaldoorheiphUondsideliphts, t ~~olwuxu~ n.i nW ~ '~~o ./(jt A. I ~ ~ MPr't ~.a ~ ' ! gip', ' t" 'y ~r•:. `'.'x`~-.:,` 1 WNV NEaM+r~Nwt~GoduMilbWhf ~ r z. hmdON ;u'„ . , ~ P' ~ 1, ~ ~ 'F.fi n:~ ~ . . ~y_ ,itC Qn1UW11kId IWNINd i.:, f ~t'` , , I ~ aanNpide on eorwnlbnclpMwd wool i~~--'- ~ at6oU bwmoomaoto 4unr edWtleae osk WCehddl ' ~ x,;-„ ~ / ~ ueloul wind and weer. WYN ev111cb1ti ~ 41 ~ ~ i~ ' m ,.t,, . , i i iramo Conttrucflon (Stud Openlny) Handfag Chart ~ rLr, _ AL_IQ~DQORSI~ ID IGHT f ; ; Sinp • Door , 2" $'h• DoublPDoor 4'/0' ~ ~ Y'M n; ~Cf~: ~ Sinpb bideNN ' ~ 3tM Y'h' W ~ RN ItN W ~t`;,~~' Doubt. SWelOe 5" 2'h' ~~kokinp 6omlaWc rooklnp from pchld~~ G ~ ~ « ~d sf , ~ ~ kY ~ I ~ coM~teNrs .~~~Tzu,~ (IUATE I v 1SLD I~;S m O~ _ G7Ai; y 'OUNDATION 1st) ra rr"OUNDATIOW (2nd) _ o/ f72 it a~ - ~ ~ ROUGH FRAME & ~ .PLUMBING ,T t~ '1~ ~ ~ r H / ~ 7J CTl 3 . ~ • ~ p ~tX~ IIJSULATIOII PER N. Y. ~ p STATE ENERGY x CODE ' - r ~c ~ ~ 4. _ ~ FINAL c 3 0 ~ • , mac, A DITIONAL C M NTS: ~ m . ~arZ D 5 H H _.c. F-1 2 x m a \ • r - ~ v c~ • b H Vr Y i~ ®p ryyy g% J ~~3 C VICTOR LESSARD ~ ~ ~ € ~ Town Halt, 53095 Main Road PRINCIPAL BUILDIAIG INSPECTOR ' ~ ,t r a~,r n ~ ~ P.O. Box 1179 <sie) 755-lsoz ti , i,-~~; Southold, New York 1197] FAX (516) 765.1823 ~ ~ s~~n -~~~ljXL'.3~ OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD January 3, 1989 Robert Braslow 1428 Deer Park Ave. North Babylon, N.Y. 11703 Dear Mr. Braslow: In order to process your building permit application for a one family dwelling located on Greenfield Lane in Southold, N.Y. we will need 3 identical sets of plans for the Project 8875, 8/30/88. We have 3 sets but they are not identical. Also the septic form from the Town Clerk has not been filed with our office. Thank you for your attention to these matters. Yours truly, Thomas J. Fisher TJF:hkd Building Inspector CAUTION Tel. 389- 39p0 ExeosuRE TO CCA ~ 3901 ~ WINAOW$ PRESSURE TREATED DOORS WOOD MAY PRESENT Oakdale Lumber Corp. SKYLIANTS , HAZARDS INSTRUCT- AOOFIyO IONS ARE POSTED pN ~ -OECNING. ' ouR PREMISES. WINDOW WONDERLAND FeNeINC., 1625 MONTAUK HIGHWAY P.O. BOX 508 s OAKDALE, N.Y. 1 1769 15°b HANDLING CHARGE ON ALL RETURNS. 2% PER MONTH INTEREST CHARGE ON NO REFUNDS ON SPECIAL ORDERS. ALL INVOICES OVER 30 DAYS OLD. CUSTOMER'S ORDER NO. DATE , .p ~ ~ I9 /1.: NAME MFM~ ? 1 ADDRESS SOLD SY CASH . O, D, CHARGE ON ACCT. MDSE. RETD. PAID OUT l \ ~ . l ~ ~ 4~ \ . QUANTITY DESCRIPTION PRICE AMOUNT , ~"~-h ~ Cap--l ~7 - I " ,s~ ~ . ~ TAX TOTAL ALL claims and retornad goods MUST 6e accompanied by this bill ~ o Rac`d by WBB E BIl51NE89 FORM9INC NEW VOPK, NY 10001 IB2CM 9X 765-1802 BUILDING DEPT. ~r,sPEC~r~oN [ ]FOUNDATION 1ST [ ] 1ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL ~ z.~. DATE ~ INSPECTOR `~1 t s G ~7~'9 765-1802 BUILDING DEPT. .INSPECTION [ ]FOUNDATION i5T ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ 7 FRAMING [ ]FINAL REMARKS: _ .t.?~~.. .~..._...t'~ ' ~ ~i-- DATE ! 0 INSPECTOR ~ ~ ~ ~ 65.1802 BUILDING DEPT.~'~~ J INSPECTION [ ]FOUNDATION i5T ( ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ~RAMING [ ]FINAL REMARKS: ~ cc ice` _ < ?2._ oi, ~Q tioT DATE INSPECTOR d7?~ 765-1802 BUILDING DEPT. rNSPEC~reoN [ ]FOUNDATION iST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] fNSULATION [ ]FRAMING [)FINAL 4 REMARKS: ~ 4 i i` DATE v °Z' ~ ~ INSPECTOR i~~~~~ rss-iso2 BUILDING DEPT. INSPECTION [ t~FOUNDATION 1ST ( ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ] F((I~~NAL REMARKS: ~ ~ ~ ~~J Qwt.c,q~ 0 ~o ~ ~ ~ n DATE ~'~Z INSPECTOR _ ~ _ C THE I~EW YORK BOARD OF FIRE UNDERWRITERS PAGE t 1U8`;i1146 BUREAU OF ELECTRICITY 8,5 JOHN STREET. NEW YORK, NEW YORK 10038 ~A4te JUN£ 1h, iy4Y1 - gpplicotian No. on file 6fiH573411{9p N 135ikU~i THIS CERi1F1ES THAT only the electrical equipment a decrihed 6Ydom and introduced 6y the appliront named on [he ehose ePPlication number in the premise of , 80ft HRA~61 OW. AI?EENFIf:LI) t.ANP_, SCiUTHHUI D, N. Y. in the fdloscinq IYMDtIOR; ®Baeement © tat Fl. ©Ynd FL A k / 011 i Sertion5 {t Bloch Lott maa examined on •T (1NF 14, 190 andfound to 6e in complionrr with thAreyuirernenta of thin Board. gKTUEE RXTURES RANOK COOIIINti DKKS OVENS DISH WASHERS EXHAUST FANS OUTIETS KEPTACIES SWITCHES INGNDESCENi FlUd1ESCENi OTHER NAT. K. W. AMT. N. W. AMT. K.W. AMT. W. AMi. N. P. DRYERS FURNACE MOTORS NITUR! MFtIANCE REDERS fFlCIAL REC'/T TIME CLOCKS EELI UNIT NEATEES MUlll-OUTUiT gMMERS AMT. K. W. OIL N. P. GAS R. P. AMT. NO. A. W. G. AMT. AMP. AMT. AMPb. TRANS: AMT. H. P. SYSTEMS AMT. WAITS No. a ner SERVICE DISCONNKT NO.OF 5 E R V I C E AMT. AMP. TYPE INTER 1,e TW 1 A JW J ! JW J / AW NO. Of CC COND. A. W. G. NO. GF NLLFG A' W' G' NO.OF NEUTIIAlS A. W. G. R~ EDUIP. PER / OF CC. COND. OF NIdEG OF NEUTMI i lC'~Il CIS 1 % .i 211 t ?SCI OTHER AMARATUS: f,.1.1 T: -h 'SMOKE DE: ikil Cik;~.t ~o~ iHUMAS B.HANNAN,FLF,f,.iNt:. I1r„g8?5 E 486 GCJ(tURLCH AVE, NI)R7H BARYI.UN. NY, 11711;5 a ]Y p fT•~ , ; This certificate must not bs aHered in any manner; return to the office of the Board if incorrect. Inspectors may bs idsn~ifiad by their andKrLNah. COPY FOR BUILDING DEPARTMENT. THIS R 1 IG1TE MUST NOT BE ALTERED 1N ANY R. r N r N r v v D _ ~e ~ t1\ b m~ p ~i `b ~ " ~J . ~ O ~ Vi N m y ?~_~y~ ~n a "D ~h ORt r,. ~b ~h y$~~ o ~ (n ~ Y ~ u1 l1 Qj3 ~ sit Z O ~ ~i^n ~ V] ~ n ~ q~an~~"a"' n bfi~ ~ ~2~Oa~ ~ ~ 4 6" t>M C T"' r ~ ~ ip„ ~ aC~,sy~~JC~ b ~ i^n'"~ x~ O w e~ Z r ~i°a ~ ~ -;fir 1 a ~ lA ~ e ~ wop° FE.,c , ~ ~5 ~ W ~y f TF ~ n ~a ~ ~ ^y. .rye A..n ` 'q ~ ifi "~v ~A V' m .,r.,, .ti Gt V b t9 fl,~ o m o ~ : J,, "t~'.~ n b.~ r a a' ~ ~ V ~ ~ s ~q ~ ~ r- ~ y ----52 ~ ~ B~c~ ' ra ~ _ ~o -n ~ _ ~'~'s'N'cE ~ 'ti, ~ a) ('gy'p ~a ~ ~ ~ ~ O.a ^C3r'w. z ~ a n . 4 o _ ~ t~ ~ ~ ~ /,54'~ o ~ ~ as m n u `r ~2fa~o'~3p~ Is "~.4~~~ ~ , v ~ y ~ ? y rv a~ fr ~ W ~+bll e .r ?7 ~ Z v+ N ~ ~ ~D ,-,M,..-.. .a..-- m ~ b' d ~LMZ ~ "t r~ v a~ 1 ~ 0 ~ ~ ti ~ ~ ~ o ~ ~ a J yggiiZZ' q 9'f~~' N ~ ti~ s~ J q ~ 4 ~ ~ ~ ~ n ~•a0 '73/1 ya 9 .Q ~ u4l ~ ° ~ ~ ~ ~ ~ ~ a w ~W ~ o ~y ~ „O~•~ ~j ~ M J ~~i ~ ~ ~ta~~ ~ ~ ~ ~ ~,yyi~o ~ ~ • ~3 O ~ ~ i ~ ~ ~x w ~ ov 2 p V~ a, " KL~ ~ k 0. x ut' ~,~4, " n~ .y sc Q ms ~ p ~ ~~o v ~ o ~ N ~ ~ ~ N ~ m 4 ~ ~~.r.po~~ ~ ° a ~ a zQ~~ ~a ~ ~ ~awY'~~ ~ ~ ~ t~ ~ N o ~ ~ Q O ~ oY n y~ (1'~~(~Q © f}~ , tld W O V ~ ~ p to w 4 9 ~Y ~ w ~ ~ ~ a ov~ ~w ~dz~ Q y~ tW- ~ q Yi N y~ K V Q 4 N N p m ~ ~ J ~ N BOARD OF HEALTH 3 SETS OF PLANS FORM N0. 1 SURVEY . TOWN OFSOUTHOLD CHECK EUILDING DEPARTMENT SEPTIC FOAM ' TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY l ~1~~ TEL.: 7G5-1802 CALL ~~1.` . ~y MAIL T0: Examined 19 ~ Approved 19 Permit No~. ~ ~ E y~,~ ~r~ if ~~l ?~j? t Disapproved a/c ~ /.;}r~ . . •;,~i' . • • ~ • ~/d" ~i 1~~ . ~~t ~ ! ` I cl("' ~ye~ i~~7C c1~ I . o~ _~II t{~~ 4Sfn . 4..<.. 70V fsf~CG.rLa,u'1-:..,.e.~.a~ w'~! ~t .sCUTh9(7Lt7 (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ~f ~ 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 ins e2tio~ns./v' n c1 ~ ss:`: ~.dLw. J.~9c'~R•if~N 15ut'atlttC.r 1-~oso~.~4~~ fie. ~ignature of applicant, or name, if a corporanon) F. . tit??? ..QAgk {Vo?:~h~RS~ln~! a~,~.. . (Mailing address ofapplicant) //7p~ ` State whether a plicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..~~~e2 Jowrree(z . Name of owner of premises Victorian, Buildinc~`•.,Asso!ciatesr Inc: (as on the tax roll or latest deed) If applicant is torpor r n, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. R~r.`3. St,1fF•~U. Plumber's License No . . , Electrician's License No . . Other Trade's License No . L~ 1. Location of land on which proposed work will be done.'~RrJ~2 O;~• GR~N~~2L95 ~.RdJe ~ gf~(L ~,~q~12 House Number Street Hamlet County Tax Map No. 1000 Section .5.~.' o.~ • • • • • • • • Block . ~ Lot . ~~~.•,®l3 • • . , • • Subdivision (s(~N~IC'LD_S', ; , , , , , , , , ; , Filed Flap No.63/3 . , , • • . , , , , Lot . . (Name) 2. State existing use and occupancy oC premises and intended use and occupancy of proposed construction: a. Existing use and occupancy V(-leAr~~ ~Aro~• , , , , , , , , , , , , , , , , , • b. Intended use and occupancy ..3~..S; OQ+~F1~ • S~ (ZtnC~".`~•~ . , ~,-~Ami) V • . • . • • • • • • • • • • • . , , , , . , , a.a.: ~u~a~ - ~ nog ~~~aSserfdx3 uofssiwwop >IroA maN;o a;e;8 ~i94Z98-Z9 'oN uea?Idde3o amleu5[g) Mo~ ~ s>?zff ~zaQo2T OllBifd A21tllON ~ SNHOa 'S NA7INVW L/ ~ ~(luno ,a[Ignd,Gcfo~ ~I 88 G[ zagtua~d~g. .•JoArp.. ..u~8~ ~ SIL{i and a10;aq 03 n10Ms •t{3rMa1ay3 Pa(J uopear?dde ay; u{ quo,{ las Sautn:w acp u{ pauuoiSad aq IpM ,ySOM a43 ier{i puc :;a??aq puc a9palMOUx sit{ )o isaq at{3 0l an1; aSe uo?lea{idde sttf; u? pau?t:;uoa sluawa;els Ilr. lcyl : uo{lca[Iddc srt13 ala puc axew of pue .ySOM p{esl aql pawlo,TSad anrtr So w1o~Sad of pazuogine Alnp s{ pue `slauMO So SauMO p{es ,To ~ aia'Saa??3o a3c1od1oa `iua3e `SO3ae11u0~) ...........6E~?IQ'1 ~i • tzI 'sagpiaoss~ buipTrng u~tzogotn ~o at?3 sr aH ~uapYSazd •parucu anogc (iacSiuoa Bu?u5rs Irnp?n?pu? ~o au[r,~) " iueacidde aqi sT at{ let{i s~Ccs pue sasotap'tuoMS ~C?np Su?aq • • • • • • • • • • • • • • • • • • • • • • • • • • • • MO'ISF12Iff ,L~ffff02I S S ........~'T0:3'3[lS' 30 ~.LHROJ `~I2I0~ A13N :IO 3.L~.LS s ~ 2 oo. G~ i • sre i d• i ~2~~~1~ ~ J~~~ ~ ~,~-~r ,.a3Ht4 NUIl~f1f2J.~N0~ 102)dS53~ iSQ1.1.~f1k1.4SN0~ AVM3hf>~i0 ~ I ?1 ~ !.A'i JNtaVEriJ~r~ ~ ~i Alf 83151W3aeS :311Q&i1 ~+it)d~ 1 ''t/J~®~Iddtl 53Cif1"IOfvl J.IWM~d 1 Q ~ z,,2 •3oT Sawoa So Souaiur Sag3agM aiea?puI pue satueu iaaS;s Mo~{s puc `paap of 8tnploaae uo?iduasap So Sagwnu xaoTq pue iaaSis anr0 •saug ,gladold wo13 suotsuaunp xaeq-las ?p; alea?purl~ptre `pasodold So ~uTis?xa Sag3agM 's~rr?P1?nq IIe ~Iiou?is?p pue riiSeata a;eao7 • I~iV2IOdIQ .LO'Id pas?nbaz aq 6am ]?miaa saaasn.zy ueroy pZognnog 'sa6 3I~ •.021 " ST[s r.Pua?laeii Zap?~ r. 30 7aa3 OOE °iq~?x pa3eact :.~addOiu s?q~ sI'SI • ~S//-•f~~j oN auogd~'°~..'T,S:eb~;Fr°5~965~ssa1PPV ~d '~~o So3oei3uo~3o atueN T^.t'~ .9:'t o aunt ~ ssalPPd 1o~N3 ~;[~a iaai?i(aSd}o atueN •tiShss Sz6 9/s N ud ...~+5! 1 I~db N Id.' NUJ %}g .g-~e~i{.yoo~ ~b~ssalPPd 'r,;~"~~ • sastwald,To Saump ~o atueN 'ti i o a sasrwald w S an N }p aura a t ssaaxa ? AP 41oi1lhl '£I q TL3 [I M a e18a1 a r ' ' ' ' ' ' ' ' ' d'N :uo?lc?n3a1 So aaucu?p1o `Mef 3u?uoz Cue aie?o?n uo?3an13suoa pasodold saoQ 'Z I • • . • . ' v;{~~.~aS~b'i ~a~ paicni?s ale sas?wald t{argM u[ iarllstp asn zo auoZ ' I 1 iauMO Satulo3 }o aweN • (~2~ q'~ ~ ascgamd 3o a3cQ '01 p'•1r,,;~' g3daQ ~ Seau ............~F".f. ~ iuol o oazr : sauolS Jo SaqumN ~ it15?ag t{3daQ rb~ Seal n$• ibh 1uo13 :uo?3an13suoa Mau alpua jo suo{suaunQ •g ......................sauo3S3ofTaqum(~(......................it{S?aII......................u3daQ ' ' ' ' ' ' ' ' ' ' ' ' • • • • • • Sean • • • • • • • + • ' ' • ' ' ' ' ' iuo1~ auop{ppc So suo?3c1a3{c t13?M alnianS;s awcs,To suo?suaurrQ ..................,.....sauoJS3oSagwnN•,...........•• ;q~{aH ' ' ' ' y1daQ 3 i • • • • Scat' • • • • • • • • • • • • • • • 1uo13 :,Cue `salnlaruis Sups?xa •{o suo{suatu{Q ' ' ' ' ' ' ' ' ' ' ' • • • • • •asn o adAl',yaca 3o iua;xa puc aln;cu A~raads `Aoucdnaao pax[w So Iccalawwoa `ssau{snq 3I '9 sSCa}oSagtunu•a~eSe811 • ....Soo aea uo s;{u[j ~uy{amp)o SagtunN .shun 8utpantp~o Sagwnu `~urilaMP 3I 'S U4 I (uo[icar{dde s?y7 Sutl~ uo p?cd agl,oll aa~ ~Q ~ar~Ol ~ iso0,palcwpsg (uonduasaQ) ~ ~SOhC Sat{lp ! • uo{;{IowaQ ?enowag Sn;dag uopcla;~+ po{1!PPV • Su?P11na ma{y :(a{gea?{ddc t{a?gM>[aat{a)ySOM•Jo alnlclj