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Home My WebLink About17299-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z1S727 Date OAN. 18, 1990 THIS CERTIFIES that the building ADDITION TO ACCESSORY GARAGE. Location of Property 300 PVT. RD. #17 MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section 123 Block 06 Lot 016 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 4, 1988 pursuant to which Building Permit No. 172992 dated AUGUST 5, 1988 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 TO AN ACCESSORY GARAGE. The certificate is issued to ROBERT ANDERSON (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NfA UNDERWRITERS CERTIFICATE NO. N107456 DEC. 14, 1989 PLUMBERS CERTIFICATION DATED N/A ' BuI ding I" nspecto" "r Rev. 1/81 r~oaat 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) ~ fl ~ g. 7 2 9 9 Z Date .,/.~1/.~..[.........~~?~....., 19. Permission is hereby granted~tro~: ...C.tin~e.Q~ .........~:?..:~..t...1..5.9...~ I' G~a......G! ~ .....Ls,.. . . ct premises located at 4~.PYT Caunty Tox Map No. 1000 Sectio ....~.t~..s~,........ Blto~ck .....~~......`.,.pLot No......~.~0 pursuant to application dated ..A.1:.r!•~••!••.•• 19.I..S?.., and approved by the Building Inspector. i Fee $..`~...J..' Building Inspector Rev. 6/30/80 TOS7N OP SOUTIIOLD BUILDING DEPART:lE17T TO1lN HALL ' SOUTIIOLD, NE47 YORK 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPAt7CY ,(,r'~~~_ p~7 . DATE.k..F: t:~~a:~~~wll.7,, NEST CONSTRUCTION ~.~,OLD OR PRE-EBISTING IIUILDING......VACANT LAND..... Location of Property... _/:(.Q~l ~IALK ~ UOUSE NO~ STRGET UAHLET Owner or Owners of Property...~~.~:F`',/,,..,~f?C~~~"',~Oh County Tax Hap No. 1000 Section ~°2;~. Block .Q.r°.... Lot' ~X,...... Subdivision Filed Map _.......Lot__........ Permit Ho. ..........Date of Permit ......_._.Applicant 8ea1Ch Dept. Approval Underwriters Approval._............ Plaaning Boatd Approval Request for Temporary Certificate Final Certificate v' Pee Submitted: ~~./.Q`~___...,__ ~ ~~~""lll . . ~.3~~~~ ~o Z/g~a7 rev• !0/14/88 4 ~....vl FORM N0. 6 ' TOWN OF SOUT[IOLD BUILDING DEPARTMENT TOWN HALL 765 - 1802 APPLICATION FORCERTIFICATE OF OCCUPANCY INSTRUCTIONS A. This application must b;e filed in typewriter OR ink and submitted to the Building Inspector with the folk wing; for new buildings 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 of Da~alth Dept, of water supply and sewerage-disposal~S-9 form), 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement fro~q plumber certifying that solder used in system contains less' than 2/10 of Iz lead. . 5. Commercial buildings, industrial buildings, multiple residences and similar. buildings and installations, a certificate of code compliance from the Architect or Engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildingsl(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, buildings and unusual natural or topographic features. 2. A properly completed application, a consent to inspect signed by the applicant and a certified abstract of title issued by a title company which shall show single and sepdrate ownership of the entire lot prior to April 9, 1957. Zf a Certificate ofiOccupancy is denied, the Building Inspector shall state the reasons therefor in'~,writing to the applicant. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informatign required to prepare a certificate. C. For Vacant Land Certificate of Occupancy: 1. An application for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership pf~the entire lot prior to April 9, 1957 shall also accompany the application. I£ a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. i D. FEES: 1. CERTIFICATE OF (JCCUPANCY - New Duelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swism~ing Pool, $25.00. Accessory building $25.00 Addition to Accessory buildings, $25.00 - Businesses $50.00. 2. Certificate of Occupancy on pre-existing dwelling - $100.00. 3. Copy of Certificate of Occupancy - $5.00 - over S years - $10.00 4. Vacant Land Certificate of Occupancy - $20.00 ' 5. IIpdated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy -$15.0,0 Residential Commercial GO. 10/14/S8 THE NEW YORK BOARD OF FIRE UNDERWRITERS IrArl~i ~ 7. 1,2`.OL5 EIUREAU OF ELECTRICITY 8E JOHN STREET, NEW YORK. NEW YORK 10038 Date DISCF,NRER 14,19$9 APPlicotionNo.onjile 6%-i7.$HF39/$9 N 1074,6 THIS CERTIFIES THAT only the slastrled equipment ae described 6elota and.introduced by the applicant named on the drone application number in the pretniesa of RiJRV:R'1' ANDbRSON, CAMP NT.NE4LA RT3_, Ll1,C'ii ~4, MA'PTITIh'K, N.Y. in thefdbtcinR bmtioni ? Basement ? Ist Ff. ®tnd Fl. fAR Sertiun Bloek Lot uas examined un DSCENBER 07,19$9 andfoundto be in compliance uit.h the rryuiremenu of thu Board. tUtT1r!! AtAK fYt1i01[I FIXTURK RANOlS COOIIINO DICKS OVENS DISH WAStgRS T FANS ODTYTS INGHDESCKNT FlUOtESCENT OTNEn AMT. K.W. AML K.W. AMi. K.W. AMT. K.W. AMT. HP. s9 3'1 19 26 3 F DRYlRS RIOiAOE MOTORS FUTUR! AFKIANC! 1~lRS SNCIAL RIC'rT i1ME CLOCKS Ytt UNIT HEATERS MWTI+OUTIli DIMMlRS AMT. N. W. ql H. P. GAS M. P. AMT. NO. A. W. G. AMT. AMP. AMT. - AMTS. TRANS.. AMT. N. P. SYSTEMS AMi. WARS 110.0/ 1RT F i. 600 SRRV101 DIlODFNNCT NO. tk S S R pp V 1 C ! AMi. AAV. TrP! ~ 1 / 7W 1 / SW 3 / SW 3 / AW tt0. ~C. COND. CC. Cg1D. NO. q N4LEG Of Nl NO.OP NEUTIIAlS OP NlUAAL 7 15n cs 1 x ~~ro 1 z/0 oTHn APMRATUI: W2RING FOR v"ARAGE & RCHiM~ ABCIYF-1. li.k'.C.1':--?. 3NOKF~ DETECTOR: -a bAKE Ps7,EC.TRt(' 1,SC.111845-E s I/ ~ 17 FOREST TRAIL R. L DGE , NY , 7.1.'1 Fr 7. o IRAI MANAOM i jf' Psr ' Thit rnHFicah must not be altered in any manner; retool, AR 111a ofliw of Mle Board if incornci. Intpactors. may by 1Mir credentiab. COPY FOR BUILDING DEPARTMENT. COPY OF CERTIFICATE MUST. BE ALt IN -7r:LD II: S: EC:TUIJ ~~DAiE ~ COMMENTS ~ ~ H '3 ~ FOUIJDATION (1st) o ~ P~ ~OUNDATIOiJ (2nd) _ 2. z o ROUGH FRAME & PLUMBING ~ t v tid H 3, m ~ y IiJSULATZ0P1 PER N. X. ~ STATE ENERGY ~ CODE x a • 4. m H i c FZiJAL ~j o~r ~ i ADDTTIONAL OMMENTS: x ` _ p~ x v' N H 71 a h H H 00 O .Q 2 ~ • r H T d m w H ~ ~ i2C;;~]~ED APPLICATION FOR PUBLIC ACCESS TO RECORLS , TO{YN OF SOUTHOLD :~?ix ~t»,r~~t~ SECTION I. TO BE CO:IIPLETED BY APPLICANT ?pw' ` ' INSTRUCTIONS TO APPLICANT: Please complete Section I of this form. Give the f to the agency Freedan of Information Officer. The rreedom of Information Officer v return one copy to you as a response to your request, or as an interim response. T0: FREEDOP4 OF INFORP;IATION OFFICER ~ " AGENCY NAAfE: _ AGENCY ADDRESS: I HEREBY APPLY TO INSPECT THE FOLLO{YING RECORD (Please describe the record sought. If_possible, supply a date, a file title and number, and any other infoxma ti n that will help 1 to iihe record desired)': " W ~N'1". e,~~y 5 , 1~.Z~,7a`~91~t11~;D~~t>~t ~ivu,i:~.~s'~rr~ Signature of Applicant rnand Printed Name; Applicant Represents: f ~ 1 t~ ~ 6' ~ J`~ Applicant'sDlailingAddress: ~n~ ~j~9 ~f~~q~ fj~~ Date of Application: ~ ~-V ~ ' • SECTION II. FOR USE BY AGENCY FREEDOM OF INF0R1[ATION OFFICER ONLY [ ] Approved [ ] Denied:~(for the reason(s) checked below) [ ] Confidential Disclosure [ ] Part of investigatory Files [ ] Unwarranted Invasion of Privacy ] Record of Which This Agency is Legal Custodian Cannot be Found • [ ] Record is Not A7aintained by This Agency [ ] Exempted by Statute Other Than the Freedom of Infornation Act [ ] Other (specify); [Receipt of this request is aclmowledged. There will be a dela requested record until Yin supplying tt for the.follbwing reason; Signa e;. ~ Title: / ' r ~ CAL-t` Date: (~,IaS~( ~j Freedom of Information Officer SECTION III. NOTICE TO APPLICANT YOU RAVE A RIGII'I' TO APPEAL A DEiVIAL OF THIS APPLICATION IN 11'Rb'FING WITI. IN 30 DAYS OF THE DENIAL. INFORMATION AS TO SHOWN BELOW. TIIE CONTACTED PERSON MUST RESPOiVDETOEYOII INO{YR~TINGT{YITHIN SEVEN BUSINESS DAYS OF RECL:IPT OF YOUR APPE1>'. Name: Southold Town Board Business Address: 53095 Hain Road Telephone: Southold, Nc~v York S1G-7GSLiS00 ~~~~,~~°j i ' .a',lr'((.TY.-'=-f.'c~ h-~2~,G"i~-~'-lt ~ C ~'f"Lt ccYM.q ~ ~ l ,m, ao ~ r o ! L_ ~ o ca ~ C,s~~+ ? Wz 3 eu: ~i q. e ~ 071 ~ V ~ ~ X11 ~ cei n. t~ t.> Z Z p bO ~s ,~w-~ ZµOZ .~I O ~ z~sv~zns v~ 2 uC~UC7 c~ LL ~ r u. cv ~ 4 ~ Sri c.-~ _ .,t ~ ~ o ~ 'a v \ ~ ~ r ~ cy ~ ~ ~ ~n ~ o~~ ~ n. ~ ~ a",~ ~ v-,. c.» ~ o~~r.~ 3 P"i ~1~ ~ t ~ ~ t VICTOR LESSARD ~ f~.~~ ~~0.•; ~ Town Hall, 53095 Main Road PRINCIPAL BUILDING INSPECTOR ~ P.O. Box 1179 (516) 765.1802 ~ ,t~~e.,-~";~~,F• ~ ~ Southold, New York 11971 FAX (516) 765 1823 ko ~.>,'a ~ ~~~:a,.._, - ~ ~ a ~i~iR 3 I Lice- ~ OFFICE OF BUILDING INSPECTOR /o2.',rd 1 TOWN OF SOUTHOLD .SLUG. L7~~ '~/"7-`~/ TOWN UP 50UTHOL[7 ,Qn March 29, 1984 ICtl.O~.~.vo~~-°"""'"'"~ a/3a~~ TO: ZONING BOARD OF APPEALS ` FROM: PRINCIPAL INSPECTOR V,• VICTOR G. LESSARD SUBJECT: MR. & MRS. ROBERT ANDERSON TWO STORY GARAGE ADDITION I am responding to your "TO WHOM IT MAY CONCERN" Inter office ~I3'o~89 memo on Anderson addition. `\e I personally went out to the site yesterday and inspected ~'~M 6aooul> 7'0 the structure. Measuring height of structure, I read 17'-8"half' way between upper plate and ridge. I then went into the structure to the second story. It is one big area with one partition. I then had a conversation with Mr. Anderson and the following are the results: Mr. Anderson is a collector of old and rare books. His intention is to make his own private library and store these books. The partition is to close off an area for his office with a computer, he will then be able to record and have easy access to any of the books in his his collection. Please be aware that this office has not received any complaints on this matter and find no violations of the code at this point in time. Be assured that a thorough final inspection will be done, as always, before any Certificate of Occupancy will be issued. cc Town Attorney Z.B.A. Members I . I .~r ~N BUILDING CONSTRUCTION 37 of construction in whit 3b•2Thefire-resistance rating of such firewaltshallberequiredforthe ;bustible materials havir 1~•higher type of construction. ms and afire-resistant ~al members being who' ~,3b-3 Where the lower of the types of construction has a combustible required forheavytimb root, the fire wall shall extend above the combustible roof. X 70y,3b-4 Exterior wall openings in the higher type of construction, located construction in whicht•, within 10 feet horizontally from the fire wall, shall be equipped with partly of wood or oth: opening protectives. See 738.4a-5. ~,3c Where portionsofabuildingareofdifferentheights,theheightofthe ~e classified by sub-tYPe :u~~drng shall be the greater height, and except that where a fire wall aterialsandassemblies~ ~parates such portions, each such portion is permitted to be regulated if each structural eleme ;,cparatelyfortypeof construction and maximum heightand firearea, under I-704, II-704 and III-7p< conditions set forth in 704.1. construction, but vary; elements. PART 705 HEIGHT AND FIRE AREA AND BUILDING LIMITATIONS ich all structural eleme^ tt75.1 General Requirements. materials of the ratr ttK.ta The height and fire area of a building shal{ be determined by the :c~upancy and use group, the construction classification, the fire protection ch the structural eleme• .cu~Pment, and the fire hazard classification of the building. to have any specific fr Tent for the protection fp5•tbBuildingsotherthanone-and two-family dwellings shall be 100 feet iterials is established. er tess from a street, road or driveway so as to be accessible to the fire twJartment and emergency service apparatus. - r35.id The maximum fire area permitted for the highest story of a building ~aermines the maximum fire area for each story of the building. :onstruction required b} iith the requirements fc r95.te The height in feet of a building shall be determined from a datum on of its construction is'. established by the average elevation of paved open spaces which are w>table for the approach of fire department equipment, and curb levels .^~reestablished, both of which are within 50 feet of the exterior walls of the noretypesofconstruce. r,~,td,ng; where such distance js exceeded the height in feet shall be ding shall be the lowes~ ~a.termined as set forth in 705.1f~t""Such height shall be measured from such re wall separates twotyp a,rtum to the highest level of a flat or mansard roof, or to the average height regulated separately t cr a pitched, gabled, hip or gambrel roof, excluding bulkheads and other es CI-704, VII-705, b'lll• 4.apf construction as set forth in 705.1 g. 105.11 The height in stories of a building shall be determined from a datum ustible material and s'++aublished by the average elevation of the finished grade adjoining the 2. *~'~rorwalls of the building, where such walls face legal open space or abut 1 i _._._________._____._v____....__~..~..w..~_ cs c, ~ ~ v`s C (.;r 'v ~ e7~~a„ ~ ' o ~ rte- L~ C7 ~ ~ O est <,~`a r~~ ~ c _ ~ _A ~.r r- ~ ~ ti~~ ~ 1. t r,> - ~y,.~ Op ~ l ~ ~ fIt A y y~ ~-.,A,f-.W n~ T Z T Q ~j f~M ~ ~ Z~ rnOnOr~-C~~zLC~a<, ~ ~o~~ca,3 ~xao~^'m e~,r.,~ LU ~+m0 Dv S ~OZDOZ n~~ ~ ~'y 4~. T2 gyp, m-,n c~a ` y~c cad a.a ~ ~ ~ ~ C ~ Re m ~ a v m' Ca ~ vmOU~~:A -a O C m T~ n , ~ t7~p ~ ~ W p ~ ~ ~ ~ yti~ 70 < < G7 O m D l " N y, @ y° a l R~CEI~/~d APPLICATION FOR PUBLIC ACCESS TO RECORLS ' TOIYN OF SOUTHOLD i~i~ ae~~r'~sI SECTION I. TO BE COMPLETED BY APPLICANT ?~v~:n . ' INSTRUCTIONS TO APPLICANT: Please ccmplete Section I of this form. Give the f to the agency Freedan of Information Officer. The rreedom of Information Officer w return one copy to you as a response to your request, or as an interim res ponse. TO: FREEDOP.4 OF INFORP:IATION OFFICER AGENCY NAME: , AGENCY ADDRESS: - _ I HEREBY APPLY TO INSPECT THE FOLLOIYING RECORD (Please describe the record sought. If._possible, supply a date, a file title and number, and any other informa ti n that will help 1 to the record desired)' > ti ~ ~ ~ d . ~R to 1~ ~ ~,f~.-q-~ 2'~`"°°"~ U~ ~ ~ > . w~~~~;-. e~p~ y I~.L~,7a4913tJ~~.jj~it7~t ~fvu.i;~fis~~l~ 1 Signature of Applicant ran1d Printed Name: Applicant Represents: / i ~ ~ ~ 6' ~ f~ ~ ~ ~J= 5 Applicant's Mailing Address: ~ ~~l „y ~j ~ 9 ~ f~ 9 ~ fj ~ Date of Application: ~ • SECTION II. FOR USE BY AGENCY FREEDOM OF INFORI[.9TION OFFICER ONLY [ ] Approved [ ] Denied; <for the reason<s) checked below) [ ] Confidential Disclosure [ J Part of investigatory Files [ ] Unwarranted Invasion of Privacy ] Record of Which This Agency is Legal Custodian Cannot be Found • [ l Record is Not Maintained by This Agency [ ] Exempted by Statute Other Than the Freedom of Information Act [ ) Other (specify); [Receipt of this request is aclmowledged. There will be a dela ' requested record until for the followinQy ~ supplying tl d reason: Signa ey. Title: - / _ f d-+-,y_ CQx..,~t Date: (t,~~! ~ Freedom of Information Officer SECTION III. NOTICE TO APPLICANT YOU HAVE A RIGICP TO APPEAL A DENIAL OF THIS APPLICATION IN tYRbTING IYITli IN 30 DAYS OF THE DENIAL. INFORIIATION AS TO TIIE PERSON TO CONTACT IS SItOIYN BELOW. TIIE CONTACTED PIrRSON MUST. RESPOND TO YOU IN WRITING WITHIN SEVEN BUSINESS DAYS OF RECEIPT OF YOUR APPEAL". Name: Southold Town Board Business Address: 53095 1(ain Road Telephone: Southold, New York S1G-7G5-2S00 . ,utp~d~zzee~ ~'~.~.0 ~ cat-a-~ ' ~v. • 1, r ' R a a ai 1 ;IIr aJ f G r- V l P,'!~ F=UUNp ~ ST~IGC~ a.'~,gol 1. `fie`?°::a.~ Mor.is. A 9,v ~ J' I C"<xJt~u~~5~"T" Morl.`~. I~19~8't a, sa v i -1, +I G 4: i; ~ ~ ~ 1 /~~1 i ` ~ I ' t~" ~ ~ r I t ~ . 1 ~ i ~ le. S', ~ . ..:1 ~ ; t I r r7 1 1Q ~ i can v. > i I~ ; l.1 I ' ` nl i i !v~ la _ ~ 1) a. ~ 11 r/1 n % / \ r - nd 'q1.~ I ; ,doi r•m of ~ ' i , U C^'YK 1, trr'.~' hcl s1l oh^I! r!~n rn~' nn Ll+bhrtli w !l'einn Ilr~t!•7 hors;«l avJ ,..r<~ m o n% n unNvrd2° I .51 + r U irpi':.Ais^: o~ vu!BMiuS n( 1- Y. 1f O i. - .I ~'J('!•,11,:vj (v1.71~ $r I~ri~~ ~ ..~-.!<'7 MOt.I. SGT MON.~s. a„!~ YIen.1 ~V~t~If=1Ef.J V F) D7 -1~ l 1 4 L. ~ t 1 -rAC:Kfp 14JF loo• ,,y r / vrG. F jh W~'r Mdt L~i~// /'~2 a. {,.4e. .14. rtlf! LI'"C11 <rj ~i F. ;7 rl C1 SUI 'l.i'J~)Yo .s `71'"~'Fi 1~ FEE C.prJ IC ` .J...._._.__-----._.. ~ . ~ I ~ ?6 FORM N0. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 ~p TEL.: 765.1802 Examined . ~?`^.h~i V?~. 19 b ~ 7 2 y C~ 'Z Application No . Approved~,1,.~.o-f~1V-o~..~.., 19~~. Permit No..f.~0.~'~~~' Disapproved a/c ................................~exa;~.... . . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ~ 1 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 issue 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 buildings for necessary inspections. ~ry-~- 1N" = .........~~~Lti~. (Sign ture of applicant, or name, if a corporation) (Mailing address of applicant) " State whether ,applicant i~s ow-ner, le7sse-e,-agent, architect, engineer, general contractor, electrician, plumber or builder. ........C~~.4!?'?!WL..C~/~ . Name of owner of premises / ®ffi*~:.. G~!"~'"'! . (as on the tax roll or latest deed) If applicant is a c rporation, signature of duly authorized officer. (Name and title of corporate office~rj) Builder's License No. ..I ~®.'~Q../.~ T Plumber's License No . . Electrician's License No . . Other Trade's License No . ~ ~ 1. Location of land on which proposed work will be done. ,-yp...:.:.`.. . #k . House Number Street Hamlet County Tax Map No. 1000 Section ~ Block Lot J . Subdivision Filed Map No. Lot . (Name) 2. State existing use and occupancy of prem/i~_ses~,and®®in~~tended us//e and occ p ncy of proposed construction: a. Existing use and occupancy .....`~f• (d.!i'.""c..`..`!~~.'Cb r . b. Intended use and occupancy <~~~itM.^.-.9.'~--'. W~ ..I.~C: aq,~.. ~j,~gi'!~!~!~!1 . J ~ i 3. NRetuurY of work check which a plicable): New Building Addition Alteration . ( p . r Rem val Demolition ..............Other Work . r (Description) 4. Es tmated Cost . ~~cl. ./,t17'J, , ; Fee . (to be paid on filing this application) 5. If dwelling, number of dwelling }znits ~..--.-umber of dwelling units on each floor . If garage, number of cars 3 (,~Ih.~ . 6. If business, commercia r mixed oc pancy, specify naand extent of each type of use . 7. Dimensions of existi s ' ny: Front a.. Rear Depth ~ (,7....... . Height ~ ~j.... urt>;ber of Stories . Dimensions of sa e structure w th alterations or additions: Front Rear ....jf Depth 8. Dimensions o~tire new const ~ ~ Height Number of Stories . Num ction: Front Rear G~()..... Depth ~ . Height ~ fiber of Stories , . 9. Size of lot: Frc+n , .C^,,.,. ~ Rear Depth , . 1~1. Zone or usecdistrict in which re ~ ~ ~ ~ ' ' ' ' ' • • Name of Former Owner . p mise are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation : . . 13. Will lot be regraded Will excess',fill be~r,~lloved from remises: q Yeses 7 0 p ~ .."Address ..../~^0~/. I p p7~O_.".0. 14. Name of Owner of remises !r.,~( ...........Phone No . Name of Architect ~ . Address Phone No............... . Name of Contractor (/V.'- Address Phone No. ,7.f.~:. (j.ly.~ PLOT DIAGRAM Locate clearly and distinctly allj buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block'number or description according to deed, and show street names and indicate whether interior or corner lot. I ~ ~ r g II ~I STATE OF NEW YORK COUNTY OF . being duly sworn, deposes and says that he is the applicant (Name of individual sigq~ing contract) above named, He is the .....................I~................................................................... (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 contained 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 n Notary Public, ~~:-~dnr.. lil .~.1L.4%'~, County J~~/~~//~ NELEN K. DE VOE \ NOTARY PUDLIG, State of New York . No. 4707878,So9folkCoe (Signature of applicant) Term Expires A~erch 30,19..x! 2 4 r} J a 25- > - - I m cY~ cb ~ in w ~ ~ m ~3-~ ~ ~ ~ cn ~ ~ ~ ni W ? ? u o ? ? C7 ~ ? N ~ o Q ? ~ z ? 9~. Y ~ ~ ? J ,T ~ a O u ~ W H O ° ~ ~ m J ? ? a a V- z V- ? ~ I- n~ ~ ~ ~ ~ u ~ m Z o O w U ° (n W ? ~ ? ~ ~ (n ? 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