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HomeMy WebLinkAbout17208-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219077- Date MAY 24, 1990 THIS CERTIFIES that the building INGROUND POOL AND FENCE Location of Property 11225 PECONIC BAY BLVD. MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section 144 Block 003 Lot 018 Subdivision BARTLEY Filed Map No. 770 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 5, 1988 pursuant to which Building Permit No. 172082 dated JULY 13 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 INGROUND POOL WITH FENCE ALL GATES MUST BE SELF CLOSING AND SELF LATCHING. The certificate is issued to HALUK AND MUALLA ERGULEC (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N028199 AUGUST 17, 1988 PLUMBERS CERTIFICATION DATED N/A Building Spector Rev. 1/81 roses 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~ ~ 17 2 0 8 Z Date ....'.~~w~ 19.,E ermission is hereb granted to: ~ ~~j..~....~'~~, ...9~.~ ...s~~ .....~........~~a.~ . ct premises located at ......~j`1.st~°1.....~'F•4~e~fs.~`.~ ~~~„~,,GC%............,~/....................................................... ...........................................................................t../.................................................................................. County Tax Map No. 1000 Section Block Lot No.......1~•~•.•.. pursuant to application doted ....r%`~J. ~ 19~f1.., and approved by the ~%3' Building Inspector. ,r p d Fee 4.i•••yA••••®~S~••• Btyfding Inspector Rev. 6/30/80 ',2x. Form No. 6 TOWN OF SOUTHOLD ~ ~ ~ (f BUILDING DEPARTMENT TOWN HALL ~,PR } t', ~ ~ 76s-lso2 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OA 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 1~ lead. s. 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, 19s7) 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.s 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 $2s.00, Accessory building $25.00, :;Additions to accessory building $2s.00. Businesses $s0.00. 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, Commcce77rcial $15.00 Date ........L~.:j~.':.1.~ New Construction........... Old Or Pre'existing Building.. ~ ~1 M° N~ Pf}O ~y yl . . Location of Property.. .Y S~ .~..5... ~:'4 4f~.d~.~.~..~.) ~.if... ~d LJ Z; ffe 1.1~ ~1..~~...IV. J House No. Street Hamlet ~ l~~~Z-- Onwer or Owners of Property..~:~~~-:V".~.1.~~/.~Slryl~~,.,~Ca-..:~..~~.~.~.-:L.~....~~~p.l~.`,h,.~ County Tax Map No 1000, Section....~.7.7.....Block.....~?.........Lot.... 1.~ Subdivision ....................................Filed Map....,.......Lot...................... 1 p/ ~p~ Permit No.. l~ d.-Z. ~.11.....Date Of Permit.. ~ ~ C'.~..~ :0. ..Applicant.. [ :l Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate... Fee Submitted: $..~.5~.-S.: ~ y/~4 • • APPLICANT ca z i 90 ~7 _ . T THE NEW YORK BOARD OF FIRE UNDERWRITERS ~'A`'"~ ' F2T~ooz BUREAU OF ELECTRICITY BS JOHN STREET. NEW YORK NEW YORK 10038 Aocas~) 1.~74a~ 56743sftf3/ae N oasT~~) Dale APPlication No. on file THIS CERTIFIES THAT only the electrkal quipment as described 6ekTTS and introduced 6y the applicant Teemed on the obTroa application number in the premises of NR &HRS. F,RGUTIRC, tOf1-2ti }'F,CONK FLAY" BLVD., NA'['TLT(/CK. N.Y. OI1T in thefollouinq loco t ? lot F!. ? Ynd F1. Section Block Lot ks'tsus'~~~°"f~i8 Tens a:amined on andJound to 6e in compliance Trith the rquirements of this Booed. RKTWE RXTUR6 RANGES COOKHlG DECKS ~ OVENS DISH WASHERS EXHAUST FANS OUTLETS lCVTACUIS SWITCHES INCANDESCENT ~ P1U011ESCENi vA AMT. K. W. AMT. K. W. AMT. K.W. AMT. K. W. NAT. N. P. ~ , ' 7 DRYERS RIRNAG! MOTORS !lITURE ANLANCE Tt[DEEf SN[dAI RECFT 7MtE CLOCKS FELL UNIT HEATERS MULi40UTUT DIMMERS AMT. K. W. Oll H. P. GAE N. P. AMT. NO. A. W. G. AMT. AML. AMT. AMPS. TRANS. AMT. N. P. SYSTEMS AMT. WATTS NO.OF F@T 1 ?Q 1 40 SlRVICE DISCONNECT NO.OF S E R V 1 C E AMT. AIM. TYPE ~ M 1 / ZW 1 F JW 7 / 3W ] / IW NG. D~RCSCOND. ~ CC. CGND. a NI~IFG a ~ HF~~ NO.Of NEUTRALS ~ MUTRAI Oi/1ER AP?ARATUS: f'ANP:6BOARd7S:'1-2 C7R. 50 ~+(5WIMMINC, P<1<1I,) This rertit~ica.te covers eampliance at Che date or` inapecCitau nn1y. Because of unusual env? rcTnrnents 'i t. i a advi sab7 e to kavW frequent teat/and or repairs made by a qualified person. UN11t;RGR01INll SPEC.. fN('. ?tl(J-J$ ?.N?) ST. TER/!Al MANAORR HtJNT. STAT., NY, 7.'174f. _ Per X 7. /~,t... This certificate must not be ahered in any manner; rNurn fo 1M ~~ha~ar~'I~~i o~acl. Inspectors may be idsMifisd by Chair crodsntialt. COr1r Fqt WILDING DlPARTMlNT. THIS CpK Of CERTIFICATL AYLT NOT !E ALT'dllD IN ANY AMIMIlR. ~ ~t,,j ~ ~ ~ ~ I~ ~ tvJ .E. E~ ~ ~ ~ ~ 'y~ .v .3 ~ U V g -y G~ ~ 'u ~.3 3' E a. ~ y' ~ ~ ~ 1 ~T~ ~1 j _ z • 4 ~ I n -a f ~ ~ ~ it . U ~ o ~ c:>s': - W> ~ . ti` ~i . r . m m ~ : ~ { ~ ~ ~ ~ 7 jM ~ g~,~~ V ~ Yam ~+SV L €~c t ~`J ~ ~m s-t ~p ro f _ ~j A w ttt RV m ~y ~ C ~`n ~ V ~1 O O ~ t r ; ~ ~ i~ ~ < ~ ~ , _ a.. _ 7 ZcLD Z;:SPEC:iU;: ~~llA;E COMMENT° ~ •o "~9 _ y _ H FOU1dDATION (1st) ~~O FOUNDATIOW (2nd) _ ~ h C 2. z ~ o P,OUGH FRAME & ~ PLUMBING H 3. IIJSULATIOPI PER N. Y. y STATE ENERGY CODE x a FIiJAL a~ y o e,o t9~~- DPr«-P1-2e ~ i ~ z ADDITIONAL COMMENTS: x s y 8~ ~ _ < a ~ ~ - ro 1 ~ Z ~ ' C~ ~11f~``i - ~ ~ a H QQ 2 - z ' ' ~ x c~ A • r H - ~ d tT7 ro H VICTOR LESSARD ~ n' n1~ Town Hall, 53095 Main Road PRINCIPAL BUILDING INSPECTOR " 3~~ ~ 1, ~ ~ P.O. Box 1179 4 { v~~ - Southold, New York 11971 (516) 765-1802 f ~ , FAX (516) 765-1823 ~ , ~~ifq~t OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD April 25, 1990 Haluk R. Ergulec Apt. 7B--303 Bast 43rd St. New York, N.Y. II017 Re: Inspection of pool B.P. ~172DBZ 4/23j90 Dear Mr. Ergulec: I am enclosing a copy of the inspection of your pool which was done 4/23/90. Please make the correction and call our office for another inspection. Thank you. Yours truly, Secretary FOtCSi ti0. r TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, y. t~ ' ORDER TO REMEDY VIOLATION Date ..................OCTOBER 24, 1989 1989.... TO gALUK,.K: ERGULEC (owner or authorized agent of owner) APT 7B 303 EAST 43RD ST; NEW YORK, NY 10017 . . (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation af; Zoning Ordinance CHAP. 100 Other Applicnbfe Lnws, Ordinances~or Regulations at premises hereinafter described in that A swimming pool is being used without a (state charncter of violation) Certificate of Occupancy and an expired building permit. in violation of ARTICLE XXVIII-Chap. 100-281 6 284. (State section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the low and to remedy the conditions above mentioned IMMEDIATELY The premises to which this ORDER TO REMEDY VIOLATION refers nre situated at .11225 GT PEC BAY BLVD, MATTITUCK County of Suffolk, New York. SUFFOLR COUN'CY TAX MAP /f 1000- 144- 03- IS Failure to remedy the conditions aforesaid and to comply wish the applicable provisions of law may constitute an offense punishable by fine or imprisonment or both. B.P./t 172082 ORDINANCE INSPEC OR VINCENT R. WIECZOREK ~CCrt. Mail) ~~f1"~~ f ~t~" rt ~~o. VICTOR LESSARD ti "tY~.`^F T EXECUTIVE ADMINISTRATOR ~ ~ ~ ~ ~ ~ 4=j e (516) 765-1802 . Town Hall, 53095 Main Road ~ P.O. Box 1179 ,:'ft Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD MUALLA ERGULAC 11225 Peconic Bay Blvd Mattituck, New York 11452 SUFFOLK CO. TAX ~I1000-144-03-18 Re: NOTICE OF VIOLATION Dear Mrs. Ergulac: You recently received a Notice of Violation. To date you have noC responded to that notice. If you do not remedy this situation immediately, you will have to appear in Court to answer criminal charges for violaC- ing the Southold Town Code. Please contact the Building Department of the Town of Southold at 765-]802 upon receipt of this letter. Very truly yours, U~.~ c~.)~:. Vincent R. Wieczorek Building Inspector VIA CERTIFIED MAIL FORM IdO. 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Date ......August....~.~.t 19...8.$ TO ...MUALLA E.RGULAC (owner or authorized agent of owner) 11225 Peconic Bay Blvd. Mat_ti.t.uck New York f 1952 (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violntion ot: Zoning Ordinance ",,,,,,,,,,,,CHAP ; 1 00 Other Applicable Laws, Ordinances'or Regulations of premises hereinafter described in that ..,The Swimming Pool does not have a (state chnracter of violation) fence and the pool is being used without a Certificate of Occupancy. in violation of ...,ART. III CHAP 100-30C 2A, ART %IV CHAP 100-144 (State section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned IMMEDIATELY The premises to which this ORDER TO REMEDY VIOLATION refers ore situated at „.1,12,25,,,Pe,conic Bay,,,,Bl„vd;Mat„t, i,~u,~,l~,~ounty of Suffolk, New York. SUFFOLK COUNTY TAX MAP U 1000-144-03-IS Failure to remedy the conditions aforesaid and to comply with the applicable provisions of Inw mny constitute an offense punishable by fine or imprisonment or both. I ...`~'.G~:~.. Building InspectoN Vincent R. Wieczorek ~ , , 4. ..4,r;, ~4 IsS~..9~~Ft~tFR~"ij`r~.o. a - l ~ R A A2Ytn V ry~i y, iz+[ 4 r'. C r ~ t: 4. ~ 1 ti fq4 ,a4,' t tr 4ri' ~ ~ , ~ ~.y , t II ~ ~ ~ ' srs~r ~ 4, I, ~~i, 1 3 t ~~E,~ Y i9 ~~y _ v ~ ~ , a A6: f~i ~ ~4._ ' f`' ' w • ..w• if` a• W .s 'w ~ ~ . ~ ~ ,*w 1 V ~ ~ ! I 4 ~ K { 4 ~ .~~fi,' ~ ~ ~ ~ 6 B ~ • ~ ~ V`"~t~ i ~ d s}- a Y o z ~z ? ~ ~ 1 k , ~ A ics « ~ ~W r 3 ~ v,, 'S n.~ fi r jllj r > Y 4 ~ N~ .;r t h _ f ~v~4j, 4~. 4 asy;' w ~ t ~ r 4 i t ~ .,~"q`,e, ~ 7 c a' 14 - - 'F~ - ' ~ c. w .n C ~f , ~ r` ~ ro "m,~.. .zn~ i¢' ~-o° w' .zap -'o ao > m ~ o ~ J ~ ~ c~ o o = C ~ d u ry, 1 l (y p~ p 1 1 1\ 'm 3 ~u{( N 0 'q 6 ~ ~ ~ ~~i. N ~~~e~ 1 m ° v„l1 j ~ ~ y ~a gyro m ~ R'& ~ a ~'V >'J ~ y~~ ate' ~ ~ ~ ~ ) y (i Q~ i. m ~~I l~ i `h. p ~ ~ c ~ _ ~ ~ S o `,rte a'' iR `r v !,g I 4v ' ~ ' Y is i ~ , l~ _ _w` I i II 1 ~ f`' ~ ' ` O f ~ Y 1 ~ ~ ~ ~ , ~ ~ ~ F 1 ? y fr ~ V A ,l. ~ ~`J J 'J ~ u \ rte'. w ~ ~ ~ ~ f ~ Jii ~~4 '1 yyy...~~~ i'~ i ~ ' ~ ~ ~ ~ ..~i lei ~ ~ ' " ~ 5 '1 1 \ ~ fl1 'h.' N ~ i'- a x 7 i~ r 1 -,r--._ ('tj~) A Town Hall, 53095 Main Road VICTOR LESSARD fi PRINCIPAL BUILDING INSPECTOR ~ , ,:r ` ~ ' P.O. Box 1 179 } Southold, New York 11971 (516) 765-1802 ~ „5 ~ ~ rv .t- FAX (516) 765-1823 ~-~~'~~s~"~ . ~ `~K, x OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD April 25, 1990 Haluk R. Ergulec Apt. 7B--303 East 43rd St. New York, N.Y. 11017 Re: Inspection of pool B.P. A17208Z 4/23/90 Dear Mr. Ergulec: , I am enclosing a copy of the inspection of your pool which was done 4/23/90. Please make the correction and call our office for another inspection. Thank you. Yours truly, Secretary oS~FEULKCOG VICTOR LESSARD ~ 'yam Town Hall, 53095 Main Road PRINCIPAL BUILDING INSPECTOR P.O. Box 1 179 (5I6) 765-1802 ~ ~ Southold, New York 1 1971 FAX(S 16)765-1823 y~ OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD April 6, 1990 Haluk K. Ergulec Apt. 7B--303 East 43rd ST. New York, N.Y. 11017 RE: Inspection of pool B.P.#172082 Tax map #1000-144-03-18 Dear Mr. Ergulec; I am writing to you in regard to the inspection of your pool. The inspector left a note telling you that the C.O. was denied because gates must be self closing-self latching. Double gate must be self closing/latching-one gate must be self latch- ing. If you have any questions please call our office. Yo-yu/rs, truly, ! Secretary t 7 z©s ~ ass-iso2 BUILDING DEPT. INSPECTION [)FOUNDATION 1ST ( J ROUGH PLBG. [ ) FOUNDATION 2ND [ )INSULATION [ ]FRAMING [ I~FINAL ~p 4 L REMARKS: ~ - ~P~~-~-P~" l.q~~.~.1..A,~:..~_ DATE ~ 3~R0 INSPECTOR ~ I ~ 208 765-1$02 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ~ ROUGH PLBG. FOUNDATION ZND [ ]INSULATION [ ]FRAMING [ t~]~FINAL P(~ 0 c... REMARKS: M1'C~~-S i ~ lZn-rL 1A.t,i7 SZ- p O v i3 Ig T r ?M.u S i v e=~ F SC tz ~ C214~~ S ~~--r G L o s t nF.CS__ '~Q r~~, r'"- l~.t~-~i'`~ ra, t~T.~- ..~k~' _t~~Zn 5~~ W~-?~-s o ~ ~ r ~c~ To a ttl ~ bE-7'r~ w- ~ i t~ u~-Tc ~t DATE ~6 $ 0 INSPECTOR V ~,.P~ h n v~~ ~ ~ 765-1802 BUILDING DEPT. INSPECTION (]FOUNDATION 1ST ( )ROUGH PLBG. (]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL ~ad L^ ~~;~e~- REMARKS:®~ Imo.. QP tr " ~ ~l~ ~ Y~ ' - C:'t.. DATE --~~~`=-~~INSPECTOR ~~~U~ul~ 4.. - _ 0 ~ J.- 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [~INAL REMARKS: ~~~t.,-c? ~~~+yJ ~ P DATE ~~I~INSPECTOR I' lR ` --~~j - i FORM NO. 1 ~E, 1 7r.. TOWN OF SOUTHOLD ' BUILDING DEPARTMENT l .;f TOWN HALL " ~5 9OUTHOLD, N.Y. 11971 ~ TEL.: 765-1802 /y~ ° Examined 19.FJ.~ ceiy~v~ed....`....... , 19.. . Approved 19 ~~ermit No. ~ ~,~1)~~ ~ 1/~ L) (j~ I Disapproved a/c ~ (Buildi~Inspectox) APPLICATION FOR BUILDING PERMIT t Date ..~U.?1~.. ~ 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 al] applicable laws, ordinances, binding code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary irisp c ~ ~ r t?} x=;=~?~ (Srgriatdre ~nc~~nt, or:name, if a corporation) ~ (Mailing address of applicant) (l z!n ~ , ax Y ~~i~al'1 tii ~ t State yylk~~t~i@tlapph6a~lfi'i>l~~ow3fiei lessee, agent, architect; engihe~Ys ge`iieral corifractoty electrician, plumber or builder. / ~r~.d Name gfiRSt~&tl9f~re`tfii~~~"''.~'~~ ~/.4L....~1^G1.~1f~C, . ` zJ (as on the tax roll or latest deed) ~,~r ` ` If appli at~~is a co~:pg~~ror~sjgnatu7e of duly authorized officer. 7"394W? ;,@~FoElt; ~6ta3i"'='~"§1~; i, VO~~ ~ ~I~tglloorpbiate officer) tMME tA7ELY'"` t ~t.fEli~irlrg;:'2S, It= ENVI~ ~ M.ETION T~ 8EF0 '1AtATER" Plumber's License No . . Electrician's License No. ~.7.y/~~~i~•C. • • • . Other Trade's License No. ~ U.7~,• t, 7~ ~ ~ ~ ~ //L 1. Location of land on which proposed work will be done . . yiaa~ ~T~-........~eG~i?~riu ..day.. ,~/.mod ~?.~?`>.`~.~zr,;,~ . House Number 4 Street Hamlet County Tax Map No. 1000 Section .....1 Block Lot ~ ~ . Subdivision Filed Map No. ...~?Q...... Lot . (Name) 2. State existing use and occupancy of prem/i~ses and intended use and occupancy of proposed construction: a. Existing use and occupancy `...7: Q- ~J4.... ~c5./•G7~'+°J?.~.C+...... . b. Intended use and occupancy .l. f'~m. l~. ~2Sl.C~2<.~1. C-C~.v2f'. ?~~Z? . ..4-k . ~a.,p . (,vl ~vrrr>v~Ck ~tvxanc~t~c ~oal_ i 3• 9 o~k~ch~ k!,w ~ ~aoplicable): New Building Addition Alteration . I - al . Demolition ..............Other Work~0.X~9.Crn•.C,~-2.. 4. apt- :~°2E.S I ~ (~esc~'ip~on~ I , • Fee ~ ~ (to be paid on filing this application) n 5• g units Number of dwelling units on each floor . If garage,num ere ca 6. If business, commercial or mixed,' occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structure, if any: Front ...............Rear Depth . Height ...............NumperofStories........................................................ th alterations or additions: Front Rear . D P~ sions of same structure wi Height Number of Stories . 8. Dimensions of entire new constrµction: Front Rear ...............Depth . height ...............Number of Stories . 9. Size of lot: Front Rear Depth . 10. Date of Purchase , I . . ................Name of Former Owner , , . 11. Zone or use district in which premises are situated . 12. Does proposed constructi n violate any zoning law, ordinance or regulation; , , r, 14. Nameoof Owner o premises 1.~ I ~ • ' ' ' ' ' ' • Will excess fill be removed froze i s: Yes ? No • . U,4Z/~GL .~r.~VIG..C. ,Address/AB:a.t'.~Con. ;G .49j' .°~-(~Phone~o~4$ - $q,~s,"„ Name of Architect ..................Address ...................Phone No............... . Name of Contractor .........I Address ...................Phone No............... . PLOT DIAGRAM L<ICate cleazly and distinctly all, 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. OCCUPANCY OR q3 c ~ t DATE..B.RM~C,~ USE IS UNlAWFUI FEE. LOINQ NOi'IFV~DEPART AT I ATE o?l4wIN8 AM 1b a PMT.: I~ITHOUT CERTIF C , ~Q N~~~R 0~ OCCUPANCY x. R~ 3. INlULATiON 4. FINAL - CON31'RUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCT(gN SHALL MEET i!~ ~ THE REOUIR~~ ~ Y STATE CONSTRUCTIpN i CODES. N(7f REgpONSNILS ~ y10gU', DESIGN OR CONSTRUCryON QM11bI1S "RSTAYY'• 49JS j STA'L'E OF NEW YOLK, COUNTY OF .~V.~-.~c ~AV~~... , j S.S ab~e na~( a e o ~ dividual sign ~ ~ ~ ~ • • ' ' ' ' ' ' ~ • • • being duly sworn, deposes and says that he is the applicant nine contract) Ha is the ~QY.I:~!R..~7Q` ..li. (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; that all statements cor4tained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mant}er set forth in the application filed therewith. Sworn to before me this j ~ , .......day pf ~ 4~~'~{ 19 Y ~ Notary Public, .~'~~M~QIN~~k~~~~:?........ County s ER CCTTER G NOTARY PUBLIC, STATE OF NEW YA'AK N0~ 4Y6ut::'9 , Cu;;uFlen Ir5 SUF OL1~~ .\co~L'~TY. (Signature of applicant) COMMISSION EXPIft~S..... ~......~...1.».SS...~..'.wA W L~ \ / u Z Y ~ W LL C W Y r ^ ~ v Z ~ O K S A F ~i jj V, a ~ I W ~J~~ ~ ~ ~ 0W~ 5 4 1', ~Zj y M ~ ~ ~ ? ti O ~ O V Z H ~ /1/~-~1 Y J LL W ~ 10 W 2 4 ti w ~n .r w = w 0 1~i~ v~ Z r 3~ h " ° Z ? H 4~ qc9 H v Q ~C H , ~y~ U pt~i , 4 ~ti n~ E-o W craw ~ J ~ Z -10xt g ? `z Q ~n~~ °LL T ~ ~ z ~ Q N H LLlwva 3 } ~ ~ i ~ooW ~ ~ Q zw 4 v ~ ~ H-i e°~ lel 2 ~ ~ =H O j ~ N~ W W J ~ Q J M J 0. ~ O Po j ~ i W V I 'a O ~ (aY ~ I x Q Q l~ ~ g. d i Q v r i m' N rv ~ ~ Q ~ u U N I ~ ~ O O ¢ N l!1 i h ~ ~ ~ Z I , ~ Z I I J ~ Z ~ 1i t Q~ a- a-! ~ I ° . J_ - ---a--- ~ ~ ~ O H W ti n N N' N O j j i i - U 00 ~ OO CO , p I I ~ `n n/ ~ _ . U d U P I aD ~ N i ~i 1.1.1 ~ ~ N .p 9 O r ^ m ~ I M ~+l r^ V- f V ' Q LL~~ i ~ ~ ! O~ n _ m _ . _ ~ 9 ~ _ ~ ~ I a ~ ~ ~ j x