HomeMy WebLinkAbout11705-Z FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No.2113 2.5 . . . . . . . . . . Date . . . . . . Atig170 t. .13. . . . . . . . . . . . . . .. 19 5Z
THIS CERTIFIES that the Wt4ding . .deck . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Location of Property . 565 . . . . . . . . . . . . . . . . Sound Avenue ?@conic
House No. Street Ham/et
County Tax Map No. 1000 Section .06.7. . . . . . . .Block . .02. . . . . . . . . . .Lot . . . 001 , , , , , , , . ,
Subdivision .ZeP.QntC. Ah9r0A . . . . . . . . . . . . .Filed Map No. 1 1 7. . . . .Lot No. 1.9P. . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
. . .April .26. . . . . . . . . . 19F?. pursuant to which Building Permit No. . . . . . . . . . . .
dated . . . .June. 3 . . . . . . . . . . . . . . . . . 19 .8?,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 . . . . . . . . .
a deck, ,addition. to . an, ,existinl;, orie-family. dwellinl3... . . . . . . . . . . . .
The certificate is issued to . . . William ,Carl .&. ,r,. qg. Marie Maxwell
. . . . . . . . . . . . . . . . . . . . . . . . . . . .
(owner,larae.or.ierlanil
of the aforesaid building.
Suffolk County Department of Health Approval . . . . A/4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . A/.B. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
i
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Bu ding Inspector
Rev. 1/81
FORM 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)
NQ 11705 Z Date ... ........Cl....................... 19.. rt
Permission is hereby granted to: Ile-
:.. . .a Y......7....7..........................
_ :.........�r�� _
to .........C`;J!�:?.�:. ✓.0 0.......G:/..C..5. S. a Cl/C 7..... (G....i<Y.l..; .
at premises located at ..t.' .. ........... /..'% Gf............... .�l..l�r.rG 1..�.
................ ....... ................... ....:...........................................................................
C.....= .... ......7..r�... .................Ai2 .�..... �T...../Z
County Tax Map No. 1000 Section,...... ... Block ... ........ Lott No.0.0../L........
pursuant to application dated lwC!� Z A................... 19e'/�/ and approved by the
Building Inspector.
Fee $..�. .. ......
l ilding Inspector
Rev. 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec-
tor with the following; 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 Health Dept. of water supply and sewerage disposal—(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or
topographic features.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use $5.00
3. Copy of certificate of occupancy $1.00
n " Date . . . . . I71 I $�
New Ba�B�+ng . CRC . . . . Old or Pre-existing Building(X) . , 'Vacant Land . . . . . . . . . . . .
Location of Property :?6 _ 5 p u n/0 Of✓� �eP'1//
. . . . ._ .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . .
House No. ASAtreet Hamlet
Owner or Owners of Property ".✓.�.��f(!"1 S�. l?.%^! ¢ . !%i�6P�� . .
County Tax Map No. 1000 Section . . . �.lD. . . . . . Block . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . . . . . . .Lot No. . . . . . . . . . . . . .
e
Permit No. Date of Permit 0�6 pp V .Applicant Z.
Health Dept. Approval . . . . . . . . . . . . . . . . . . . . . . . .Labor Dept. Approval . . . . . . . . . . . I . . . . . . . . . ... .
Underwriters Approval . . . . . . . . . . . . . . . . . . . . . . . .Planning Board Approval . . . . . . . . . . . . . . . . . ..
Request for Temporary Certificate . . . . . . . . . . . . . . . . . . . . .Final Certificate . . . . . . . ... . . . . . . . . .
Fee Submitted S . . . /t . . . . . . . . . . . . . .
Construction on above described building >a;ndper. ets all =es and regulatioApplicant . . . .
Rev. 10 10 73
Jac + au�� ��131��a- esL_V_p � D�
FkELD 'INSPECTION 1DATE COMMENTS -> r
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FOUNDATION ( 1st )
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FOUNDATION ( 2nd ) m�7
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INSULATION PER N . Y . .3 (�
STATE ENERGY
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ADDITIO14AL COMMENTS :
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FORM NO.a ..
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD,N.Y.
NOTICE OF DISAPPROVAL /
File No/ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date . s�f!l. . . � � . . . . . . ., 19 .��^Gf
To /. gT
l . !?/.G.r . . . . . ././.
PLEASE TAKE NOTICE that your application dated f !.� . .Z
for permit to construct �. . . . . . . . . . . . . .a at
Location of Property . . . . . . . . . . . .ch���i / ., . . . . . . . . . . ./. . J17 C. : . .
House No. Street luam/et
County Tax-M No. 1000 Section . . .ate. 7. . . . . Block . . . . off^ . . . . . Lot �!L!
Subdivisio '14C.-��'Dhsr Filed Map No. ��7 .� .. �� �. Lot No.
is returned herewith and disapproved on the following grounds ry�/� Q�
5 ofc�/ of = �c .v ! T
�Y'IE c�lCrE y�vs-d d��i`rFcl � /
Cfl/ Building inspector
arm/�Jc:E' d7�d�li�i'1 rE��cis
RV 1/00
lfOIgT-T c % f
e'o 0
HOUSING CODE INSPECTION
July 1 , 1976
1170 Huntington Blvd. R-1
Peconic , N. Y.
Tax Roll : George W. Quigley & Another
Occupied: Owner
Sub-division: Peconic Shores - N/92 ' of lot #12
Upon receipt of request for a Pre-existing Certificate of
Occupancy, I made an inspection of this two-story, framed
dwelling. I was admitted by Mrs . Quigley and began this
inspection at approximately 10 : 15 A.M. . '
The second floor habitable area consists of a kitchen,
living room, two bedrooms and a full bathroom. Heat is fur-
nished to all rooms from an oil-fired hot water furnace lo-
cated in unfinished basement. Basement provides a one-car
garage area. Building' s foundation is wood piers enclosed
with vertical wood siding .
Violations of the Housing Code, Chapter 52 , Town of
Southold, New York, which were corrected by Mr . Quigley
(re-inspection made on July 12 , 1976) , were as follows :
Kitchen: gas cooking range, no shut off valve at unit.
Article V, Section 52-52 B 2 .
Basement : gas fired hotwater heater - no vent to exterior
to remove products of combustion. Article V,
Section 52-53 H 3 . (As of July 12 , at re-
inspection, fLiEE—line to hotwater heater was
disconnected and unit is being used only as
a water storage tank. )
Inspection completed at approximately 10 : 40 A.M. .
Res ctfully/submitted,
E d H n erm nd
Building Inspector
EH:med
FORM NO.3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD,N.Y.
NOTICE OF DISAPPROVAL c
File . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date /UoV:2 I7 , . . . . .. 19
To
1�- . . . . . . . . .... . . . . . . . . .
PLEASE TAKE NOTICE that your application dated /l/3� . .U. . ., 19
for permit to construct . .rL�E� . ."vu),C.!///.avo ✓C/ . .��`1! . . . . . . . . . . . . . . at
Location of Property . ??. .!./, 7d t`/�NT/tir/—cd�!_ /SI sQ;, , , , , ,flV.6�.. . . . . . . . .
House No. Street Hamlet
County Tax Map No. 1000 Section . .().C7 . . . . . . Block Qa Lot PP.(. . . . . . . .
Subdivision Filed Map No. . . . . . . . . Lot No. . . . . . . .
is returned herewith anddisapproved on the following grounds
4r4
tE. rl��2iiox< .Tizal�./ 7
L yr
Cu`c
Building Inspector
RV 7/80 C/CG S )L/ �✓
//U Z/iD d7: /'&7'11 U
/0C) - 3 y
CIIC 111t:7 Z17-1
i
TOWN OF SOUTHOLD, NEW YORK DATE ....I./.........../82
ACTION OF THE ZONING BOARD OF APPEALS
Appeal No. 2928 by application Dated November 18 , 1981
ACTION OF THE ZONING BOARD OF APPEALS OF THE TOWN OF SOUTHOLD
TO Rudolph H. Bruer, Esq. Mr. Peter S. Terranova Appellant
Main Road Box 77
Southold, NY 11971 Peconic, NY 11958
at a meeting of the Zoning Board of Appeals on December 17 , 1981 the appeal
was considered and the action indicated below was taken on your
( ) Request for variance due to lack of access to property
( ) Request for a special exception under the Zoning Ordinance
(X) Request for a variance to the Zoning Ordinance Art. III , Sections 100-31 and 100-34
1. �� 14}f}fA6Yli'RL61f}�p]f�t79xiK�a1C&iCYeYtifdSe`flxif�bx3'pl�Ca'f�k�(a'fiZ4�4#t$x��e
granted ( ) be denied pursuant to Article .................... Section .................... Subsection .................... paragraph
.................... of the Zoning Ordinance and the decision of the Building Inspector ( ) be reversed ( ) be
c*9MRk Upon application of Peter S. Terranova, Box 77 , Peconic, NY for
a variance to the zoning ordinance, Article III, Sections 100-31 and
100-34 for permission to construct deck addition to dwelling with reduc-
tion of frontyard area and beyond property line. Location of Property:
1170 Huntington Boulevard (a/k/a 565 Sound Avenue) , Peconic, NY; bounded
north by Murdock; west by Sound View Avenue; south by Huntington Boule-
vard; east by Hoffman. County Tax Map Parcel No. 1000-67-2-1.
(SEE NEXT PAGE)
2. VARIANCE. By resolution of the Board it was determined that
(a) Strict application of the Ordinance (would) (would not) produce practical difficulties or unnecessary
hardship because
(SEE NEXT PAGE)
(b) The hardship created (is) (is not) unique and (would) (would not) be shared by all properties
alike in the immediate vicinity of this property and in the same use district because
(SEE NEXT PAGE)
(c) The variance (does) (does not) observe the spirit of the Ordinance and (would) (would not)
change the character of the district because
(SEE NEXT PAGE)
and theralcca,-.itr-wae-furthet detmn,W. enrequ sted variance ( ) be granted ( ) be denied and
that the pr z S (F V*Df gk1g tti Dori�Y) a confirmed ( ) be reversed.
THE SOU' 7s1'__ TOWN CLERK
DATE//2�/� _*.'_OUR /. /�f•�
erard P, oehri er, Chairman
GG: l Z NING BOARD OF APPEALS
FORM
To !nlerk, Cf Sou'hold
N
_ t v
Page 2
Appeal No. 2928 - Peter S. Terranova
Decision Rendered December 17 , 1981
By this appeal, applicant seeks approval of the construction
of decks/walkways along the easterly, northerly and southerly
yard areas attached to the existing one-family, one-story dwell-
ing. The deck/walkway along the northerly and easterly yard
areas would be constructed at or over the property lines, and
approximately 48 feet from the southerly property line.
The subject premises is a corner lot as defined by Section
100-13 of the zoning code and contains a total area of approxi-
mately 4 ,600 square feet of which approximately 917 square feet
are occupied by the dwelling and approximately 407 square feet
for proposed deck area. The maximum-permitted lot coverage for
residential parcels is 20% of the total lot, or in this case
920 square feet.
It is the feeling of the board that the location of this
project as applied for is substantial in relation to the code
requirements and that this location is not appropriate or
feasible in light of the closeness of the dwelling to this
intersection and the board is concerned with safety for all.
Applicant in his appeal has set forth the reasons for
locating the decks/walkways as applied for rather than in the
rearyard or the easterly yard area.
Members of the board have visited the site and are familiar
with the structures located thereon, including the deck applied
for herein which is constructed, as well as the terrain, imme-
diately adjacent properties and their structures, and private
road accessibilities.
In considering this appeal, the board finds and determines
that a detriment to adjoining properties will be created if the
variance is granted as applied for, that a substantial change in
the character of the neighborhood will be produced, that the
relief as requested will not be in harmony with and promote the
general purposes of the zoning code; however the board finds that
applicant is able to utilize decks/walkways at the rear of the
house and considers a 407 square-foot area, which applicant states
is needed , to be practical if located at the rear of existing
dwelling.
On motion by Mr. Grigonis, seconded by Mr. Doyen, it was
RESOLVED, that the application of Peter S. Terranova, Appeal
No. 2928 , be GRANTED SUBJECT TO THE FOLLOWING CONDITIONS :
1. That a 407-square-foot rear deck is permitted only in
the rearyard (southerly) area -- not to encroach past the west
side of the existing house;
2 . That the deck addition never be enclosed or used for
habitable (living) area;
3 . Suffolk County Planning Commission referral pursuant to
Sections 1323 , et seq, of the Suffolk County Charter.
Location of Property: 1170 Huntington Boulevard (a/k/a 565
Sound Avenue) , Peconic , NY; County Tax Map Parcel No. 1000-67-2-1.
Vote of the Board: Ayes : Messrs. Grigonis , Doyen, Douglass,
Goehringer and Sawicki.
Q
05�FF0(k�o
Southold Town Board of Appeals
MAIN ROAD - STATE ROAD 25 SOUTHOLD L.I., .Y. 7971 TELEPHONE
ACTION OF THE ZONING BOARD OF APPEALS
Appeal No. 2983
Application Dated May 4 , 1982
TO: [Appellant (s) ]
Mr . Peter S. Terranova
P.O. Box 77
Peconic , NY 11958 -
At a Meeting of the Zoning Board of Appeals held on May 26 , 1982
the above appeal was considered , and the action indicated below was taken
on your
[ ] Request for Variance Due to Lack of Access to Property
New York Town Law, Section 280-a
[ ] Request for Special Exception under the Zoning Ordinance
Article , Section
[X ] Request for Variance to the Zoning Ordinance
Article III , Section 100-31 and 100-34
[ ] Request for
Public Hearing held May 26 , 1982 : Upon application of Peter S. Terranova,
Box 77, Peconic , NY for a Variance to the Zoning Ordinance , Article III,
Sections 100-31 and 100-34 for permission to construct deck with insuffi-
cient yard setbacks and exceeding the maximum-permitted lot coverage require-
ment at 565 Sound View Avenue (a/k/a 1170 Huntington Boulevard) , Peconic,
NY; Peconic Shores Subdivision Filed Map Nos. 117 and 654 , Part of Lot #12 ;
and further identified as County Tax Map Parcel No. 1000-67-2-1 .
The board made the following findings and determination:
By this appeal, appellant seeks permission to construct
a 5 ' by 2016" extension to the existing deck reducing the
rearyard setback by five feet and requests approval of the
construction of a three-foot walkway along the westerly side
of the existing house.
The subject premises is a corner lot as defined by Sec-
tion 100-13 of the Zoning Code and contains a total area of
approximately 4 ,600 square feet of which approximately 917
square feet are occupied by the dwelling, exclusive of the
407 square-foot rear deck approved by this board on Decem-
ber 17 , 1981 and exclusive of any other construction (walkway)
existing at the present time. The maximum-permitted lot
coverage for residentially-zoned parcels is 20% of the total
lot, or in this case 920 square feet, for which appellant has
requested relief .
On December 17 , 1981 appellant was given conditional
approval by Appeal No. 2928 for the construction of a 407-
square-foot rear deck. The difference between the previous
appeal and the instant appeal is that applicant is not
requesting a walkway/deck along the yard area off Sound View
Avenue ; however , applicant has again requested permission to
retain the walkway along the westerly side at a width of three
feet rather than five feet, as well as the requested 5 ' extension
of the rear deck.
Members of the board have visited the site and are familiar
with the structure (s) located thereon, including the deck and
walkway which has been constructed, as well as the terrain,
(CONTINUED ON REVERSE SIDE HEREOF)
DATED: June t , 1982. CHAIRMAN, SOUTHOLD TOWN ZONING BOARD
OF APPEALS
Form ZB4 (rev. 12/81)
Page 2
Matter of Appeal No. 2983
Application of Peter S. Terranova
Decision Rendered May 26 , 1982
immediately adjacent properties and their structures , and private
road accessibilities.
Applicant in his appeal has set forth the reasons for
locating the deck and walkway as applied for rather than in
an area which may be more feasible.
It is the feeling of the board that the location of the
proposed 5 ' by 20 ' 6" deck extension in the rearyard is reason-
able under the circumstances ; however it is also the feeling
of the board that the walkway extension along the westerly
side of the dwelling is not practical and is not feasible in
light of the closeness of the dwelling to this road intersec-
tion. The board is concerned with safety for all.
In considering this appeal , the board finds and determines
that a detriment to adjoining properites will be created if the
variance is granted as applied for, that a substantial change in
the character of the neighborhood will be produced, that the
relief as requested will not be in harmony with nor promote the
general purposes of the zoning code; and that the interests of
justice will best be served by denying the walkway along the
west side, but conditionally approving the 5 ' by 2016 " extension
of the deck into the rearyard area.
On motion by Mr . Douglass , seconded by Mr. Grigonis, it was
R VED, that the application of Peter S. Terranova, Appeal
No,. 2983 be ONDITIONALLY APPROVED AS FOLLOWS:
(1) That only the 5 ' by 20 '6 " rear deck is permitted and
same shall not exceed past the west side of the house;
(2) No side deck (crosswalk or walkway) is permitted along
the west side of the house;
(3) That the deck addition never be enclosed or used for
habitable (living) area.
Location of Property: 1170 Huntington Boulevard (a/k/a 565
Sound View Avenue) , Peconic, NY; County Tax Map Parcel No. 1000-67-
2-1.
Vote of the Board : Ayes : Messrs. Goehringer, Grigonis ,
Doyen, Douglass and Sawicki. This resolution was unanimously
adopted.
APPROVED
CNIr an card of AD�eals
r ' �ti ,D AND FILED BY
lt:si SGUTHOLD TOWN CLEPUV
s G/�2/�� HOUR 9,'/531.A,,
1 own
� T rri"rn o old
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
. . ., /T E7L/.:�7 G5-180?
Examined /4//�, 1�� Application . . . . . . . . . . . .
Approved 7j14. P
Disapproved a/c._&�/ . X?�_<y . . . .
•(Building Inspector) . . . . • •
�/ < a APPLICATION FOR BUILDING PERMIT ee
iNSTRUCCIONS
a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi
Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Pl,,t flan showing location of lot and of buildings on premises, relationship to adjoining premises or public stye,
.11 areas, and givu:g a detailed description of layout of property must be drawn on the diagram which is part of this apt
v�nn.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon apprc.at of this application, the Building Inspector will issue a Building Permit to the applicant. Such pern
shall be kept on the premises available for inspection throu-1110ut the work.
e. No building shall be occupied or used in ,+hole or in part for any purpose whatever until a Certificate of Occupan
sl:all have been granted by the Building inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe
The applicar t agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and
admit authorized inspectors on premises and in buildings for necessary inspecCons.
—fir,�`F• : �. ! . . . . . . . . .
(Signature of applicant, or name, if a corporation)
(Maili,tg address of applicant)
State whether applicant is owner, lessee, agent, arc'iitect, engineer, general contractor, electrician, plumber or build
4?'VH44. .o F. m.k/.✓ER . ?� .!`"�!Ps .�oR>�,���. s/o �e �e� . . . . . . . . . .
NaImc of owner of premises . .!! !:<L!' ti` G/i✓ , , A°i�
i . ,!f'. . . . . . . . . . . .9 /y�f. . . . . . . /gX *K 5 44 .. . . . . . . . . . . . . . . . .
(as on the tax roll or latest deed)
li applicant is a corporation, signature of duly authorized officer.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Name and title of corporate officer)
Builder's License No. .. . .��?�!!✓L ;j?/J, : .
Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . .
Electrician's License No. . . . . . ... . . . . . . . . . . . . . . .
Other Trade's License No. . . . . . . . . . . . . . . . . . . . . .
l . Location of land on which proposed work will be done. ..S,C Vp
�� v. . . . . . . . . . . . . . . . . ... H. . 6. . . . . V ..iL Fes. /CC'OAl/G , /•, .;��`�53. . . .
I-louse Number Street Hamlet
County Tax Map No. 1000 Section . . . .4.0/.7 . . . . . . . . Block . . . . . .!Z . . . . . . . . . Lot . . . . . . . . . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . .
(Name)
?. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . . . . . . . 0i�4`. . .r9.�'!! y . .DK!E�<. !.�!G. . . . . . . . . . . . . . :
. . . . . . . . . .
b. Intended use and occupancy . . . . . . . . . . . . . . . . SAyN, , , .Y//d / q a Odd
6
iQEAR bt&k E'xffw$1A,v
i:e;:ar n . . . . . . . . . . . . . . CKILi r '1'IorK f<A�✓ d�>il�ifif
(Description)
. . . (i0
If dwelling, number of dwelling units . . . . . ./ . . . . . . . Nun16Cr of dwelling units on each floor . . . . . . . . . . . . . . . .
If garage, number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If business, commercial or mixed occupancy, specify na turc and e%tenr of each type of use . . . . . . . . . . . . . . . . . . . . .
Dunensions of existing structures, if any: Front . . . . . . . . . . . . . . . Rear Depth . . . . . . . . . . . . . . .
lleigttt . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dimensions of same structure with alterations or additions: Front Pear . . . . . . . . . . . . . . . . . .
. . . . . . .. . . . . Height w
g ht . . . . . . . . . . . . . . . . . . . . . Nnber of Stories . . . . . . . . . . . . . . . . . . . . . .
D pth . . . . . . . . .
i. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . .
116Z,ht . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
J. Size of lot: Front . . .... . . . . . . : . .. . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . .�. Depth
Ns . . . . . . . . . .
Date of Purchase . .?lr,4y .!�� ./.�� /. . . . . . . . . . . me of Fortier OwncrqP34rN. ?! ;411Aiw!.y. �/y>A/¢.�• ,
Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Does proposed construction violate any zoning law, ordinance or ie^ulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
+. Will lot be regraded . . . . . . . . . Will excess fill be removed from premises: Yes No
1. Name of Owner of p inKAef.t�i?✓4 «' . . Add ress%1W-`,04cA4. #*f✓E•. Phone No 46'7.bs 368•'. •
Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . !� �. ?W—%/i Rl`hone No. . . . .. .
. . . . . . . . . . . . . .
Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . .
PLOT DIAGRAM
Locate dearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from
-operty lines. Give street and block number or description according to deed, and show street names and indicate whether
terio: or corner lot.
X77tt � � ED
:. fF OF NEW YORK,
C ` fy' OF .$.kff°LK. . . . .
S.S
E��i4. . S,.T RRfj No ✓f�. . . . . . . . . . . . . being dul•: sworn, deposes and sayi that he is the applicant
(Name of individual signing contract)
n;riled.
the . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..07 (0 T. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Contr,etor, agent, corporate officer, etc.)
rn.vrer or o•A=s, and is duly authorized to perform or have performed the saw ''work and to male and file this
al 'n; that ail statements contained in this application are trrn' to the hest of his Knowledge and belief; and that the
S, l e nerfonmd in the nnanner set forth in the appli.ation filed therewith.
In to before me this
�yJo. • t�i. . . . . .day of . . . . /// . . . . . .1 19
rury Public• . . . . . County.me
/l
PUBLIC. Sore or NA YMR fJ�. . . . . .. /.�. . . . . F�/1.� . . . . . .
No. S2.8125850. Su1Potk Corti/ (5i"n�tUrc. or applicant)
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