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" to 4 °Ye, tread .: � ty- + , toy-k dopa earth roof rite a' 3a Ca6b,:.' 414-. JD ROM -'I - 5j — _ .Y, ceiling - si a t}lat�a _ I' I V Iar� ua A pear In LLL I — } - --m _ .—J L-$ _ ` Foa �- — -- — (312'r��! I� ` \� 2 ) I II I xreaIc ua' ttii0 , �� ---- -tL i•Ysa £aeczi � oar Plow M NR fE V�Pl 5 ru- r tF 'f ✓ 4� EAIE WAU TO g wf= F4*1' l ! �I) I l N ?' � '. vinyl ox Wood so fEi t Vitt* u , i GZ'JIN"r'I .I}- _ � soffit vents pie q 9e*rod' "r M� NAT�DY o ('ADE. - � ;�' I 1 � ovorhang as in�iaA,,,�ed 41 C 6or'' �vt, WAus � co% 10/10 Y' p , _ r, d— �qln ' J � � j N f p qll - a -�I . ' coPi = ix4z is erigr � � P � tt� �� 'xYE!eumlxal�nb� I .". `�,i', �pM � _PC I r � U N ` !`'p. � ) 1 ��� '` - 11 TYN$C74E E�, - ,,�'�. II,p+ I _ e il.l C _ � _ F �, Idyl N C� 2:s ye e Axl deal �., — — - .. Ia�ua#r�Wm eermlmtGatrza7�' I l49n,IwAt4�aachor oiplts F2 !'. f°VD � QR c '1' �I 11i 1/4',,9' l.�n. . I _�<:, �I -�a, iIF-- - oac Qfxaa9a1kaQ3nrn fir; '►� _.T - -__ - - - - — - - I- --- n' - -� - - ( I a# ^} `N' I 1-- 'ad ca �r� . <n a : _ I v Pte# U Nra / -10 - _ a I� I , ' --- -- "-v1 J , t -- - - - -- _ i� „ f -jr -- - ------------ - - -- - i L11111 ------------- io � D - - - 1 y `ofp of F). 1 tJ ! _ 1 I L H17 - 2G^�10ILI- 2P,g1© — _ Ll Pia iy .fir* " i, FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26208 Date: 01/12/99 THIS CERTIFIES that the building NEW DWELLING Location of Property: 1275 EVERGREEN DR CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 102 Block 1 Lot 4.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 17, 1998 pursuant to which Building Permit No. 25071-Z dated JULY 30, 1998 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 TWO CAR GARAGE, FRONT COVERED PORCH, & REAR DECK AS APPLIED FOR. The certificate is issued to KATHLEEN M SANTORO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R-10-98-0087 01/08/99 ELECTRICAL CERTIFICATE NO. 24396 12/16/98 PLUMBERS CERTIFICATION DATED 12/07/98 HI-TECH PLUMBING BuildjX Inspecto Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD 70 BUILDING DEPARTMENT TOWN 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 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. 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - .251Z. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date d /� New Construction. . . . .. . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . Location of Property. . . . . .keit/ . . . . . . . . . . . .< </ ac tle?frc9 ... . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . . . l�h �. 1�. . . ( e��n� ��... . . . . . . . . . . . . . . . . . . . . �JUrf.G?U. County Tax Map No 1000, Section. . . i .�.E::'. . . . .Block. . . . {��!�!. . . . . .Lot. . . . . . . . . . Subdivision. Fi//d Map. g�/7. .Lot. . . . ._5 . . . . . . . . . . . Permit No. . . s�:c .'. . . . .Date Of Permit. . . . ? .l. . . . 7/ f � .Applicant. lisy (S . ,c•t//.�+c-r?ii;; . J(�-�'. Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. .y. . . . . . . . Fee Submitted: $ . . . . . . . I . . . . . . . . I . . . . . . . . . . . . c _ 556_5g/ . . . �.'. . . . . co -•' PLIC 71 Town Hall, 53095 Main Road Z w _ - Fax (516) 765.1823 P. 0. Boz 1179 �+p Telephone (516) 765-!802 Southold, New York 11971 a y ® 0! c�Ol OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: 7 Y Building Permit No . 4so 7i Owner: �-A-7(*.E-+r'. !;:/,) (please print) P lumber : j1 - / Lpq PL-al4l ie //11 - (please print) III I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. 74 (Plumb rs Signzture) .�iw Cil, �� ✓CSV=C IIlC t�a�� day of 19 �7 Notary Public , Countv ROS, ?_!? ^nor+en4E pf PJew York Oualiffed in Cuflolk Counly�" Ccmmi 60nExvuwianuary3l Ut17ar ELECTRICAL INSPECTION SERVICE INC. 375 DUNTONA VENUE EAST PATCHOGUE,NEW YORK 11772 (516) 286-6642 24396 DATE: 12/16/951 APPLICATION No.ON FILE HLLAGE. CulchoRue TORN. Southold ADDRESS: Lot#3 F'yer=en Drive ISSUED TO: Zoumas Homes INTRODUCFD BY: De Lane Electric Inc. LIC No: 4354-E was examined on 12-16-98 and found to be in compliance with the National Electrical Code LOCATION: Base.. x Ist x 2nd x 3rd Attic x Det.Garage Hot Tub Pool SWITCHES RECEPTACLES FIXTURES HEATERS FANS G.F.I. AIR.COND. 31 53 31 3 5 DISHWASHER DRYER CLOTHES WASH. GAR.DISP. RANGE OCEN SMOKEDETECTOR 1 30amp 20amp 40amp 6 FURNACE OIL GAS CIR. MOTORS BELL MN. SERCICEDISCONNECT 3F 1 METER AADS PHASE 1 200 UG 0771ER EQUIPMENT Outside,Res. 1-20amp whirlpool 1-20am water pump 1-hood HUGO S. SURDI PRESIDENT BUILDING PERIYIIT No. �ma�a�=must�mneen�+N�rme hupwd ina,beidamLed by War ae bal BIAJE ORIGINAL YELLOW(COPY PINK COPY OFFICE FORM NO. 3 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) PERMIT NO. 25071 Z Date JULY 30, 1998 Permission is hereby granted to: KATHLEEN M SANTORO 1275 EVERGREEN DRIVE CUTCHOGUE,NY 11935 for CONSTRUCTION OF A NEW SINGLE FAMILY DWELLING WITH ATTACHED TWO CAR GARAGE, FRONT PORCH AND REAR DECK AS APPLIED FOR. at premises located at 1275 EVERGREEN DR CUTCHOGUE County Tax Map No. 473889 Section 102 Block 0001 Lot No. 004 . 003 pursuant to application dated JUNE 17 1998 and approved by the Building Inspector. Fee $ 784 .40 Application Fee + 75.00 859.40 Building Inspect 5e ORIGINAL Rev. 2/19/98 765-1802 BUILDING DEPT. xNS�'ECTION [�/] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS% DATE / INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [Vf FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ( ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: M�,PRAMM wr f" FRAMING UNTIL SURVEY OF FOUNDATION LOCATION NAS BEEN ePPROVEn DATE gg/;?-O B INSPECTOR x M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ROUGH PLBG. [ ] 7UNDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: -� `✓�'��`'�d�` �J DATE 10 /`� fre INSPECTOR �// M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] UGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRyMING [ ] FINAL [FIREPLACE A CHIMNEY -dam REMARKS: 6C 4 l s > DATEP��-INSPE t M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 LATION [ ] FRAMING FINAL [ ] FIREPLACE CHIMNEY DATE d" INSPECTOR �- �`7 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSPLATION [ ] FRAMING [ FINAL [ ] FIREPLACES CHIMNEY REMARKS: O. DATE 0 INSPECTOR �� • IIi It�'Z'��/»�� i'�1 /����/moi/ %----- ���✓/� s y-- r - • a o�OgOFF04 O -12 Gym Town Hall,53095 Main Road W M Fax(516)765-1823 P.O. Box 1179 • �� Telephone(516)765-1802 Southold,New York 11971 BUILDING DEPARTMENT TOWN OF SOUTHOLD STOP WORK ORDER TO: Zoumas Construction 18 Deerfield Drive Wading River, New York 11792 YOU ARE HEREBY NOTIFIED TO SUSPEND ALL WORK AT: �`% 1275 Evergreen Drive, Cutchoque TAX MAP NUMBER -1000-102-1-4 . 3 Pursuant to Section 45-8 of the Code of the Town of Southold, New York, you are notified to immediately suspend all work and building activities until this order has been rescinded BASIS OF STOP WORK ORDER: Under construction foundation does not have required 20 ft. set back side yard.CONDITIONS UNDER WHICH WORK MAY BE RESUMED: When side yard set backs are met or Z.B.A. Variance. Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by fine or imprisonment or both. DATED: August 19, 1998 /v/ LOT AREA 40 ,296 SOFT F,F.ELEV � I,° C'AR . ELEV -9.3rA NOW OR FORMERLY BI DWELL VACL\INT fd. pIpe S . .37041 30 " E . 13500' Ow ((o4cr) n rn U) m 0 O 1 O O C cm N u OC < G w >_ O q/• I o I 0 b II o o — 120'" p — SO" — N W 3 z PRpP _ = w W L5' iiGINL f . p Z 0 I _k— a > o —5 \ y' N SPIXL. .11V F482N7 O Ln Ln ti re° ''T Z R= 2 LEASE NOTE i r6ca �5 L=3 7.d . "pimu distance between welt pipe CoA i r��r.L YA4eo and rest N. 37046' 00"W. 110.00 bo,)) (zop) EVERGREEN (76—S) DRIVE I cwitl. wiG.E..i I nl REAk vi>cc>+>iT dF T�'ZOPECTi JOB NO. 98-271 FILE NO.THE WOODSC CUTCvtAjt Mc OH'GETS (09 DIMEN$IIINS) 60AkAN1EES INDICATED Htiek(M HOWN HEREON FROM THE EEWLL RUN ONLY TO THE HLRSLW SURVEYED FOR .TRUCTURES TO THE PROPERTY FOR WHOM THE SU"Y Is NIE- IINES ARE FOR A SPECRIC PUR- PARED. AND ON HIS NhALF TO LOT NUMBER 3 - OSE AND USE AND THEREFOR: THE TITLE COMPANY. G ,AE NIRN- ,giOTaa oFFiNCES,, RITA NWc iulON E0.71D 4AN, Rt%ira,Il AND O MAP OF THE WOODS AT CUTCHOGUE /JAILS, PODS, PATTOS UATING THEASS;G;IK' .F "FfE LENDING 4REAS, ADDITION TO BUILDINGS INS-i ITUTION. OUACA.NTEFS ART �R ANY OTHER toNSTRucnON. NOT TPAN:r=Ps, i e TO Arnmow„ SITUATED AT C U T C H OG U E INSTITUTIONS OR SUBSEQUENT JNAUTHORaF* ALTERATION OR OWNERS. TOWN of SO U T H O L D , SUFFOLK COUNTY ,N Y, :DcRKYN m THLS SURVFY i5 A 'I O,ATxMR OF SECTION T OF , COPIES OF THIS SURVEY MAP NOT HE NSW YORK STATE EDUCAtON BEARING THE LANb SURVEYOR'S SCALE 1" = 50' DATE 5 - 27 - 1998 AM'. INKED SEAL OR M 1105RO SEAL - __---1HAL1 NOT BE cxml FILED MAP NO. 8717 DATE 3 - 23 - 1989 GUARANTEED ONLY T'O , O W ' ' 1�'S� 1'O,P TAX MAP NO. 1000-102 - 1 - 4.3 (REF. ONLY) DISK184 . 5 � tRgryC Q" ��IrJ - IJG vo yo HAROLD F. TRANCHON JR. P.C. O .,ys}iFR. 2 LAND SURVEYOR Im 6!1 -----'� '7r - � 1866 WADING RIVER-MANOR RD. WADING RIVER, 14^1-... ���/`''- a�/JRN� S�Q 048992 , 0 NEW YORK, 11792 HAROLD F. TRANCHON JR. PENN 5516-929-4695 L E LOT AREA 40 ,296 SO. FT 98, 446 FF.ELEV GAR. ELEV L. 19 , NOW OR FORMERLY BI DWELL V"� 1d. pi p¢ S. .37°41 ' 30 " E . 135.00' �4 X191 m en 0 fAl D O — 120'± div` — 50' — N LLJC co 7 � Q Z —50,5' > 074• W FOU NO ATIO N Or 4 Z � N — ibq V > J � o N N C6SSPoc�- L M � �� ,eo •�- z R- 25.00' L= 39,2 �' 1d . pipe /011) N. 37046' 00"W. 1 10.00' EVERGREEN DRIVE 8 - 17— 1998 FOUNDATION LOCATION JOB NO. 98 -271 FILE NO.THE WOODS(4 CUTCHOGUE 9 elt'H1 V SURVEYED FOR LOT NUMBER 3 ado?/ MAP OF THE WOODS AT CUTCHOGUE SITUATED AT CUTCHOGUE TOWN OF SOUTH OLD , SUFFOLK COUNTY ,N -Y . SCALE 1•• = 50' DATE 5 - 27 - 1 9 9 8 F' N FILED MAP NO. g7 1 7 DATE 3 23 - 1989 GUARANTEED ONLY TO qP O 5 OF, -1RAIyO,y R�• TAX MAP NO. 1000-102 - 1 • 4. 3 (REF. ONLY) DISK184 i O" 02 HAROLD F. TRANCHON JR. P.C. _ ..,;•+:;,+,ryzy ' LAND SURVEYOR �O' iRg992 ,OA 1866 WADING RIVER- MANOR RD. WADING RIVER, ti SupJ� NEW YORK, 11792 • (( t•. T +• 048992 516-929-469 5 ottt�s l LOT. AREA 40 ,296 SOFT . NOTE: CESSPOOL, SEPTIC TANK AND WELL 98. 445 LOCATION BY OTHERS. 98 -619 NOW OR FORMERLY BI DWELL VAC/-\NT fd. pipe S. .37°41 ' 30 "E . 135.00' N In U) r. 0 N N W "L tt �bCJ WOII0 v ) r • / — 50 2 3 3 V . z 4- cwAtmovow- WO ZW O ridA 0 � p > JTN o N m z ^ R. 2 5.00' L= 9.2 7' Id . I pipe N. 370 46'00"W. 110.00 EVERGREEN DRIVE 11 - 18 - 1998 FINAL SURVEY 8-17-- 1998 FOUNDATION LOCATION OEE Ts i % _, JOB NO. 98-271 FILE NO.THE WOODSC CUTCHOGUE b:.,. N TO TIC EERSB- �Jc vers .cr ,y, a r F SURVEY IS PRE SURVEYED FOR ? }HS edHAII` TC eovEUNrusN LOT NUMBER 3 srr INE INSTI Cl;• '.'91014, ANO TO T TOE _ENDING MAP OF THE WOODS AT CUTCHOGUE ,.JARANTEES ARE - - KdAIlU TO ADDITIONAL li,:)7U OR SUBSEQUENT SITUATED AT CUTCHOGUE o• s-'+_rior. OONE a TEM 3uraY M Nor TOWN OF SO U T H O L D , SUFFOLK COUNTY ,N Y. HE NEW YORK STATE EDUCATION BEARING THE LAND SURVEYOR'S Aw. INKED SEAL OR BMOOMW SEAL SCALE 1" = 50• DATE 5 - 27 - 1998 Ix CONSIDM TO K r�Y FILED MAP NO. 8717 DATE 3 - 23 - 1989 GUARANTEED O 1$ 1F Q^.----�� �Fa "M TAX MAP NO. 100 0-102 - 1 - 4.3 (REF. ONLY) DISK184 r rt, HAROLD F. TRANCHON JR. P.C. LAND SURVEYOR �40, �"p ✓0 04 Y`2 �p 1866 WADING RIVER—MANOR RD. WADING RIVER, LAND SNEW YORK, 11792 HAROLD F. TRANCHON V LIC. NO. 048992 PENN. LIC. NO. 21115-E 516-929-4695 f717 /7 FFO(K G't� y 2 Town Hall, 53095 Main Road p try e ;{ Fax (516) 765-1823 P, 0 Box 1179New York 11971 � � Telephone (516) 765-1802 Southold, N OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD STOP WORK ORDER TO: YOU ARE HE EBY NOTIFIED TO SUSPEND ALL ?'RKT: i TAX MAP NUMBE2— Pursuant Pursuant to Section 8 of he Code of the Town of Southold, New York, you are notif ' ed t immediately suspend all work and building activities unti � t � s order has been rescinded BAS OF STOP WORK ORD CONDI IO S UNDER ICf WORK MAY B RESUMED: Failure to medy the conditions aforesaid and to comply with the applicable rovisions of law may constitute an offense punishable by fine o imprisonment or both. DATED: � O BOARD OF PLANTS . . . • . . . . . . . . . . . FORM NO. I 3 SB78 OF PLANS . . 7 TOWN OF SOUTHOLD SURVEY . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . TCM OF BlDO DEPT SOUTHOLD, N.Y. 11971 TEL: 765-1892 NOTIFY: c� (V Exanined..J/ 3Q .�U, 19.... 1 MAIL TO: . . . . . . . . . . . . . . . . . . . . A111)TgVEKI. ,. . I. ZOUMA&CONTRACTING CORP... .. 18 DeWeld DrW 19.... Pena 1: tIo Disap{nnrvce a/c .... ... ............ `i � � `"" ""Wadfrig River,NY 11792 (building Inspector) LICATION FOR BUILDING PERMIT Date. . . p. . . . . . . . , 19 g�. T NS'I'RucT i ONS a. 'nubs application must be curpletely filled in by typewriter or in ink and submitted to the Building Tnspector wd 3 seta of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings an premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property mist be dram on the diagram which is part of this application. c. 'nue work covered by this application ray not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building inspector wilt issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection througimt 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. AMACNrTON IS IICREBY M6M to the Building Department for Uwe issuance of a Building Permit pursuant to the Building Zone Ordinance of the Tom of Southold, Suffolk County, New York, and other applicable Iaws, 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„mud to admit authorized inspectors on premises and in building for necessary Inspection. (Signature of applicant, or name, if a corporation) R.. a...��i.��..w�o�,� (Nailing address of applicant) IA1•Y. /f79Z State whedwr a licant is owner, leasee, agent, architect, engineer, general contractor, electrician, pltrdner or Imilde .............. .It.l.!-0.2..... ....................................... ......................................... Name of owner of premises .... ....�6!7.V ....................................... (as on the tax roll or latest deed) if applicant is corpo ' , signature of duly authorized officer. IEI (Pare aril tit a of .....corporate officer) --- r-�ONN ZOUMA--'- u/Ce Builders License No. ......................... _-.._..- Pludbers license No. ....... ��2Q..P........ Electricians License No. ... ?.-7..J�....... Other Trade's License No. .................... I. Incation of land on which proposed work will be done.............................................................. .............I......................(QfR �... 9V.(..........Cu.T(rA(Z&ct ......................... Ibuse limber Street lismlet County Tax Map No. 1000 Section ......i.0 Z_. Block ......f.....r.... Lot ..... .�..... subdivision � Q O _;j'�er_1.uooAs.�->: cyk �v Filed Map No. lot ...�......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. rxiating use and occupancy ..................................................-........................... b. Intended use and occupancy ............................................................................. ci 3. Wuure of work (dheckuiiidu applicable). Neu lluilding ...h...... Addition Ceration I ;.:.. . Repair Removal ............. Demolition Other Ikb tc:' ... ..:. ....... intiml 4. Eatinoted Cost L D:QO©............ fee ........ J930.pAJR (to be paid ah filing this application) S. If (k+elling, mailer of duelling unite ............ Iisiber of dwelling unite on each floor .......... ... ... ifgarage, nxmm,er of care ...................................... A. specify nature and extent of each type of use..... ................. 7. Ulu "a,o 'ex iat�t g arictures, if any: Front................ Rear Ilaiglht ......................... liaber of Stories ...................... Dinensiohs of sane structure with alterations or additions: Front ............... Rear ............... I)epth .................... llelglit .................... Rxiber of Stories ..... R. Diuenniaha of entire new construction: Front ... y./.... Itear .... ��/.Y,.. Depth i lieight ........ ........ Naber of Stories ..... ..A............ 9. Size of lot:: Fra,t ..../3pp�®®........... Rear ...:1.-!?../........... Depth ...0?.9/.q ..... ..... ib. Ikile of Purtimse ..........L RS....... Name of Fortier Ozer ........................... If. Zone or use district in xbidh premises are situated .............................................................. 12. Ones proposed construction violate arty zoning lar, ordinance or regulation. ........................ B. Will lot be regraded ............... Will as fill lie removed from premises: YES NO 15114-Aa,O r v�nrrA&4^'.Y- 14. Nares of Owner of preit a ..... 4! 1�.S . .... Address .X43.M/�ta t�4 N fi Aha No. .7165 :d�/!/ pp p� p N.y, �J Nape of Ardhl[ecC .. 7....J.D.Q.I:! ........... Address .P.o.T?r.,2°i g5.1-4M.�E�!BS//Mq%one No. 3.y /� L WlAOI N` JPA,N-4 Nixie of Contractor ...ZPS�J.'A/6-�.6.'V.Tst?�r.(... Akdreas .J.$...QE �•.FCFF?.Ul?iv¢..P{...Iihone No. /,d9-�lS7b 15. Is this property vithin 300 feet,of a tical wetland? * YES .......... No .......... *1F YES, SMUD MM TIMEMS S PERMIT MAY BE RG(XIIRFD. PLOT DIAGRAM - locate clearly and distinctly all buildings, ulbether existing or proposed, and indicate all set-back dimensions frrn, property lines. Give street and block number or descriprion according to deed, and show street narea arxl inlicate hAheiiher interior or corner lot. \ 7-r{ 4 9r L4 , A5� e /In . 0jG � SI'niti (M' N}! Y(MtK, EUEeGaEE� Ptzl�F SS (IM)NIY (Mr .... .�c?C..li.... ....IF SO"� .......o�?r??.L� ...............being duly sworn, delx,ses soil says Clint be is the applicant (Mme of ioilivikkaul. signinga chtract) above oined, Ile is [lie ....W...N7AC7o�..fa1!0,CPnegyl! o ��e„ (cAxhtractor, agent,-corporate officer, etc.) of said ummr or owners, soil In duly authorized to perform or hrrve perfon,ed the said work arxl Lo mmke and file this applicaLiou; that all staLenents contained in this npplicatian are trice to the beat of his knwledge and belief; anti (hat. the wrk will be performed In the manner set forth in the application filed therewith. .worn to before me this g /.�......illy �o7f� ,7/..........19..rCll! Notary Mille .224., ••:••�••. a STEPHEN G.REMUZZI,JR (sign of nppl*cn LLIITARY PlIBl1C,81tY a lMw Yak 1 IM amw in91/s1lCangr Cmadat MsEVIMAdy31, 2