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Home My WebLink About23858-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24871 Date JANUARY 29, 1997 THIS CERTIFIES that the building ADDITIONS Location of Property 1895 LEETON DRIVE SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 58 Block 2 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 26, 1996 pursuant to which Building Permit No. 23858-Z dated DECEMBER 11, 1996 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 DECK ADDITIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR "AS BUILT" The certificate is issued to ARTHUR E. & GLORIA FUSS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A uil ing nspector Rev. 1/81 FORM NO. f 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° 23858 Date ./C-2. .. ........................................ 40OC315-, Permission is hereb, grant d to:............ .....l..... ..�.. ...... .....�...:! /�G ..�.Q... . . .../.,1.. /.... ........... . ........... ...c .. . .��.. ,1..� to . ... .e4 ..... 1.- -...... 1...._ ..��n: .......... ..... .�-t-� .....o.......��... .. ..... ..... .. ..... . .� ................................................ at premises located at . ..7.4�..... � �. ... '..... Gl' .......................................................... .............................................. . .... .�"G•`'`f •� . � ........................................................ ................................................................................................................................................................. County Tax Map No. 1000 Section .....Jh....�........ Block ......��.................. Lot No. Zo............... pursuant to application dated .... ... ..........................................I 19VAC?, and approved by the Building Inspector. Fee $... . .... ... .1....... ....................... Bu'��ng Inspector Rev. 6/30/80 b Form No. 6 • TOWN OF SOUTHOLD , 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 l% 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, 1.957) 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 - .25C. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 / Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construct-ion. . . . . . . . . . . Old Or Prey-exi tinrilding. . . . . . . . . . . . . . . . . Locationof Property. . . . A_�l . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House No. �SSttreet Hamlet Onwer or Owners of Property. . . . . . . . . . . . . . . !. .`: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . . 5—*- . . .Block. . . :. . . . . . . . . . . .Lot. . . !� .... . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filled Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. .,:3.Evf. .Date Of Permit. . .��//„(,91�'. .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . ... . . Health Dept. Approval. . . . . . . . . .r><�. . . . . . . . . .Underwriters Approval . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . .��. . . . . . . . . . . . . Request for. Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICANT Co� �g71 cm N Z Town Hall,53095 Main Road 0 • Fax (516)765-1823 P.'0. Box 1179 y �� Telephone (516) 765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD FAX COVER LETTER DATE: March 3, 1997 TO: Robin Levinbook FROM: Georgia Rudder, Southold Town Building Dept. RE: William Steal - Premises @1895 Leeton Dr. Southold,NY TOTAL NUMBER OF PAGES INCLUDING THIS ONE - 2 If all are not received, please contact the above at 765-1802 . y� 0 h Z Town Hall, 53095 Main Road p • Fax (516)765-1823 P. O. Box 1179 y� 0� Telephone (516)765-1802 Southold, New York 11971 OFFICE OF THE BUILDING'INSPECTOR TOWN OF SOUTHOLD Re: Premises @ 1895 Leeton Dr. , Southold, N.Y. Suff. Co. Tax Map #1000-58-2-10 To Whom It May Concern: Please be advised that building permit #4351 issued for the above premises expired and was voided. On December. 11, 1996 a new building permit was issued under Building Permit #23858-Z for deck additions to existing one family dwelling as applied for "as built" . Building permit #4351Z was incorporated into this permit, and a Certificate of Occupancy Z-24871 was issued on 1/29/97 . If you have any questions, please do not hesitate to contact this office. Sincerely yours, SOU HOLD TOWN BUILDING DEPT. Gar/y/131", . ish, Building Inspector GJF:gar ) _ THE NEW YORK BOARD .,•OF - FIRE UNDERWRITERS PAGE 1 7 BUREAU OF ELECTRICITY "I(—�"h:7 ''' "8S JO'HN`STREET, NEW YORK, NY 10038 Date Ak1jGUST 1.4,199 7 Application No.on file 13889897/9% N 428578 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of WIT:,Lfr\\?�`zT� R!' STELE, 189 5 LEFT ON DR1 t1 E., SI;3UTH0LD, N.-f in the following location; ❑ Basement ® Ist FL 0 2nd Ft. OUT Section Block Lot was examined on AUGUST 11,1997 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES. SWITCHES FIXTURES RANGES' COOKING DECKS " OVENS DISHWASHERS EXHAUST FANS OUTLETSINCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS AMT. K.W. OIL M.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. SYSTEMS NO.OF FEET AMT. WATTS SERVICE DISCONNECT . NO.OF - S. E R V I C E MAT. AMP TYPE METER L 0 7W 1..3W 3 0 3W 3 A'IW NO.OF CC COND. � 'A.W.G. NO.OF HI-LEG A.W.G. NO.OF NEUTRALS A.W.G. IF. PER 0 OF CC.COND. OF HIAEG OF NEUTRAL OTHER APPARATUS: 6d ML FTM P--I PADDLE FANS-4 G.F X.r:-2 SHOKE DETECTOR;—2 L L `l'HONA,S J. GA—TAM LIC,#24.904 B07. 39 lUj,gADI 'F ONT) GENERAL MANAGER AQUEDYGUE, ITY, 119 31•-00 39 _ »5 Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR -BUILDING.DEPARTMENT. THIS COPY OF .CERTIFICATE -MUST NOT BE ALTERED IN ANY.MANNER. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [6j-`F`INAL [ ] FIREPLACE 8 CHIMNEY REMARKS• L- 41 a 0 a--, -'d �v67L//1 v'Y.aaoT �eLie� DATE INSPECTOR ,65.1802 BUILDING DEFT. 'SPECTION [ ] OUNDATION iST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE CHIMNEY REMARKS: DATE � � ' INSPECTOR 765-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 CATION [ j FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTO ,.rIrLD_INSPECTION—REPORT —A'r_E _____ COMMENTS__ ----_ I II II FOUNDATION _ u n � II i u , Nk, u it I II n -0IINDATI ON (2ND) u u u u II I, II I ROUGH FRAME & U PLUMING l �—u � u cn II � INSULATION PER N. Y. STATE ENERGY CODE u--;I If dF (o If u t i u I II II II FINAL II u II I � � ADDITIONAL COMMENTS:7-Zz&-- 4:�� _ /,7 � f i I � I v I O z I I I I BOARD OF III?nl.rN' . . . . . . . . . . . . . . . FORM NO. I _f Sl"I'S OF VI,AN S . . . . . . . . . . . . . . . TOWN OF SOUT1101.1) SURVEY . . . . . . . . . . . . . . . . _ HU1.I.U1NO I)EPAR'Tt•tliNT ( IIRC:R . . . . . . . . . . . . . . . . . . . . . . . . . TOWN IIAIA. SI;Y•1.1.0 FORM . . . . . . . . . . . . . . . . . . . SOU-1'11(11.1), N.Y. 11971 '1.1711:: 7 fi 5— 111U7_ NOT 11?Y (:nt.l. Deborah Doty 734-6648 l.x:mirxtd../. . ....., 19.!.� rin.11. 1'0: . . . . . . �� U Apprcrvc'cl....` , 19.1 1'ermil' NcJ. .... ..................... . .. ........... Oisnlyroved it/(. .................................. ............................. ..... ...................................................... (Ikri)dial; .to ) AP1'I.1CATION FOR IIlI1LI)1N(; ITI MIT Tate. Nov. 26 1{� 96 1 NSTRUC:TI ONS- a. )his ;111)1ical:i(xt trust 1)e coinlActely f:il.led in by IjIvtariter or io hk arxl sulitnilted to the IkdIdinp, inspector will) J svla of plan;, occurnLe plot. plan Lo scale. Fee according to sclledole. " b. ).'lot plait sltuwing locakicxt of lot arxl of: Ixtil.(Iinl;s rn) prunises, relal:icniship to :xljoininl; pic-nises or lxlblic stmels or areas, arxi giving a deLnil.ed descriptiot of layout of property must he drawn on the diagram c)1)i(1) is i)irl of Lhi s appl icaLioo. c. 'llle work covered by LhIs applAcciLicm my lxri: I)e eaanetx:ed 1)(JOre 1SSUan(:P of lklilding fertnit. d. Ulxnt lippromal of this applicoLion, Lite tktilding bispec.Lor wil.l. issue a Wilding Yennif Co the applicant. Such Ixtrmil' shall Ite kept: rnr the premises available for. inspection Lhroop)iOxJL the murk. e. Pk) bill Idiog Mull be occupied or used io whole or in.part. for any Ixirpose wl)at:ever until a Um-Lifi.cale of Occ."palwy shall. have lweo granted by the IkJildinl; 'Inspector,. AI't'I.I(;NI't(1N Ili 1EIi1�.l1Y tlnUG-Lo Ille IkAlding 1)eparinrnt for the issuance of a Iklilding Perini) ix)r scant to the Iklildhip, 7xn1e Ordionoc:e of Lite 'I'mro of Scx)tl)old, FAir-folk 0mrity, Nets York, atxl other applicable 1:)ws, Ordinaoces or Itegolat:iolm, .for UK-, colsLrrrcHrto of Ixri1diogn, :xldiliotis or :Jteralionn, or for r"noval or dentol10m, ns hvreio (kescrilx:d. 'Ihe apiiLicanC agrees to c(nq)ly with all. altiilicably laws, orditkmcen, Imildiog ccxte, lxx)sing code, :nxl regrll»lima, alxl to :xkuil: :nitlx)riz(cl inslxtclors o) pruldsen riml in Imilding for iiecesimry ivirpec,tio)n: Deborah Doty, as attorney for Gloria Fuss, Owner i (Sigtiolure of applicant, or vane, if n corlx)ral:toll) c/o Doty, PO Box 1181 , Cutchogue, NY 11935 .............................................:..... (fL7iLinl; address of al>lAicanl) SLat:e wlwlher niq)l icant is owner., lessee, agenL, architect, engirxper; gel>nral crn)lrnclor, eleclrir_ian, pluiber or lxli lcicr. .,,agent,.., ................................................................................. ........... ...... Mmict of owner of prcnnises .....Gloria,M.-fuss...................................................................... (as cm the fax roll. or InLest (leed) If alylicant is n corixmiLicm, sigINAUre of duly nuthorimi officer. ................ ......................................... Migne a1x1 title of: corixmite officer) W ilders I.icense No. ...........n/a.......... Pludmr s License No. ...........n/-ca.......... 1"slec:l:ricians I.Acense No. ............ Other TrixWs l..i.cense No. ......ri/a....... I. lAwatiou of larxl oil wl).ich pr,olx)nec) worl( will be (loop.............'.................. ..........:................... 1895 Leeton Drive, Southold, NY Ikx)r:e Pk>triwr ...........Street .............. ... ....................IL:n)let'........................... (kx)rtly Tax My No. IO(X) SmLiort' .058 ` Iflcx:k � ;•., I c)l: . 1� .... c;(rlxlivi.^.icn) ... t.lecl M. No. ............... l,ol ............... (Noss.) 2. Slate existing Lire arxl occttlk-ttxy of promises nd inLe.Wed use aril occuporxy of proltosed ecnislnmcl.ion: :). iixisLiiij, t)r;n :.lrxl (x:cul>u1x:y one-family residential... b. lntelxled use atxl OCCUIztrx:y .. same..._...._ ........... .................ii....1........................... �JS_ . )iy•f w ,I 9"vA�,i 7. Nililre of 1�)11( (cl$'!(:It %AIi(it 1114)1icIII)Ie Addition .. . ..... . . AlIevilt.ion . .... .. IG:lxllr Ilf-1lK;vfll .....:..'.: ... Ilk+1j)l i1.ioll ....:`:: oil% 'I- Ik)11( �ras,builtn ..... .. . . .. . .... . . (I)ewcripl:ioil) 4. Est illot e(I (;()sI.. ._.......n/.a.......... .. I'ee ....... .............. ..... ..... ........ .... . (to IX! Imid on fil it;l; 111in application)) 'i. III Iltx:l I inl;, )rulx:r of (hn:ll illg unil s . ). . . ..... .. thnlHer of Ihrel I inl; unit's (1xl encIl floor' .. . .. ...... .... . I` llnlal;e, imntH i of (::.u'll ........ . . ..... .. .. .. .... . ... . .. . .. . .. (i. II` Ixl:lilK::;n, c(no l-cial or mixed mckipancty, npeciljr n7U.ure i))KI ext.enl: of eiich I.ylx! of use...... . ..... .. ... .. ... 1. Ililliumlioll:; of: exitainl; sl.11whirefl, if wry: Vi-on( .. . . . .. . . . ... ... Real. .. ....... ..... . Ik:III II _.. . .. . .. . .. . ... . I k:i gl)1. . ... .. ......... :.... .... .. rJ n l,e r of: !i 1 o r•i e a . ..:.. ....see,property card (annexed) Diil)(Gnsi(Hls of wivie W nwhire with alleraLi(x)s or fxklil:io11:7: Front: .... . . ... .. . . .. hear Ik:pll) IIei11111: •.. . ... .. . .. ... . ... .. . 14,11her of M-orins .. . .... ... ..... It- Iliur:naicxlfi of (911II(: Im34 c0f1st11v:l:1(Hl: I -ofit: Itear Dept11 .. . . ... . .. .. IlLi0ll. .... ............... ..... 11milwr (if: Sl:orien !.. ........... ....... ... . 9. size of: lot : Prow: ....?03...... . .. .. . Refit' . .. bept11 . . .ZOO.... .... ..... IO. 11:11 a of [Nit cliose1965 ...__ _... _ M-mv-1 of Pottiur Oilier. ........... ... .. ... ...... I. L(m)e or tine (lislricc io i-Aiir-Il prolliflea fire stlual.��l R40 11. Ikx:n p10lxlre(1 cm.10 nx:Lion violfil'e any z(xliol;. lirw, ,or(lifunrc:e:or red;ulfil;ii)u: . ... .no.. . ......... .... Ili I I lot: Ik regrmle(1 : r4Ji I1 exceaa' fi 11 IH:� ra' mwe,il fron lir'cyai sew: YES l!I) Ih. Millms of Woer of preen ses ............ ............... Mklrens .................. .. ...._.. ... Moot! Pk). ..._... .. . . . . lliriii! of Ar'c:llite(:1• . ....... .:..:. ... . .... Mkll'etf:f 111o1m! 1J). P otw of (:(xit,rfictor ......... MI(Iress ........ 111o1x! tJ). .. ... .. .. .. . . Is lllis plolx:rty wil.ilili W) feel: of fi tidal 1,,elliilul? 'A Ylul; R) All,' YES1 RXIIII(ND 'IMN 'I1W.S"WiS 11,04111' IIAY 1% Ith-gJ11w.n. PLOT DIACIIAI-I Im-fite clearly fool clist:itictly rill Ixlil(linlgs, (4lelher, exisl•inl; or proposed, filol indicnVe fill set.-back (Iiuleni.ionfi (•l llil l)1'0lx!1't-y l llie.m. Give wt:r•eet: 1110 1)1(H:I( I'll aI1)(:r or (lee-'-li)l 1 oil Il(:covding I•o fl(!ed,'' (KI fill()w fit r'eCt ollilYafl 111)(I ili(ll(:71t.1! 1du:llK:r interior or coriier lot:. BP for "as built" deck per BP 4351 ,(6/T.8/65) ; Note: part of deck�was built per BP 17240, which has c/0 #Z17163 issued: 1,.P FP s��v i,iO 91 Y BLIff.NG 'AR.y i'l y 's� s3 Tlsl 4 plvr 1= rile' a 1 k 0,! 1..a:'-<°W,,;K; ft—"PECTKM a; Ir. t- i:1;1a-3E 1s Y I�fi+rf f pp 7'f 6' ^y:a'air;;_ q L `, qq�� gam. y spy,• �,�? f:t St �y if�iil 81J�(,)-Ra EC).Uf7't FD `1 f "F F•S ia�l 1 IvG b?3 Y'I•aF�f tL'`iYi OG Y"'?.)l d4'u11,:I.:CONCRETE NSW P. V,, IGH �. E= 'al..; .. COi'cST'i=1UCTIIu)I49 MUS`! C It::af' r,• BF COMPLETE FOR C.O. Ail, tONST'RUCTION SHALL MEET T"i1 REQUIREMENT'S OF THE N.Y { STATE CONSTRUCTION & ENERGY fu,C Ci tl,lq P`!`� � '4 ��:43C felt N�S ��7Y THE Y4 )1 � ..�,n y� MYVIE.. (>t� 1•04 Y(Ht1C �a , �, C(IDES. NOT' RESPONSIBLE FOR `JPh( tiro arnv; flp l �K Fi -�1 t( BOI z5, i rt f 1 DESIGN ON CONSTRUCTION ERR°®R,,S, v ;i) 0><1(rlY (x� SIIFFOLK x 4�1 ' °�i ;' i "� Deborah Doty rlg . .... .. . . .. .. .. . . . : ... ... ... ... .... . . ... ... . . . ..... . . . .. .loan!; (lily !sworn, (lelx)ses film! t;llyll tltal: Ile is the wppl ici")l 0111r: (If ilKlivi(lusll nigrlioll cool racC) alxrvc: n(llmil, . She is the agent for .. .... .I. . . .. .. ... (On It.rficlor•, nl;coC, corlwi-ate officer, (:L(:.) ol` sni(I 0%41K31- or cn�iH:rfs, filml in (duly mithorize(I. l•o lxmfoim or III;Ve Ix:rl`ol11KA Ills- nfii(I w)rl( filxl.lo lirlIte film! fide IIIiit nlipticrlt:iurl; Ihill. Ill litatc.illellls cixltalllod ill I.Ilis,opplicaIion-1ir 1IIW10. the IH:1;1: of Ififi lux)wlcxll;e 7oKl Ix:lief; wKl Ilml. Ilse )n)?k will I,e perforllx!(l In tlm livuoW!r fie!: fortll ill,ille fippli(ifil:ion filed theremit.11. -will to Ix:lul(: "tt! Ihis 2 .. . . .....(hfy ov ...... . .... ..... . ... . ... . . : .. .::. ROBERT I. SCO`�T,jR, (S iliniit ui e of Alrpl NOTARY PURL C.State of N.Y. No.h72508�,Suffolk Cou Term Expims May 311.19 ' \ 3. Nature of work (check which applicable): New Building .................. Addition --U --- AJtmroYkzn .................. Repair ................... Demolitionn --- Other \A\zrk (Describe) ........................................ *CM� 4. Estimated Cost ..... .!'��.—.—.—.-----..--Feo .—. --------...—~—,,._._~_.__._______ (to be paid on filing this application) �, 5. IfdwmU/nQ, number of dwelling units --.^--.---.NumberofdweUing units on each fkoor ---------. _- , ` Ifgarage, number of cars --.--.^--------'---.----rr----'~^---'~-^~--'r`'~----�'----- 8. If business, commercial or mixed occupancy, specify nature ' extent of each type of use ....... .----. 7. Dimensions ofexisting structures, if any: Front ............................ Rear ..... .......... Depth ............. Height ........................ Number of Stories ..... " _--.-----�——.--�''-._--..-' _—_.--.--.—'--. . ____.. �y Dimensions of same structure with o|terotkono or additions: Front ....'0............... .......... Rear .----` —.�r L// �~^ [�mt� —.._.^.-_.---.- Height ---------.Nun`6or of Stories -- -------.. 8. Dimensions of entire new construction: Front ---' ........................ Rear ............................ Depth -----.--. � ` . Height ------- Number of Stories --.---.---'.-__-_-_--__.—.-----.-----.---.,___. 0 of k�� F � �� /�m�~� %*�� . 9. �e Front ---.-----.. Rao, --- --� -----. Depth --..-----.--` 10. Date of Purchase ..................... ........................... .......Name of Former Owner ......................................................... ll. Zone or use district in which premises are situated ------.--...----,,_----.—.---.--.—___.___ 12. Does proposed construction violate any zoning law, ordinance or regulation? .......0jm.............. ................................. 13. Nome of Owner of premises ........................................Address ............................................ Phone No .................... Name of Architect ......................................................Address ---.------------ Phone No ..................... Name of Contractor .................................................... ...... Phone No ..................... PLOT DIAGRAM Locate clearly 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 n, corner lot. . Loei oAl --_- . . HB ^� �"� �- �NCP 056[> DECK /n'^* . PNAW AcMms4$& ` 0, PC- ' NoPoS ' AW|T'/mN 7h ��,� 6�/TS( D�' r��k� ^ LOCwS7- �D=�. 67'00y HOUSE SUPfbaT5 ' -1"Xi ^ FP-A" - AND ' ��EW��e� T/eD 7-0 6-X/-Sna 6- STATE OF NEW ( ' S�� COUNTY OF --��^--"--} ' w� --.. ..................................being duly sworn, deposes and says that he |o the 000||comd (Name of individual signing application) above named. He is the —.� ,. .----------.--.~-----..-_-----..-^.----'--_'-,...~..-.—___,~___ (Contractor, ogmnt corporate of�ce , e�.) of said owner o, owners, and is duly authorized to perform or have performed the said work and to make and f/|o this application; that all statements cnnhrne6 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 methis � ~~� /� ]. �� --�`=--. l94�K Notary |ic -�� »m/n �3�noture'of------ ------an PHU P91A of New York ---'' No. 52-,�g7rq3O5 Qualified in Suffolk County C"'"'"""io'' "°v°smarcn30, /y1m . ^ ^ ' ' �