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HomeMy WebLinkAbout23481-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold; N.Y. CERTIFICATE OF OCCUPANCY No: Z-25683 Date: 04/24/98 THIS CERTIFIES that the building ALTERATION Location of Property: 38785 MAIN RD EAST MARION (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 15 Block 8 Lot 1.1 Subdivision Filed Map No. •Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office. dated JUNE 10, 1996 pursuant to which Building Permit No. 23481-Z dated JUNE 6, 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 REPLACE EXISTING COVERED PORCH AND ALTER GARAGE TO FAMILY ROOM IN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DANIEL L FISCHER . (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N 451194 04/22/98 PLUMBERS CERTIFICATION DATED N/A B ilding Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25684 Date: 04/24/98 THIS CERTIFIES that the building ACCESSORY Location of Property: 38785 MAIN RD EAST MARION (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 15 Block 8 Lot 1.1 Subdivision Filed Map No. Lot No.. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 10, 1996 pursuant to which Building Permit No. 23481-Z dated JUNE 6, 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 AN ACCESSORY PLAYHOUSE AND SWING SET AS APPLIED FOR. The certificate is issued to DANIEL L FISCHER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A B lding Inspector 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° 23481 Z Date . ..: ............................................. 19. .... 110141PPIn/ Permission is hereby granted to: L� .. ...... .. r ................................ ......-- .... ........................................... . .. ....... ..�. :�. o ...�� - . . : ..... ...... .. . . at premises located at ..:_.. .�ef, .. ....... ..................................... ............. ................................................ ............ . ��............................................................................ .... ....... ............ .... .... . ......................................................................... ........ County Tax Map No. 1000 Section ..... .....z`5..... Block �. ........ Lot No. . ............ pursuant to application dated ......................... ., 195�., and approved by the Building Inspector. Fee .. .. ... . .............................. ilding Inspector Rev. 6/30/80 Zr r rsrcc ` / r 46FNO • F"D _ OO � N CELLAR r PIPE W LLE = SLAB • O ` 1 STORY. O ow- �. (p _. - `� v pULowe v ATTACHED amm' METAL BLDG. All uj z G p oUcl- y SURVEY OF FND PROPERTY AT ORIENT Form No. 6 �C.Q (� TOWN OF SOUTHOLD �x 0 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 $25.003 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 Buildinc - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . .. . . .. . . . . . . . . . . . . . . . . . . . . . . . . New Construction... .... . ... Old Or PrC-ex�j'sting Buildings�.. . . •. - Location of Property... .a�7�.�. . ............ ...... . . ....... . . . . .. . . . . . . .. .. . . . . . . House No. Street Hamldt cr __ Onwer or Owners of Property. P?�!�l.°U.! .. . . «.�: •• -• •- • - • • • • " " " " " " l a. . .Block. . .Lot. ... . . . . . . . . . . . . County Tax Map No 1000, Section. . .. . .... .• • • • • • • Subdivision. . . . . . . . . . . . . . . . . ... . . . . .. . . . .. . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . AA ,, . . . . f Permit No. .J..�,• .Z•Date Of Permit. . .(A �: )je� . . .Applicant- . . . . . . . . . . . . . - • • - Health Dept. Approval. . . . . . . .. . . . . . . . . . . .. . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . ... . . .. . . . .. .. . . . . . Request for: Temporary Certificate. .. . . . .. . Final Certicate./: . . . . . . . . Fee Submitted: $ • • • • - •• • • • • • y 57 � _I,� . . . . . . . . . . . . . . . . . . . . . . . . . . Lq 5 APPLICANT 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 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. r B. - For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: I 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 . . . .qlZolV .q �.. .. . . . . . . . . . . . . .. . . . . . . . New Construction. .. .... Old Or Pre-existin . g Building. .!'.. .. ..... .. Location of Property..... ..�. � .. ....9-.... ...........6..� ., . . ... .. . ...... .. . . . ... . ... . .. House No. Street Hamlet c Onwer or Owners of Property.klh.'1J1 .. .1�h :�. ..i .lbf-Y4 . .. • . • • • • •• • • • • • • • • • •• • " " " County Tax Map No 1000, Section. ..!. . . . .....Block. .. .• • ... .Lot. A. .1. . . . . . . . . . . . . • • • Subdivision. . .r.�.'. . .. . . . . . . . . ... . . ... .. . . ..l. .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . .. - Permit No. . .. . . . . . . . . .. . .Date Of Permit. . te.,�. . .1. . . . .Applicant., Health Dept. Approval. . .. . . . ... . . . . . . . . . . . .Underwriters Approval. . . . . ... . . . . . . . . . . . . . . . . . . Planning Board Approval... .. ... . .... . ... . . . . . . . Request for: Temporary Certificate. .. . . . .. . . . Final Certicate.X. .. . . . . Fee 'Submitted: $. . . . . . . . . . . . . . .. . . . . .. .. .. . .. . . . .. . . .... . . . . . . . . . . . . . • APPLICANT FORM NO. 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 NO 21304 Z Date ...3`..:s...................................... .. 19.Z:" /ws�2 Permission is hereby granted to: ...... .�......�, ............................................ to . . ........ atpremises located at .��.. .7 �./....t.. .................. ........................................................................ ................................................`.� r. ..'T.'G................................................................................... ... ....�........ .................................................................................................... County Tax Map No. 1000 Section .......�—?�........ Block .....Y.......... Lot No. ....1.:../............ pursuant to application dated ......................................................... 19......... and approved by the Building Inspector. Fee $...11®.".. .... .:... . P.c ............ uildi I for Rev. 6/30/80 1, :'I:yLll S:'EC:iON IIDATE COMMENTS don zx�n x H FOUNDATION ( 1st) FOUNDATION ( 2nd ) _ 2 . _ o � ROUGH FRAME Qb • J -•PLUMBING oC0j En 3 . 1-3 INSULATION PER N . Y. . 3 STATE ENERGY n CODE V . x 4 . 3 - 9 _--� U kl FINAL u rn z ADDITIONAL COMMENTS : x , x x � N o •, x d r� H o��S�FFO(,�cOG �� yam► O 1 co = 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 September 27, 1995 Mr. Daniel Fischer 38785 Main Road Orient, NY 11957 Re: Building Permit #21304-Z Premises: 38785 Main Road, Orient Suff. Co. Tax Map #1000-15-8-1. 1 During a review of our files it was noted that the above building permit has expired, and a Certificate of Occupancy has never been issued. According to the Code of the Town of Southold, Article XXVIII 100-284, it is unlawful to occupy or use a structure until a Certificate of Occupancy has been issued. Please contact this office as soon as possible so that we may clear up this matter. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Thomas J. Fisher Senior Building Inspector o��SUFFO(,�co � G Print Key ?mac Page 1 5738SS1 V2R3M0 931217 COD D 09/26/95 15 : 32 : 13 Town Hall,53095 Main Road p • Fax(516)765-1823 Displ%q). Mgxti-be . . . . . 9�ij� �� Telephone (516)765-1802 U§eq�hold,.New York. 11971. . . . . . NYSRPS ASSESSMENT INQUIRY DATE 9/26/95 473889 SOUTHOLD SCHOOL OYSTER PONDS SCH ROLL SEC TAXABLE PRCLS 1 FAMILY RES TOTAL RES SITE 15 . -8-1 . 1 OFFICE OF THE BUILDING INSPECTOR TOTAL COM SITE 38785 MAIN RD TOWN OF SOUTHOLD ACCT NO 01 OWNER & MAILING INFO ===!=MISC !======== ====== ASSESSMENT DATA FISCHER DANIEL L & !RS-SS ! **CURRENT** RES PERCENT NANCY L ! 1 !LAND 2,700 **TAXABLE** 38785 MAIN ROAD ! BANK !TOTAL 8,200 COUNTY 8,200 ORIENT NY 11957 0115503 **PRIOR** TOWN 8,200 ! !LAND 2,700 SCHOOL 8,200 ! !TOTAL 8,300 ==DIMENSIONS =__!______= SALES INFORMATION ACRES 1 . 77 !BOOK 11064 SALE DATE 05/03/90 SALE PRICE 180,000 !PAGE 129 PR OWNER WOODHOLLOW PROPERTIES INC =======TOTAL EXEMPTIONS 0 _____________!_= TOTAL SPECIAL DISTRICTS 5 CODE AMOUNT PCT INIT TERM VLG HC OWN CODE UNITS PCT TYPE VALUE !FD025 IPK065 !OM060 !WW020 F1=NEXT PARCEL F3=NEXT EXEMPT/SPEC F4=PREV EXEMPT/SPEC 75 . 10- 03-011 F6=GO TO INVENTORY F9=GO TO XREF F10=G0 TO MENU T`'E NEW YOR BOARD OF FIRE UNDERWRITERS Nr�G 7. ©i?122 ° BUREAU OF ELECTRICITY 85 J- N STREET, NEW YORK, I ' YORK 10038 t7C1'J ?I,R @1 992 cation ,o.o Date r-•-- pplication o.on file F• �2 t a�• � THIS CERTIFI`..S THAT only the electricdL-eIquipmeent as described below and introduced by the applicant named on the above application number in the premises of DA.NLEL FISCbb1r-1'_a`i-?on;� , NAIM ROAD (BOX 79) , Ott in thefollowing IN Basement El1st FL 2nd Ft.y, ou , l Section Block Lot was examined on� 'lip,P, lRB E 11 30 r 199 2 \i�d' and to be in cdmpl`a ice with the requirements of this Board. _ FIXTURE A FIXTURES �RAN"G COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPT/ACLES SWITCHES INCANDESCENT1.FLUORESCENT OTHER m - �K.W. AMT. I K.W. AMT. K.W. AMT.. K.W. AMT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE-FEEDERS SPECii REC'PT TIME CLOCK BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT., AMP. AMT. ehmPS-1 `TRANS. AMT. H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V 1 C E AMT AMP TYPE METER I W 2W 1,U 3W 3 9 3W 3,0.4W NO.OF CC.COND. A.W.G, NO.OF HI-LEG A.W.G. NO.OF NEUTRALS A.W.G. d EQUIP. PER b" OF CC.CO D OF HI-LEG OF NEUTRAL 1 200 CD 1 r � 1 2/0 � 9 OTHER APPARATUS: I n X PAUL R. BURNS LTC, #V32-F 275 `POUN HARBOR i,I)JIB S O U T H O L D r NY, ,j 1 r 7 1 GENERAL MANAGER 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. 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It yy Aid v ,. �� - A CHAIN Z 2.3N FENCE W LINK \� �•� 2 �a FND .a— — �` N FND PIPE O PIPE NE CpK�LARz SLABSLAP Co c. aATTACHED METAL BLDG. cmm f� }o ash \2 0 o_ 2 39.6' _ — — APIOAt o�� 2 a ui0. uj Ao ti r� P SUR VE Y OF FND �I PROPERTY MUN AO6 O A T , ORIENT zid �J. 3.211 �, � i ! ee r i � s cc� � of OcSC oiv caR�LLB' s � 3 a_ t I f I Elrl � a lg Uv,s60 j cias� ( BLDG. DEPT. !✓!j/V i P�oT{cr��✓G i TOWN OF SOU7HOLU r._ r- ! j l I � � I ��1 r i,�,•� I I i � I � i � I I I I �' ! C!N idLpG Y alv OAY oll� �6/✓T 1 L i i 1 Do(tB(ED 2�r8 C14 ouh I To.CO✓E,H MINT/AYEX YA ce7- i KiiTsS! �/ ov i S �Dlovey I i i Or-,IVd� •��'�s)4ee�s l6 o r 1 r r if. dee t d 4 � lbpd 7 � r Ll C/71Z- ram i i `TOWN OF SOU7NOL[� j i j j ! ` BLDG �✓��'// I PROT�c>iNG �Q�e4f� ''00, i � , � r i I lJ � I� � � � fou��/1rio� Y6/✓7' , I � 1 .. •7�0�>�Q r7d! 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G�/�'f16� v✓yT/J P/�OTCCT'/I✓G TM4 C)r �C 9 l4uLl7` A��fF� z NcftJ� -3/Co��j-. _`_ _._—i//_�:�—. 8�� - � _.. • ��� �� � I � ��G .. _fOpT/IVY It t�oih.-W Y,4hX EF GUT '/C��ryrill/HIV �• ,� � ter.✓"- Hatt;;( GliX�r/fE✓/,�'v � �v 2 .c. i . . . . . . . . . tZ Cfra;7r� �"-L1�J ', ^ xJo�r t3tt .1� g Coil ya�sTs IL .� f --- TflTrri� - .. _ . �. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1000121 BUREAU OF ELECTRICITY F_ 40 FULTON STREET, NEW YORK, NY 10038 Date APRIL 22,1998 Application No. on file 15863298/98 N 451194 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of D_ANIEL FISHER, 38785 MAIN ROAD, ORIENT, NY in the following location; ® Basement r' Ist Fl. K 12nd FL OUT Section Block Lot was examined on APRIL 09,1998 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENTI FLUORESCENT I OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECTT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E METER NO.OF CC COND. A.W.G. A.W.G. A.W.G. AMT. AMP. TYPE E9UIP. 1 0 2W 1 0 3W 3 0 3W 3 0 4W PER 0 OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: *NO VISUAL DEFECTS: "An electrical survey has been made of the exposed electrical equipment in the premises indicated. " "No obvious unsatisfactory condition was found. PAUL R. BURNS I, ,LTG:#3897-E � L PO BOX 1061 SOUTHOLD, NY, 11971-0932 GENERAL MANAGER 11 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. .� BOARD OF HEALTH . . . . . . . . . (� FORM N0. I 3 SETS OF PLANS . . . . . . . (p v . . . . . . . . . . . . :. . . . . . . . 1 TOWN OF SOUTHOLD SURVEY EE BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . E:# MAY 10 TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 BLDG.DEP'� TEL: 765-1802 NOTIFY: T CALL QLlJ!'1P/�i ..7.. . . U. . ExaminedPa/c 19.� MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved ........, 19. Permit No. .......... .................................... Disappro ................................. ................................ ...................................................... (Building spec r) / APPLICATION FOR BUILDING PERMIT _ /d &�Pae " # ��.�®� Z Date- - - cz . �c� , 19 INSTRUCTIONS a. This application nust 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 &failed description of layout of property mist be drawn on the diagram which is part of this application. 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 MAiE 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 building/for necess7inpec lions. ... ................. •(Signature of applicant, or name,' if a corporation) f/ f ................................. ... . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............ WJ�eE!................................................................................................. Name of owner of premises .. GQ hie; .. Ci ha�.. ??.� .�../Is.che' ............................... (as on the tax roll or latest deed If applicant is a corporation, signature of duly authorized officer. ......................................................... (Name and title of corporate officer) � .�..Builders License No. Plumbers License No. ......................... Electricians License No. ...... Other Trade's License No. .................... 1. Location of land on which proposed work will be done.............................................................. House Nudber Street QQ Hamlet ck County Tax Map No. 1000 Section ..... ....... Blo ..prl........... Lot ..�'.�:........ Subdivision ...................................... Filed Map No. ............... Lot ............... (None) • 2. State existing use and occupancy of premises and pintended use and occupancy of proposed construction: a. Existing use and occupancy .....S a J�! 9l�./.(�.?r, .I .:"C�5 q.�e:AI x' �................. ............. b. Intended use and occupancy ...............:e:........................................ ................... a. Nhlure of ►.rock (cd►ec_k %A►icl► applicable). New Ikiildinj. .......... Addition .......... Alteration ..... ... . Rep air ............ Removal .............. Demol ition'�/ ?�� a.. 0v11er Work �Ali.o.a-� �j4%Gcin ).'i1�;e..kv,4f' �1 (Description) 4. Esc imkhted Cost . f0.r?04?..'............. `�/ fee .............................................. (to be paid on filing this application) 5.- 1f dc-)elling, cxnber of. &,elliog units ............. limber of choelIing units on each floor ................ Ifgarage, cxj►ber of cars ...................................... 6_ If Ixisioess, cannercial or mixed occupancy, specify nature and extent of each type of use...................... 7. Dimensions of existing sLrrctures, if any: Front..5,0........... Rear v.......... Depll► ............ lleigl►t .�.................... Umber of Stories ............... ... .. Dimensiorhs of sane structure with alterations or additions: Front ' C-�?�r�Ls��'�:`i'. (tear ............... Ileplh .................... lleigl►L .................... Umber of Stories 8. Dillensions of entire'new construction: Front ..� ......... Rear ........... Depth ......... De'lglht .......................... Nuber of Stories ..................... 9_ Size of lot: Front .............. Rear ...Z 8 19.......... Depth .' 7r JT....... 10. Date of Purchase ...if 94....________ Ibm of Former (knher ..Ala ad.h o e4?-s..?t. ...... ll. 7xx►e or use district in wl►ieh pranises are situated .............................................................. 12. I)oes proposed construction violate any zoning law, ordinance or regulation: -1V'10...................... 13. Will lot be regraded ................. ... Will excess fill, be removed from premises: YES ( N0/� Ill. Names of owner of premises �..>.!%✓ ": .... 54. Address 3eMCA/4 ©A>'e;,7' ... Plhone�No�'`� .. Name of Arc►i test .................................... Address ....._........................ P1►one No. ............ Mine of Contractor l/��-r?-�`iJ !se"6 ?. Acklress 3 .i .ter,,!�e, .©1r/e?'9�...... .iL 3 6�. .Phone No. 3 M_ ' 9� 15. Is this property within 300 feet of a tidal haetlanl? * Yl'S .......... NO .......... *IF Yl?S, S(1U11101D inm 1RUSr11:S i,,owr MAY 11E wgfi FI). PLOT DIAGRAM Locate clearly and distinctly all lxuildings, whether existing or proposed, and indicate all set-back dimensions fro►n property lines. Give street and block nnber or descriptiai according to deed, and slxxa street nan►es'and indicate %Aiether interior or corner lot. t S['A'Il's (IF ".-,w Y(AIK, SS MINH U ... ._- -. .!-: L._..tr.:.. i. 4r.'.�!�.`.............. winlq duly sworn, delxwes a►xl says that he is Lhe appl ic'hnl: (Mn►e of individual signing contract) alcove named, Ik! is Lhe ... ...........................................•- ......................_........................ (C)nLracLor, agent, corporate officer, etc.) of sai ether or owners, and is duly authorized to perform or have performed the said work and to mke and file Lhis appl icaLcou; that all. sLaLeiwnLs contained in this application are true to the best of his k►xhwl.edge and lxil.ief; and IhaL Lhe work will. be performed,in We nranher set forth in Lhe appl.icaLion filed therewith. .%wrt to/beforep►e this Notary 1'iulilic�>�......:q..... . G✓." \` ` LEi�i:D. F1CIft1Vlr (Signature of Applicant)v; )i :_ �6tary Public,State of New York No..4951364 lified in Suffolk County