HomeMy WebLinkAbout44468-Z �4A1P1gUFfOr Town of Southold 4/14/2021
y� P.O.Box 1179
o -
c • 53095 Main Rd
4j Southold,New York 11971
L
CERTIFICATE OF OCCUPANCY
No: 41845 Date: 4/14/2021
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 6640 Skunk Ln, Cutchogue
SCTM#: 473889 See/Block/Lot: 104.-5-6.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
11/27/2019 pursuant to which Building Permit No. 44468 dated 11/27/2019
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:
"as built"bathroom,window replacements, central air conditioning and outdoor shower to existing single-family
dwelling as applied for.
The certificate is issued to Hudgens,Thomas&Carter,Christy
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R-20-1315 2/8/2021
ELECTRICAL CERTIFICATE NO. 44468 6/17/2021
PLUMBERS CERTIFICATION DATED 3/4/2021 omas Hu ens
A t ri ed Signature
ik
gu KTOWN OF SOUTHOLD
o� oma. BUILDING DEPARTMENT
-i TOWN CLERK'S OFFICE
o . SOUTHOLD, NY
4A
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 44468 Date: 11/27/2019
Permission is hereby granted to:
Hudgens, Thomas
95 Horatio St Apt 622
New York, NY 10014
To: legalize "as built" bathroom and outdoor shower to existing single-family dwelling as
applied for. Additional certification may be required.
At premises located at:
6640 Skunk Ln, Cutchogue
SCTM # 473889
Sec/Block/Lot# 104.-5-6.1
Pursuant to application dated 11/18/2019 and approved by the Building Inspector.
To expire on 5/28/2021.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $448.00
CO -ALTERATION TO DWELLING $50.00
Total: $498.00
1;;;Inspector
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use:
on of all buildings,property lines,streets,and unusual natural or
1. Final survey of property with accurate locati
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 I%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 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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00,
Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00.
2. Certificate of Occupancy on Pre-existing Building- $100.00
3. Copy of Certificate of Occupancy-$.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00 �}
Date.
1 —4z!(
New Construction: Old or Pre
U-existing Building:� (check one)
G Location of Property:' 7a 155 P""! 4 j4to 6
y
Hamlet
House No. Street
Owner or Owners of Property: O C
Suffolk County Tax Map No 1000,Section 1 0 Block V 1 Lot d
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: AI/ k one)
Fee Submitted:$
A piicant Si ure
®�',OF SOUr�,®�
Town Hall Annex ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 a sean.devlin0'_)town.southold.ny.us
Southold,NY 11971-0959 a®
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To Thomas Hudgens
Address: 6640 Skunk Ln city:Cutchogue st. Ny zip- 11935
Building Permit#: 44468 Section. 104 Block: 5 Lot 6.1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: AS BUILT License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service Only
Commerical Outdoor 1st Floor X Pool
New Renovation X 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph X Heat Duplec Recpt 4 Ceiling Fixtures 1 Bath Exhaust Fan 1
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures 1 Smoke Detectors 1
Main Panel A/C Condenser 1 Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel A/C Blower 1 Range Recpt Ceding Fan Combo Smoke/CO 1
Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 3 4'LED Exit Fixtures Pump
Other Equipment. 1- 115 ARC Fault Breaker
Notes. " AS BUILT " " NO VISUAL DEFECTS " New Wiring of Bedroom, Bath and AC
�Inspector Signature: = Date: June 17, 2020
S Devlin-Cert Electrical Compliance Form As
qvSOCfr ,
Town Hall Annex t Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT MAR - 4 2021 y
TOWN OF SOUTHOLD
CCARTI ICATIO-N
Date: ko-"C L� 2 d2
Building Permit No. Ll l L�
Owner: 6VI40_ RNLf P vt
(Pleaseprint)
Plumber:",,.
(Please print)
I certify that the solder used in the water supply system contains less than 2/10 of I%
lead. .
(Plumbers Aigna
Sworn-to before me this
day of&tA 20 �2,
LYNDSEY BARKER
NOTARY PUBLIC,STATEOF NEW YORK
No. 01 BA6156676
Qualified in Suffolk County ��
(� ( p Commission Expires November 27,20_
Notary Public, County
of souTyolo l 1, `7 4 6614 v jkVA
# # TOWN OF SOUTHOLD BUILDING DEPT.
�ycoulm, 765-1802
INSPECTION
[ ]_ FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND -- [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE-&-CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
N C 0 et 17
C.,Af RX�62 AZ
U
Gn/sc-7 /� �� �Q. AAA
�n ax
DATE Al INSPECTOR C:S
OF SOUTy� Li q f7 4 140
SKurvt
# # TOWN OF SOUTHOLD BUILDING DEPT.
°`ycou►nv��' 765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ]. ROUGH PL13G. }
[ ] FOUNDATION-21SID [ ] INSULATION/CAULKING
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY ` [ ] FIRE SAFETY INSPECTION ,
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ]" ELECTRICAL (ROUGH) ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
a
DATE 7 INSPECTOR
CHITECT
MARIA SCHWARTZ &ASSOCIATES 28495 TMain Road•PO Box 933•Cutchoguc, NY 11935
631.734.4185 www.mksarchitect.com
March.04,LVLT k i ✓� t
c ,
as.i o
a MAR — 4 2021
Southold Town Building Department
54375 Main Road :.<<,. _ 1'" —D
Southold,New York 11971
Re: Hudgens House
6640 Skunk Lane
Cutchogue,New York
To whom it way concern,
I have been on site during construction to review work for the aforementioned project. Thh e Plumbing
pipe insulation has been installed and to the best of my knowledge,meets or exceeds the New York
State Code requirements at the time it was constructed.
Please call this office if you have any questions or concerns.
�1
Sincerely,
a,
a C,p- 0
Mark S;.hwartZ
Q
AIA
Meinboi American hisbaile of A,,cl;itCcture
R "HITECT
MARK SCHWARTZ &ASSOCIATES 28495 iidain Road•PO Box 933•Cutchoguc, NY 11935
631.734.4185 www.mksarchitcct.com
March 18,2021
Southold Town Building Department
54375 Main Road
Southold,New York 11971
Re: Hudgens House
6640 Skunk Lane
Cutchogue,New York
To whom it may concern,
I have been on site during construction to review work for the aforementioned project. At the time of
installation of the bathroom,all plumbing was installed to meet or exceed local and New York State
codes including all piping and plumber's pressure test. The bathroom also was constructed with
proper insulation at the time of installation and meets or exceeds local and New York State codes.
Please call this office if you have any questions or concerns.
Sincerely,
CA-
MAR 1 S 2021
Mark Schwartz
AIA
MemUer r1mc31can lnst�lute of Arch�techne
FIELD INSPECTION REPORT -DATE COMMENTS
_ b
FOUNDATION(IST) y
--------------------------------------
FOUNDATION (2ND)
ROUGH FRAMING&
PLUMBING y
r
INSULATION PER N.Y.
STATE ENERGY CODE
FINAL
ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
Southoldtownny.gov PERMIT NO. va Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined ,20 Single&Separate
Truss Identification Form
Storm-Water Assessment Form
Contact:
Approved ,20 Mail to:<H&"w 2='r7
Disapproved a/c p
Phone:
Expiration ,20
t Building Inspector
l„ter s
NOV 27 2019 APPLICATION FOR BUILDING PERMIT
-77
Date J , 20
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
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 waterways.
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 a 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 what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim,the Building Inspector may authorize, in writing,the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County,New York, and other applicable Laws, Ordinances or
Regulations,for the construction of buildings,additions,or alterations or for removal or demolition as herein described. The
applicant agrees to comply with all applicable laws, ordinances,building code,housing code,and regulations,and to admit-
authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant or name,if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, age t, architec engineer, general contractor, electrician,plumber or builder
Name of owner of premisesRuo G60 L5
(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. Loc ind on which roposed work will be done:
l�-.
Hou er Street Hamlet c�
County Tax Map No. 1000 Section Q Block ( J Lot
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ( �}l��_( LI 92� f
b. Intended use and occupancy -41 ' ✓/tlq
e�l
3. Nature of work(check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work /-}5— V IC jl
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars
6. If business, commercial or mixed ocmany: Front
specify nature and extent of each type of use.
7. Dimensions o ee 'structures, i Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth � ��h Number of Stories
8. Dimensions of1��6w��nq 'ct>,on: 7dStorie Rear Depth
Height Num as
9. Size of lot: Front -Rear Depth
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated Q
12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO
13. Will lot be re-graded?YES NOVLWill excess fill be removed from premises? YES L-,/NO
14.Names of Owner of pre ses 0i �tJ Address Phone No./�7 Z 543 4'
Name of Architect Address Phone No - 1 Ar
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES V NO
* IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES NO
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
18. Are there any covenants and restrictions with respect to this property? * YES NO
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF U Gj
G �/ being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contrac above named,
(S)He is the
(Co tra for Agen orpo ate Officer,etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
that all statements contained 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.
S to before me this,
day of 20 o9-M 20_n_
RACEY L. DWYER
Notary Public NOTARY PUBLIC,STATE OF Signature o -Applicant
NO.01 DW6306900
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,2
Scott A. Russell '01111z"r STORNIWAXIER
BUIPMVISOR MAN-4AGEMENT
SOUMOLD TOVM BALL-F.O.Box 11" 16
&3095 Matin Road-SOUTHOW,MWYORK nM Town of Southold
CH"TER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT)
DOES TMS PROJECT LWOLVE AN`Y OF TM FOLLOWING
Yes No "ECL ALL THAT APPLY)
0 A. Clearing, grubbing, grading or-stripping of land which affects more
than 5,000 square Teet of ground surface.
0 B. Excavation or filling involving more than 200 cubic yards of material -
within any parcel or any contiguous area.
C. Site preparation on slopes which exceed 10 feet vertical rise to
100 feet of horizontal distance-
0 Site preparation within 100 feet of wetlands, beach, bluff or coastal
i erosion hazard area-
0 E. Site preparation within the one-hundred-year floodplain as depicted
- on, --Map of any waftremrse.- - - -
Installation of new or resurfaced impervious surfaces of 1,000 square
feet or more, unless prior approval of a Stormwater Management
Control Plan was received by th&Town and the proposal includes
in-kind replacement of impervious surf-aces.
of YOU aEkSWCrCd NO to @1 of the questions Wkwc,SWPI Complete the Applicant section below with your Name,
Signature, Contact Inftmaillon, Date a Cminty Tax Map Number! Chapter 236 does not apply to your prciect.
If YOU answered YES'to one or more of the above,please submit Two copies of a Stormwater Management Control Flan
and a completed Check List Form to the Md1ding Wpartment with-y—our Building Permit Application.
APPU (Property Owner,Design Praesstonal,Agent.Contractor,OtbC4 S.C.T.M. = 1000 I)ate:
NAW-
FOR BUILDIING DEPARTMEN7 USE ONLY
Contact Wortnatim
Reviewed By-
- — — — — — — — — — — — — — — — — —
Property AddressLocation of Construction Work: — — — — — — — —Date
4 .71 — r I Approved for processing Building Permit.
a S 0 VVIte, -Stormwater Management Control Plan Not Required.
— — — — — — — — — — — — — —
F1Stormwater Management Control Plan is Required.
(Forward to Engineering Department for Review.)
FORM SMCP-TOS MAY 2014
o�OSA3fFO(,4-co BUILDING DEPARTMENT- Electrical Inspector
C=5
Gym TOWN OF SOUTHOLD
ZZ) Town Hall Annex - 54375 Main Road - PO Box 1179
C#' - Southold, New York 11971-0959
y p� Telephone (631) 765-1802 - FAX (631) 765-9502
rogerrCcDsoutholdtownny.gov sea ndCq�southoldtowriny.gov '
APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All information Required) Date: 1 Ick 2 .
Company Name: �,pw•r✓. ®wA f -
Name: T�%urAb"y s
License No.: rn JA- email:
Address: ( Skv k La
Phone No.: 2 S- k 34
JOB SITE INFORMATION (All Information Required)
Name:
Address: �� l7 f' Nf C t
Cross Street: w
Phone No.: y _ Z —L( L{
BIdg.Permit#: LiA L U� email:
Tax Map District: 1000 Section: OL4 Block: Lot:
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Circle All That Apply:
Is job ready for inspection?: (P/ NO Rough In incl
Do you need a Temp Certificate?: YES / NO Issued On
Temp Information: (All information required)
Service Size 1 Ph 3 Ph Size: A # Meters Old Meter#
New Service - Fire Reconnect - Flood Reconnect - Service Reconnected -,Underground - Overhead
# Underground Laterals 1 2 H Frame Pole Work done on Service? Y N
Additional Information:
PAYMENT DUE WITH APPLICATION
Request for Inspection Form.xls
S
Attn : John Jarski
Regarding a rm It
' # 44468
Mr. Jarski,
The enclosed plans from Suffolk County Department of Health
are to amend my open permit for 6640 Skunk Lame, Cutchogue.
There is a long history with this open permit, which you may
remember when you open the file. in any case, obtaining and
providing these stamped plans for this permit was the next step
in my process.
I am not sure what the next step should be, so if you or
someone from your office could help guide me in the right
direction, then I would be very grateful.
Lastly, -my address on the permit is out of date. If possible,
could it be updated to:
8555 Main Bayview Road
Southold, NY 11971
Thank you very much,
SEP 2 8 2020
Thomas Hudgens r
347-325-4347 r: �`
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,�'�LSURVEY OF PROPERTY
A T CUTCHOGUE � '�
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y. �w
1000-104-05-6.1
SCALE: 1 `-30 PA=S
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JUL Y 13, 2020 °� c
AUGUST 4, 2020 (PROPOSED SEPTIC)
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HOUSE SLATE OR OTHER CAST IRON
F.F. EL 14.8' SUITALE COVER LOCKING COVER
STOPPER END PLUG
//EL. 12.0' FINISHED GRADE
FINISHED GRADE EL.12.0' EL.12.0'
LE. 0 o 12
11 0' MASONARY CHIMNEY
12" 6'MIN. I MAX SCTM
" AREA 1000-104-04
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OF
I.E. i, 14 18' I.E. m
10.80WELL
6" 10.3' I.E. m DWELLING
'
1,/4" PER FOOT MIN. PITCH 2 8 1/8'PER FOOT MIN. 10.2' m m 0 = PUBLIC WATER
MIN. 4" DIA PIPE PITCH MIN. 4'DIA PIPE63
CU1SS 2400 PIPE OR EQUAL 4" ti CLASS 2400 PIPE OR EQUAL m m m
min.', 00 00® 23 ® m m s 3' MIN
+
3' MIN 0 m 27 05 C9 � m m O COLLAR 125
1000 GAL. PRECAST COLLAR 0 m m m ® M m o 0
SEPTIC TANK 0 0 0 � ® m m m a
0 0 2! on ® M m m A
4' LIQUID DEPTH o 0 0 29 27 ® es m m 0 s
N 0 0 27 2M G !S m B a _
320M 0 m m m 0
to3 200gn EnmESE m0
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SEPTIC SYSTEM DETAIL 00® � ® � m ma
Wminy
NIS 8,� = 0
'4 (2] LEACHING POOL$
(80 x 6' DEEP)
SLATE OR OTHER STOPPER END
SUITABL COVER OR PLUG GROUND WATER SCTM#
1000-104-04-6
DWELLING
SEWER PIPE PUBLIC WATER A •154)
VC EL 13.5'
30' ELBOW 00 +
60' WYE 1• �' N C N
CLEAN OUT DETAIL P``v CMF
Ft 0 EL 13.3'
NTS SCTM CLF MEETS
P �, WP OF PPS 2Nt ON
V8 M STOCKADE FEN.
1000-104#04-5 G.2'w
DWELLING j915° � N 1000 SCTM#1045-8
NOTE. WELL 150'+ N6�2 / ON CMF a DWELLING
EXISTING SEPTIC SYSTEM TO BE REMOVED AS PER SCDHS REQUIREMENTS
0 PUBLIC WATER
12 ON ZEX
EL 8.7' N v` – �� pExlsEArlNc �� SCTM
0 ? SEPTIC ➢� m 1000-104-05-7
CMF LP /8- LP TH DWELLING
011 EL 9.8' O �^I�� / ® EL=13.2' PUBLIC WATER
t� 0 STOCKADE FEN.
/ \ �`'•//
PROPOSED SEPTIC SYSTEM y
�' O ST AROUND AC UNIT slOCKpoE FEN
(3 BEDROOMS) PROP
0
1-1000 GAL. SEPTIC TANK Na, TANK AN cots^
2-80 X 6' DEEP LEACHING POOL �. BRICK PATIO WITH
GJ' -A BRICK STEP
:F.Ag C 0 CONC./BRICK
TEST HOLE DATA -, STOOP "GN CE
MCDONALD
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GEOSCIENCE 7% ' ��v
2227 Z
1 + CP 2 WK6 OUT SHOWER V1. 16
EL. .13.2' , DARK BROWN SANDY
0.5 LOAM OL �'� .,� 222
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BROWN CLAYEY ' STOOP
SAND SC WATER SED
� WATER SERVICE • ,_
O FEN.COR. '�r0 ""'� �i` ° ..w. ' w. `•: :w:�
EXISTING WELL TO BE O.TW W _ - ' t }-
^ ABANDONED. DWELLING TO BE 0 7'N s v~r ^; �- --i R:t;; a :'i ' r
CONNECTED TO PUBLIC WATER 1 f',
GMF a^g��ts."•r�i?•� as,
END FEN. EL 13.2'
SCTM# 0. WELL 0.8'N �.^'ii:it i ' j
PALE BROWN F/NE SAND SP '0 o.1'N
O + CLF END
1000-104-05-4.1 N
DWELLING 0. �N��N 12g• 0.1.w
WELL
EL. 1.4' �-+
CMF Fdr'i:
WATER IN PALE BROWN FINE SAND SP +5° SCTM#
1000-104-05-15 �--�-
CMF DWELLING
t W �, i
17' L 10.3 rj6g SCTM# WELL ;�r^ � R .0 a�,i1
FEN.END 1000-104-05-16 �^c . ,. , �'41;:AIRF i' -0 .----
�Q> 0.5'w DWELLING E �'€
�.�.,.
NOTE.• WATER ENCOUNTERED 11.8' BELOW 0.2'N PUBLIC WATER
SURFACE
ELEVATIONS REFERENCED TO NAVD 88
1000-10405-18.1t
1
d.
DWELLING �'b on-iic'A
e ..
WELL .. 1 s1:�e-..-,-`r•���: �:..1-:.
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KEY :�...��__ aw
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L
= REBAR
® = WELL
SCTM#
A = STAKE 1000-104-05-19
DWELLING
TEST HOLE
IS = PUBLIC WATER AREA
O WELL
B = PIPE
13 = MONUMENT
= WETLAND FLAG
71) = UTILITY POLE
= HYDRANT �4-� ��,�•y��
THE LOCATIONS OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM
FIELD OBSERVATIONS AND OR FROM DATA OBTAINED FROM OTHERS - `
THEREFORE THEIR LOCATIONS AND OR EXISTENCE IS NOT GUARANTEED.
ANY AL TERA TION OR ADD1 T7ON TO THIS SURVEY IS A VIOLA 77ON OF
N. Y.S. LIC. N0. 49618
SECTION 7209 OF THE NEW YORK STATE EDUCA T7ON LAW. EXCEPT PECONI C SURVEYORS, P.C.
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SIGNATURE APPEARS HEREON. 1230 TRAVELER STREET
20_03
SOUTHOLD, N. Y. 11971
SCDHS REF# R-20-1315 KEY
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