HomeMy WebLinkAbout45107-Z Town of Southold
o� o� 10/23/2021
P.O.Box 1179
N z 53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42475 Date: 10/23/2021
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 1590 Anchor Ln, Southold
SCTM#: 473889 Sec/Block/Lot: 79.-4-12
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
8/5/2020 pursuant to which Building Permit No. 45107 dated 8/14/2020
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"finished basement to existing single-family dwelling as applied for.
The certificate is issued to Fugosich Eva Fam Trust
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R-20-0337 8/24/2021
ELECTRICAL CERTIFICATE NO. 45107 9/21/2020
PLUMBERS CERTIFICATION DATED 8/25/2020 Cc#NRatsey
0
riz ignature
i
,Tr .b TOWN OF SOUTHOLD
S�FFod,��p�a BUILDING DEPARTMENT _
N z TOWN CLERK'S OFFICE
o +p SOUTHOLD, NY
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#: 45107 Date: 8/14/2020
Permission is hereby granted to:
Fugosich Eva Fam Trust
PO BOX 423
Southold, NY 11971
To: legalize "as built" finished basement to existing single-family dwelling as applied for
per SCHD approval. Additional certification will be required.
At premises located at:
1590 Anchor Ln, Southold
SCTM # 473889
Sec/Block/Lot# 79.4-12
Pursuant to application dated 8/5/2020 and approved by the Building Inspector.
To expire on 2/13/2022.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $1,512.00
CO -ADDITION TO DWELLING $50.00
Total: $1,562.00
Buil or
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:
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:
L 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.
New Construction: Old or Pre-existing Building: (check one)
Location of Property: D &4az__ lsls tee_ „�dc. �v�L
House No. Street Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section 71 Block 0 Lot
Subdivision Filed Map. Lot:
Permit No. I D7 Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
p 'cant Signature
®�*rjf SO(/l�,®l
Town Hall Annex ~ ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 ® o sean.deviin((-town.southold.ny.us
Southold,NY 11971-0959 •t° a
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Fugosich Eva Fam Trust
Address: 1590 Anchor Ln city,Southold st: NY zip: 11971
Building Permit# 45107 Section- 79 Block 4 Lot: 12
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: Jim Shaw Electric License No: 33381 ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement X Service
Commerical Outdoor 1 st Floor Pool
New Renovation X 2nd Floor Hot Tub
Addition Survey X Attic Garage
INVENTORY
Service 1 ph X Heat Duplec Recpt 29 Ceiling Fixtures 5 Bath Exhaust Fan 1
Service 3 ph Hot Water GFCI Recpt 4 Wall Fixtures 1 Smoke Detectors 2
Main Panel A/C Condenser Single Recpt Recessed Fixtures 30 CO2 Detectors
Sub Panel A/C Blower Range Recpt Ceiling Fan Combo Smoke/CO 2
Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 15 4'LED Exit Fixtures Pump
Other Equipment
Notes* "AS BUILT, NO VISUAL DEFECTS" Finished Basement
Inspector Signature: Date:
SLSeptember 21, 2020
S.Devlin-Cert Electrical Compliance Form As
o to SO�T�,QC
� o
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 G •
Southold,NY 11971-0959 Q
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CIERTIFICATION '
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i
1
Date: - 1,7S, �
LqBuilding Permit No. i
Owner:- _ -�_ 6_ .�6 l� /—�
(Please print)
Plumber•
lease print
I certify that the solder used d in the water supply system contains Iess than 2/10 of I%
lead. _
(Plumbers`Signature) -
Sworn to before me this a� !
i
day of 's 2040
1
Notary Public, S,-) tX-O I k County
_ LYNN E STEVENS
Notary Public-State of New York
NO.OIST6269424 s
Qualified in Suffolk,Count3
Commission Expires '7'c�y c�ORO
{
ho�apF 50UlyO� ' 45107 f �+ 1
# TOWN OF SOUTHOLD BUILDING DEPT.
co 765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] 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:
DATE C7 INSPECTOR
q 50U1y0��
TOWN QVSSOUTMOLD BUILDING' 'DEPT".
'765-18®2 b
ON.
_ .
[",],,'FOUNDATION IST",, ['"',] ,ROUGH PLOG. ,
],'FOUNDATION°2ND > �[ ];INSUL.ATIOfV/CAULKING
[ ] FRAIUIING/STRAPPING ' [ ],.`FINAL `} ,: ... %+
yx_>"
[`Y= J:_.FIREPLACE,&.CHIMNEY I ]� ,EIRE SAI=ETY INSPECTION
. . [ ]] FIRE"RESISTANT C- 6 y:T _ FIRE
. x �C_®�NSTRUCTION�,_',[:=-]-, RESISTANT`PENETRATION
[ ELE
C RICAL%(ROUGH) [ ],,'ELECTRICAL (FINAL) .
CODE V OLATI®N [ " PRE�:C/O ' , d
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DATE
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�NS1 ,10- I I NS E JER, I �N-SG
APR 8 2021
".7
February 1,2021
RE: 1590 Anchor Lane,Southold
BP#45107
Building Inspector
Town of Southold
Main Road
Southold,NY 11971
Dear Sir,
I have inspected the interior insulation and the rough plumbing and I certify to the best of
my knowledge that they meet New York State Building and Energy Codes.
NE
SS1
BOARD CERTIFIED IN SYRUCYURAL. ENGINEERING
J 0SEPH PFIS cH F--r-ri.cam FISCHET-I-IEN GIN IEERI NG.CDM 631 -765-2954
1 725 HOBAR-r ROAD sou -rHOL. D , NEw YORK 1 1 97 1
FIERY)INSPECTION REPORT DATE
COMMENTS
b
FOUNDATION(IST)
FOUNDATION(ZND)
i13)
ROUGH FRAMING& �
PLUMBING (1
INSULATION PER N.Y.
STATE ENERGY CODE
FINAL '
tn If
' d
fN
•4DA :VPS'AL COUNTS
zk 660�2 ® .
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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. �/ , Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
_ Flood Permit
Examined '20
�U Single&Separate
Truss Identification Form
Storm-Water Assessment Form
Contact:
Approved ,20 Mail to:
Disapproved a/c - - -- - - - ,- .- --- --- -
' /1 Phone: i
Expiration 120
i FCJIC 1� ! Bui gctor
- AUG - 5 2020 1 APPLICATION FOR BUILDING PERMIT
Date � Z6 , 20
BUrLDING DEPT. 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 app cant or na ,if a corporation)
�g ���
(Mailing address of applicant)
State whether applicant is owner, lessee, agent archi ct, engi er, general contractor, electrician, plumber or builder
Name of owner of premises
(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. .FS'
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed wo will be done:
�Z_
House Number Street ,""_'Hamlet
, 1,
County Tax Map No. 1000 Section 7 Bloch 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
b. Intended use and occupancy
3. Nature of work(check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work g,,�e,s5
(Description)
4. Estimated Cost /E0 d 0 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 CD
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existii g structures, if any: Front U Rear Depth
-Height f Number of Stories
Dimensions of same structure with alterations or additions: Front Rear ��—
Depth �' <— Height ,SA1V1%--1--- Number of Stories 1
8. Dimensions of entire new construction: Front �}°'-TL-� Rear -5A�-Depth
Height S' -- Number of Stories +: ,' "1Fr
9. Size of lot: Front -760 Rear Depth
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO
13. Will lot be re-graded? YES NO/—Will excess fill be removed from premises?YES NO
14. Naives of Owner of premies � /��>5 e-® Address Phone No.
Name of Architect /// JL4 / Address Phone No
Naive of Contractor e-P11 ®� Address Z25L_Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES 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)
nn //�� SS.
COUNTY 0173 ' 1 )
/i ✓ being duly sworn, deposes and says that(s)he is the applicant
(Name of individual si ing contrac ove named,
(S)He is the
ontractor,Agent, Corporate 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.
Swor t c ore me this
ayof rJs�" 20�C)
F-, LYNN E STEVENS Notary Public-State of New Yor
Notary Public NO 01 ST62694 Signature of Applicant
Qualified An Suffou
Commission Expires y"
o�OS�FFO(�-CO BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
� all,Annex - 54375 Main Road - PO Box 1179
N � uthold, New York 11971-0959
y o i rt Telephtoln (631) 765-180,2 - FAX (631) 765-9502
��l SEP � o2o,ldtownny.gov -�- seand(a�southoldtownny.gov
APPLIC I ,.,.ELECTRICAL INSPECTION
ELECTRICIAN INFOR Anr" T O�t (AI In1oUa on Required) Date:
Company Name: zs'1�,,, t/_-PJ Qu_G�Z�
Name: '7::S)
License No.: - email:
Address: i J _
Phone No.: 3j - r-5--T—
JOB SITE INFORMATION (All information Required)
Name: Fi)c,0 S 1 c A
Address: I SNc�idn �N S�✓
Cross Street:
Phone No.: 5_S3'S3
Bldg.Permit#: 45-10-) email:
Tax Map District: 1000 Section: Block: Lot:, '
BRIEF DESCRIPTION OF WORK (Please Print Clearly)
Circle All That Apply:
Is job ready for inspection?: YES)/ NQ Rough In ina
Do you need a Temp Certificate?: YES N'0' 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: h✓l`
PAYMENT DUE WITH APPLICATION G
�I-Ah
Request for Inspection FormAs v
I V0
I �
I
s
.y ,•'fi
-
81 - 15 218 Street
APR 8 2021
Queens Village, NY 11427
April 6, 2021
Southold Town Building Department
R O. Box 1179
Southold, NY 11971
Re: Building Permit No. 45107 for 1590 Anchor Lane, Southold NY Finished Basement
Dear Building Department Representative:
For Building Permit No. 45107 the following outstanding items are being submitted:
1. Final Survey from Peconic Surveyors, R C.
2. Certification of insulation and rough plumbing from Fischetti Engineering
If you have any questions, please contact me at (516) - 592 - 3127.
Thank you for your attention to this matter.
Sincerely,
( Ms.) Carol A. Fugosich
(Trustee)
2 - Enclosures
caf
�181 :3 CIQ q
Town Hall Annex Telephone(631)765-1802
54375 Main Road 411 Fax(631)765-9502
P.O.Box 1179 a
Southold,NY 11971-0959
G �
BUILDING DEPARTMENT
pril 26, 2021 OWN OF SOUTHOLD
Eva Fugosich Family Trust
P.O. Box 423
Southold, New York 11971
IEL1§90 Anchor Lane, S old
Note Smo e e ectors required in each bedroom, also 1 outside bedroom area within 14'
of bedroom smoke detectors. Carbon monoxide detector also required.The detector
outside the bedroom area can be a combination smoke/carbon monoxide detector.
TO WHOM IT MAY CONCERN:
The items marked below are required to obtain your Certificate of Occupancy
Chapter 236, Soil stabilization required.
Electrical Underwriters Certificate. (631-765-1802)
X Final Health Department survey.
Plumbers Solder Certificate or Pex Affidavit
Trustees Certificate of Compliance. (Town Trustees # 765-1892)
Final Planning Board Approval. (Planning # 765-1938)
Final Fire Inspection from Fire Marshall. (631-765-1802)
Storm Shutters required for all glazing
Energy Test Results and Manuals required
Final elevation certificate from surveyor.
Spray Foam Insulation Certification from a NYS licensed architect or
Engineer
BUILDING PERMIT: 45107-Z "as built" finished basement
81 - 15 218 Street
Queens Village, NY 11427
September 20, 2021
Southold Town Building Department
P. O. Box 1179
Southold, NY 11971
Re: Building Permit No. 45107 for 1590 Anchor Lane, Southold NY Finished Basement
Dear Building Department Representative:
The Final Survey from Peconic Surveyors, R C with Suffolk County Health Services Approval is
being submitted to include in the file for Building Permit No.
gslo7
If you have any questions, please contact me at (516) - 592 - 3127.
Thank you for your attention to this matter.
Sincerely,
( Ms. ) Carol A. Fugosich
(Trustee)
1 - Enclosure
caf
Dwyer, Tracey
From: Carol Fugosichl <carol.fugosichl@verizon.net>
Sent: Tuesday, February 02, 20212:18 PM
To: Dwyer,Tracey
Cc: Carol Fugosichl
Subject: 1590 Anchor Lane - Southold NY 11971 Final Inspection -45107
Attachments: Document-2020-08-31 Southold Building Dept Inspection.pdf
Dear Ms. Dwyer:
RE: 45107 Town of Southold Building Dept. -Final Inspection
As per your request, I have attached my copy of the Town of Southold Building Dept. - Final Inspection for
45107.
If you have any questions,please contact me. My home telephone number is ( 718 ) - 464 - 3424. My cell
phone number is ( 516 ) - 592 - 3127.
Thank you for your attention to this matter.
Sincerely,
Carol A . Fugosich
i
REGE LD
CONCRETE R z+, N� General Construction NotesCOLLA
S1oPPER FND
7EST HOLE DATA ItOR.PLUG �® 1 LOT AREA 22,000 S F OR 51 ACRES Q
McDONALD GEOSGENC£ i LIAR Y 6 2020 �lS�6�� � 2 SCTM#1000-79-0412 �
9/10/19 RISER It col R � L�
Q' 22•2• CO
,PINT 3 BOUNDARY AND TOPOGRAPHIC INFORMATION FROM A SURVEY BY Peconic Surveyors dated November 15,2019 O
PACK a ELEVATIONS REFERENCED TO THE NAVD 88 DATUM
PALE BROWN SILT ML '°1"�`S ^"'-' I 4 ALL MATERIALS AND METHODS OF CONSTRUCTION SHALL CONFORM TO THE STANDARDS AND SPECIFICATIONS
_ SUFE• CO.0O '•` '" ,ICES r OF THE TOWN OF SOUTHOLD AND THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES AS REQUIRED
3' O (nPIPZPECAO C�++ °.'- - !r. a ,,p i!J
®EEB�sE Se+ ��L.a..:. f.��+.•+wt r e`V3�aT. Z 5 THE CONTRACTOR SHALL FIELD VERIFY THE LOCATION AND DEPTH OF ALL UTILITIES PRIOR TO THE
PVC PIPE D304 COMMENCEMENT OF WORK THE CONTRACTOR IS ADVISED ALL SUBSURFACE INFORMATION SHOWN ON THESE pj-'
C1 3d `''oR' s t�®. PLANS IS CONCEPTUAL AND MUST BE CONFORMED ACCORDINGLY IN THE FIELD nn
PALE BROWN SILTY SAND SM TO S �O 6 THE CONTRACTOR SHALL BE RESPONSIBLE FOR SECURING ALL NECESSARY PERMITS BEFORE COMMENCING
�qy OME.LJNC TANK u vr/
SCTM# 1000-79-04-5 SS%O�� WORK IJ ^ h�iNq
13.0` GL 60°PVC WW N�,7,�� DWELLING 7 ALL UNSUITABLE MATERIAL AND DEBRIS SHALL BE DISPOSED OF IN ACCORDANCE WITH TOWN,COUNTY,STATE I, „ `Z
,�; AND FEDERAL LAWS CODES AND ORDINANCES CONTRACTOR SHALL BE RESPONSIBLE FOR DISPOSING OFF ALL v�
PUBLIC WATER SUR;"ACE WATERS 250' NORTH UNSUITABLE MATERIALS OFF SITE DEBRIS SHALL NOT BE BURIED ON THE SITE
BROWN FINE SAND SP CLEAN OUT DETAIL 1
ACROSS ANCHOR LANE >- reO
I 8 ALL PRECAST STRUCTURES SHALL BE APPROVED BY THE COUNTY AND COMPLY WITH THEIR REGULATIONS
1119' N.T.S. 7 0• j
NOTE.• NO WATER ENCOUNTERED9 ALL PRECAST STRUCTURES SHALL BE MANUFACTURED WITH 4000 PSI 28 DAY STRENGTH CONCRETE M O
£LEYANIONSR£FER£NCEDTONAVD88 SCTM# 1000-79-04-6.1 10 SANITARY PIPE TO BE SDR-35 PVC OR AS SPECIFIED ON PLANS �J
78s• E , - - 11 DURING CONSTRUCTION,EROSION AND SEDIMENT CONTROL MEASURES TO BE UTILIZED AS NECESSARY TO Q G�
AbAbandonment p p� DWELLING PREVENT THE TRANSPORT OF SEDIMENT TO OFF SITE AREAS,PONDS,DRAINAGE INLETS THE METHODS AND
andon nt of existing.�:Z��Car*al s., rnust be in MATERIALS EM_P_LOYED IN THE INSTALLATION AND MAINTENANCE OF EROSION CONTROL MEASURES SHALL
PUBLIC WATER CONFORM TO THE NEW YORK GUIDELINES FOR EROSION AND SEDIMENT CONTROL
comfom, anee with department requirement Mitt
y �$J� Jy/� 12 ALL BACKFILL SHALL BE SELECT GRANULAR MATERIAL COMPACTED TO 95%MAXIMUM DENSITY AT THE OPTIMUM a�--
com lee f®ri'n yr ®Y IM- `�s proof. 1 MOISTURE CONTENT AS DETERMINED BY STANDARD PROCTOR TEST z
d' 700�
L 18.9' EX @9ATI m jNsPECT �9 REQUI NMAP Oo F �II�° G�3CBOo G3 ��C��ITS Q
WELL ® CMF /Q n q a��` ARY SYSTEMESTATES SECTON til �
~ (LOCATION BY OTHERS) O� `S6'4e 1�/� HF—AL DEPARTMIENT FLED 1965
LOT 38 70"
pUevc w�O SCTM# 1000-79-04--
&CTM# DWELLING 04 0 4 oo WATER ebce pF A�R�H)� DWELLING I��I
WELL ^ METER p �F FT q
A PUBLIC WATER
O EL=22.2• Np 160 j
0' ub
EsJI >
gspygC ® M im W d
[� TDR/
2 SHA y 04
in �L. � ,� ® n n z_ O
CONC. ro ?20 0 2Oo e= _a 1 Im 8g. luul
ORCH
0¢ OCON ./STONE 00' `t � C� ia
g�cq ® � z I�
�V ?3 ASPyA�7 D EL 15.3' = i i LOT 39 R�0� ECONIC. ti �SCTM# h PATIO7 83, �� c� 3 LJ1J z P1000-79-04-15R12 r:, N 1� 0 _
DWELLING ,3 C • 6U�'�R. EL 16.9' 0 �� y
WELL LL
EL 22.8' �O� PROPANE�p ^ FF CV �R9 ANG °`45. rs
EL 24.3' TANK ?I,N. 64' enNDOW ^i CE 1 LOT 40 0 � ,� 1 d W x
FE.END �
PIPE WELL "� EXISTING O ® R. F'° =3- O
�p 0.2'N VENT 3p0. SANITARY TANK EP O 0 w (�� r Uj
CONIC. O TO BE REMOVED-;, I 81 0MIN rae0
SRF PORCH AC U
NGS[O GENERATOR�ICO O O ?; O LP ,"fig �; t y
O S SRF END O ,, 8' PROPOSED
70,,
0.3'S PROPANE GAL 500 C
WELL � , MIN 8'X12' �, O
TANK f1$ 0 � Ed �l
CLF END 150.2' �J
0.6'S FROM WELL
DRAWN f�� :JF/JP
N 'FR. SHED LOCK
C. �� LOT 9
ON BLOCKS LINED V� SCTM# 1000-79-04-11 MARCH 9,2020
04P ^"? N4?� COMPOST hpc D WELLI N G
PUBLIC WATER SCALE:AS NOTED
20000. �N ROBERT CARVER SANITARY DESIGN
%LOT 41 TIMBER 1740 ANCHOR LA. 5BEDROOMS SHEET NO;
RET. WALL RET. WALL END SEPTIC TANK=1500 GALLONS=8FOOT DIAMETER 5 FOOT LIQUID
1.2'W LEACHING=(2)8 FOOT DIAMETER X 12 FOOT LIQUID
SCTM# 1000-79-04-13 FE.COR. 21.1' EXPANSION=(1)8 FOOT DIAMETER X 12 FOOT LIQUID
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o sEpne OL145 CLIPPER DR. HTE PL E
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SCDHS REF# R-20-0337 A T SO UTHOLD
TOWN OF SO UTHOLD
SUFFOLK COUNTY, N. Y.
SCTM# 1000-79-04-4.1 1000-79-04-12
DWELLING
PUBLIC WATER SCALE: 1'=30
101, // NOVEMBER 15, 2019
JANUARY , 2020 ( ION
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SCTM# 1000-79-04-5 MARCH 11, 2021
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9/10/19 DWELLING
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FILED /N 1NE SUFFOLK COUNTY CLERKS OFFICE AS FILE NO. 4.362. y,s LIC.'-NO. 49618
ANY AL7FRA77ON OR ADD177ON TO THIS SURVEY/S A WOLA77ON OF SEC77ON 7209 OF PECON/C SURVEYORS P.C.
THE NEW YORK STATE EDUCA77ON LAW. EXCEPT AS PER SEC77ON 7209—SUBDIVISION 2. ! SCTM# 1000-79-04-17.26 631 765-5020 FAX 631
AREA= 22,000 SO. FT. ( ) ( ) 765-1797
ALL CERI7FICA170NS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY /F DWELLING P.O. BOX 909
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR WHOSE
SIGNATURE APPEARS HEREON.
1230 TRAVELER STREET
SOU7HOLD, MY 11971 19-056
N . SURVEY OF PROPERTY
SCDHS REF# R-20-0337 AT S,0 UTHOLD
TOWN OF SOUTHOLD
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THE NEW YORK STATE EDUCATION LAW. EXCEPT AS PER SEC77ON 7209—SUBDIVISION 2 (631) 765-5020 FAX (631) 765-1797
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APPROVED AS NOTED
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NOTIFY BUILDING DEPARTMENT AT NEW YORK STATE & TO`�Vt CODES ON LEAD CONTE i RE
765-1802 SAM TO 4 P FOR THE AS REQUI-RED AND COR: 1I -!CNS OF CERTIFICATE OF DCMANCY
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