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HomeMy WebLinkAbout13051-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z'138q7 Date September 3 19 85 new dwelling. THIS CERTIFIES that the building ................................................ Location of Property .... 7.~:5 .................. ~g_.m.m.5,~..I)?... ................ ~..~.i.~u. 9k t~ouse No. Street ~ Hamlet County Tax Map No. I000 Section .... .'I.0.C~ .... Block ........ '1. ......Lot ....... .~.~ ....... Subdivision .............. X ................ Fried Map No .... .X .... Lot No. X conforms substantially to the Application for Building Permit heretofore Fried in this office dated ...... JaI~.uary. 2~...., 19 .~3q-pursuant to which Btrilding Permit No .... .~3..Q~.'l .~. .......... dated ..... g,p~.Sj[..!.~ .............. 19 .~./~., 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 ......... ...... A. ~e~r. ~.w.e~-~-~g, ........................................................ The certificate is issued to .............. 33~"~O~..&. ?.~1~..X..Q .g~.._~, .~.~. ..................... (owner~ of the aforesaid building. Suffolk County Department of Health Approval ......... 'l 3-S0-2~ r? N662392 UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 FORM NO. ~B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEPJ~IT N[UST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13051 Z County Tax Map No. 1000 Sectio~n ...... ~...0...~¢. ....... Block ...... ..~...[ ......... Lot No ....... ..~....~. ........... pursuant tO opplicotion doted ...~.......~...~ ................. , 19.~....~., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ia ~[11~ to the Building Inspec- tor with the following; for new buildings or new use: il. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. ~2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). '3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Su bm it P lan n lng Board app royal of completed site p lan requirements where applicable. B. For existing buildings (prior to Aprit 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 c.o. _ Dat .~. New Building ...."~ ....... Old or~Pre-existing Build, in9 ............ Vacant Land .... , .....~. ·. Location of Property..~'.-. ~. .... ~~./~ ................. .'~.~,..~..~.C:~... House No. Street Hamlet Owner or Owners of Property .~..~--~-4~,~,>,~.',*,.v-~..w .~.~¢~ ......................... County Tax Map No. 1000 SectionYf--~. ........... Block .. Z~Z ......... Lot..(~. ~J.~. ........ Subdivision ................................. Flied Map No/' .......... Lo,t~lo.. ~. .......... Permit No../.~.d,,.).~. ate of Permit . .Applican ........ v" ~ ov Health Dept. Approval ........................ Labor Dept. Appr a ........................ Underwriters Approval ~'. ...................... Planning Board Approval ..~/./~.-~..f~.'~.'. .......... Request for Temporary Certificate ..................... Final Certificate ~ ..................... Fee Submitted $.. ,~.~.~..(~....~'..~. ~.~. .... Construction on above described building and permit meets all applicable codes and regulations. Rev, ~o-~o-78 ~f James V. DeLucca 12 LindaLane East Riverhead, NY 11901 April 4, 1984 Town of Southold Building Department Town Hall Southold, NY 11971 Mr. & Mrs. Byron Canaris 735 Summit Drive Mattituck, NY 11952 Dear Mr, Hinderman: TO answer your notice of disapproval dated Jant~ry 27, 1984, referencing the above building permit, the following corrections are being made so that a building permitmaybe issued: SITE PLAN 1. Letter from owner, .(which is enclosed) r~eleasin~i~th~' To~n of Southold from any liability of structural damage. 2. Access to the building is off Sound Beach Road, with appropriate driveway rather than Sunrait Drive (survey enclosed). BUILDING PLANS 1. Calculation of glass area verses wall area is noted on sheet 1 of 5 and lneets Energy Code Requirements. 2. All other items listed ~der your conr~_nts are not re- quired for the reason being, this is a totally new structure. Please note estimated cost of construction of new structure is $90,000.00 verses $120,000.00. I would greatly appreciate if you would expedite this building permit. If you have any questions regarding the above, please feel free to contact me. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 1197! TEL. 765-1802 April 24~ 1984 James De Luca 12 Linda Lane East Riverhead, N,Y. 11901 RE: B.P. #13051Z-Byron Canaris Dear Jim: This is in answer to your inquiry regarding access- ibility requirement to premises from both Sound Beach Dr. and R.O.W. off Summit Drive. Once the R.O.W. has been improved and approved by the Planning Board~ you may amend your application for this permit by abandoning driveway access from Sound Beach Drive and submit new site plan showing R.O.W. from Summit Dr. as access to property. Only the R.O.W. from Summit Dr. will be recognized as the access to premises and driveway,from Sound Beach Dr. will not be required for purpose of issuance of Cer- tificate of Occupancy. Trusting this will clarify any questions you may have. Ed Hindermann Building Inspector EH:hd THE NEW YORK BOARD OF FIRE UNDERWRITERS 10000~2 BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW YORK 100~8 THIS CERTIFIES THAT only the electrical equipment as described beJo~ and int~duced by the applicant na~ed on the above application number in the premises of B. C~n~ria~ ~ of :,[iri~n ~ad & ~ ~nJ.t Drive, C~tz~l ~ ~i~ ~, ~;~tituck~ in the yollowing location; ~ Basement ~ 1st FI. ~ 2nd ~7, Section Block Lot wasexamlnedon ~O~i~X' ~7~ ~.~ andfoundtobeincompliancewiththerequirementsofthisBoard. FIXTURE ] [ FIXTURES RANGES COOKING DECKS OVENS DISH WASHER~ EXHAUST FANS ~1 40 39 41 i 11.7 1 ] ' 3 F Z ~0 I SERVICE DISCONNECT NO. OF S E R ~ I C E ~T. ~P ~PE EQUIP. 1~2W I ~3W 3~3W 3~4W NO OFpERCC~COND OFAccW, G,CONO NO OF HI-LEG OFA'W'GHFLEG NO~ OF NEUTRAL: oFANEuTRA[ ~ ~5o cbx, ~ ~/0~' ~/0 227 N. B~vat~ ~ad ~ ~.~- } / ~ttJ.~ck, N,Y. 119,52 Lie. 1529 GENERAL MANAGER This certificate must not be altered in any manner; return to the offce of the Board if incorrect Insnectors ma be identf ~~~.~~~~ y ed by their crede~trals. YOFCERTIF ANY MANNER.~ TOWN OF SOUTHOLD OF£.iCi.; Ok BUiLDiNG INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-I 802 CERTIFICATION Date Builains Permit ~o. ~ ~ O (please print) pluraber ~ S~m,~R~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s signaturei Sworn to before me this ~-~ay 0f~2)~7£l~ , Notary Public,~._~_COunty I~SPECTION COMMENTS FOUNDATION (lstl FOUNDATIOH (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: TOWN OF $OUTttOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y, 11971 November 5, 1984 TEL. 765-1802 James De Luca 12 Linda Lane E. Riverhead, N.Y. 11901 RE: B.P.#13051Z Dear Mr. De Luca: This will confirm that a final inspection was made of dwelling constructed under this per- mit and was approved for issuance of Certificate of Occupancy. Please refer to my letter of April 24, 1984 (copy enclosed) which makes reference to improve- ment of R.O.W. from Summit Dr. before a certifi- cate of occupancy can be issued. If you have any questions regarding this matter contact me at this office. Elt;hd Byr~ Canaris i38 37 62nd Ave. Flushing, Buildi/g Ynspector N.Y. 11367 P.S. Underwriters Certificate, Suf, Co. Health Dept. and application for C.O. required. C~mmAL OONDITIONS All work of the entire project shall c~1¥ with state, county, local laws and regulations including the D.E.C. All material shall be new and of good q~alitv. All workmen shall be skilled in their trades, and all workmanship shall be of good quality. The contractor shall unconditionally guarantee all materials And ~rkman- ship furnished or installed by. him or his sub-contractors for at least one (1) year frcm the cc~pletion of the entire project. The contractor acrrees to ren~dy and deficiencies of the above appearing within that period with- out expense to the owner. The construction contract shall include and provide all labor materials, ~equipment, transportation, taxes, etc. necessary to the completion of the house and decks as specified in the construction drawings and in these specifications. The contractor shall include everything necessary for sati~facto.rv cc~- pletion of the work including all work not shown or called for that in c~.,~'on practices would be deemed to be covered by or reasonably able to be infez£~d frc~ the specifications and drawings. The contractor shall be responsible for satisfactory performance of all work, be responsible for all acts and ~issions of all parties involved in the work, ensure that each trade is fully informed of full extent of work required and coordinate installation of all _equipment and systems includina items supplied ~v the owner. Work shall conform to the published specifications of the applicable manufacturers unless othez~ise specified or indicated. The contractor shall at all times keep the site clear of debris and rubbish, and at the completion of work prc~otlv remove tools and ecn/iD- ment, rubbish and surplus materials, leaving the house and site clean of construction debris. .~XCAVATION AND ~ILL All ground cover where proposed' house will be located must be re,Dyed off site. Top soil must be stripped as required and stock piled on site. At the cc~pletion of the house top soil must be spread as reGuired. Excavation and fill as reouired for driveway and foundation, ali. as deterred_ned bva licensed surveyor and the Town of Southold, N.Y., setback and elevation requiredments. It is f-he contractor's resronsibilitv to maintain and restore any damage w~ich may be done to the Right-Of-Way Driveway. FOONn~I~ All footings are to be footed c~ virgin soil and be made of 3,0~0 lb. concrete mix. All concrete foundation walls are to be 8" poured concrete and 12" footing poured concrete below chimney. Basement and garage slabs are to be poured on compacted fill over %rapor barrier with 6" X 6" steel re-enforcing wire throughout. Foundation is to be dampproofed in L~o (2) stages. First staae to be brush on coat of dant0proofing. Second coat to be trowel on with damp-'' proofing mastic. Before tittle,roofing is apglied snap ties must be broken off at ¼" below surface of foundation and marqed with portland cement. Fireplace Living t%oom to be brick front up to mantel height and 1 ft. on beth sides of fireplace opening. Brick type to be chosen ~ c~a~er. Fireplace flue liner to be 13" X 13" clay pipe and boiler flue linin~ to be 8" X 8" clay pipe. Heatalator to be a 48" Model A Heatform brand, with an' 18" bluestone Provide firestopping at floor and roof framing at chimney. Flatroof to be U.S. Intec Brai, Mebrain tyme. With three 3" internal drains, aluminum gravel, stop at edge and cover roof with alumin~n roof coat. Pitchrcof 240-1b. selfsealin9 asDhalt shingles over 15 lb. felt. Color of shingles to be chosen by owner. 3% batt insulation in ey+erior walls (kraft foil). 9" batt insulation in flat roof (Kraft Poll). 3%" batt insulation (foil faces) at underside of floors. facing unheated space. Provide adequate roof ventilation as shown on drawings. 12" bart insulation pitch roof. Pac~e -2- EXTERIOR 1" X 6" T/G cedar sidir~, grade No. 1, treated v~ith preservative such as Cupinol or ecp,~l. No loose or open kDots. 15 lb. building paper. 1/2" sheathing grade plym~od, CDX. 2" X 4" wall studs at 16" o.c. 3% fiberglass batt insulation . 1/2 plasterboard - ta~ed, .spackled with at least 3 coats to provi~ smooth and indistinuuishable joints and painted. All framinq lumber must be Douglas Fir #l. All 2" X 4" wall studs must be kitm dry. All exterior he~ders shall be (2) 2' X 12") except as noted All exterior nailing shall be done with galvinized nails. All exterior decking and sfai rs shall be CCA lumber. Ail exterior siding soffit and facia shall be 1" X 6" V oroove All exterior lumber must be pre-stained before installed, including CCA lumber. INi'~RIOR W~tT .T ~q All framin.~ lumber must be Douglas Fir #10 2" X 4" walls studs 16" o.c. 1/2 plasterboards both sides - taped, spackled and rk~_nted. Use waterproof sheetrock, be~hind all ceramic tile work. CEILINGS 1/2 plaster board, tarried, soackled with at least 3 coats and painted. All window,s to be c~radco w~od case3~nt with insulated qlass and wood screens. Sizes as noted on drawinqs. EXTERIOR SWINGING & SLIDING Ail exterior doors are to be Peachtree type with insulated class. Screens to be provided for slidinq doors. Sizes as noted on drawinqs. SKYLIGI~fS All skylights are to he Insula Dome, clear tk~e %~ith insulated qlass. All skQ~,li~hts to be vented type. Sizes as noted on drawings. Should be flat ~an~t~ v.~dl w~th cedar ap.~lie~ to ~atch sidinq. Sizes as note~ on IDleR/OR F/NISHING All interior doors are to be birch veneer stain grade, except as noted on drawings. Interior base t~im and door jam trim to be 1/2" X 3" square edge stain qrade pine. Closet ~aelving and supports are to be of #2 pine stain. Medicine cabinet for master bedroc*n bath s~u3_ll be Miami Carey, (Broadview CSP 422-60) Antique C~ld. .~licine cabinet for hall bath, quantity two (2) (Broadview CSP 420-36) Antique c~ld. Stairs frcm living roc~ to bedrocm area are to have oak treads. Handrailing to be of oak frc~ liv/n~ room to bedroom area. Spi~al staircase frc~ basement to loft must be Mylen type~ (C~q-100) with pipe railing as rec~uired. 1% oak treads and platfozm is to' be installed on stairs as r ~equired. Loft railing is to be manfactured to match railing for spiral stairs. Floors ~ to be prepared to accept finishing. Materials as noted in finishing schedule. Walls are to be water~roof sheetrock. Unglazed cer~ic tiles on floors and walls (4 '-0" high) except tub srea. All tiles selected by owner. PAINTING & STA!NIL~ Ail walls & ceilings to have two (2) coats of latex r~mint. C~lor to be chosen by owner. Ail interior trim to be either painted ~rith two (2) coats of semi gloss paint or stained as rec.,/ired. Owner to choose stain or paint. Exterior %~indow & door trim to receive two (2) coats of oil base paint. Owner to choose c61or. Exterior siding, facia and soffit to receive one (1) ~oat of oil base stain before installation. O%~er to choose color. ELEt'rRIC-AL Codes, perm/ts, certificates: Regulation of Local and State Authorities, National Electric code, Local Telephone and Electric Cc~oanie$, shall be com~ plied with. Obtain necessary certificates and perm/ts frc~ Board of Fire Underwriters, arrange for electric, telephone service installation with local utilities. Electric service to house shall be 150 Provide and install general or e~uiva/ent circuit breaker type panel box in basement. All wire to be copoer Romex, sized to code. Page -~- HEATING Installatic~ and equipment shall cc~fozm to New York State Energy and New York State ~uilding Code. Insulate all heat piping in baser area R -- 4.6 minin~ra. Equipment and systmns subject to damage from freezing shall be adequately protected against freezing. Provide and install a complete 3 zone central oil fired warm air system with heating capacity guaranteed to assure an even 70 o F. indoor temperature with ~ outdoor t~mperature of 10 o F. and a 15 mph wind. Provide and install 550 gallon oil ..tank (fiberglass coated), complete with fill and vemt lines and fuel supply lines to burner, with a filter bet-w~en tank and hamer. 1. fine 3 zone heating system with Rmpco boiler with tankless coil for domestic hot w~ater or equal 2. 3/4" Grundfus circulator or equal 3. Beckett burner with Honeywell controls or equal 4. Embassy 3/4" baseboard or equal 5. Honeywell T 451 line voltage thermostat or equal. KITCHEN Allowance to be provided. I~itchen to be selected by the o~ner. Appliances to be selected by o~ner. PLI~YBING All fixtures to be American Standard. Color and model selected by owmer. (fiberglass tub enclost~res). All faucets and tub diverter shall be C~rber or equal. Provide two hose bibs at the exterior.. Provide floor drains where required. All pltm~bing ~rk to be done in full conformity with local and state codes. Equipment and systems subject to damage from freezing shall be adequately protected against freezing. Sanitary. drainage syst~n to include all required septic tanks, cesspools, and drainage pipes. Contractor to obtain all permits, inspections, and approvals. Pa~e -5- Cmntractor to maintain cleanliness during ccnstruction. Cx~ntractor to remove all debris at the final ccmpletion of the construction. GRADLNG AND lANDSCAPING Ccmplete all grading as required, + or - 2". landscaping to be provided by owner. 5" well to a depth of 180 ft. at ground level. 5' ft. stainless steel scl~en. 1 H.P. ~uld sui~ersible pump. 1" galvanized drop pipe. No. 12 sutmmersible .Dump cable. 5" well seal. Block ~11 pit and trenching. DRi%~E~V 20' wide asphalt driveway with, 1½" wearing course .New York State Mix .Type lA. & 1½" base course of stone blend. Page -6- TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No. ,. ~ .............. · ............. PLEASE TAKE NOTICE that your application dated ... .- ~. -, 19 ~<~. for e~it to const~ct...~/~., ~ ~(~ ................................ at P ~ Locauon o] rrop Y ~s~ No. Street " County Tax Map No. 1000 Section ..[~ ....... Block . .~.~ ........ ~t .~.~ ...... is returned herewith and disapproved on the following grounds ................... . ............ ............ . .... ~. ~r<~.~r/~... ~cr2x~xm~ ............... $3uilding Inspector RV 1/80 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST I/X,] ROUGH PLBG. FOUNDATION AND [ ] INSULATION [/~/FRAMING [ ] FINAL REMARKS: DATE FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined....C~... ! .~..., 19~.~. Approved . . .C~...~.~...., 19~.q. Permit No.]. .~.O.~.)..'~.. Disapproved a/c ..................................... Received ........... t9... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ................ , a. This application must 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 detailed description of layout of property must be drawn on the diagram which is part. of this appli- cation. 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 issued 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 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 f%r~removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, buildi./~.g//code, housi~, and re~d~)ior~s, and to admit authorized inspectors on premises and in building for necessary ~ //~ j ) ~ · ~.-~'~e'o'~ ~pli~e, ~fa corporation) /.//..z../, :.T./T, State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ..................................... /4,, 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) Builder's License No.. [/,¥I~./UOW..~...~..-[7.. T./?l/. Plumber's License No. t~..P/k./Y.O.~.~. · .... o Electncmn s L~cense N · Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. · · ./3. ...... ... ~ House Number Street Hamlet County Tax Map No. 1000Section ...... /~..~. ...... Block ..... .C?.[. ........ Lot. '~4 Subdivision C/q~...~?./t~/ /~/~t~ ~" .~.~.~../T.~'..~.. Filed Map No...~. ~:>.7..~. .... Lot.../..~. ........ ~ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed constrttction: a. Existing use and occupancy ....................... .~ .......................................... b. Intended use and occupancy . . .'~.../. '.~Y~.~.~.'r~...../~...~. · .~7./- (/· · ../~- - -/'~- -/~.~. -~. //.~.- 3. Nature of work (check which applicable): New Building ......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... (Description) 4. Estimated: Cost, /-/Al, i (to be paid on filing this application) 5. If dwelling, number of dwellin~ units ....... L. · · .,. · · Number of dwelling units on each floor..'~ ........ If garage, hum ber of cars .... i ~ ....~,A/~./~'' ~.~.~._q~.. .............................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ........ ~ ............ 7 D' ' fex' 'ngst tures 'f F -- Re D pth · lnlenslOllS o lstl ruc ,1 any rout ..., ar ..... '7 ........ e ............... Height '--' Number of Stories Dimensions of same structure with alterations or additions: Front . ' .............. Rear .................. Depth ~ " Height Number of Stories 8. Dimensmns ofe ttre new construction' Front --~ . .F~/~' Rear O ~ De th .4(0 ~ . Height .. 2..~....7~.... Number of Stories ..... / .................................................. 9. Size of lot: Front .... /_O_O..!.~.C~.. ........ Rear . /O.~f..-.O.&? ....... Depth,~../~.~'...,~.zJ.~..,~(~ ..... 10. Date ~feurchase ./~./.D.~(.. ~.q.'7...~. .......... .~,~ ~a~; ;~Former Owner . .~.AY//q~.~tf~.fK2./~./ .............. 1 I. Zone or use district in which premises are situated./('~'.,~/..~..4f~. ,/.~.~ ................................ 12. Does proposed construction viblate any zoning law, ordinance or regulation: ../~/l~P ........... i ............. 13. Will lot be regraded ...... x~ .,!/!~;~· .......... Will excess fill be removed from premises. Yes 14. Name of Owner of prergises ~ltfaPf/l~l~.,ffL,.U--.~.g~/~l..~..Address/o~.",.~,7..~ .fl.//~. .... PhoneNo ............... Name of Architect . G/.~tt4. ~.~....~'..'/~.~.. ~.~¢ff.,~.. Address /2,J[-.IKOgq./-,,f~7~...~./~.'~hone No.'2~.7.~..~.O.O. . .~../7~; Nmne of Contractor .. g/~t. ~.~.O(,<~za/ ........... Address . .,~ .~.F./~.~./J?. ..... Phone No ................ Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and bloci: number or description according to deed, and show street names and indicate whether interior or corner lot. TAFE OF NEW YORK S S ~K/f.~?/~/Es /~i'..~. ~ ~2~C~ being duly sworn, deposes and says that he is the applicant abov~ namied. He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is d~ly authorized to perform or have performed the sai~g[k and to m~e and file this application; that a~l statements con~tained ~ this application are true to the best o~$~d belief;and that the work will be perfo~ed in the m~ner set forth in the application filed therewith. ~, ~ ...."* ..... O~ ~, Sworn to beforejn~ this ~ ff~*'~RENE j~o... ....... ~. .......... day of. :'. ....... , 19.~./ ~ No. -~ HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT N SUFF CO. TAXM~F DIRTI000 SECTION 106, IM. OCK OI LOT 44 K. TME~ ARE NO DWgLLI~$ WITHIN I00 FEET OF TH~$ PROPERTY ADDRESS ''~MONUMENT FOUND O= PIPE FOUND AREA= 25,608 S.F. SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON JAN. 19, 1949 AS FILE NO. 1672. ELEVATIONS EHOWNTNUE, ~o 0 ARE REFERENCED TOMEAN 9EA LEVEL SURVEY FOR JAMES DELUCCA PART OF LOT 15, "CAPTAIN KIDD ESTATES" AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK DATE: SCALE: NO. SEPT. 7, 1984 AUG. 29, 1983 I": 40' 83,-701 !1 YOUNG a YOUNG ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N.Y.S. UCENSE NO. 12:845 HOWARD W. YOUNG, LAND SURVEYOR N.Y.S. LICENSE N0.4§893 400 OSTRANDER AVENUE RIVERHEAD, NEW YORK