HomeMy WebLinkAbout16334-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold,
CERTIFICATE OF OCCUPANCY
No Z-17770
Date FEBRUARY 17, 1989
THIS CERTIFIES that the buildin~
Location of Property 305 NORTH SEA DRIVE
House No.
County Tax Map No. 1000 Section 54
Subdivision
FOUNDATION
SOUTHOLD~ NEW YORK
Street Hamlet
Block 4 Lot 5
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 10, 1987 pursuant to which
Building Permit No. 16334-Z dated AUGUST 14, 1987
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 APPROVED CONCRETE FOUNDATION ONLY~
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO,
PLUMBERS CERTIFICATION DATED
MONROE & BEVERLY SONNENBORN
~uilding Inspector
Rev. 1/81
FORBS NO. ii
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~_ 1~334 Z
Permission is hereby granted to:
.......-~...Lu.~ .................................................
~. .... ~.~.~.......~.;.~.,....,..!..~.~. ........
,o ...~.,~...~..~.~....u,..~..'..m.....~..~.~- .....
at premises located at~...&....~........~....q~:~.~...~t-..:......~ ..................
County Tox Map No. 1000 Section ...... ~.~...~. ...... Block ...... .~A...~. ........ Lot No .......~.,...~'.. ...........
to application dated ..... ~..A"~...'~....!....? .......... , 19.~....']..., and approved by the
pursuant
Building Inspector.
Building Inspector
Rev. 6/30/80
FORM NO.6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted a to the Building Inspec-
tor with the following;for new buildings 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 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. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of pYaperty 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: Additions $25 . 00 POOLS $25 . 00 ALTERATION $25 . 00
1. Certificate of occupancy New Dwelling,$25.00, Accessory.., 10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50-. 00
3. Copy of certificate of occupancy $ 5 : 0 0 , over 5 years $ 10 . 0 0
4.Vacant Land C.O. $ 20 . 00 /
5.Updated C.O. $ 50 . 00 Date . .JaW -31*/90e . . . . . .
NewConstruction. , , • , , Old or Pre-existing Building . . . . . . . . . . . . Vacant Land . . . . . . . . . . . . .
Location of Property . . . . . . . . . . . . . . . . . . . &Wrff-5,FA A91ZAV.. . . . . . . . . . . . . . . .514( LO.
House No. Street Hamlet
Owner or Owners of Property , , , , , , , , , , , , , , , , , , , ,
County Tax Map No. 1000 Section . . . . . . . . . . . . . . . Block . . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map No..�� . . . . . . . . . .Lot No. . . . . . . . . . . . . .
Permit No. 1.63 F- Date of Permit . . . . . . . . . .Applicant . Ald�: JYIC# F -. f4U&./C-4 /�G7? e,
Health Dept. Approval . ./. /A: . . . . . . . . . . . . . . . . .Labor Dept. Approval . . . AM: . . . . . . . . .
Underwriters Approval . .,l'!'A: . . . . . . . . . . . . . . . .Planning Board Approval . .9-h. : . . . . . . . . . . . . . . .
Request for Temporary Certificate . . . . . . . . . . . . . . . . . . . . .Final Certificate . . . . . . . . . . . . . . . . . . . . .
Fee Submitted $ . . . . . . . . . . . . . . . . . . .
Construction on above described building and permit meets all applicable codes and regulations.
Applicant . .� .�, ,/ G . . . . . . . . . . . . . . . . . . . .
Rev.10-10-78
T65-1802
BUILDING DEPT.
INSPECTION '
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS: ,au�
If 61
DATE 114111fIN8PECTOR ✓b�
765-1802
BUILDING DEFT.
INSPECTION
[ ] F 1DNDATION 1ST [ ] ROUGH PLBG.
[ FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING ( ] FINAL
REMARKS:
DATE ) 30e.7INSPECTOR e4,2,zj ,�,
633�r
aLoiNa DEPT.
INSPECTION
[ ] FOUNDATION 1ST [. ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ l FRAMING [ ✓J FINAL
REMARKS:
ti� Z421,
DATE 1)3 � INSPECTOR .�.`
---------------
UNDATION ( 1st)
C
UNDATIO14 ( 2L d ) cn
UGH FRAME &
PLUMBING kr
H
LT7
SULATION PER N . Y. 'j J
STATE ENERGY
CODE
• x
-r
FINAL
z
ADDITIONAL COMMENTS : x
-• • - `ate
x
• H
H J
' O L
� L�
y
. d-
.v
H
bUAKU OF HEALTH . . . . . .
�- 3 .:SETS OF PLANS
FORM NO. 1 . SURVEY . . . . . . . . . .
TOWN OFSOUTHOLD CHECK . . . . . . . . . .
BUILDING DEPARTMENT SEPTIC FORM . . . . . . . . . . . . .
TOWN HALL NOTIFY
SOUTHOLD; N.Y. 11971 CALL
TEL.: 765-1802 " " " " "
MAIL TO :
Examined . . . . . . . . . . . . . ... . 19 . .
Approved . . . . . . . . . . . . . . . .. 19 . . . Permit No. . . . . . . . . . . .
Disapproved a/c . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . .. . . . . . . .
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date . . . . . . . . . . . . . . . . . .. 19 . .
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector,with
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 stree
or areas,-and s;iving a detailed description of;layout of property must be drawn on the diagram which is part of this apl
cation.
c. The wnrk 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 perr
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 Occupane
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 tl
Building Zone Ordinance of the Town of Southold, Suffolk County, New York and. other applicable Laws, Ordinances
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein-describe
The applicant agrees to .comply with all applicable laws, ordinances, building code, housing code, and regulations, and
admit authorized inspectors on premises and in building for necessary inspections.
Scott Simons, Architect, P.C. . . .
(Signature of applicant, or name, if a corporation) ,
853 Broadway, New York, N.Y. 10003
(Mailing•address of applicant)
State whether applicant is owner, lessee, agcsnt, architect, enrincer, general contractor, electrician, plumber or builde
. . Architect:.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Nanie of owner of premises Mr..&,Mrs. ,Monroe Sonnenborn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(as on the tax roll or latest deed)
If applicant is a-corporation, signature 1rduly au iorized officer.
Scott Simons, President
(Name and title of corporate officer) '
ALL. CONTRACTOR' S MUST BE SUFF03LK COUNT LICENSED '
Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . .
Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . .
Electrician's License No. . . . . . . ... . . . . . . . . . .. . . . .
Other Trade's License No. . . . . . . . . . . . . . . . . . . . . .
4 - �i North Sea Drive, Southold, N.Y. 1.1971
1 . Location of land on which proposed work will bu done. ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . : . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
House Number Strcet Hamlet
Tounty Tax Map No. 1000 Section Block . . . . . . . . . . ... . . . . . . Lot . . . . . . . . . . . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy Single Family Residencial
Single Family Residential
b. Intended use and occupancy
' Nature of work.(check which applicable): New Building . . . . . . . . . . Addition X (decics) Alteration X (inter.
Repair . . . . . . . . . ... . . . Removal . . . . . .Demolition . . . . . . . . . . . . Other Work . . . . . . . . . . . . . .
(Description)
4. Estimated Cost .$50,.000..00 . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
` (to be paid on filing this application)
5. If dwelling,number of dwelling units . . . . . . . . . . . . . . Number of dwelling units on each floor . .1: . . . . . . . . . . . . .
If garage,number of cars . . . .? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6. If business, commercial or mixed occupancy, specify nature and extent of each.
4h.typ of use . . . . . . . . .81-0'1 . . . . . . .
7. Dimensions of existing structures,if any: Front . . . . . . . 0
. . . . . . . . Rear . . 5
. . . . . . . . . . . . Depth . . . . . . . . . . . . .
Heiglit . . .22'—.0 . . . . . . . Number of Stories . . .1 .+.full .bsmt. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dimensions'of same stnicture with alterations or additions: Front .45'.-0'.' . . . . . . . . . .)Rear . . .45:-0'.'. . . . . . . . .
Depth . . . .44'.-0" .UT)Q . .sGz. .rMTishb . . .W-.Q.. . . . . . . . . . . Number of Stories .1 .+.�411 .b-5m4. . . . . . . .
S. Dimensions of entire new construction: Front . . 45'—0" . . Rear . . .45!-0.. , . , , , . Depth 44'-0", (scr, ,gq
Height . . .22'-0" I- + full bsmt. . . . . . . . . . . . . . . .
r of Stories
9. Size of lot: Front . , 1U0.0 Rear . . 700:07' Depth 311 ' .Average . .
10. Date of Purchase . . . . . . . ... . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11. Zone or use district in which :remises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12. Does proposed construction violate any zoning law, ordinance or regulation: . .No . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13. Will lot be regraded No . . . . ... . . . . . . . . . Will excess fill be removed from premises: Yes X No
14. Name of Owner of premises I1z,& . .79 .West .12 .St.i YC?hone No,. 212-62Z-2681 . .
Name of Architect Scott ,Simons, ,4rc4t,PC , , , , , Address M -VwuX .NXQ . . . . . Phone No. 212747,7.-9401 . . .
Name of Contractor . . . . . . . . . . . . . . . ..... . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No: . . . . . . . . . . . . . . .
15. Is this property located within 300 feet of' a tidal wetland? *Yes . . . . . No . . . . .
*If yes, 'Southold Town Trustees Permit may be required.
***See below PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
***See. D.E.C. 1` ^
t3y
z o
s, ct 111 r-•:14 149, 1 >t:
VA, 4 C-Z}21!Eiatr p ......
u
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� Cotes. 13gM(T.
' I
STATE OF NEW YOI K, S.S
COUNTY OF . .,--Ir : .
Scott Sim .s , , , , , , ; . , • . , . being duly sworn, deposes and says that lie is the applicant
(Name of individual signing contract)
above named.
Ile is the . . . . . . . . . ... .Agent. . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... . . ... . . . . . . . ..
: . . . . . .-. . . . ... . . . . .
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is di:ly authorized to perform or have perfonned 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.
Sworn to before me this � � Q
day , 19 . . .
Notary Public . . � . . : . . . County
::t . . . . . . . . . . . . . . . . . . . . . .
NOTARY FuELlC,Stzas ci;"'e'N Yor}c (Signature of applicant)
No.TR-01 ILZ J3°�5
Qualiffed in Passau County
Commission Expires Oct$1,>.959
.Application Received Disapproval Issued Permit #
19 19 19
FORM NO. 10
APPLICATION FOR DEVELOPMENT PERMIT
IN THE TOWN OF SOUTHOLD
(,,07- 14 19
1 . 'rype of Development Proposed: New structure tincs -- rorage tanks_
Addition and/or Alteration Flood Proof Below Base Flood Elevation_
Other (specify)
2. Elevation Data in relation to above mean sea level of:
(a) Lowest floor elevation, including basement feet inches
(b) In a V Zone , bottom of lowest structural member feet inches
3 . FIRM--Flood Insurance Rate Map, Zone designations A -7
4 . Owner of Premises D d` I
5. Location of Property:
�-
� 85-_' N047-P
House # Street Hamlet
County Tax Map No. , Dist. 1000 , Section o�q Block ® 1 Lot (s) O
Subdivision Filed Map# Lot (s)
6 . Permission to be granted: CC Owner as above _ New Owner
Under Contract Lessee Contractor Phone #
Name if not given above Mailing address
7. Approval from other (s) before Permit is issued:
DEC /' -7 Wetlands (Town Board) �j
Health Services 1j 114 ZBA N_0A
Building Permit J& Z Z R Planning Board k)1A
8. I, , the applicant, am the Owner _, Co-Owner
New Owner , Under Contract _, Lessee _, Agent _, Contractor
and agree to comply with all applicable sections of the Code of the Town
of Southold; County, and State and to admit authorized inspectors to
premises 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 my knowledge and belief and that the
work will be performed in the manner set forth in e application filed
therewith.
STATE OF NEW YORK 1
COUNTY OF S2 SS
Signature
SWORN TO THIS / DAY OF 19 d 7
UNDA J.COOPER
Notary Public,State of New York
N to�yNblic D 2 BKu lk County
Term Expires December 31, 19�
Applicant ' s mailing
address and phone #
if not given above
--
FORM NO. 10
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
(516) 765-1802
P.O. Box 728 Town Hall
Southold, N.Y. 11971 Main Road
Southold,N.Y.
ADDT,TCAT.TON Fnp DFVET-0DmFNT PERMIT
Instructions : The application to , the Building Inspector includes (each
in duplicate) 1 . Form No. 1.0 filled out in ink or typewritten, 2 . Sur-
vey of premises with elevations above mean sea level, 3 . Drawings of pro-
posed work. The application must give complete information to show that
the proposed can comply to the Local Law No. 1-1980 , Chapter 46 of the
Code of the Town of Southold known as "Flood Damage Prevention Law" of the
Town of Southold. The applicant must submit approvals that any other
agency requires.
General Standards as required in Section 46-17 of the law to minimize flood
damage:
A. Anchoring of structures, 'including tanks and mobile homes
B. Use of construction material and methods
C. Design and location of utilities
D. Subdivision proposal with drainage, public. utilities design and
base flood elevations
Specific Standards as required in Section 46-18 :
A. Residential construction
B. Non-residential construction
C. Mobile homes
The applicant must submit plans and specifications as well as any other
information requested by the Building Inspector to substantiate the facts
that the structure has or will have the lowest floor, including basement/
cellar, elevated above the base flood elevation or; if permitted by the
Federal Regulation, that: 1 . such structure is flood proofed in such
manner that below the base flood level the structure is water tight with
walls substantially and impermeable to the passage of water, 2 . that
structural components -are capable to resisting hydrostatic and hydrodynamic
loads and effects of buoyancy, 3 . applicant must submit certification by
a registered professional engineer or architect that the standards set
forth in Section 46-18B '(1) (2) (3) of the Southold Code are satisfied.
Coastal High Hazard;. area (V Zone) 46-19 . Applicant shall submit plans ,
specifications including the required certifications and such other in-
formation- as the Building Inspector may require, in that the provisions of
46-19 are complied with. Mobile homes are prohibited. The lowest portion
of the structural member's of the lowest floor cannot-,be lower than the
base flood elevation with all space below open except breakaway walls .
Sand Dunes. If sand dunes exist on the premises and the applicant pro-
poses to alter same, plans and specification must be shown in detailed
nature of any alteration submitted.
Building Permit. A Building Permit is also required for any structure .
Both a Development and' a Building Permit must• be issued before any work
can start in a special flood hazard zone. . A written disapproval or a
permit must be issued within ten (10) working days.
During construction, the inspector shall be notified in time so he may
make--the required inspections.
Upon completion, the required certification of the final elevations and
work must be submitted before the approval to use or occupy can be
approved.
. (Fill out the form on the back of this sheet)
11/85
SCOTT SIMONS ARCHITECT, P.C. L[ UMEQ OF TUR3. UML
18 West 23 Street
NEW YORK, NEW YORK 10010
DATE S .A - JOB NO.,
(212) 206-0423 ATTENTION 6/
TO RE:
EsL�G. DE?T.
�J
WE ARE SENDING YOU 2XAttached ❑ Under separate cover via the following items:
❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications
❑ Copy of letter ❑ Change order - -
COPIES DATE NO. DESCRIPTION
THESE ARE TRANSMITTED as checked below:
❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval
❑ For your use ❑ Approved as noted ❑ Submit copies for distribution
❑ As requested ❑ Returned for corrections ❑ Return corrected prints
❑ For review and comment ❑
❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS
-Q.
Y
COPY TO
NED:
reoouct2aa2 Inc,Groton,Masi 01471. It enclosures are not"as noted, kindly notify u at on e� , / `
TOWN OF SOUTHOLD
BUILDINC DEPARTMENT
TOWN HALL
SOUTHOLD, NE~ YORK
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING..X...VACANT LAND
Location of Property .... 30~ ............... S~ Drive Southold
., ~ort~ ...............................
HOUSE NO. STREET HAMLET
~O~rP~ ~ D~v~F~y ~opnenborn
Owner Owners of Property '
Gounty Tax Map No. I000 Section ..~.. Block ~ ..... Lot
Subdivision ....................... Filed Map ........ Lo~ ..........
eermit No...........16334 Z Date of Permit . ~/~/~F...AppllcantRp~p. ,.............Bids for Owner
aealrh Dept. Approval .................. Underwriters Approval
Planning Board Approval ................
~equest for Temporary Certiilca~e Final Cer~i£icate X
Fee Submitted:
. I~or Owner
ev. 10/14/88
Environment East, Inc.
R. R. No. 3 - 3075 Indian Neck Lane
Peconic, New York 11958
516-734-7474
February 10, 1989
Southold Town Building Dept.
Town Hall
Main Road
Southold, NY 11971
Dear Sirs,
Enclosed are our check and an application for a Certificate of
Occupancy to satisfy permit # 16334Z dated 8/5/87.
All additional work is covered under permit # 17168Z dated
6/27/88. Approvals required, will be met upon the completion of
the work cov~d by' This permit.
If
Sincerely,
Peter R. Stou~nburgh
President /
Environmen~E~st, Inc.
Encl.~/
PRS:jm / /?~ / ~ /
FOItM NO. 11
%?OWN OP SObPI'IIOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY
DEV ELO PMI:4NT I'ERM Ii'
?ez~lisslon i~ hereby granted to:
Catty Tax Map No. 1000 Section
pursuant to application dated
by the Building Inspectom.
Building PexElt No.
Building Inspocto~,
4/80
New York State Department of Environmental Conservation
Regulatory Affairs Unit
Bldg. 40,SUNY, Rm. 219
Stony Brook, NY 1~794
(516) 751-7900
Thomas C~ Jorling
Commissioner
July Zl,' 1987
Monroe R. Sonnenborn
79 W. 12th St., Apt.
New York, NY 10011
14F
Re: 10-87-1187
Dear Mr. Sonnenborn:
In conformance with the requirements of the State Uniform
Procedures Act (Article 70, ECL) and its implementing regulations
(6NYCRR, Part 621) we are enclosing your permit. Please read all
conditions carefully. If you are unable to comply with any conditions,
please contact us at the above address.
Also enclosed is a permit sign which is to be conspicuously posted
at the project site and protected from the weather.
Very truly yours,
1
Region No.: Office:
Amount: $ /~ ~ OO
Application Identification No.: 10";~'7 'lis
Permit Type: -r"L~
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
UNIFORM PROCEDURES ACT
Receipt No,U
DRA - Stony Brook
Check [Z]~/ Money Order
Check or M,O. No.: dO~
32-14-13 {9/77)
Robert A, Greene
Reg, Permit Admin,
TITLE
95-2~)-g {9/g6)-- 25C
DEC PERMIT NUMBER
10-87-1187
EACILITY/PROGRAM NUMBERIs)
N/A
Article 15, Title 3; 6NYCRR 327,
· 328, 329: Aquatic Pesticides
Article 15, Title 5:
Protection of Water
Article 15, Title 15:
Water Supply
Article 15, Title 15:
_ Water Transport
Article 15, Title 15:
Long Island Wells
Article 15, Title 27:
Wild, Scenic and Recreational
Rivers
PERMIT
Under the Environmental Conservation Law
[-'~ 6NYCRR 608: ~
Water Quality Certification
~ Article 17,SPDES Titles 7, 8: ~
~ Article 19: [-----1
Air Pollution Control*
~ Article 23, Tit,e 27: ~
Mined Land Reclamation
~-----~ Article 24: [-~
Freshwater Wetlands
N--New, R-Renewal, M--Modification, r---']
c-construct (*0nly), o-operate (*0nly)
EFFECTIVE DATE
7/21/87
EXPIRATION DATE(s)
7/31/92
rMe 25:
ida{ Wetlands N
Article 27, Title 7; 6NYCRR 360:
Solid Waste Management*
Article 27, Title 9; 6NYCRR 373:
Hazardous Waste Management
Article 34:
Coastal Erosion Management
Article 36:
Floodplain Management
Articles 1, 3, 17, 19, 27, 37;
6NYCRR 380: Radiation Control
PERMIT ISSUED TO
Monroe R. Sonnenborn
ADDRESS OF PERMITTEE
79 W. 12th St., Apt. 14F, New York, NY 10011
AGENT FOR PERMITTEE/CONTACT PERSON J TELEPHONE NUMBER
N/~
I
NAME AND ADDRESS OF PROJECT/FACILITY iii different from Permittee}
305 North Sea Dr., Long Island Sound
LOCATION OE PROJECT/FACILITY COUNTY TOW~,~/.it,lgJ~:~ UTM COORDINATES
Southold Suffolk Southold
DESCRJPTDN OF AUTHORIZED ACTNITY
Relocate existing dwelling 150+ ft. landward of present location as per attached
NYSDEC approved survey last dated 6/19/87,
GENERAL CONDITIONS
By acceptance ot this permit, the permittee agrees that the permit is contingent upon strict compli-
ance with the ECL, ail applicable resulations and the conditions specified herein or attached hereto.
The permlttee shall file in the office of the appropriate regional permit administrator, or other office designated in the special conditions, a notice of intention to commence
work at least 48 hours m advance of the time of con~mencement and shall also notify him/her promptly in writing of the completion of the work.
2 The pem ted work shall be subject to inspection by an authorized representative of the Department of Environmental Conservation whkh may order the work suspended if
the pubhc interest so requires pursuant to ECL §71-0301 and SAPA §401(3).
3 The perm~ttee has accepted expressly, by the execution of the app[ication,, the full legal responsibility for ali damages,, direct, or indirect, of whatever nature, and by whomever.
suffered, arising out of the project described herein and has agreed to ~ndemmfy and save harmless the State from suits, acbons, damages and costs of every name and descDp-
A.y rnodification of this permit a~pg~ O.~e , I17.I
PERMIT iSSUANCE DATE PERMIT ADMINISTRATOR ADDRESS
7/21/87 ' Robert A. Greene Bldg. 40 SUNY Rm. 219 Stony Brook, NY 4
cc: C.T. Hamilton
95-2~6a (1106) - 25c
ADDtTIONAL GENERAL CONDITIONS fOR ARTICLES 15 (title 5), 24, 25, 34, 36 and 6 NYCRR Part 608 (
10.
11
13.
That if future operations by the State of New York require an al*
)
other environmentally deleterious materials associated with the
teration in the position of the structure or work herein authorized, or
if, in the opinion of the Department of Environmental Conservation 14.
it shall cause unreasonable obstruction to the free navigation of said
waters or flood flows or endanger the health, safety or welfare of
the people of the State, or cause loss or destruction of the natural
resources of the State, the owner may be ordered by the Department to
remove or alter the structural work, obstructions, or hazards caused ' 15.
thereby without expense to the State, and if, upon the expiration or
revocation of this permit, the structure, fi)l, excavation, or other 16.
modification of the watercourse hereby authorized shall not be cam-
pie{ed, the owners, shall, without expense to the State, and to such
extent and in such time and manner as the Department of ~nvironmental
Conservation may require, remove all or any portion of the uncompleted
structure or fill and restore to its former condition the navigable
and flood capacity of the watercourse. No claim shall be made against
the State of New York on account of any such removal or alteration. 17.
That the State of New York shall in no case be liable for any damage
or injury to the structure or work herein authorized which may be caused 18.
by or result from future operations undertaken by the State for the
conservation or improvement of navigation, or for other purposes, and
no claim or right to compensation shall accrue from any such damage.
Granting of this permit does not ~e~ieve the applicant of the responsi-
bility of obtaining any other permission, consent or approval from 19.
the U.S. Army Corps of Engineers, U.S. Coast Guard, New York State
Office of General Services or Ioca[ government which may be required.
All necessary precautions shall be taken to preclude contamination
of any wetland or waterway by suspended solids, sediments, fuels,
solvents, lubricants, epoxy coatings, paints, concrete, leachate or any
project.
Any material dredged in the prosecution of the work herein permitted
shalt be removed evenly, without leaving large refuse piles, ridges across
the bed of a waterway or floodplain or deep holes that may have a
tendency to cause dame. ge to n~vigable channels or to the banks of
a waterway.
There shall be no unreasonab[e interference with navigation by the work
herein authorized.
If upon the expiration or revocation of this permit, the project hereby
authorized has not been completed, the applicant shall, without expense
to the State, and to such extent and in such time and manner as the
Department of t!nvironmenta) Conservation may require, remove all or
any portion of the uncompleted structure or fill and restore the site
to its former condition. No claim shall be made against the State of
New York on account of any such removal or alteration.
If granted under Article 36, this permit does not signify in any way
that the project will be free from flooding,
If granted under 6 NYCRR Part 608, the HYS Department of Environ-
mental Conservation hereby certifies that the subject project will not
contravene effluent limitations or other limitations or standards under
Sections 301,302, 303, 306 and 307 of the Clean Water Act of 1977
(PL 95-217~ provided that all of the conditions listed herein are met.
Ali activities authorized by this permit must be in strict conformance
with the approved plans submitted by the applicant or his agent as part
of the permit application.
such approved plan~ were prepared by
on .
SPECIAL CONDITIONS
1. Exzstlng sanitary system will be utilized.
2. Place 100± cubic yards of clean fill arouBd new foundation.
in from upland source.
3. First floor elevation must comply with local reqnirements.
Supplementary Special Conditions (A) through (J) attached.
Fill to be trucked
DEC PERMIT NUMBER
10-87-1187
PROGRAM/FACILITY NUMBER
N/A
Page 2 of 3
SUPPLEME~TARY SPECIAL coNDITIONS
The following conditions apply to all permits:
A. If any of the permit conditions are unclear, the permlttee shall contact
the Division of Regulatory A~f~irs at the address and t&tephone noted below.
B. A copy of this permit or approval and supplementary conditions shall be
available at the project site whenever authorized work is in progress.
C. The permit sign enclosed with the permit or a copy of letter of approval
shall be protected from the weather and posted in a conspici~us location
at the work site until completion of authorized work.
D. At least 48 hours prior to commencement of the project, the permittee shall
complete and return the top portion of the enclosed receipt form certifying
that he is fully aware of and unders~auds all provisions and conditions of
this permit. Within one week of completion of the permitted work, the
bottom portion of that form shall also be completed and returned.
E. For projects involving activities to be accomplished over a period or more
than one year, the permittee shall notify the Regional Permit Administrator
in ~iting at least 48 hours to the commencement of resumption of work each
year.
?. If project design modifications take place after permit issuance, the
permittee shall submit the appropriate plan changes for approval by the
Regional Permit Administrator prior to undertaking any such modifications.
The permittee is advised that substantial modification may require sub-
mission of a new application for permit.
G. All necessary precautions shall he taken to preclude contamination of any
wetlands or waterway by suspended solids, sediment, fuels, solvents,
lubricants, epoxy coatings, paints, concrete, leachate or any other
envlro~mentally deleterious materials associated with the project work.
H. Any failure to comply precisely with all of the terms and conditions of
this permit, unless authOriZed in vt!ting, shall be treated as a violation
of the Environmental Conservation Law.
I. The permittee is advised to obtain any permits or approvals that may be
required from the U.S. Department of Army Corps of Engineers, NY District,
26 Federal Plaza, New York, NY 10278, (Attention: Regulator)* ~unctions
Branch), prior to commencement of work authorized herein.
J. The granting of this permit does not relieve the permittee of the
respomsibilit~ of obtaining a grant~ easement, or other necessary approval
from the Division of Land utilization, Office of General Services~ Tower
Building, E~pire State Plaza, Albany, I~f 12242, which may be required for
any encroachment upon State-o~med lands under water.
Regional Permit Administrator
NYS Dept. of Environmental Conservation
Bldg. 40, SUNY--~oom 219
Stony Brook, NY 11794
(516) 751-7900
DEC #
10-87-1187
Page 3 of 3
C}IAPJ~ES To ItA~ILTOU
Chief, ~ARINE REGULATOFJf
~PfS DEC, Bureau of }:arine I1aDitat Protection
Bldg. 40, SUMY, Rm. 225
Stony Brook, ~. Y. 11794
Permit ~o,
Issued To.
Contractor's Address.
Contractor's ~one #
Dear Sir: Contractor's Name
Pursuant to General Condition Mo. ! of the abov~ referenced permit ~ou
are hereby notified that the authorized activity shall commence on
· This Notice is to be sent at least two d~,s i~ ~d-
vance of commencement of the project. The Permit sign will be pestled at
the site and copy of Permit will be available ag site for inspection.
Submitted by
FAILIng TO NOTIFY OR POST SIG~ UILL LEAV~ O~ER/AMD/OR CO~TP~CTOR SUB
JECT TO APPLICABLE PE~ALTIES FOR ~0~3-COI~LIA~]CE'1~ITH PEI~tIT COS~ITIOP~.
C1L~P~EE To }LA2iILTO~
Chief, Marine Regulatory Section
X~S DEC, Bureau of ~Iarine Habitat Protection
Bldg. 40, SUNY, Rm. 225
Stony Brook, N. Y. 117~4
Re:
Permit ~]o.
Issued To.
Contractor's Addr~SSo
Contractoz~s Phone #
Dear Sir:
Contractor's Hame
Pursuant to General Condition No. ! of the above referenced Permit, you
are hereby notified that the authorized activity was completed on
guhmitted by
DATE:
THIS ~OTICE, WITH PHOTOS OF CO}'~LETED %IOP/~ AND/OR COMPLETED SURVEY, IS
TO BE SENT TO ABOVE ADDRESS PROMPTLY UPON CO~LETION OF PROJECT. FAILURE
TO NOTIFY U!LL LEAVE OI~'ER AND/OR COntRACTOR SUBJECT TO APPLICABLE
PENALTIES FOR NON-COI,~LIA~CE I~ITH PEP~IT COS~DITIONS.
New York State
Department of Environmental Conservation
NOTICE
The Department of Environmental Conservation (DEC) has-
issued permit(s) pursuant to the Environmental Conservation
Law for work being conducted on this site. For further informa-
tion regarding the nature and extent of work approved and any
Departmental conditions on it, contact the Regional Permit
Administrator listed below. Please refer to the permit number
shown when contacting the DEC.
Expiration Date
PermitNo. J~ "~[_~' Il ~'--/
Regional Permit Administrator
NOTE: This notice is not a permit
S 50° ~6'00"£.
N/O/F ELLIOT PASKOFF
CROSS
SECTION
309.95'
KENNEY'S ROAD
MONROE
~'- ~ooo
0
:7
SON
AT SO~
TOWN OF
SUFFOLK
- 54
SCALE
JUNE 19,
AREA ,~ :31, 174 SQ.FT.
5 N.Y.S.
020
362
'FORM NO. 1
TOWN'OF SOUTHOLD CHECK
BUILDING DEPARTMEN~ SEPTIC
TOWN HALL
$OUTHOLD, N.Y. 11971
dt~ ~ TEL.: 765-1803 CALL
MAIL
E, xamine .~...~...t.., 19~..~.
Approved~..g~..~-../..~.., 19~..7. Permit No.
Disapproved a/c ......................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
BOARD OF HEALTH ......
3 SETS OF PLANS .......
SURVEY ...........
FORM j ............ :
TO:
Date.. ~.{..~' ........... , 19~.'~.
INSTRUCTIONS
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 ~ Certificate of Occupancy
, hail 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 for removal or demolitions herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code/an/o/regulations, and to
admit authorized inspectors on premises and in building for necessary inspection~., t9 o { /
.......... ...........
(Signature of applicant, or name, if a corporation)
?..,.,.,.,.. t*. .........
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder.
o. or,..
Nameofownerofpremises e~l"'X'.... ~[ ..... d~...~.....~..o..o,?..~..~. ~.~.~.~ .......................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer) -
ALL CONTRACTOR'S HUS_T lie SUFFOLK COUNTY LICENSED
Builder's License No.. I..~.~I].~..~ ~ .............
Plumber's License No. '1.,% t,,.t.,. ~
Electrician's License No. ~.,4'Z. t~
Other Trade's Licerise No ......... .'7. ...........
d
1. Location of land on which proposed work will be done. ~ ' · ' ~
House Number Street Hamlet
County Tax Map No. 1000 Section ..... .~..~ ......... Block .... ?..~. .......... Lot .... .o..~. ...........
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
I T~%~
a. Existing use and occupancy .: ...............................................................
b. Intended use and occupancy ....................................................................
3. Nature of work (check which applicable) New Building ..... ' ..... Addition .......... Alteration ..........
Repair ........ :.: ....RemovaLa ............. Demolition .............. Other Work..~ ...........
4 Estimated Cost . · · · Fee
~ " (to be paid on filing this application)
dwelling, number of dwellin* units ..... [. ......... Number of dwelling units on each floor.. ! .............
5.
If
If garage number of cars
6. If business, commercial or mfx~d occupancy, specify nature and extent of each type of use ' --
7. Dimensions of existing structures, if any: Front....'~.'~Y.~.~. ..... Rear ...~'..~-..'? ~ .... Depth . ~ .~..':~..Z ......
Height . .I.'~..'D?. ~ .......Number of Stories ...... '.~; .... 2 ................... '..'...'. .... . .' .............
D/mensions'of,~s~ amc structure with alterations or additions: Front . .~--..I..-?-~..? ........ Rear .'.
t 't,~--~ ~' He' t }~'"'~ ~ ·
Dep h .......... -. ....... ~... lgh ...................... Number of Stones ......................
Dimensions of entire new construction: Front .. ~ ! .~z...~,. ..... Rear . .d/.~. 7?. ~ ...... Depth .?..~.?. ~ .......
Height I~."~ * Numbe of Stories
Size of lot: Front .... [..~.. :.~. ........... . Rear ....I..o~..'. ?.~ ............ Depth . .~..t.?: .~...~_. ..........
Date of Purchase ' Name of Former Owner
Zone or use district in which premises are situated ...................................................
Does proposed construction violate any zoning/aw, ordinance or regulation: .... ~..~. .........................
Will lot be regraded ..... .~..~ .................... Will excess fillbe removed from premises~ ~es No
Name of Owner of premises~.~.~..~*3q .~.~.o.~...~.~.*~.q*Address~, .~.'*.R .~..t~..~.~.* .o.~,... Phone No.~ .G.~...%. ~..~.~. ....
Nme of Architect ....... ~ ................. Address ...... "?. ............. Phone No....'~. ...........
Name of Contractor . ,~l.....I.(.[, .~ ~, ~.~.~. ........... Address"~..~ ! ! ~..~..o.~..~.~..?... Phone No."[ .~.~*..* .'t:..~.~.'~ ....
15. Is this property locatedI within 300 feet of a tidal wetland? *Yes ..'~... No .....
· If yes, Southold Town TrUstees Permit maybe required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and bloc number or description according to deed, and show street names and indicate whether
interior or corner lot.
10.
11.
12.
. 13.
14.
STATE O F NEW cY~ RK...,~-,
COUNTYOF...~..~.[.~..[~..,
........ ~.~ ~..~~ ................. being du1~ 'sWorn, deposes and says that he is the applicant
(Name of individual sig~ing contract)
above named.
He is the .....................................................................
~ [ (Contractor, a~ent, corporate officer, etc.)
of said owner or owners, ~d is duly a~.thorized t6 p~rform or hai~ ~effo~ed the said work and to m~e and file this
application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the
work will be perfomed in the m~nCr set fgrth ~ the application filed therewith.
Sworn to before me this I
............ ..... d o.f.
............
...................
u ~LlZAS~H ANN h~ILLE (Signature of applicant)
FORM NO~ 10
TOWN OF'SOUTHOLD
~U~LDiNG DEPARTMENT
(516) 765-1802
P.O. BOX 728
Southold, N.Y. 11971
Town Hall
Main Road
Southold,N.Y.
nDPLTCATI~N FOP DEVE!.nDMENT PEPMIT
Instructions: The application to the Building Inspector includes (each
in duplicate) 10 Form No. 10 filled out in ink or typewritten, 2. Sur-
vey of premises with elevations above mean sea level, 3. Drawings of pro-
posed work. The application must give complete information to show that
the proposed can comply to the Local Law No. 1-1980, Chapter 46 of the
Code of the Town of Southold known as "Flood Damage Prevention Law" of the
Town of Southold. The applicant must submit approvals that any other
agency requires.
General Standards as required in Section 46-17 of the law to minimize flood
damage:
A.
B.
C.
D.
Anchoring of structures, 'including tanks and mobile homes
Use of construction material and methods
Design and location of utilities
Subdivision proposal with drainage, public utilities design and
base flood elevations
Specific Standards as required in Section 46-18: A. Residential construction
B. Non-residential construction
C. Mobile homes
The applicant must submit plans and specifications as well as any other
information requested by the Building Inspector to substantiate the factq
that the structure has or will have the lowest floor, including basement/
cellar, elevated above the base flood elevation or; if permitted by the
Federal Regulation, that: 1. such structure is flood proofed in such
manner that below the base flood level the structure is water tight with
walls substantially and impermeable to the passage of water, 2.-that
structural components are capable to resisting hydrostatic and hydrodynamic
loads and effects of buoyancy, 3. applicant must submit certification by
a registered professional engineer or architect that the standards set
forth in Section 46-18B (1) (2) (3) of the Southold Code are satisfied.
Coastal High Hazard. area (V Zone) 46-19. Applicant shall submit plans,
specifications including the required certifications and such other in-
formation as the Building Inspector may require in that the provisions of
46-19 are complied with. Mobile homes are prohibited. The lowest portion
of the structural members of the lowest floor cannot be lower than the
base flood elevation with. all space below open except breakaway walls.
Sand Dunes. If sand dunes exist on the premises and the applican% pro-
poses to alter same, plans and specification must be shown in detailed
nature of any alteration sub$itted.
Building Permit. A Building Permit is also required for any structure.
Both a Development and a Building Permit must be issued before any work
can start in a special flood hazard zone. A written disapproval or a
permit must be issued within ten (10) working days.
During construction, the inspector shall be notified in time so he may
make the required inspections.
Upon completion, the required certification of the final elevations and
work must be submitted before the approval to use or occupy can be
approved.
(Fill out the form on the back of this sheet)
11/85
-Application Received19
Disapproval Issued
19
'Permit
FORM NO. 10
APPLICATION FOR DEVELOPMENT PERMIT
IN THE TOWN OF SOUTIIOLD
1. Type of Development Propose~: New ~tructure ~inc4u~ing ~orage ~an~s
Addition and/or Alteration Flood Proof Below Base Flood Elevation__
Other (specify)
2. Elevation Data in relation to above mean sea level of:
{a) Lowest floor elevation, including basement ~ feet inches
(b) In a V Zone, bottom of lowest structural me~er .___ ~e~'t .__ inches
3. FI~--Flood Insurance Rate Map, Zone designation~
5. Location of ~Property:
House 9 Street ~ Hamlet
County Tax Map NO., Dist. 1000,
subdivision
Section ~ Block ~ Lot(s) _~
Filed Ma~# Lot(s)
6. Permission to be granted: _~ Owner as above -_
Under Contract Lessee Contractor
New Owner
Phone It
Name if not given above
Mailing address
Approval from other(s) before Permit is issued:
DEC /~-- ~ -- 7/ ~ wetlands (Town Boa~d)
Health Services ZBA
Building Permit _/__~ ~ Planning Board
I, , the applicant, am the Owner __, Co-Owner
, New Owner , Under Contract , Lessee , Agent __, Contractor __,
and agree to comply with all applicable sections lof the Code of the Town
of Southold; County, and State and to admit authQrized inspectors to
premises 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 my knowledge iand belief and that the
work will be performed in the manner set forth in the application filed
therewith.
STATE OF NEW YORK
COUNTY OF ~Pj.x~/~'~_~
SS
SWORN TO THIS /~ DAY OF _~~-
~ ..., .,~ ) LINDA J. COOPER
,~-'~/v .-~./~. ~/~/~.,.,,~,~.., ~/NotarYPubllo, StateofNewYork
Applicant's mailing
address and phone #
if not given abov~
ii/8
N /O/ F CHARLES MALLOY , SR. 8 WINIFRED MALLOY
i II 4 S. 50° 36 00 E. 313. 63' '
` o >
Z o O —
o
0
SURVEY FOR
I 86.0
,STD° - - - - — - - - - - - w MONROE SONNENBORN
�n
z w ' 3 O UTHOL
_ , I .a, c cl �,� � AT S D
6
1 o� ° ° a h o = TOWN OF SOUTHOLD
_ 1110
N SUFFOLK COUNTY , N . Y.
r ` o ? 0) 1000 - 54 - 04 - 05
� M I 80• th 0 SCALE In = 30'
Z z ' Z JUNE 19 , 1987
3 09.9 5� DUNE 8, 1988
N . 50° 36 00 W. `
0
o
00
N /0 /F ELLIOT PASKOFF fi AILLEN PASKOFF r
MEAS HM WA MR MARK N p"
JUPJE 1H,.F_9t3r
AREA = 31 174 SQ . FT. 'z
_ - 1
KENNEY' S ROAD
p Prepared ui atcordanta' With R sfic as
nc!arcls for title surveys mfntstttspn
N the L.I.A.L.S. and Y eftbli k`d by
approved and adopted
O S for such use by Sttrta Laud
N C Title .Association.
G A i si
la
o 2
A ` E N
exi� �ii q�Lc�e 7
S ,
° SAND
N.Y. S. LIC. NO . 49618
CROSS SECTION
'' P S EYORS a ENGINEERS , P. C
5 020
oB� ,
N
S , N.Y. 11971
85 - 362 A
If ~opper tubing il ul~4
for waler dts~'|butln~
~ piping shill b~
d ~ K or L only
SOLDER USED
SUPPLY SYSTEM
EXCEED 2/°I0 of
CONTENT B£FORE
CEIIg'IFICA~'E O,F OCCUPANCY
O~U~N~ OR
USEISUN~WFUL
Wl~O~ CERTIFICATE
OFO~U~N~