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HomeMy WebLinkAbout15606-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Bulldlng Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z18079 Date JUNE 5~ 1989 THIS CERTIFIES that the build,n§. ONE FAMILY DW~3J.ING Location of Propert~ 890 ARROWHF~AD LANE PECONIC House No. Street Hamlet County Tax Map NO. 1000 Section 098 Block 02 Lot 5 & 6 Subdivision ARROWHEAD COVE F~led Map No. 3810 Lot No. 35 & 36 conforms substantially to the Application for Building Permit heretofore f~led ~n this off~ce dated DEC. 29, 1986 pursuant to which Buildlng Permit No. 15606z dated DEC. 31, 1986 was issued, and conforms to all of the requirements of the applicable provmslons of th~ law. The occupancy for which this certificate as issued is ONE Fk~tLY D%r~J.INGWITHGARAGE UNDER. The certificate is issued to JOHN J. & MARGARET J. MOYLAN (owner,)Lv~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 85-BO-213 DEC. 27r 1988 UNDERWRITERS CERTIFICATE NO. H007502 JAN. 17~ 1989 PLUMBERS CERTIFICATION DATED JOHN J. MOYLAN DEC. 27r 1988 CORRECTED SOLDER JUNE 5, 19B9 Building Inspector Rev. 1/81 FO~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 15606, Z Permission IS hereby granted to. ~__ ,o County Tax Map No 1000 Sect,on... (~...~... Block ...... .(~....2:.. ...... Lot No.......~......~. ....... pursuant to application dated .~.LLt~,..... ~...~ ...... , 19..~.~., and approved by the Budding Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 765 - i802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Thru apphcat~on must be/died in typewriter OR ink, and submttted m -- to the Buddmg tnspec- tor w~th the followmg; for new buildings or new use: 1. Final survey of property with accurate location of all buddings, property lines, streets, and unusual natural or topographic feat-ares. 2.Fmal approval of Health Dept. of water supply and sewerage disposal--{S-9 form or equal}. 3.Approval of electrmai mstallat~on from Board of F~re Underwmters. 4. Commercial buddmgs, Industrial buddmgs, Multiple Remdences and s~milar buildmgs and installa- tions, a cert,/mate df Code compliance from the Architect or Engmeer responmble for the buddmg. 5.Submtt P[anmng Board approval of completed s~te plan requirements where apphcable. B. For existmg buddmgs~ {proof to Aprd 1957), Non-conforming uses, or buddmgs and "pre-ex~sting" 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 buddmgs. 3. Date of any houmng code or safety mspection of buddmgs or premmes, or other pertment informs- tlon required to prepare a cert~hcate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Cer~]ficate of occupancy New Dwelling $25.00, Accessory ,$]0.00 Business $50.00 2. Certificate of occupancy on pre-exlstmg dwelling $ ]00.00 3 Copy of cert~flcste of occupancy $ 5.00, over 5 years $ ]0.00 4.Vacant Land C.O. $ 20.00 5. Updatecl C. O. $ 50. 00 Date ....~.c.'.C..~..~..~ ~. ......... NewConstructIon Old or Pre-existing Building Vacant Land ....... Locat,on of Property ....... ............................................ Hou~e No. Street Ham/et Owner or Owners of Property County Tax Map No. I000 Section ............. Block .............. Lot ................ Subdwm;on ............................... Fded Map No ........... Lot No ...... ........ ].~O/~, -~- D~te of Permit /,~..'.~/.'~ Apphcant Permit No .................... Health Dept. Approval ....................... Labor Dept. Approval. ................. . . . .. Underwr(ters Approval ........................ Planmng Board Approval ............. .. . . ... .. Request for Temporary Certificate Final Certificate ............ Fee Submitted S ................... Construction on above descmbed buddmcj and permit meets allapphcab[e codes and regulations. A~pheant ........................ TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P O. BOX ?28 TOWN HALL $OUTHOLD. N.Y. ! 1971 TEL. 765-I 802 CERTIFICATION Date/~/ Bulld!ng Permit No. /~-~ Owner ~/~o/~/ (please pr!nt) Plumber (please p~lnt) I cdrtlfy that the sol~e~ used in the water supply system contains less than 2/10 of 1% lead. · /k~/ (pl~ber's signature) Sworn to before me this ~ day of , ~;otary Pub!lc, ~ County Notary PubLic NOI'ARY PUBLIC. t~alt~ M New Yed~ No. 4707878. Seflolk Tern ELm,'es M~ch 30. ]~_ - TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P O BOX 728 TOWN HALL SOUTItOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No./~--~O~d.~ - (please print ) (please prxnt) I certzfy tna~ ~h_ solder used in the water supply system contazns less than 2,/10 of 1% lead. signature} Sworn to before me thzs Notary Public, County Notary Pubtzc NOTARY PU~UC St~te,,o~ New York Term ~res THE NEW YORK BOARD OF FIRE UNDERWRITERS 85 JOHN STREET. NEW YORK, NEW YORK 10038 JANUarY ]7 ]9~g ApplicotionNo. onfile a~aR47~7/~7 H 009~0~2 THIS CE~IFIES THAT ~Y~ and found to ~ in ~mpllance with the r~ulrements of ~fl~ ~. RXTURE RXTUI~S RANGES OVENS D~ WASHI~S EXHAUST FA~ OEYEES FURNACE MOTORS IIUTUB~ AP~JANCE ~ TIM~ CLOCKS MULTI-OUTIIT 04MMIRS S¥STIMS .~ACCUZZ ! SMOKE DETECTOR :-1 TRACK hIGH'tIN(;:-7 JOHN J. HOY[,AN H~i~IT[N(.~TON S"A.. NY ~o. % / 0 NO, ~ HI-LEO I1 mint I~1 be altered in ony manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING ~--~.* .~._. __ ~. ~ _- ,::.DEPARTMENT': ~ THIS COPY OF CERTIFICATI OUNDATION P~(1st) OUNDATION ( 0/<: OUGH FRAME ?LUMBiNG NSULATION PER N. STATE ENERGY CODE Ye FINAL [ONAL 765-~.802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]ROUGH PLBG. [ ]/~UNDATION 2ND [ ]INSULATION / FRAMING [ ]FINAL R'=MAR,~y ~ DATE INSPECTOR., 765-1802 ~ INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING ~ DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ RO~~UGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [ ] FINAL REMARKS: DATE INSPECTOR OUNDATION 1ST [~ROUG" PLBG.~'t~'%~-~~'- FOUNDATION 2ND [ ] INSULATION FRAMING FINAL 765-1802 BUILDING DEPT. INSPECTION [ ~/F/OUNDATION 1ST E ] ROUGH PLBG. FOUNDATION 2ND E ] INSULATION FRAMING [ ] FINAL REMARKS: DATE 765-1802 BUILDING DEPT. INSPECTION [~FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL INSPECTOR COUNTY OF SUFFOLK PATRICK G. HALPIN SUFFOLK COUNTY EXECUTIVE DEPARTMENT OF HEALTH SERVICES John J. Moylan ~79[~ ~J Huntington-Station, N.Y. 11746 Dear Mr. Ma~: Re: new house Arrowhead Lane, Peconic May 3, 1989 DAVID HARRIS, M D, M P H ... __T_pW.~N OF SOUTHOLD.. The Department of Health Services has performed a small survey to spot check for %ompliance with the state lead solder ban. The survey was a fo~owup to the recent incident in Smithtown where a licensed plumber was found using solder containing lead for making connections to the public water supply. The solder in your plumbing was tested as part of this survey. Effective Jandary 1, 1986 New York State limited the amount of lead in solder used for piping to convey potable water to 0.5%. In 1987 the law was amended to limit lead content to 0.2%, as well as requiring any solder containing greater than 0.2% lead to prominently display a warning label which states, "Contains lead which may be harmful to your health. Not to be used for joints on potable water service piping." The ban on the use of lead solder was enacted because ingestion of excessive levels of lead in drinking water can contribute to health problems including megtal retardation, interference with neurological and kidney f~nctions, and hearing loss in children. Children are at greater risk to lead toxicity due to the im- maturity of the central nervous system and because their bodies absorb a greater percentage of lead ingested. Results of your solder and water analyses are listed below. Solder - 1st Joint 41.6% lead 2nd joint Water - 1st d~aw sample 2 minute run As you had declined to be retested, the follow up testing on a second soldered joint and the water analyses were not performed. The current drinking water standard for lead is 50 ppb. This in- formation is being transmitted to your local building department. Should you have any questions, feel free to contact this office. Sincerely, Martin Trent Associate Public Health Sanitarian Bureau of Drinking Water cc: Southold Town Building Department/// TOWN OF SOUTtlOLD OFFICE OF BUILDING INSPECTOR ILO. BOX 1179 TOWN IIALL SOUTIIOLD, N.Y. 11971 June I, I989 TEL 765-1802 Mr. John Moylan 890 Arrowhead Lane Peconic, New York 11958 To Whom This May Concern, We are unable ro complete your Certificate of Occupancy because .of the following reasons. /--//An_ application for Certificate of Occupancy is not on file. (ENCLOSED) /7-/~,. NO Underwrzters Certificate on file. /--//, 'File check it~(~m~o~/not on file.) $25.00 /~ No Health Dept. Approval on file. /-'/ Mo final insi~ectzon has been made. Please contact our office on this matter. Thank you for your cooperation. lluildir,~3 Permit It I 5 6 0 6 Z Buzldinq Dupt. **~/_ Ilo Plumber Solder Cert%ficate on file. '( all pormit~ involving plumbing being issued after Aprzl 1,1984 LETTER FROM HEALTH DEPART'MENT APPROVING LEAD CONTENT IN S~LDER. VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (516) 765-1802 I FAX (516) 765-1823 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O Box 1179 Southold, New York 11971 May 10, 1989 John J. Moylan 890 Arrowhead Lane Peconzc, N.Y. 11958 Dear Mr. Moylan: I am writing to you regarding your B.P. #15606Z. You wrote to us for an extensxon on this permit, which was granted. With the extension the expxration date was December 3I, 1988. A letter was sent to you March 14. 1989 znform~ng you that the permit had expzred and a Certzficate of Occupancy has not been issued. You have not responded to our letter to renew the permit. You must renew thzs permxt ~mmed~ately. of the Code of the Town You are now in vzolation of Southold. Yours truly, Secretary VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (516) 765-1502 FAX (516) 765-1823 Town Hall, 53095 Main Road PO Box I179 Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD March 14, 1989 John &Margaret, Moylan 890 Arrowhead Lane Peconic, New York 11958 Building Permit ~15606-Z Tax Map 998-02-5 & 6 Dear Mr. & Mrs. Moylan: During a review of our files, it was noted that the above building permit has expired and a Certificate of Occupancy has not been issued. According to the Code of the Town of Southold Article X]fVIII 100-281 and 100-284 a building permit is needed for construction of a new dwelling and it is unlawful to occupy a dwelling until a Certificate of Occupancy has been issued. In order to avoid any legal action you must correct the above violations i~mediately. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. VRW:gar Vincent R. Wieczorek Ordinance Inspector VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (516) 765-1802 FAX (516) 765-1823 Town Hall, 53095 Main Road PO Box 1179 Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD May 10, 1989 John J. Moylan 890 Arrowhead Lane Peconic, N.Y. 11958 Dear Mr Moylan: I am writing to you regarding your B.P. #15606Z. You wrote to us for an extenszon on thzs permit, which was granted. With the extenszon the expzratzon date was December 3], 1988. A letter was sent to you March ]989 znformzng you that the permzt had expired and a Certificate of Occupancy has not been issued. You have not responded to our letter to renew the permit. You must renew this permit immediately. You are now in violation of the Code of the Town of Southold. Yours truly, Secretary 'r-E~CE W O~ L,NP_ -BIO. Q ~ G ~:' , D: , ° D. 1~'!7.40 E. 0 FORM NO 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N Y NOTICE OF DISAPPROVAL PLEASE TAKE NOTICE that your apphcatxon dated for perm~t to t.~o~2~ ~.)o~o~J~' /0~. ~, Location of Property House No ~ ~ Street Hamlet County Tax Map No t000 Section C2~.q ~. .. Block . ~ ~ Lot :~../~. Subdlwsmn~ ~ Fried Map No ~ ~ / O .. Lot No.. ~ .~.. ~sreturnedherew~thandd,sapprovedonthefollowmggrounds. ~ ~[~ .~. ~o.~. &~~ &~. ~ ~..~..~.. ~.~d..W~&.~. ~.~,. ~..~.¢.~. g ..L · ................ Buxldlng Inspector RV 1/80 MAP OF F'FzOPEF2TY J. ¢ h tAF =AITET hIOYLAH AT P E'CO N I C 4_o_:_g? ; LOT NO5 ~EFEf?... '~ MAP OF COVE'~FILEP 1I'4 ~'k,E $LIFF FO__ ........ CLE~Ic.'~ OFFICE AS R~pERIEK VAN TUYL~ 6 LAND SURVEYORS GR~EN~RT N~W YORK SUFFOLK CO HEALTH DEPT APPROVAL H S NO STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL ; SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS O~ THE SUFFOLK CO DEPT OF HEALTH SERVICES APPLICANT SUFFOLK COUNTY DEPT OF HEALTH SERVICES -- FOR APPROVAL CONSTRUCTION ONLY DATE H S REF NO APPROVED SUFFOLK CO TAX ~4AP DESIGNATION DIST SECT BLOCK PC:L IDS'D_ 0,9~ P- ~6 OWNERS ADDRESS DEED L I'.~t'A p TEST HOLE STAMP F SEAL Examlned"POoz~ ~1 Disapproved a/c . FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL 765-1802' Permit No. } kL-7°O/~ '~ (Budding Inspector) APPLICATION FOR BUILDING PERMIT Recezved ........... ,19. INSTRUCTIONS a. Tins application must be ~ompletely filled in by typewriter or in ink and submltted to the Budding Inspector, wltl sets of plans, accurate plot plan tp scale Fee according to schedule b. Plot plan showing location of lot and of bmldmgs on premises, relationship to adjoining premises or pubhc sire or areas, and giving a detailed descnptlon of layout of property must be drawn on the diagram which is part of this apl cation. c. The work covered by this application may not be commenced before issuance of Budding Permit. d Upon approval of this application, the Budding Inspector wdl issued a Budding Permit to the applicant Such pets shah be kept on the premmes avadable for inspection throughout the work. e. No bmldmg shall be occupied or used in whole or in part for any purpose whatever untd a Cerhficate of Occupa~ shall have been granted by the Bmldmg Inspector. APPLICATION IS HEREBYIMA~DE to the Budding Department for the issuance of a Bmldlng Permit pursuant to i Building Zone Ordinance of the ~Town of Southuld, Suffolk County, New York, and other apphcable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herem descnb. The applicant agrees to comply iwith all applicable laws, ordinances, budding code, housing code, and regulations, and admit authorized inspectors on premises and m buddmg for necessary lnspe~lo~cs...~¢ ~_.~ ,~ (~'glgnatur~"~f appbcan~, or name, if a corporation) (mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrlman, plumber or budd, Name of owner of premises ,/,p,o',i/ d /./.~.~,z6~-z- J ~oY~J (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 ~e- Plumber's License No Electnman's License No.. ,,,'v,v~ Other Trade's L~cense No Location of land on which proposed work will be done. House Number Street Hamlet 2 County Tax Map No 1000 Section ~,-'q~ . . Block .. . ~.E-. . Lot...,~..d.. ~ .... Subdivision ~.,~.O,wz, g/z~:~ z~ 4'~'~" . .. F~Ied Map No .~J.O .. Lot ~.~' .-~4 (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construchon a Existing use and occupancy .,..,:d,.~e,,~,~,~,~ ~.o~/o ................... b. Intended use and occupancy .~'~'*~.~,oe.,, e.e-- e'. t~' ,s 3. Nature of work (check which apphcable) New Bufldmg -K Addition Alteration . Repmr ..... Removal ........... Demohhon ......... Other Work.. (Description) 4. Estnnated Cost ............................ Fee ................................. , (to be paid on filing thru apphcatlon) 5 If dwellmg number of dwelhng umts o,~' Number of dwelhng umts on each floor If garage, number of cars .... .':':. ..... 6. If business, commercml or m~xed occupancy, specify nature and extent of each type of use ..... --7 ..... 7. Dimens, ons of exastmg structures, if any Front . .~ ..... Rear .. ': ....... Depth.. -:. ........ Height .. ~ .... Number of Stones .... -- . .. Dm~ensmns o,f~ s~rllie w~th alterations or addmons Front .. --7 ........ Rear ... ~. ......... Height ..... Numberr of Stones . .° .~'.~i~-- ................... ) .......... 9 Size of lot Front 11 Zoneorused~stnct~nwtuchprem~sesares~tuated ..,,O,,:~..~,,.:~.~r?.t;?.~'~.(?.~:~'.~,~+ 12 Does proposed construcnon wolate any zomng law, ordinance or regulation: ...~. ....................... 13. Will lot be regraded . .F~'?...a .. ......... Will excess fill be re~m. oved from premmes Yes Name of Arctutect .................. Address .......... Phone No .......... Name of Contractor . . : ............. Address ............. PhoneNf~N'9~< ~ ~: ~ ..... 15. Is this property located with~nl00 feet of a t~dal wetland? * Yes ...... · If yes, Southold Town Trustees Fermi[may be required. PLOT DIAGRAM Locate clearly and dmtmct]y ali buildings, whether existing or proposed, s_nd mdmate all set-back dmlenslons fro property hnes G~ve street and block number or descnptlon according to deed, and show street names and indicate wheth .... nor o~-c~mer lo~ ....... STATE OF NEW YORK, ! ~./ / S.S COUNTY . . . OF ~W~ ~ / .~<~ ~- . ~ ~ . bexng duly sworn, deposes and says that ~ the apphca: (Name of md~wdual s~gnmg contract) above named W~the .. ~~ ............................. (Contractor, agent, corporate officer, etc.) of smd owner or ownem, ~d is duly authorized to perfom or have perfo~ed the said work and to m~e and file fl apphcatmn; that ~ statements contmed m thxs apphcatxon am true to the best ofh~s ~owledge and behef; and that tl work w~l be perfo~ed m the manner set for~ m the apphcat~on filed therewith. Sworn to before me th~s ..... ~/.. ~ dayof .&~/<~-~ ..... 19.~ Ou~l~ m Suffolk COUn~ ~mmm~ ~r,s ~r~ 30, 1~87 ~ (' ,/Ai,~I-JT ) SLJE2VE Y' PZ[) A-l- f C,_ i -,' .n ~ -: di' -:& . ' : -C/___ _:'__" ]~I~I~[CK ~AN TUYL~°.C LICENSED LAND survEYORS GREENPORT NEW YORK SUFFOLK CO HEALTH DEPT. APPflOYAL H.S NO ~'I"ATEM£NT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILl. CONFORM TO THE STANDARDS OF THE SUFFOLK CO DEPT OF HEALTH SERVICES IS) .......... . APPLICANT SUFFOLK COUNTY DEPT OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE ..... H S. REF NO APPROVED ............. SUFFOLK CO TAX MAP DESIGNATION DIST SECT. BLOCK PCL OWNERS ADDRESS z'2 b.!~_ r_4~",' TEST H'oLE' DEED L. H/A P ........ sTAMp :- SEAL 0 U © o 0 LI MAP OF PFJOPEFZT"r" I',IOYLAN SUFFOLK CO HEALTH DEPT- APPROVAL H S NO STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLI CO DEPT OF HEALTH SERVICES SUFFOLK COUNTY DEPT OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTIOH O N I.~.X~ DATE //-- ~'- ~'~ H S REF NO , ~-'~-- APP~O~V~E~D ~ ~ "~ . biCYCLE PAMiLY DWELLI,,S O:,LY SUFFOLK CO TAX MAP DESIGNATION DIST SECT BLOCK PCL OWNERS ADDRESS TEL. ?..'1, - ~ ~ ) IEED L. i~ 4/A P TEST HOLE STAMP SEAL UUL I~' BLDG DEPT TOWN OF $OIJTHOLD LVAC ANT ) ~...s8.42 ,_ .o_B.._ ~s,o SUFFOLK COUNTY DEPARllvII~flT ' _ SI~N~.J:~NIILY QWEL. LIN(; The sewa£e dmpesa( and ~ ~ Bu~ JOt-4¼ MAP OF. PKSOPE'f2T",/ 5L,~VEY ED ,~OF, L. f~. '""-' & r-' AT PEC'ON, ,... ly_c.,!N).q.. ............ ~rA~rEMENT OF INTEN. T rile WATER SUPt>LY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO DEPT OF HEALTH SERVICES (SI ................... APPLICANT SUFFOLK COUNTY DEPT OF HE:AL1 H SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY · DATE ....... H S. REF. NO ,~e,:~ ~t"' .... APPROVED ............... SUFFOLK CO TAX MAP DESIGNATION DIST. SECT. BLOCK PCL IC,£O 098 ,'"_ '., '~'' - OWNERS ADDRESS ' ~ TkST HOLE DEED L.l'qT,':\ P ........ sT~.,~ '-, SEAL E. LF. VATION , , /~pPRO'~/~D AS NOTED NOTIFY BUIIJDINc: OEPAR'r~ENT AT /~o-1802 D h~',/~ t'O ~ ~ POR THE CO~:~TR ~CI'~ g, OCCUPANCY'OR'"',,, '. % _J i L I t, ~ PFIA. LT ', ~¥ c:m'~t5