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Home My WebLink About14870-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z..1.6.5.9..9 ......... Date January 20, 1988 THIS CERTIFIES that the building One family dwelling 6000 Indian Neck Lane Peconic Location of Property ............................................................... House No, Street Hamlet County Tax Map No. 1000 Section 098 . .Block 5 .Lot 17.2 Minor Dr. Meyer Rosenberg 3 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Bailding Permit heretofore filed in this office dated .... ~.a,y.. 8. ;. ,1.9. 8..6 .... pursuant to which Building Permit No..1.4. 8, .7.0.Z ........... ... dated May I 2, 1986 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 ......... .... 9.n.e...f.a.m.~l..y. dwellin$, attached 2 car garage, amended to include area over garage. The certificate is issued to RICHARD E. & DIANE M. ALLEN ..................... io¥,,'.;. ..................... of the aforesaid building. Suffolk County Department of Health Approval 8..57.8.0. 7 .2.2.2. . J .I ./.3. 0../.8.7 ..................... UNDERWRITERS CERTIFICATE NO. N84935/4 1/8/88 PLUMBERS CERTIFICATION DATED: Stephen O'Connor 1/I6/88 Rev. 1/81 TO~N OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ~~..~.~.~ ....... ~ ................ .~..~..o.....~. ~....~.. ............................. ...~..~.....~..:~.:...u...~..~../. ........... ...... ..... ~ ......................... ~- ....... ~; ...... ~...~,,....~...~...;.~.._..~ ...... ;..:.~......:.....~ .......... at premises located ot ..~.:.~. ............. J.I.])....~9:%..q93~... ........... lt~..J~., i~.~..: ....~..~ .......... County Tax Map No. 1000 Section ...... ..~..?~,.~, ....... Block ...... .~..~'.. ........ Lot No ..... .~.g..:...'~.,. ...... pursuant to oppJication dated .... ...~....~..~. .......................... 19.',~o.., and approved by the Building Inspector. Rev. 6/30/80 ~-- FORM NO. G TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATIOI~ FOR CERTIFICATE OF OCCUPANCY Instructions I 5 1988 BLDG, DEPT. TOWN OF SQIJTHO,L,D,, A. This application must be filled in typewriter OR ink, and submitted J ~ 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, end unusua~ natural or topographic features. 2.Final approval of Health Dept. of water suppl~/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-existir~g" land uses: 1. Accurate survey of p:Coperty 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. ;~. 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 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 $ 5.00, over $ yea~s $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ...~..'.~.~.'.~..~ ............... Old or Pre-existing Building .~ ........... Vacant ~'~¢'¢'/¢//~' Newt°ns t~uc t i°n ...... /~¢',/L~ ~////t/~ Land ............. Location of Property .~.~¢~ .~ ................................................. House No. Street Ham/et Owner or Owners of Property ~,~. ~,. ~.. ~..,~, .... ~ ~.~.[~ ........ ' ........ County Tax MapNo. 1000 Section ...0.~ ....... Block ..~ ........... Lot..~t~ ......... ............. Subdivision .................... Filed Map No ........... Lot No. ~ PermitNo.'./.~¢.~OateofPermit ...........J-I'-~ Applicant ~]~4~1~ .............. AJl~ Health Dept. Approval (I/~¢/¢~ ~¢-¢¢-~D~ . .Labor Dept. Approval Unde~riters Approval ........................ Planning Board ApprovaJ ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Rev. 10.10-78 Construction on above described building and permit meets all epplicable codes and regulations. Applicant ¢~¢~.. ~'~, .~I~.~,~,~ .......................... FIELD INS~'ECTION FOUNDATION FOUNDATION ( 2nd ) ROUGH FRAME & ?LUMBING INSULATION PER N. STATE ENERGY CODE Ye COMHE~'~TS FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT., INSPECTION [ ] FOUNDATION lST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [Z~I~NSULATION 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION INSPECTOR~ 765-1802: BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ R~OUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL DATE INSPECTOR 765-.o2 /~//~ ~ ~/~ BUiLDiNG DEPT. ~. ~ ,, INSPECTIOH FOUNDATION 2ND [ ] INSULATION , [Z/~RAMING [ ] FINAL INSPECTION FOUNDATION 1ST [ ~ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [ ~-]~RAMING [ ] FINAL BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ RO~~UGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL ,REMARKS: 7GS-~.802 BUILDING DEPT. INSPECTION DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL DATE ...... INSPECTOR//~~ BUILDING DEPT. INSPECTION FOUNDATION 1ST []ROUGH PLBG. FOUNDATION ZND []INSULATION []FINAL [ ] FRAMING REMARKS: BUILDING DEPT. NSPECTION FOUNDATION ~ST [ 1 ROUGH PLRG. [ ] FOUNDATIOH 2ND [ ] INSULATION FRAMING [ ] FINA~. , DATE TOWN OF $0UTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 June 26, 1987 TEL. 765-1802 Mario M. Giannoni, P.E. 40 Maple Circle Northport, New York 11768 Re: Building Permit #14870Z House of Richard Allen Dear Mr. Giannoni: In regards to your letter dated September 16th, 1987, and received by this department on June ~9, 1987, please be advised Item #5 of your letter in regards to 3" waste line under Article 9, Part 900, Table II 903 of the N.Y.S.U.F.F.B.C. not more than 2 water closets are permitted on horizontal 3" waste lines. Mr. Allen's house does not meet this requirement. Very truly yours,~ .~.~ Thomas J. Fisher, Building Inspector Town of Southold TJF:gar MARLO M. (BIANNONI,P.E. CONSULTING ENGINEER 40 MAPLE CIRCLE, NORTHPORT, N.Y. 11768 (516)2~5't~,~,0f5 September 16, 1987 Bt. OG. DEPT, TOWN OF SOUTHOLD To: Southold Building Department Re: Building Permit 3148702 House of Richard Allen In accordance with the request of the building inspector as to points of question raised in the field I have the following comments: Splices in the roof rafters over the master bedroom and large front room are called for in the plans and are -..common,practice and are acceptable. The main valley rafter has been installed in accordance with the approved plan and is adequate to support the imposed load. 3...Adequate flashing of the chimneys makes the use of crickets unnecessary. 4. At the turning point of the concrete block chimney support, the partial overhang of part of two blocks is adequately supported by the interlocking of the blocks and requires no additional support. ~. The exposed three inch waste line is acceptable, and the arrangement of the vent lines, one for the garage bathroom and one for the rest of the house meets code requirements. 6. 2x6 ceiling joists over master bedroom are adequate for a live load of ten pounds per. square foot and may be sub- stituted for th%-~ZX ~ shown on the plan. Very truly yours, Drll~ P. FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL for permit to ~_~a~,e.2~- ~ /~...~0...~,~~ .... '. , at tocationofPronertv 0ooo ~'~.o..u~.. ~[..~.b.~.~A.~...g~.- .... ~.~. ~ ~ ~ h~S~ ~o .... ~ ~ ~ Street Hamlet County Tax Map No. 1000 Section .... ~ ~ ~ .... Block .... ~ ~ ...... Lot . J. 7: .~ ...... Subdivision ~g~g. ~.~ Filed Map No. ~l. q9.q 7.~ ~ ...... Lot No.. ~ .............. is returned herewith and disapproved o~ the following grounds..~ ~. ~. · ~.~& · · ............... Building Inspector RV 1/BO TOWN OF SOUTIIOLD OI'~PICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTIIOLD, N.Y. 11971 TEL. 765-1 ~02 January 15, 1988 Richard & Diane Allen 500 Daly Lane Southold, N.Y. 11971 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. /~ An application for Certificate of is not on file. ENCLOSED /_--~ NO Underwriters Certificate on file. /~ The check i'.;(dt~t~lifg~/not on file.) /~/ No Health Dept. Approval on file. /~/ No final inspection has been made. Occupancy $25.00 Please contact our office on this matter. Thank you for your cooperation. Building Permit # I 4 8 7 0 Z Buildi;l~ Dept. **i/~/ No Plumber solder Certificate on file, ( all permits involving plumbing being issued after April 1,1984 ) THE NEW YoRK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN ,STREET. NEW YORK, NEW YORK 10038 THIS CERTIPIE5 THAT Dick Alleu Indian N~ck Lan~, 6Q0 in Ihe foliou, ing location; ~ Basemen~ ~ Ist Fl. ~ 2nd ~7. Section Bilk Lot ~sexamlnedon Deg~ber 28~ 1987 attdfo~ndtobeincompiioncewlththereqt~irementsqfthlsBoard. FIXTURE BXTUEES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 62 54 DRYERS OTHER APPARATUS; Mot:ors: i-,],jacuzzi P~m~l~o~r~; ~l~Scir, ~l~SamPs C NO OF HI-LEG G &$ Electric Box 215 S~thold, N.Y 11971 Ltc. 578E GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectdrs may be identified by their cred'enfials.~ COPY FOR EUILDIHG DEPARTMEHT. THIS MANNEI TOWN OF SOUTIt. OLD OFFICE OF BUILDING INSPECTOR P.O, BOX 728 TOWN HALL SOUTHOLD, N.'~, 11971 TEL. 765-1802 CERTIFICATION Building Permit No. Owner ?{tl~:,,~ (please print) Plumber ~7'~N O'~O~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this ... [ ~day of _ ~-~ ,' Notary Public,_ ~ County (plumber's signature) Notary Public Approved .' .~. · .' ~ /; .~.':., 19 .q.~. Permit No. t .~.~.. ?.0..~'. · · Disapproved a/c ..................................... 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 TOWN OF ~OUT~OLD Received ........... ~19... (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 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 for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ............................ -- (Signature of applicant, or name,Al' a corporation) .5.0.o. uo d ........ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .[~,.q-k~e~.cL ¢.,..o5...~.l~..~.. (~'1 ~.....~...[_.L:.~..~. ........................... (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 .......................... Plumber's License No ......................... Electrician s License No ....................... Other Trade's License No ...................... I. Location o f land on which proposed work will be done. O ff~. ttouse Number Street F/amlet County Tax Map No. 1000 Section . .O.~}.~0.O. .......... Block . 0.~.,..t~. ........... Lot. 0. t.~ ~0.0..q~ ........ Subdivision ~R.,. ,~1 ~¥~a. Re,e.g. 6 rrc4 ............ Filed Map No...[17.~."/.~.~ .... Lot . ~ ............. (Name) .a 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . ~.(t.C, .tY.t'J?'. ............................................................ b. Intended use and occupancy p.R. { .M.~g.~...~.C:.~..I.~.e.~..~.~ ............................................. 3. Nature of work (check which applicable): New Building ..~...' ..... Addition .. ........ Alteration . .I ........ Repair .............. Removal .............. Demolition ........... i. · · Other Work ............... (Description) 4. Estimated Cost , ~. }5.0~0o~ ............................. Fee ...................................... · (to be ~aid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling unit~ on each floor ................ If garage number of cars g, ~ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............. , ........ 7. Dimensions ofexlsting structures, if any: Front..~..~. .......... Rear .~. ~....' ...... Depth . .~.~ ........... Height ,3.~} ............ Number of Stories . .~,. Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of .Stories 8. Dimensions of entire new construction: Front .. ~., .......... Rear ...~g,'.. ....... Depth . .,~ 8. ~... ~ Height :~.¢~ Number of Stories g, ' 9. Size of lot: Front . .qt~, .q-.6..... .......... Rear ...~1¢, .q$ ............. Depth . [~.q:.,.8~ .... ,~ ........ 10. ?ate of rurch~as.e } .~'¢ ,~.~ ~.~.~ !.q.S.t~ ..... , ......... Name of Former Owner ~.t;;eO~.d ~,..~. :;r!4d tI~ .I~tgt~GeR.T. NI~R 1 1. ~one or use aistrict in wmcn premises are situated ........ : ............. ~ ..... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ] ............................ 13. Will lot be regraded ................... ; ........ Will excess fill be removed from t~remises: Yes No 14. Name of Owner of premises-~tc.k~a~[ .~.,..~.l~)tl~l?..Ok Address ,~.q~. ~ ttl.-)l. 1.41~.~,.~9p g~6tNo . .-/.t~ ~qt~.~. Name of Architect"~, tO.,. ga t,t,~ .......... t0.t..~.rnq Address/t~l./-r-.*/q~'~d./>.~,. i Phone No l.'. ............. .... Name of Contractor ......................... Address ,~t~ I~.Tp.,o..~} Phone No .... 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, /0 0 STATE OF NEW YORK, COU~Y OF ................. S.S ......... [, ~k~ .................... being duly sworn, depoges and says that he is the applicant (Name of individual signing contract) above named. He is the (Contractor, agent, corporate officer, etc.): of said owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e and file this application; that all statements contained ~ this application are true t0 the best of his ~owledge and belief; and that the work will be perfomed in the m~ner set forth ~ the application filed therewith. Sworn to before me this Sota~ Pub lc, . A~~~ ...... County So. 52.7069995 ' S~lo* Goa,xty (Signature Southold MAIN ROAD- STATE ROAD 25 Town Board of Appeals S0UTHOLD, L.I., N.Y. 11971 TELEPHONE (516) 765-1809 ACTION OF THE ZONING BOARD OF APPEALS Appeal No. 6390 Application ~ated Au§ust ], ]985 TO: Mr. and Mrs. Ric~ara Allen 500 Daly Lane Southold, NY 11971 At a Meeting of the Zoning Board of Appeals held on 0ct0ber 3, ]985 the above appeal was considered, and the action indicated below was taken on your [ ] Request for Variance Due to Lack of Access to Property New York Town Law, Section 280-a [ ] Request for Special Exception under the Zoning Ordinance Article , Section [X] Request for Variance to the Zoning Ordinance Article III , Section 100-31, Bulk Schedule [ ] Request for Application of RICHARD AN6'DiANE ALLEN far % Va~iahce to the Zoning Ordinance, Article III, Sec'tion 100-31, Bulk..Sched~le~'¥or. permission to construct new one-family dwelling with an insufficient rearyard setback. Location of Property: Private right-of-way located off the South Side of Indian Neck Road, Peconic, NY; County Tax Map District 1000, Section 98, Block 5, Lot 17.2; Lot #3 of Mi'nor SubdivisiQ? ND.. 141 approved ll-27-78. WHEREAS, a public hearing was held' and concluded on September 12, 1985, in the Matter of the Application of RICHARD AND DIANE ALLEN, Appeal No. 3390; and 'WHEREAS, the board members have personally viewed and are familiar with the premises in question and the surrounding area; and WHEREAS, the board has considered all testimony and documentation submitted concerning this applicatio,n; and it is noted for the record that there has been no public.opposition; and WHEREAS, the board made the following findings of fact: 1. By this application, appellant requests permission to locate a new.single-family dwelling having an insufficient rearyard setback from the %2sfenl~ pfop~t~ lin~,at 46 feet." ~' ' 2. The property in question is ~nown as Lot #3 on the Minor Subdivision Map of Meyer Rosenberg approved by the Southold Town Planning Board on November 27, 1978, and is located on the east side of a private right-of-way located off the south side of Indian Neck Road, Peconic. 3. The premises in question contains a total area of 1.267 acres and ~s presently vacant. 4. Article III, Section lO0-31, Bulk Schedule of the Zoning Code requires a minimum rearyard setback of 50 feet for new prin- cipal buildings, and the applicant is requesting a variance of four feet for a 46-foot setback, or a variance of eight percent. (CONTINUED ON PAGE TWO) DATED: Form ZB4 October 15, 1985. (rev. 12/81) CHAIRMAN, SOUTHOLD TOWN ZONING BOARD OF APPEALS Page 2 Appeal No. 3390 Matter of RICHARD AND DIANE ALLEN Decision Rendered October 15, 1985 5. It is the opinion of the board that the relief requested is the minimum necessary under the circumstances and!that it is the location of the right-of-way that lends to the difficulties of building on this parcel. In considering this appeal, the board finds and determines: (a) that the relief requested is not substantial under the circum- stances, being eight percent of a variance of the requirements; (b) that by allowing the variance there will not bela substantial change in the ch'aracter of~h~"di~t~ri~ct~; (c) 'that~ ~e'~safety, health, welfare, comfort, convenience and order of t,he town will not be adversely affected by the proposed business use and its location;" ('d) tha% th'~ circumsta~nces are 'un'ique; ! (e) that the interests of justice will be served by allowing the ivariance as applied. ~ Accordingly, on motion by Mr. Sawicki, secondedl by Mr. Goeh- ringer, it was RESOLVED', that permission BE AND HEREBY IS GRANTED AS APPLIED UNDER APPEAL NO. 3390 in the Matter of the Applicati~on of Richa-~-- and Diane Allen, to construct a new single-family dwelling with an insufficient rearyard setback from the easterly prop'erty line at 46 feet.. ~ Vote of the Board: Ayes: Messrs. Goehringer, iGrigonis, Douglass and Sawicki. (Member Doyen of Fishers Island was absent due to weather conditions.) :~ This resolution was adopted by unanimous vote ~f all the members present. 'i October 15, 1985 SUFFOLK CO. HEALTH DEPT. APPROVAL S~. DEPT. OF ~' 'S~ ~ STATEMENT OF INTENT ~ ,~t~. , THE WATER SU~Y AND SEWAGE DIS~SAL ~ ~: ~:C. ~.~. SYSTEMS FOR THIS RESIDENCE WILL ' CONFORM TO THE STANDARDS OF THE SUFfOLK~CO. DEPT. OFHEA~TH SERVICES. ~ APPLICANT ~0 SUFFOLK COUNTY DEPT. Of HEALTH pR~t e~ /~-$[ CONSTRUCTION ONLY / t ~k*~ ~, ~ ~ ~' ~LL~t~ H. 5. REP. SUFFOLK CO. TAX MAP DESIGNA~N~ DIST. , ~CT. BLOCK PCL. OWNERS AD~E~: DEED: L. ~= ~, ~ ~'~- TEST HOLE STAMP ' to~r~ LICENSED LAND S YOES NEW YO.K SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO, STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL ~- ,/ ' ', ..~ ,-- SYSTEMS FOR THIS RESIDENCE WILL .......... /:':'~J~'J"~? CONFORM TO THE STANDARDS OF TH~ SUFFOLK CO. DEPT. OF HEALTH SERVICES p,j. -,/. APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY APPROVED: SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOEK PEL. OWNERS ADDRESS: DEED: L. zff, . TEST HOLE STAMP . T-r 'de ~*~d, SEAL ROD~RICK VAN T~YL, P.C. LICENSED LAND SURVEYORS GREENPORT NEW YOrk ...... S.C, DEi~'. OF /~[-~' '-.TX-: /Z~)~_>~&.. , x~- S~RVICES ~ATEMENT OF INTENT ~ 2~'/~ ~ THE WATER SUPPLY AND SEWAGE DI~SAL .... ~ _~. ~ , I ~ , ~ ~ ...... ~..~: ; ~.. .~ ~/ SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE ~ANDARDS OF THE ~ , APPLICANT ~ SUFFOLK COUNTY DEPT. OF HEALTH ' SERVICES -- FOR APPROVAL OF ,, , ...~ ~ ~ ~ // , ~ SUFFOLK CO, TAX MAP DESIGNATION n ~, ' ~ ~ * ~ ~ DIST. ~CT. BL~K ..., ..... ' SINGLE F~iLY DW~LI~G 0NL? . ~ ......... ", -~, , The sewage dispo~l arid wa~uppty faciliti~ ~ ~ , ' ' '" ' ~' ~ . ~x~ ~ ..... ~cati~ have ~en iflspe~ ~this ~pa~ment~ , i · . ~he~n~es and found ~ ~e ~sfam~,, ~ ~ ~ ~ ~'~c~ '~ :~e ;~ /&e~. ~vet~'g' SEAL , . ..... , ,/, ~ ~ey~d ~ ~,1~. ~ , + ,' RODERICK VA~YL, P-C. LICENSED LAND SURVEYORS GREENPORT NEW YORK Jf ~ tubing ia Used for ~ distributing at~ Piping Ihall be OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY PLU~IBER CE~7/,~..A TION OIV I..~AD COi~EIk'T ~£FORE CERTIFICA?E OF OCCUPANCY APPROVED AS NOTED PEE:,~/~/'~ BY: ~ ~.~- NOTI~ BUILDING DEPARTM~T AT 765-1802 9 AM TO 4 PM ~R THE FOLLOWING INSPECTIONS: 1 FOUNDATION ~O REQUIRED FOR POURED CONCRETE 2 ROUGH ~RA~ING & PLUMBING ' O0 oo "1 -I r- ,l