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HomeMy WebLinkAbout26117-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27745 Date: 06 13/01 THIS CERTIFIES that the building ALTERATION Location of Property: 590 BUDDS POND RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 56 Block 5 Lot 17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 21, 1999 pursuant to which Building Permit No. 26117-Z dated NOVEMBER 1, 1999 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 ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN & JEAN WEBER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. PENDING 06/07/01 PLUMBERS CERTIFICATION DATED N/A (1— Author zed Signa re Rev. 1/81 FORM NO. 3 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) PERMIT NO. 26117 Z Date NOVEMBER 1 99 Permission is hereby granted to: JOHN & JEAN WEBER 53 WOODHOLLOW RD ALBERTSON NY 11507 for CONSTRUCTION OF ALTERATIONS FOR AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 590 BUDDS POND RD SOUTHOLD County Tax Map No. 473889 Section 056 Block 0005 Lot No. 017 pursuant to application dated SEPTEMBER 21 99 and approved by the Building Inspector. Fee $ 75 . 00 Authorized Signature ORIGINAL Rev. 2/19/98 jForm No. 6 �F \� \ j r �j TOWN OF SOUTHOLD IBUILDING DEPARTMENT �C) TOWN HALL 765-1802 � (1/ APP,LI ATIO FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply. and sewerage-disposal(S-9 form) . 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1 . Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a,consent to inspect signed by the applicant. If a Certificate of occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. - 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - .25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential //$15.00, Commercial $15.00 Date Cn L . .� . . o. . . . . . . . . . . . . . . . . . . ... . . . . . New Construction. . . . . . . . . .. Old Or Pre-existing Building. . . . :. . . . . . . . . . '. Location of Property. .-? .�o , �N`ld::. .�� �n o/. . Sm u�l o l . . . . . . . . . . . ... . . . . House No. Street Hamlet Onwer or Owners of Property. . .70 h h. .//. .. . . ..... . . .. .y. ?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . .%. . . . . . .Block. . . . .:J. . . . . . . . . .Lot. . . l.!. . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . .. . . .. . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. A.L.6 7 Z. . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . Fee Submi ted: $a S O 0 . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICANT I NSPECTI~~ [ ] FOUNDATION 1ST [ ] ROUGH PLBG. II [~FF~MN iDNAGTION 2ND 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROU - PLBG. [ ] FOUNDATION 2ND [ ] I ULATION [ ] FRAMING [ FINAL [ ] FIREPLACES CHIMNEY REMARKS: 0 - � A ,DATE ® INSPECT g14FI'01.t h� OGy� Town Hall,53095 Main Road p Fax(516)765-1823 P.O. Box 1179 W Telephone(516)765-1802 Southold,New York 11971-0959 tp BUILDING DEPARTMENT May 21, 2001 TOWN OF SOUTHOLD John & Jean Weber 53 Woodhollow Rd. Albertson, NY 11507-1425 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) XX No Underwriters Certificate on file. The check is (not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. _ No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 26117-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 53 Woodhollow Road Albertson,NY 11507 January 11, 2001 Town of Southold Office of Building Inspector Town Hall P. O. Box 1179 Southold,New York 11971 Re: Addendum to Owner Applicant Building Permit No. 26117Z 590 Budd's Pond Road, Southold,New York Dear Sir: Regarding the above referenced addendum, enclosed please find a letter regarding the framing from my licensed professional engineer,Frank J. Oliveri. If you have any questions, please call us at(516)621-5422. Thank you. Sincerely, and Jean Weber Enclosure I'D TVSPECTION REPORT DATE COMMLCIII r II it II if INDATJON ( IST) -------- n II IIII_ ----___--____ __-----------------------------.__—_ 0—_—--II . rq lye INDATION2ND) �"--__ __________________<___________ '--------------= I JGR FRAME 6 II PLUMBING to I SULATION PER N. Y. uZ4 �/ ! H STATE ENERGY11 11 a jj <t� CODE u1I a It ---------------------- it ------------- I I y II II � IIII_ _ It II 11 N -- FINALit II H OL ADDITIONAL—COMMENTS: ====___—________________ L �' H b o z ro 4 _ . ' S Y Ti S�Uf i'. 9 January 11, 2001 Town of Southold Office of Building Inspector Town Hall P. O. Box 1179 Southold,New York 11971 Re: Building Permit No. 26117Z 590 Budd's Pond Road, Southold, New York To Whom It May Concern: On December 14, 2000, I did a visual inspection of the Weber property located at 590 Budd's Pond Road, Southold. The inspection included attic framing and all other framing. All work was done in compliance with New York State and Southold Town Building Code. a ri Licensed Professional Engineer of NEW ���c. 0 yip O /µV K) xzl 'll IM p nT 3 f3 ' O�^EUFwG- ! J r ' 0 f O � F 4 E ISTI � � tasPrFNLr 5H irrGcc 200 F M - - -- - - r . --- -- ------ ti cam,- f New N �r.o � 2T i Z, -A I Ew i X L{ Fier qz PL Yr L _ V 4 1. K _ OINK s - — - - xi J 5 �o J n7 I C nr _- � N _ ,� �'vl - ----- FT�s - wi-rrk g ' A� DcaSo � � � •.� oo .�.� ---------------------=-------------------- --- New E Nr j Z.x i STCvt?3: 1 V - N Z - 0 VA k.Jfa1 �2 ?�. r 2 well 6oH�l� L` � � cATF Yo c- Lo �� � `271 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FO NDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: 47 141, ,DATE INSPECTO 53 Woodhollow Road Albertson,NY 11507 December 14, 2000 Town of Southold Office of Building Inspector Town Hall P. O. Box 1179 Southold,New York 11971 Re: Addendum to Owner Applicant Building Permit No. 26117Z 590 Budd's Pond Road, Southold,New York Dear Sir: Regarding the above referenced addendum, we would like to make the following alterations to our home: - Relocate existing kitchen - Relocate existing bathroom and install new fixtures - Replace existing 2ft. window with new 5ft. Andersen window Please refer to the enclosed drawings. If you have any questions, please call us at (516)621-5422. Thank you, y John and can Weber Enclosures �� ;i� 2 1 2000 AREA OF DETA:I-L i�pf iVc';yy —_— _— 2 1 2000 EXISTING O OF ee9 DECK NEW ANDERSEN WINDOW\;ESSIONP� ,Zhyl G — 55 — �� Qr EXISTING I it �— �� EXISTING ' KITCHEN I— II(y 3 BATHROOM 17 REMOVE INEW NON LOADBEARING WALLS F1 n GARAGE - - - - - - - - - - - - EXISTING EXTERI_O_R_ WALL X z' X miR. m a � r NEW NON LOADSEARING INTERIOR WALLS O - li, � `� �t �r`•�h � 3 /ly�pY�, c'SS;©NPS 1 7 a 2-2X4 ,rt ` 2X4 16" ON CENTER DETAIL OF NEW NON LOADBEARING WALLS �pROFfSS10NP� 1Z �ly��C 1 - E -�- - - - - - - - -- 2 - 2X72 HEAE> EFk X S in- T � N G J y _ N 2 S - > U C � - O A T C � H O X N W ,N H y T i pi I Ki \ J 1 2 - 2X4 2X4 7 6" ON CENTER DETAIL OF NEW 5' ANDERSEN G-55 WINDOW :! A '7 �c eE6a F, �� -'ftSS;G�A m MATTITUCK PLUMBING&HEATING CORP. P.O.BOX 1429 MAIN ROAD MATTITUCK,NEW YORK 11952 Phone 631-298-8393 Fax 631-298-1130 PROPOSAL JOHN WEBER 53 WOODHOLLOW ROAD ALBERETSON,NY 11507 NOVEMBER 07,2000 REFERENCE: 590 BUDS POND ROAD RELOCATE KITCHEN AND REMOVE BASEBOARD RADIATION -NECESSARY PLASTIC WASTE LINES -NECESSARY COPPER WATER AND HEAT LINES -NECESSARY SUPPLY VALVES AND TRAPS LABOR AND MATERIAL $1,155.00 RELOCATE BATHROOM,INSTALL HEAT IN BATHROOM AND BEDROOM, AND INSTALL NEW VALVE ON WATER MAIN -NECESSARY PLASTIC WASTE LINES -NECESSARY COPPER WATER LINES -NECESSARY SUPPLY VALVES AND TRAPS 1 -BALL VALVE -NECESSARY BASEBOARD RADIATION -FIXTURES AND FAUCETS BY OWNER -EXISTING BATH REMOVED BY OTHER LABOR AND MATERIAL $2,915.00 AUTHORIZED SIGNATURE NECESSARY STATE,TOWN&MUNICIPAL CERTIFICATION PROV115Ab UPON PAY NT IN FUL . ALL MATERIALS GUARANTEED&ALL WORK TO BE COMPLETED IN A MANNER ACCORDING TO STANDARD PRACTICES. ALL QUOTED PRICES WILL BE UPHELD FOR 30 DAYS. DATE OF ACCEPTANCE SIGNATURE 53 Woodhollow Road Albertson, New York 11507 June 14, 2000 Town of Southold Office of Building Inspector Town Hall Southold, New York 11971 Re: Addendum to Owner Applicant Building Permit No. 26117Z 590 Budd's Pond Road, Southold, New York Dear Sir: Regarding the above referenced addendum, we would like to create a family room by removing non-load-bearing walls separating two existing bedrooms, and also by replacing the existing six-foot window with a new Andersen eight-foot window. We would also like to make an eight-foot opening in a load-bearing wall to give access to the newly created family room. Please refer to the enclosed drawings. Thank you. Sincerely, John and Jean Weber Enclosures 47s .. IT 5, 1966 - . .�� �; :�ol�Q. �` No's '34 •� 'a :W YORK _05_17 98 A. `w&si'' �00 �- pg .o at y [ " c�pagm w xlnaNr~R.IN T!E rtir zcti a\Oo o at" ivr suw to nc iav Yaar SGTE wo 1 � +pf"*Pp45 �LANa s`Q � �� �0 j Q D S$ •� �j 9 e P M.Y.S. Lic. r - N uj nuTnra®xmvrw ae NomcN ." m, �,. a.NWl1Yl1 Joseph A. Ingegy 1F" n r SELIOK TX8 6 TC NET ltia(STAIC tD D EDIL"g101 SIR. Lm,ci Surveyor La m ee a tvEn nue carr. ,{ ' h CfRIFWl1O�6.OGTE�KRml 4itll IIUE AL �.m nE Pp6pN, N.a , LOGIC 16NMIfl1[El[O NFk1TN MU CL'' TQ: • MpT�,� �Lnpwt Fh10NE (516)727-2090 � (Sifi)? Ft z NATIONAL TITLE INSURANCE COMPANY OF NEW YORK THE ;j*nNM a OMM OF wax 0FM-10 WCATO AT f in,..I wrnro un lro .....— — T.•..-• r� Uwkl �,i on w, Y �1 } ti G �. � • 1 ` ry,lo ..µyy`Tpra Y.'�a aYnd+. �< T�N S�Md, r y»•i 1W.�id - r tr a v� C i A � TE �� ^T y? J 1 l illlyl �, I 4 j 3 m� + w i a C) \j (Z H t'tNCr otirt � �— -- ---------z----------- Ext STr NG e i I STIr- 4 Z -Zxy Z - Zxc( Cvws-rl"(, CYISTr' G LrGNT2 µ j L1gHT1u1) F,ATua< t � l GL � Sc GL � y t l S� r r•= � � � � � � � � S T-r t`s G G 1440 . 1 ,0„ Con, c2e"TE fiSLPTEY.rS'fl #4G SLPa A Lrc __E �s%i. GB`P� cluQ� � 1Noo,J w,TH _t>_0_4f3i,N--t7ooIL GAL2 -- S� o -E Tom, ¢= T cz o 0 S' �j t� ��L` SNEATN�t+ � F Izi ` -•/ �O � � P � x) to=Z�t �I 14 tiao ti Z - ZXiv H, c NEW NESP`_ `C t: P2F P2Sor�1 �To 2- 19 " Fx � INSUtPF1oU OCCUPANCY OR = � APPROVED AS NOTED DATE: - � , B.P.#�D(011' z USE IS UNLAWFUL -- FEE LLS-BY �• c vVITHOUT CERTIFICATE Z x v CAT i E x s > i Nc NOTIFY BUILDING DEPARTMENT AT OF OCCUPANCY r ; 765-7802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: i. FOUNDATION - TWO REQUIRED i UNDERWRRERSIERTIRCATE ]]] FOR POURED CONCRETE ` 3 REQUIRED 2. ROUGH - FRAMING & PLUMBING - - 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEETTHE REQUIREMENTS OF THE N.Y. 4 �' p -XT =S i•+N --- - STATE CONSTRUCTION & ENERGY i -.-.__— � - -- { �_-,., = Z-2)fq'-__„_ CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS - 5 � O (�v40,5 X ST � N� 3�oe1c F o � �O #T,ow f SovT"I{olb h1v• 11911 WORK 7-17- T1 -5 -"-49E4 o^.y S'i'R11___N_ctJ- _5 �in�_IVB-_ ). oaQt' L.��I.,tit Ow _ I{ornt 5tto Gzt - sq,47- Evt „ Q:, w ,1lo ,,�4 P.bS-.T Y BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . ... . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CALL .($16,) ;621„5422 Examined.................. 19......, MAIL TO: . .JQHN WU.A9. . . . . . I Approved...../!' ......., 19.1...1 Permit No. F4QOt?RULO11-40 ))......... Disapproveda/c .................................. 1.15.Q7....... 6 (Building Inspector) SEP 2910 PPLICATION FOR BUILDING PERMIT ptr,;,, rIEFT. SEPTEMBER 1 Date. . . . . . . . .?r. e, 1999. . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and mtnitted to the NAlding Inspector wii 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 moat be drawn on the diagram Wch is part of this application. c. the work covered by this application may not be cumenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be,kept on the premises available for inspection throughout the cork. 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 F3L9l N MAIL to the Building Department for the issuance of a Building Permit pursuant to the Building Tare 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 inspelctionns, + �. (Signature Ig applicant, or name, if_a corporation) 53 WOODHOLLOW, RD. ALBERTSON,NY„11597 (Mailing address of applicant) State whether applicant is owner, lessee, agent,, architect, engineer, general contractor, electrician, plumber or builder OWNER .......................................................................................................0................ Nam of owner of premises JOHN ,and, JEAN WEBER ............. .......................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ....................................0..................... (Name and title of corporate officer) Builders License No. ......................... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License lb. .................... 1. location of land on which proposed work will be done..... 590 BUDD;S POND RD: SOUTHOLD NY 11971 ...............................................................................................0....................... House Number Street Haslet County Tax Map No. 1000 Section ....5 6 ......... Block ..... 5......... Lot ... .J -L... Subdivision ....... Filed Map No. 4.65.2......... lot ....1.5 ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...........RErS 1 RiJNTT1ik................................................. b. Intended use and occupancyRESIDENTIAL ............................................................................. Miture of work (check which a licab / . • PP le): New Ikiilding ........,, Addition .......... Alteration ....Y... , Repair ............ Radnval ........'..... Deaulition ............ Other Work .................................. (Description) Gsthaoted Cost .......$7r5.Q.0.v0Q...;.... fee ........ ............................. oto be paid on filing this application) If dwelling, nunber of dwelling units .....1..... IW)er of dwelling units on each floor ....1 .......... Ifgarage, ember of Cara ..........!i............................ If business, connercial.or mixed oc 'cupency, specify nature and extent of each type of use...................... Dinrensions of existing structures, ilf any: Front...6 1.n.......,. Rear ... 1.� ......... Depth ., 38 ' ..... .,.. s Dimensions of sane structure with a r Stories .,....,.1......., alterations or acklitions: Front ....... �ebe b 1 i ........ Rear ...61:.....,.. Depth ...........311!..... Belglnt . !.....141..........,, Nudber of Stories .....1... . Dinensions of entire new construction: Front ................ Rear ............... Depth .............. Ileiglnt ......................... "ber ofiStories ..................... Size of lot: Front ...223.'.......;.... Rear ..172 :13......... Deptin ...9957,,,,,,,,, 0. DdLe of ILrcl+ase DkrCk14MR.199§., Nano of Fonrer Owner JOIIN SZALA........ .1`+ I. Zone or use district in w1iide premises are situated ......, ....................................................... 'L. Aces proposed construction violate any zoning law, ordinance or regulation: ........................ 3., Will lot be regraded .......N.Q.....F..... Will excess fill be rennwed fran premises: YCS NO 'i. Nares of Owner of premises ,•JOHN�jEAN WEBER,._ gess 53_WOODHOLLOW RD; pts x,621„-5,477,,,, Name of ArchiLecC .................'.................... Address ...................' Pirrone No. ........... .............. Name of Contractor ................I;................... Address ................................Phone No. .............. 5. is this property within 300 feet of; a tidal wetland? * YFS ...Y...... NO .......... *IF YFS, SWIIUD ?CIIdl 1id1S117,S M, MT IMY DL MQARM. PLOT DIAGRAM IocaLe clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions inn property lines. Give street and block nxnber or description according to deed, and slow street nines and indicate lrrether interior or comer lot. l 'PAIN OF "MY(M U1NlY (A' S4 ............ ............. ....being duly swom, deposes and says that he is the applicant Name of individual signing contract) bove named, eis Line ... .'C.LJ,f'✓G�............... !,................,.................................................. (Contractor, agent, corporate officer, etc.) f said weer or owners, and is duly autborized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belieU, and hat the work will be perfonned in the nenuer set forth in the application filed therewidn. kom Lo,(before me 011s . ....�J.�........day ane ... .i,,. 19.L�.,.. Notary Rilrrlic ... .... .. .... ., (Si vre of Applicant) JOHN 0.LASEK Notary Public,State of New York No.01LA4672701 QuallNed In Nassau County Commission Expires June 30,20 LOT 15 . . • e .. . .: , D .MAP OF � ;. � ' ,�5•47 O � WILLOW POINT FILE No. 4652 FILED JUNE 16 1966 s YY SITUATED AT SOUTHOLD • _• TOWN OF SOUTHOLD FFOLK COUNTY, NEW YORK ; . SC. TAX No. 1000-56-05- 17 D'_' ♦ • Qo, ,o SCALE 1 "=20' e •• ♦ • a• ' DECEMBER 28, 1998 ; ` . ers' ��. AREA = 16,396.27 sq. ft. ct (To BULKHEAD) 0.376 ac. ��\ ?l; "$_ , 91.6 ' 1''� a. ie 4b� °�' o' ,:iX+?` _ .. ♦.D • , h6 ' �6,lcj FRS GO PREPARED IN ACCORD04M WFFH THE WMN - �O 9 C] p £ STANDARDS FOR TRLE SUMIDS AS ESTASMEDBY THE UAoLS. AM APPROVED { TIFORR ME ASSO USES THE NONM ST - ani3 , �-�LANDS 04�A !rye :e ttT � .-.. En $1000 Q 0 • x R=25.89' tX3 L=39A, .76' Z , cP 's'i: D.� N� " �l tii H G N.Y.S..Uc. NO. M UNAT40R4ED ALTERATION OR ADDITION 9* x,18,+ w oRVEY IS A VIO[AIM Of SOF TFIE NEW YORK STATE Joseph A. 999 '[kw, s , COM OF THIS SURVEY MAP NOT SEARING Q S l4Z LD THE LAND SURVEYORS "CED SEN. OR *I�` ./�_. 28• {n EIROSSED SEAL SNAU.NOT BE CONSIDERED Land' Vw ♦ j TO BE A NAM TRUE.COPY, CA o A TT id SHAII RUN ONLYW TPERSOT'/ FOR YAidl SURVEY _ AMD CN.i/S'BQiALF T rim 5171VMy! - �; "sft PIOnt x4 ! s LENOM CERTIFIED TO: 70 lKn. > ,, FNONE (St6 727 X40 �o�t{Si6 x M O 1 FIDELITY NATIONAL TITLE INSURANCE COMPANY OF NEW YORK . _ . AMERICAN HOME MORTGAGE n+egt awr oaar� PA YQ JOHN WEER wo/olt"c + tasx � ,uv ,tee „M n A.,ii� �� �11'[ ''. $",. i., •' ':!,' ,�,. .a. BUILDING-PERMIT REVIEW CHECK LIST Applicant/ Date Owners Name: (I)ghm, Reviewed: Architect/ Date Engineer: Submitted: SCTM#: `(- District: 1 000 Section: .)G Block: Lot: I 'll_ Project Sgo � (� Subdivisio9 Location: bt�� PO-N9 AD J1p( Name: lt3 l L Single&separate Requd� certtfication: (Yes/WoXrI5 T'w5 *S Req- ! ( R� Zoning District: �1"—I� [Lot size: Actual: . 1 [Lot coverage Proposed: � Req 10, Req ,Q s Req- (Front eq[Front Yard &. Proposed: (Side Yard '3J Z7 Proposed: 1 [Rear Yard J`� Proposed: Project Description: C AGENCY PERMITS permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation??? =f-eMFlood Zone: Elie Notes,-.