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HomeMy WebLinkAbout26049-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26928 Date: 02/14/00 THIS CERTIFIES that the building ADDITION Location of Property: 110 SELAH LA MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 106 Block 9 Lot 4.8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 5, 1999 pursuant to which Building Permit No. 26049-Z dated OCTOBER 20, 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 UNHEATED ENCLOSED PORCH ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to SALVATORE J & IRENE T. ARIOSTO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 96993 02/07/00 PLUMBERS CERTIFICATION DATED N/A A horized Signature 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. 26049 Z Date OCTOBER 20 99 Permission is hereby granted to: SALVATORE J ARIOSTO 110 SELAH LANE MATTITUCK,NY 11952 for CONSTRUCT AN UNHEATED ENCLOSED PORCH ADDITION AS APPLIED FOR. at premises located at 110 SELAH LA MATTITUCK County Tax Map No. 473889 Section 106 Block 0009 Lot No. 004 . 008 pursuant to application dated AUGUST 5 99 and approved by the Building Inspector. Fee $ 75 . 00 Au iz d Sig ature ORIGINAL Rev. 2/19/98 + TOWN OF SOUTHOLD �l BUILDING DEPARTMENT TOWN HALT. V 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the bu. inspector with the following: for new building or new use: 1 . Final survey of property with accurate location of all buildings, property streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 i 3. Approval of electrical installation from Board of Fir ��.,..-� 4. Sworn statement from plumber certifying that the sold r^� ctd ,,Q°4n �yfte7 f'7`+ less than 2/10 of 17 lead. " ^ �5 5. Commercial building, industrial building, multiple residenc�*.and similar bi and installations, a certificate of Code Compliance. from ar tIai nginl responsible for the building. r - 6. Submit Planning Board Approval of completed site plan requirements. ,t1 B. For existing buildings (prior to April 9, 1957) non-conforming uses, oi' bu-iltly7 "pre-existing" land uses: 1 . Accurate survey of property showing all property lines, streets, building at unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the appl If a Certificate of Occupancy is denied, the Building Inspector shall state 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 Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildine - $100.00 3. Copy of Certificate of Occupancy - _2W. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . .�l.r .�1 G�. . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing rBuilding. . . . . . . . . . . . . . . . . Location of Property. . . . .,11P. . . . . . . . . . . . . . . . . . . . . . . . . . . . .�/".. . . . /?CC House No. Street Hamlet Onwer or Owners of Property. .S9C✓frj0(Z`L . . . . . . . . . . . . . . . . . . . .A�ItJrJ � v . . . . . . . . . . . . . . . . . . (�yy County Tax Map No 1000, Section. . . . 1��. . . . .B1ock. . . . . J((��. . . . . . . . . .Lot.vay! Q�.R Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . Permit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICiT � . o�OSUFFO(�-c Town Hall,53095 Main Road o '� Fax(516)765-1823 P.O. Box 1179 y x Telephone(516)765-1802 Southold,New York 11971-0959 O y�o4 # �aoe BUILDING DEPARTMENT TOWN OF SOUTHOLD January 4 , 2000 James Cullen 9622 North Bayview Rd. Southold, NY 11971 RE : Salvatore Ariosto, 110 Selah Lane, Mattituck. To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : XX An application for Certificate of Occupancy is not on file. (Enclosed) XX No Underwriters Certificate on file. XX 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 # 26049-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. I,D INSPLY--TION REPORT _DATE _ _ COMMENTS ====o=-- ------------------- If =--- --- c=_= - --- - ---- ------ 'NDATTON IST) ii °------- -- - -- -- '' --- --- ---- --- If INDATION----(2ND)_===__�-------- ----- ------------ I fGfl FRAME fi II �I—__-- -----�—___--- PLUMBING II ij lr— II II II _______ cn 1 r-- WLATION PER N. Y. u—^f y STATE ENERGY CODE li ri ------------------------_------------- FINAL if ---il ri ADDITIONAL COMMENTS: L� H H H O x r r� nh S.'1�57OD E. 0'- wFii c 44 Z u, tu 4t of Jj 31,949 � � { . Sal 3 ' fit N-72 44 ()o "Al p y� y T , _ � •A f -i UIYTV fir PTj+� d rn ACCOW"Ce with Article Vi, Soct, ` Jhe Sc f9lk Csanty Unitary Ode, is that the RAQTl {/} -� ) NARl75 AA10 I�EF7 2tC; eQu(tva n¢as ggNal to, or less than, that,Of 4-1 Lk '.+.11^ l:+! ,'i ''� t^'�iy er _ _�}°.{�y - or Ue to ------ � "_� r5_t. r - sir pme+it,�siagfe.fanyr noes it ofarr:area ot•at leash y USEQ 1167 r — - --- ------— — 3 . A _E S 37 4 43z5. Y DATE _ MAP a ... r 1 70-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INION [ ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY REMARKS: t. DATE 47) INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ ] ROU H PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ j--rFUMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: /t c DATE ( ]' INSPECTOR t. LONG ISLAND ELECTRICAL INSPECTION SERVICE, INC. 670 Middle Country Road e Saint James, NY 11780 Tel: (516) 265-3075 Date 02/07/00 Apple ionNo..File 96993 Building permit No.210492 THIS CERTIFIES THAT our local district inspector coaducted an inspection of the visible portion of electrical installation described below and introduced by the applicant wined on the above application in the premises,of SALVATORE ARIOSTA 110 SELAH DRIVE MATTITUCR in the following location; ❑ Basement ❑ lit Fl. ❑ 2nd Fl. ❑ Outside Section Block Lx* _ was examined on 01 /11 /00 found to be to compliance with the current edition of the National Electrical Code. ❑ this certificate may be accepted as 'letter of Approval m that all circuits,are in goad working cenditon,not overlaaded,and all wiring,future and other electrical equipment are in standard condition. FIXTURES /YNGE.S COOKNG DECKS OVENS DRYERS UTEP FANS "'W"NEs PECEIRACIES Gn GIMMEM1 INGINDESCENT RUOFESCW KID )ATT I SZE W SIZE W. SNE AW SZE EXHAUST PAtHHE 2 1 3 1 6W LAUNDRY 1HEAlINGEDUIPIACITOR EXIT WERE. SUB PENT TIMER TMNSPOPMERS Ax EQUIP MOTORS GENERATORS AMT. SIZE AER SIZE Arca KP. SIGNS LIGHT AME. SIZE AMY SIZE ABIT AMP TYPE. AMT " HP AMT I SIZE 1 20A ; i G POOLSMIGRO WATERFEAIER smog TRACK ELECT. SERVICE INFO ' ABY ❑ HOT DETECT LTG EFAT SINGLE ILTI CONDUCTOR NO OF TUB ❑ AMT, 42E W. SIZE eFT TVPE AMPALITY PNYSE PRASE VOITs SNEAttP� METERS WKHL ON quo E] roa ❑ y OTHER APPARATUS Sun Room This cenfchB Is not intended as an Bpptoval or guarantee of electrical effirAenq ant tDVels Dny TB elecmnl equipment and Installation not date. Upon the Imoducson of additional equipment or alternations,application shall be�ptompptyymade for Inspection. APRLur: FOUR .WINDS ELECTRIC ' ° 41 ST. NICHOLAS SMITHTOWN, NY 11787 LICN4775--E GENERA BuucEn a WHITE-ORIGINAL COPY - YELLOW-MUNICIPAL COPY • PINK-AGENT COPY • GOLD-OFFICE COPY am ' s _.suers BOARD OF HEALTH . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . .. . . . . . . . . ." BUILDING DEPARTMENT CHECK . 1 . . . . . . . . . . . . . . . .. . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . .. .. . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: 1 � �.., 19g CALL TO•� . �. �. . . . . . . Examined...... ...//.. Q Approved...../P[J'Q..., 19 Permit No.a� 1..27- ................................ Disapproveda/c .111................................. ................................ ...................................................... (Buildi tor) APPLICATION FOR BUILDING PERMIT 9q Date.il-/. . . . . . . . ., 191. ! INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector 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 mist be drawn on the diagram which is part oC this application. c. The work covered by this application may not be commenced before issuance of Building Permit. J. 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 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 buildi for nece ry in ections. ..... . ...................................>........ (Si Lure of applicant, or name, if a corporation) ..(l�2�.�/-..-�.Y� �f ............ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build ........ . ........................................................................................ Name of owner of premises ....:Sff (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 No. .................... / 1. location of land on which proposed work will be done..../......................................................... fl`•2 �GG9 .................................Alt.T//Z�(r-1�".............. House Number Street HandQg�� Can0./P. County Tax Map No. 1000 Section ....� . ..... Block ...f.......... Lot ... .IJ....... Subdivision ...................................... Filed Map No. ............... lvt ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of roposed construction: r/� a. Existing use and occupancy G...e CGf2 C/ .if,rcC 4 I ....6/1��..✓P.' -L ..... ............................ ,; 19 A 6rVyl b. Intended use and occupancy ........................................MARIA.'.::'; ?-'4 YfNAf0Y1 T 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: �J CALL Fxnmined......1.�/ ..> I9. llq MAIL TO: . . . . . . . . . . . . . . . . . . Approved...../0.0.... 19 Permit No.��.... 1..�. ................................. Disapproveda/c .................................. ...................................................... (Buildi tor) APPLICATION FOR BUILDING PERMIT 9g Date.ilr. . . . . . . . .1 19./.1. INSTRUCTIONS a. 'this application mist be completely filled in by typewriter or in ink and submitted to the Building Inspector 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan stowing 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 mist be drawn on the diagram which is part o this application. c. The work covered by this application may not be commenced before issuance of Building Permit. 0. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Sur 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 1EB86Y MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Tam 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 amply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on presses and in luildi for nese ry in ections. ...... . ...................................:....... (Si ture of applicant, or name, if a corporation) ✓. ?y. �r .Y.lE�✓ .`2� ............ (Mailing address. of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buil Name of owner of premises . sg.4f'E7.'J:a1LF,,, (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Name and title of corporate/officer) G' Builders License No. Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. location of land on which proposed work will be done..../...................................................... ll ........................... ................................ ? 1. ................. House timber StreetHams Cany Block County Tax Map No. 1000 Sectio, ..../0..�..... Blo ...7'.......... lot ...�:. :..... Subdivision ...................................... Filed Map No. ............... lot ............... (Name) 2. State existing use and occupancy o``f premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ...q?... C/........✓cch.. I O!.-.....�✓. 1�..f��L� IF '7n NA RC hvt J b. Intended use and --9 �'1RA4tlWF ........................................ -'q ............. y.. T ....`..�.... �,.. ^. ?3U'FFOLK C'U.I! ACTF(�E19Or'=)011111911 'yWklr aw ; — . As :Jt H.S. No-, L _- l-i 2_1 tic E.RE 1.-��_��4t' RE J. -well ` TO MATT-IT-Ucv- WELL-* ! � � TOWW OF 5OUrHOLD 14-Y In IL •_ �� _ 6 i© All06 . I STORY M Ho. t u r TzocPED GAR. RooFBD PCN SUFFOLK CO. TAX MAP DESIGNATION: -- w " DIST- SECT. BLOCK PCL. v � > I . 4.8 r X53 �,fl EI X 4 W4 S �� Q OWNERS ADORE55: . c � tfQ SELAH LANE y s t -SEPTIC c Pace. 1 "�. MATT1TUCK,W.Y, it9�2 DEED: L. \1P. P. j;':'_.r+•� f..f..-..� - TEST HOLE STAMP , ,y�.. - bUua 9uvM'�e+dahilond Jbr — _ _ ___"..- .-. .- - _____._. _ __ .- r-,r- n .•' 9aciM]bif�t.n new Ymk f" wrvq•map not mal-~ - (VACAM-r) . AQEA' 4624623'I 3. .� r. me z^e sun sbtyed seal x�- 'Fr ` 1111+^_sseC asd ahW nolM unsidrrsl 0• MONUMENT < mea sea due SPY. G.a�.moeell koll4 hereon Mwe^ G ... �^ 0-,/'9me OersM ixwhan Lhe 9'+n'e'/ -��-! I'• Iti h:••'.r8Z,H11'J On h:9'a^.^..f:4 N9 n _ aY� _ UQVEYED-M_AY 28 19% u -• KAP AMENDED-JULY 19' FOCT.`ll _> -NAME CHANG>rAND `s r-.c 2969!h UE AD2EP - EFT. 1,}QQ6 SEAL -M. COMMONWEALTH T1TLE_NO. QH 96-11.'535 LAh1D T1T� E (NGi S��[2lNC� 2MPAh6Y u` A5 /,4P F `n 7 A5 SURVEYED sWT.,I I L 1 t A, u.L'�� RODERICK VAN TUYL.P.C. fv.�nw. y LICENSED LAND SURVEYORS GREENPORT NEW YORK - �IeP6eJP7pgpgryb qe•. y,j��W�MFfdLL ,pc., Y ��eppalpEooceet�° ASF'FkA LT (z.oa'F SHIM'- T✓S 7o NAP-% Seal and Signature: .Nlhl�oy� �ZoUcyH oPE-t�InJcy FXhJTr•+-q --- -� CPx- f{-YbJaof] 00 y"xplo' 1��20-0¢ {ZPFI Ido o c, 00 nllha �,�•A -- .� N F�c157h4-, 5UPIn•ka 4L. oc-Q5 7c F:ZJYNIN / !-- U - - -- - '7-•i 2 12 •-LY1'IGALF �' ot� �S?fZ• - yD oro `I �� 032 ten• ALurnIJUM ca 5 Lee. _ a m -� 12" bIA. MINIMUM P�UPF..47 _ 2'nG°R,R.e lw''a•(., rjoxG" R•R.R.ICo'.. UT y • A' N CohJG. T{Z$p.IL,W FccTlt.l4 31_0 irl '2u,@' a. eIG'".. I '2"do"c.J,c.ld'., . c. .e. o- II n f E56LoW cw ue .. — xG Woa� F✓ s�lA W, METAL cL a�. 6 I a E"Typ GAL l0 f' r cl f f IJulf2N G,N.6, -II-�•TF'. GoI.ITIi�UoUSL`r �,.�.I�'"�I� vIIJYL Sr.'"FI"� 4 O kn L11�II�IS'"T'LVR851� �1L. II i '- 3 EkISTIh '7 br-rlL z l�ifN"(R-19) IIJ=uL. ' 1 e _ V O 0- __ �' z f'P•�5 ENGI.o5Go-17 �1 'Kp h_ -�cr--ISI- re n--fi.�°--Tf2.. FI -o a i� 0 1'o2u{a o +bwz=t47AL vINYI. elo-k, 7- March AbD r I ) z A 8 c,c,A. - -� v No H A`T) x 9�' i Aun Yq waN - G w s1s7BZ2o Tb r�15r1 56 F i nlrk� Flo Jo151 . -�F N I g-T adi 13 17 _ I/zI' cnx- pLyWk�c� `�I.Ii=�+TNIN� _ V lea" o.c• [v \ ` - 51 ' Fh'I�fri Zlx gns L G�IR.bEn. 'F o�T11Jr.1� "fYL WIIJ�o�J 5�E ecM CgAI.YA1:l7�L'7 po5j• AI�4G-loris II TO w 'AlQ tl �24511.2 _ -8 . 3 - I _ I �"- -- DIA. pd..lr c�Nc. -Furl-IcN FOo�'I i III- 011 U FOUNDATION PLAN , FLOOR PLAN CROSS-SECTION A-A o N � 5 .ALE_ � . M�oLd-AL Asf lW ( RmF S f kaL ra A�� Ise Z- 18 DIA. IZouN✓..� \^'-..Iyl., Oo I oUVERP� vE� }J W/ \` tl cG RFJ - -- Q o -- -Fo, - - --- - �1- �lF 132 sF -1o55v F.Rr.3- ovF� 6h ' r _ T ❑ rF nI-IeS� AWz9_ HoWZoIJTp.L. sln Jra Ta Fa- iil -- Dry _— — o ExIfilNcn - -- _fes o. — — - _ � 7 / P,025.o Ax. W 215.0 _ '-ri•7.� + L I I_J � �. L,a.•N LANA o ]2FiR ELEVATION WEST SIDE ELEVATION EAST SIDE ELEVATION Z LE:r�1.1.0,1 sGe,�: ,aN_l•o. ya1JS*. ! ' PLOT PLAN a UNDERWRITERS CERTIFICATE REQUIRED E>E7�RPT.�.�, p N I. ALL WORK TO LQFOFdN TO PoAES AD FffQAATIGN5 OF TFE LXAL MOM DEPARRBR. Ln OCCUPANCY OR USE IS UNLAWFUL 3. E TRILALH TO BE FIRE L{DERVRITERS IFEFEGTB2 MO AFFRP/®. WITHOUT CERTIFICATE 4, GpERTOEFFEGTAFDMAIIAD5VATEIIFi.RHCETOPRO T OF OCCUPANCY IN W5 PR0FLT r 5. CONTRACTOR TO NOTIFY ARGNITEGT OF FIND C ITONS OTTER TNAN IMSE 900 •� HEFR LR OF YHBNS?N-DI56REPANCIF5 WIOR TO CGMFEN M CONST TION APPR41VW AS NUI ED EFFEGTFD aY SAMEw 1'1 6. ALL FRAALL LLlE£q TO W COL'59VI FIR HIST PND 75 M.n 6FAOE WITH A Q \ �'`''rF' �� � ®.P.# 6 b�9 n1wM,M AuowaE R,�nTrlr=BBD1W sTRTSs of eTz M. o k / F D UUI!DlT, pROv1DE GGEIE�IlG LtLER ALL PARTRIg5 PARALLEL i0 S4 E. PlCF 4I°k PIO La;SFAkZ AEPIT AT w (802 :.I A,IY7 TO -". NO FOR 'HE 6. P IX 10�N&4&-0OL.MAXIMx+. p Q -u"JI !,u l,Rl2 Pl(11h14i6'�CA(O111i q ' KY5,MOM C015T TN C MANUK,PAGE P 101 FOR HALM YFEaA.E. fYl{f Ff VIiHFR f6 'Ph`lim iFc " COMRILTLR TO R2WIOE H IM AS REfiIIRED TO FROTELT 5IRIGTRE FROM Mfr ypJq HM FF:AP:h:+O h, ;R flit F1 CON5T TIM LOA7II5. ., r •.;u,l nil,r.: I. TO THE BEST OF Mr BMIEF 1 KNWLE THE C yIN"THE UTI DWG. NO. . �. RE34RBEM5 GF TIE RY5.ENH+ST CGfEERVATOW CON5T 70N COOS. 12. LARRY ALL r-C TN66 CGY41 TO UDISRRBFD`AIL WRH A-MINI"SWIM LAPACITT .-.I .i _$1 B.K.Fi1�.R `:IIA' . •d,] GF I TO Fm 59lWE FLGT. 7 A 1 ()I11i4NIi-.P FI13. I TaVS E%I GF SOIL G BLE MA5 EE F5, TO TM LESS BFIRIN6 G I TY TIWI `CEDE 4;(NO TRUCSPO {I LP!FF:'�'t IiIXVi,LR OF THAT AELE MING MA,LfMIRALTOR IS TO NOTIFYARG FRIM CODES. NOT RESPONSIBLE FtkS 1MrmwTar`A THAT rFE FoonN65 MAY�AtT-r+amwTELr RECE51c�ED PRlaz ro 0175 IGN OR CONSTRUCTION ERRORS «'°'�=' I'DN caaTwlGnoN OF SAhE A- 1 N. ALL CONCRtIE TO NXk A MINMAN&L MATE 2D DAYS OF STRBISTN OF 3000 F51, AID WFGRM TO TIE LATEST fd4L1REFE3115 OF ALL 318 FGR MANE,nP M, FO HIM AND 57RW i I 5 a ro 8 'I L 4.8 BUILDING PERMIT REVIEW CHECK LIST Applicant/ / '' Date Owners Name: Sh4 *Z,A/— *TalK All Dj)-O Reviewed: O chitec n�_ �- Date ngtneer: Si P/i�i'.J 7 jz��/� ✓.Q Imo`< Submitted: SCTM #: District: 1.000 Section: I Block: Lot: Project ((�' Subdivision Vzs/ A Location: 1 1 o J,�iL/� Name: Single&separate Requ certification: (Yes No Req: , Req Zoning District [W size: c (Lot coverage ���-Proposed: 1 .�! R —+ [Front Yard 56* goposed: [Side Yard Proposed: t (Rear Yard 0 Proposed: Project Description: AA) 4 Ccz ,c7�t I7 rte✓ �S �7i��i ��Al ` 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 Pla�f Elevation ??? Flood Zone: