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HomeMy WebLinkAbout25883-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27799 Date: 07/09/01 THIS CERTIFIES that the building ALTERATIONS Location of Property: 615 HARBOR LIGHTS DR SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 71 Block 2 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 20, 1999 pursuant to which Building Permit No. 25883-Z dated JULY 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 ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to KENNETH A PETERSON & WF. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 52668 06/15/01 PLUMBERS CERTIFICATION DATED N/A Q.�— 71. 6'�' Authorized Sig ure 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. 25883 Z Date JULY 20, 1999 Permission is hereby granted to: KENNETH A PETERSON & WF. 146 JOHN ST HAUPPAUGE,NY 11787 for CONSTRUCT AN ALTERATION AND ENCLOSE AN EXISTING PORCH TO HEATED LIVING SPACE TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP#24583-Z at premises located at 615 HARBOR LIGHTS DR SOUTHOLD County Tax Map No. 473889 Section 071 Block 0002 Lot No. 002 pursuant to application dated JULY 20 1999 and approved by the Building Inspector. Fee $ 75. 00 Aut1forized Sign/Lure ORIGINAL Rev. 2/19/98 Form No. 6 P, iv7 54 Ft; WN OF SOUTHOLD '. �iiLDING DEPARTMENT TOWN HALL 765-1802 W" R-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 b 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 building,, 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 Occqpancy 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.QO. Businesses $50.00. - 2. Certificate of Occupancy on Pre-existing Buildinz - $100.00 3. Copy of Certificate of Occupancy - I -2410 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 -Date \'Jj . .. . . . . . . . . . . . .. . . . . .. . .. . . . . . . . . . . New Construction. . .. .. . . .I. . old Or Pre-existing Buill 'r .. . .4 . . . . . . . . . . 1 Location of Property. ... . . . .. . . .�AAr.)MrJl t House No. St et Hamlet Onwer or. Owners of Property. .. . . . . . . . . . . . . County Tax Map No 1000, Section. . . . L . . . .Biock. . .OQQ.C9i . . . . .Lot. . . . . . . . . . .. . . Subdivision. . .. . . 4A . . . . . . . . . . . . . . . . . . . . . .``. . . .. .Filed Map. . . . . . . . . . . .Lot. . Permit No. . . . .. . . . . . . . . . .Date Of Permir. .'. Applicant. Health Dept, Approval. . . . . . . .' Underwriters Approval. . . . . . . . . . . .. . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . 4 .. .. . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . iee Submitted: $. .. . . . . . . . . . . . .. . . . . . .. . . . . . A 1ni 1n I. I'M�'��1,:•:�e1 y�f����t��Y�,y\t r. y'.a- SSfd+G3',,`yll l' 4,,,.•"7}`.�Elsr: I�l:'G.r'w\, •d1 gg „•+, •: • 1•jr y,F• iti< , : • �li}; yll,Y �};,. ..ii.. ait4', ; A '`' oP 'w . Ally'91`t: .k>:'p., Ir(:%'.ih:��!,. , I .",'{...1r Sr+ S.ri ):• .dF '•S'ii% .I 'y'•,'Y,• ..•; .� ..,�' +.•,Y.;.s�.:1,,•!�c ,;d�^,jS r:� �„• J+r3t;�ii� :II(r it'r9,;1�v' I'i•S r ,t�l�t�' ,u ,ti; r, j. ; „�. ;'iri,a+7,�::.,rr�' �,;.�t� ,I;:<,,. ;�.„. �h�v , 'tt'lC 1 r'i�„•,.,:' . i} }� } f ,• <i, � I� � i.. . sn... 5.,, y:"it,y ,� Ijt"'f,'{' �,.j/i) lti r/i,Le4�• `'i+�g1� ki.' �i i• `Si 'i<} pi,'.s; '' f rn..,..£}qy j�t�i`��:y::�.• '�' i'. h,:i".',? ��., t»>t Electrical Inspection Certificate >' s' Electrical Inspection Service Inc. ;"z; 375 Dunton Avenue arir'•\- East Patchogue, New York 11772 1\ (631)286-6642 ' "i d .904M � Date: 6/15/01 __>w Application No. . 52668 •� Issued to: ` ,4 Peterson, •, ;.c� Street; 615 Harbor Lite Drive - Villa x ?}, 1'? ge: Southold Zip: 11971 Town:Southold ?z,• Section: Block: Lot: "A- _• ,i Introduced by: Richard Kleinfeldt Lic•# 665-E •;.. was examined and found to ke in compliance with the National Electrical-ode ❑ Commercial ❑NV Defects ❑ Pool ©1st Floor ❑Indoor ❑Basement ❑ Hot Tub Sy ( ==- a © Residential ❑ Det. Garage ❑Attic ❑2nd Floor ©Outdoor ❑ Addition ❑Survey ; Switches Receptacles Fixtures GFl P Heaters A/C Fans '�- 5 3 3 r . �.A Dishwasher Washer/qmp Dryer/Amp Oven Range/Amp Garbage Disposal `'3 s W Furnace Oil Gas Circulator Smoke Detector Bell Transformer s �,...,: - e•,,s-fir Meter Amps Phase UG/OH Telephone Television Carbon Monoxide '�`= EJ El Other Equipment: "'=a- rtq �:;r• Hugo . Surdi YA� President r�; .3:. �• �ti .. Building Permit No. g8 � Z This certificate must not be altered in any manner 2rn.t', Inspectors may be identified by their credentials ' Fnal Inspection: 6/15/01 Rough Inspection: Inspector: Ed scavelli *a A // ;,ji ..yli'ivilrr'Y'.i.,,='i"i�iSJ�� •�i }S r,:."tN', , tj'i'iSu �'ii� ••i-, .._ '+Nii:;• -.;•„",�t� ,.r,'. ;1 �u.,i s,,sn„ .,d, `?;i�ii�,r,,,,i.,.<,}•,ar•t.s�`;^'�1.�i°�Ivf,.,: •i,i.rf,+ ,,is ,,.::.,,q y,�_ ;.,. ..'.-,. .,,r,'i:;::. ay ,r\;,lt , v.,. a •r".,,?t ,'X . .:, ,r,, J,..,z; ••}xr£• ,9..,...:i�rr ...,. .,t s,., s.!'.; j, iai .0 ��Fsrt� i {a . ,ss 5,,.,.q,('!+1! ,f,'„' ;t, /s ;lv...p ,ss. ,. , ,x.. ., .,i ;:,el„>.>_,: .•r'.. �, ' Y. • t .•! n,.'rfl,, , r{.r :ur e,,1i ;;;''�,,i'ii:.:rrrrtil�'iS`Ii;=,;is',,:,.i+,h':ual':t-` :t,•t,'ii7 �ir,S��y••1{} � Er )t tyS�hY t. .L..tt i v •f'I r(' lljyl .�.,r .. v :d.S r{r+,l, rfl.H$U .,7' •'illS'6h�%tSigf,?�Ij&'•...j,,$sj��,4�t'{�1}� �{, r)i4,:.MPsjiE'{{a})Iii.,l`:'ff)i'ri°Igobi c r;;•,�-{ •.,i,.j�.s'��� .S� 1Sf�y� •r{l�t.� ;<.'ti.'�iF+°iii 3si<'.y`�.F ;rt{��3 ;Srf�l ,;tiiu�Y o��gUFFO(,�coG s� Town Hall,53095 Main Road H Z Fax(631)765-1823 Ply P.O.Box 1179 WO Telephone(631)765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD April 26, 2001 ENVIRONMENT EAST P.O. BOX 190 PECONIC, N.Y. 11958-0190 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 # 25883-Z PETERSON, K. Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. FR ` 4 'k� v kt . .- HAR Z 6 Environment East, Inc. bf; _ 't- 2885 Indian Neck Lane P.O.Box 190 Peconic,New York 11958-0190 r = 516-734-7474 Fax:516-734-5812 Petersono Permit #24583 Z To Whom It May Concern; March 23, 1993. Please be advised that although we applied for the above named permit we are not working with the Petersons on this project. We have given them the copy of tht�r Building Permit and trust that they will contact your office as their work progresses. l Thank-you,,,, 7 Peter R. St enburgh i M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROU PLBG. [ ] FOUNDATION 2ND [ ] I ULATION [ ] FRAMING [ FINAL ( ] FIREPLAC CHIMNEY REMARKS ,DATE4 0 INSPECTO r� 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY REMARKS: ,DATE INSPEC a 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] F [ ] FINAL ( ] FIREPLACE 8 CHIMNEY REMARKS: DATE L' INSPECTOR 765-1802G �f BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] F MING [ ] FINAL FIREPLACE A CHIMNEY.-- - REMARKS: /! J - 1 DATE �� INSPECT r 12(7 70-1802 BUILDING DEPT. INSPECTI [ ] F NDATION IST [ ] ROUGH PLBG. [ ] OUNDATION 2ND [ ] INSULATION ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY --�- REMARKS: itl D ol. - ` / 'moi sem- g DATE INSPECTO X5"8?3 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ( ] FINAL REMARKS: DATE i ?f INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] RO GH PLBG- [ ] FOUNDATION 2ND [ ] SOLATION I [ l FINAL [ ] FIREPLACE & CHIMNEY REMARKS: Al�� Z. DATEIP114Df----INSPECTO I;UI it 11:11 I'll ----------------- 931 -----——------—------- or ---------------- -------- Z. ----- ------- ATI1. I'Mr. . IkIlY 4e ------------ -- A -"k-------- I'l IIA I. - ------------------------------ --------- -- AIII)ITI--OPIAL -•- ------ ---------------- - ---------- ----------- -------------- ord S-r19 udo 9AL 0-Ao V-PaS ..sl5m6"—C6Luy4zp roo+;wSChebers a4e,. 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'y r z ab 0 � \ 'c sv •j re' I,/i y j^- 'A 4'4 P •vanrs �U i r M LnI'q)J u•y/G oyc.e;E Iq !1 �� � '' ! y Nw'� fs.'efns y fnoNrS rac, ad �/Y/N/O V. � ..: .. I I J I asv-•s nnnl BI" � ��� a I • r, o ib/ n.�G_y -'' " osf.w,E r�P.W i � n/iv r,L,iPiP i •/-, rO i� l/�iF ..vI C;.:/ �:i .,I I —r / z �� N r'A'p � ( zW S_P••L tLJ rn. .fr; . ✓ Om^I. D r0 NIV L0r3";0',u r•-+'- t,.e v.t k Ifni ta., • r d^D �_- HJd"Gd_ 0 n n� I�._ N Z' -.tom:b9 I �-�--- .I N c, n � D'EYr .9s•_v>_ .o•�s 0 4 _ •^___ _ > 4 �/:�S y ! D IZh Ll ____ A j I� I a o h F•L rLJ 1 � ��__ � .. e•.Q a.nsn.a- >•L.' dccD ac snr-_.� _ _ Sd)-S'DMCD I I I t fir✓ r-i--------------- •I'_�n -Y-- ��I-_ _-- _�-I J ,�. ;,. •�'.% .cam I„CF;,;'� I �--_.__r��V y OV '�? (_Nto� �A.SU � ._ cic , . � o " 15T- i ZZ iSTs ff `/ �HUh Sid. .� � E 5 s 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) Date.....JANUARY........... ........................... 19..98.... 24583 Z Permission Is hereby granted to: ENV'.EAST(A/C) KEN. PETERSON ...................................................... PO BOX 190 ......................................................................... PECONIC,NY 11958 .................................................................................. CONSTRUCT AN ALTERATION AND ENCLOSE AN EXISTING PORCH TO HEATED to .............................................................................................................................................................. LIVING SPACE TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR ................................................................................................................................................... .......................... ................................................................................................. .................. ............................... 61 at premises IoSated at......... ..............5 HARBOR LIGHTS DR SOUTHOLD ......................... ........................ ................................................................................................................................................................ County Tax Map No. ....473889..... Section ..071............. Block ....0002,........ Lot No. 002............... pursuant to application dated ,,,DECEMBER 3 19.....97.,,., and approved by the Building Inspector. Fee$........ Bu ding inspe or Rev. 6/30/80 FORM NO. 1 TOWN OF SOUTHOLD 73q - 1 (_,j ) l_/ BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL. , t � Gr' 02 as p � � � � lisamincd �P. . . . . . a ved . . . . . . . . . . . . 19 . . . Q. . ., J 1'cnnil Nf/.. . . .. ,:. 9 Dis;ylprove alc . . . . . . . . . . . . . . . . .. . . . . . . TOWN OF gO� . ow .!!4 . . . . . . . . (Building Insp tor) APPLICATION FOR BUILDING PERMIT Date �. 4 3. . . . . . . .. 1997- INSTRUCTIONS 997-INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 set,^ 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 dtawn 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 armit 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 OcQancy 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. � Nc :. . . . . . . (Signature of applicant, or name, if a corporation) TP:. x. . . �9'q. . . . N.I . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Get�1cP-A�--. . . . . COt•JVKACTOP— . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises E .Y. . .efui h fv—�2s 0.. (as on the tax roll or latest deed) If applkc- i 0- dprp ration, signature of duly authorized officer. / . . . . . . . . . . . . . . . (� (Name and title of corporate officer) Builder's License No. . .R.(. . . SSS& Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . i. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . .R.!�8aR LLG(iT5 _. . �( uE . . . . . . . : Jilt SCJ. . . . . . . . . . . . .. House Number Street Hamlet County Tax klap No. 1000 Section . . . . . . . . . . . . . Block . . . . . . . . . . . . . . . Lot . . . . . . . . . , . . : .'. Subdivision HAKa f! , Y.GKT3. . . .E,sTS.. . .�G� .Z . riled klap No. .4/a&I . . . . . . Lot . . :i ' . . . . . .. . .. (Name) State existing use and occupancy of premises and inlended use and occupancy of proposed construction: a. Existing use and occupancy . . . .... .`. ��. . t�.. . . c� (uP . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . .��1,J . . . . . . .. .. Nature of work (check which applicabl I,): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteration . . 1/. . . . • . Repair . . . . . . . . . . . . . . Removal . . , . . . . . . . , Demolition . . . . . . . . . • . . . . Other Work . . . . . . . . . . . . . . . (Description) Lstimated Cost ,.. . . . . . . Fee . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) IIf f dwells g, numb orf f dwelling units : . . ,. -rt "Niirlliber of dwelling units on each floor . . . . . . . . . . . . . . . garage, . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If business, commercial or mixed' I p'ecif f ll v and extent of each type of use . . r�.`. • • • . . .i. . ... . . . . . Dimensions of existing structures,' y: nt . . 5.-,b, . , , . , . , Rear . .55.:4. . . . . . Depth . .•.Z�a?. . . . . . . Height . . . .b. . . . . . . Numb r . .` . . . . . . . . , . . Dimensions o� Xr- salute structure with .I ations or ad+ditips: Front . . uJl"f?" Rear �_pu Depth 10.:f?. . . . . . . . . . . . . iiiiii,I fen ht-�f;i^ :t?. . . . . . . . . . . . • Number of Stories . .? . . . . . . • . . . . . . . . . . . Dimensions of entire new construction..10 t LL W cTtt kt ak^l 6 . . .VJIk4 4 rs `Hepflt N�? `�/�NSt gN' Height . . . . Numbci O torics . . . . . . . . . . . . . . . . . . . . . Size of lot: Front . . .1DR:9S': . . . . . . . . . . . Rear . . . .io . . . . . . . . . . . . Depth . .7-44.1.0. . . . . . . . . . . . Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . ... . . Lone or use district in which premises re situated . . . . . . R -to. . . . . . . . . . . . . . Does proposed construction violate any zoning law, ordinance or regulation: . . . .�� . . . . . . . . . . . . V . . Will lot be regraded . . . . . . A . . . . . i . . . . . . . . . . . . . Will excess fill be removed from premises: Yes Nance of Owner of premises K4 A .E�: �2�? 0(:. . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . • . . . . . ,'•architect Address . . . . . . . . . . . . . . . . . . .Phone No. . . . :;ut,eoCContractor AddressPD; x,��(�.���ont4P}tbneiGu:'Z4( PLOT DIAGRAM ,ocate clearly and distinctly all buildi�igs, whether existing or proposed, and.indicate all set-back dirtiensions from. erty Imes. Give street and block numbe or description according to deed, and show street names and ;iloicate whether for or corner lot. I � ti� ri, • rE OF New Olt NEW s.s � I . . is -w4, gw.�, . . . . . . . . . . being duly sworn, deposes and says that he is the applicant I (Name of individual si nin co tract) { named. 1 the . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . , . • . i (Contracto , agent, corporate officer, etc.) id owner or owners, and,.is duly authorize to perform or have performed the said work and to make and file'thls cation; that all statements contaln 41 this application are true to the best of his knowledge and belief;and that the will be perfonned in the manner set forth in the application fled therewith. it to before me this . . . . . . . Y7.4. .day of Y rQQ e r . . . .. 19 1.7 ry PuUli �IkCout I:BETH ANN NEVILLE Note rvry Public,state of K:.w York • • • ! • • . . No.62-8126850,Suffolk Coyggr (Sign ure of applicant) Term Expires October 31,19 5 ' I'I - w-t-0121 } I 4 s n c.- . _ f a ; STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL '34}sir . SYSTEMS FOR THIS RESIDENCE WILL I �-, .- t� � ,^ r� �•. � � 1�1 r.;i :_ �.,: ;-; �'ir"v Or_ .SQ(j j'�-l�j��,�` ,,j.�' ! CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. APPLICANT buftchecrai5.64°OJ%O E SUFFOLK COUNTY DEPT. OF HE LTH �J1 1OC3O SERVICES FOR APPROVAL OF 1 �. CONSTRUCTION ONLY T DATE: _ L i H. S. REF. NO.' t ( , . Q APPROVED: Lo+ H(jttlbBr'S Showa rear' 4� • Q 6�3 "Mtrp Gf- l- cyrbar Lfghfs ESFa.- �C.2, I iSUFFOLK CO. TAX MAP DESIGNATION: �. �' � 't>'~ Courrk� Cler�a I , f DIST. SECT. BLOCK PCL. az A-4 1+b. 4Gz3f. I OJCr ' Q'j { f _ __ 3 I ,1�, �.` =lev:x; ;.t: I-e- r �, r*1G•7rr . 7 , s;ftai . OWNERS ADDRESS: PEF G .)0E4N S~- Q c�ri� l F-4.^,uPr-NiuG�, [�f.V 117f37 � . c Ah-e 24, GOG S9'. DEED. LI. j P. ` _ �•f, r5 r 1� �, , TEST HOLE STAMP bis-M walk_ te;'i.."'I 12-fnh^a�tfOM1 Cr vi ,!R !ti T,;.4 .ritl AR:rr"I+iBttf' E+t. .� ('• c!Sr.; r� - t7 t!'is r.tr-• .,is n rF�•iin,of d,-. •� ` � -- fig^-:q/1 r,�2:79 Tf.?V'�Qrk SL$LC i Caries J•<t.i:: . o r i. ., rq + L 4t .► I ! �!'r�.�.. :hc land>-: r rn. r to ____ ... _. ,�.i+•--------- - --� ,r+� - _ _ _. _-__ __ .. - -z - ---• - _ __ __ ___ red �, t r. I t rrtdr 1 to theIc` i:L;:.l =,.cti_ ----- - -- f tuticr'.G�i.f "?s a^re not ir-.', chis to ecditiona",inctitutions or subs,-queni ( ovne a. SEAL i r 4;4 i pf NEyy I ? Surve-r feci Oc h. 09, 19- 4 {j r } ls� j +� RODE,�RI,Cr. VAN TU.Yj-, P r r r ms ' s jr@�t G(cti C!` (re 3 1 a(c nce } - 1 YJLC+]tti f f s� S 2 g8 fiJ .: <Inn _ LICENSED LAND S�J'RV LAND ) � t : , 3 . _ . .. Q►REENPOR NEW YORK F ,. 7 - st� t APPRNM AS Nm ONE -lvDl°► B.P.# 1- �}p1�NDtS� Pt,A ,,',, ago FEE: BY ' .� _, 05[RaL(URRtr C1FAN�ES �g VIN Cyy' NOTIFY BUILDING DEPARTMENT AT 765-1902 9 AM TO 4 PAA FOR THE FOLLOWING INSPECTIONS: • 1 FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2 ROUGH - FRAMING & PLUMBING `s 3. INSULATION gyp 02 3 I 4 FINAL - CONSrRUCTION MUST F BE COMPLETE FOR C.O. A'-L CONSTRUCTION SHALL MEET j T,'E REQUIREMENTS OF THE N.Y. S-',TE CONSTRUCTION & ENERGY C"`ES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS i Orn, mANCY OR 104 J UNLAWFUL ;TOUT CERTIFICATE JCCUPANCY T I* Der f = FEW a - — _ - Lt�i1� _w —mw lyy9 1�� JUL 2 ° _- 3 { 1 � f 1-11 71 - f 6a gi0 a qcy y NSCiy��� I �a r Y ------- ----�- ( s qa 2233Q to¢ F f? � � rw --t OC]Gf A t I -- - — -- I _ i' s -- � f I I .."N -4, S`t� F t CO"IH /�4&H:DEPT rAP f{1)VAit. . y'y '. -ids`" 'e}. #a•. ��4Y i'{i. a i.�h,. _.. ,ir5 •� -•e. .._ .. ..,., i, 7 ' 4'n,, t ya ` ,t w f. I r. ,,Nt: 3 i, .:. 3 I_. a. 4cAtiF1. '. i. t -p{ '•" ^ ;-3 � •t s. :}jl b a y1-.:�5. - {�xs ,J;4a bt" �r4 's�'�.� k 1 r� t''�V."..�-'.�-.12rY'� • �., .,� ..'_ � I - . , , ?�( ., a .:.:i- '+ y� .�S.;'��° •� 3!u ,tar , �� e _ t�r e +,:i<'' a. ,y" ;^- i� -„i °'x< -.• r, _(� vq{• ,;:. - �:,pp•+'',� .`� .r-. :- W v.. Y 4' X r r•s }� ' �J�' .? 'c' v- • '. �i; ;. } � ha ' ,. yF'., -.ry� -r 5�))• !i�{:'` -pl •y; �g� xa` :1” r �l:� ,e.: -�r rq 1 .- v - �'; .,, . .ti ,x �i,.•, ..,... ,,.y r .. r :, �. .. ,.. � . L �.'.� •]1✓` 2 :S r}� 1 cJ ',ke s. .i� x �y - .!.. - - , 2j 5., iy�.�,.../r�V�r •.-.5, .y .7'. r . .q, ..,,_4ra . : yc`�`rp:• +'r`�`r 3t y.. 4 _ :�,. r ^ $ F, 4 ,� , `r` .�k•}9'A 3sL. 4p O f�= `"_ iG' 0'pC�-F�,; i t STATEMENT OF INTENT 1- 47 THE WATER SUPPLY AND SEWAGE DISPOSAL aR'VfY1f SYSTEMS FOR THIS RESIDENCE WILL of-- JOU7-"OC_o,['•/.? ' CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. !SI rtnil APPLICANT 14 to SUFFOLK COUNTY DEPT. OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY DATE: I 7 ` H. S. REF. NO. (y } O } Y APPROVED: C3 0 b Nam: Lo+ nutrtbsrs Shown refer -h: r`g3 cl "Mai n f Harbor- Lrylrtssfe.- pec.�, I! c SUFFOLK CO. TAX MAP DESIGNATION: 7`'Iad ,n flre .xtfoll~ Courrk� Clerks }} , DIST. SECT. BLOCK PCL. ' r 4 of�rce a'8 Max hb. 46z 1, ;pJ J7i 2 L, OWNERS ADDRESS: 1-787 y2 1r ♦ JOE!/. 9•719_"4,74 2 1 � ` .2;..> i✓"Jri! 4t:it J,�..P U 1X t, ', .� GY/E : 40 ._ 1.. al `'• t,- - rs iUi - 4\�jY � e� ��' to - F#t�a 2'O,OOCi s '. f DEED: L. .V/A f P. CJ = (Y'Oti JolfaB TEST HOLE STAMP ` trw r•e Vron nr'e,tion r - 5 ' �;,; f., � :t this n�_r•w fc o rN^:im of -7vicetion Law. - ' � �`'� 1 � �#})F^a O`.tin�0�5"•--.o rt p_�.re•3 • rSf�:. 1b fle 3 V Ire ..._ _ .. . . .- O . fi _ t -•.. ! / �r OtlQrJ1 oche is t ctx x.ls' r' _. tb tory i3cr -S are not tr ie ( / -rh r�c v::--•.^f .,jr,'; .� . = y tovmld)z*mt tucrtueons w suEscauer, «� r� A LIGE-� 1 .. ^ 0 12 1 vc ' M :Y'G. _., ..:- SEAL Aug. g J ()P NE u - et�qr I ce VA 1 Sulverf-d Oc f-. G?9, 1979 „ 0 a ^ t > ROD;RIC VAN TUYJ_, P. �' � .� ;vaccint; ..<re3iilcrrcr� lra3iotertca� �;:. ��,,,.-,.. �T•-w• � �C `• g�,,o ,. � - - . ya S•2S tic LICENSED` LAN 6RV YORS G.RE15NPORT NEW YORK_ 1 i. y • ,r M • a i t � � I `cx1=,TING G�rK � � • PROVIDE OPENINGS FOR w I, pgRrTNCY ESCAPE AS RCQDIRED E.Y Rf.RT, 714 OF - �u.. N.Y. STATE Du-DING CODE. - 1 NFJautx I � I ? �', tp.� n1v_•FI ^'K.tl. roe d6 �.�: CI°F - B . II E.�c1�. jiE,j�RNi E�kIST. LI.l� �.fv�� M � � A 'D �' �I, • j .I n v 7 . , I I AVD tAtw LUL. Q. 1/2wA "-I ovI _ - - -- - • � I -- T�` -�h 'L� ! L I -- I UNDERWRITERS CERTIFICATE li . REQUIRED LJ �-'`�-'.' _ .tet � � OCCUPANCY OR USE IS UNLAWFUL aK I GT. C-AF-Ace WITHOUT CERTIFICATE OF OCCUPANCY FCC7r�C LCXJ f fc1- FL .Oo F, I I I . f'"FY PUILPIVC 'd fl02 'I AM T ' I h-n;_I_f➢'INXNC INSPECTIONS: � 'd rebOMDATION - nVO REOUiRETz A FOR POURED CONCRETE 2, POUCH - FRAM IIVG & PLUMBING 3. ;NSULATION t • , I h FINAL . CONSTRUCTION MUST , RF COMPLETE FOR C.O. radL CON:TR{1CI'ION SHALL Iti;E w Ti,. REOUIREAAENTS OF THE Kd . %j-E CONSTRUCTION & ENEP, •"' •I I 4 tNOT RI"bPONSIBIE F • F - ;V;[' 05,CON:"FRUCTIOV6 CRR(�i y - IJ_ lig pPpR VEO 9Y: � . , _ Lr ' I oepwN avi, - sCpLE� j V +. t DATE FLw 00 OR^WING NUMBER E'V�T . . :, :. „ ._ ,t'�- .. ..,.,,,. 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