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Home My WebLink About25934-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27566 Date: 02/28/01 T~IS CERTIFIES that the building NEW DWELLING Location of Property: 415 HARBOR LIGHTS DR SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 71 Block 2 Lot 4 Subdivision Filed Map No. __ Lot NO. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 4, 1999 pursuant to which Building Permit No. 25934-Z dated AUGUST 10, 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE AS APPLIED FOR. The certificate is issued to ROBERT & EMMERENCE STICKLE (OWNER) of the aforesaid building. SIIFFOLK COLYNT~ DEPARTMENT OF HF2%LT~ Ai~PROVAL R10-98-0145 ELEC~ICAL CERTIFICA~ NO. 100723 PLUMBERS CERTIFICATION DATED 02/21/01 DENNIS FRANKS 01/05/0i 11/21/00 /~ho~4zed 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. 25934 Z Date AUGUST 10~ 1999 Permission is hereby granted to: HAROLD JR REESE 855 SUNRISE HIGHWAY LYNBROgK,NY 11563 for : CONSTRUCTION OF A SINGLR FAMILY DWELLING AS APPLIED FOR. FLOOD ZONE PMT INCLUDED. at premises located at 415 HARBOR LIGHTS DR SOUTHOLD County Tax Map No. 473889 Section 071 Block 0002 Lot No. 004 pursuant to application dated JUNE 4 1999 and approved by the Building Inspector. Fee $ 604.60 /~~ uthC r~ z~d S i~gn a ture Rev. 2/19/98 ORIGINAL APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 Thia 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Upre-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. 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,S25.00. Businesses $50.00. 2. Certificate of Occupancy ~ Pre-existing Buildinz - $100.00 3. Copy of Certificate of OcCupancy - i -~D 4. Updated Certificate of Ocdupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .............................. New Construction .... ~..... Old Or Pre-existing Building ................. Location of Property ............................................ House No. Street Hamlet Onwer or Owners of Property. 5'l-ld.~b'~-- ........ 2! Blo* ox .. .o..'t. County Tax Map No 1000, Section ........... ~ .............. Lot ................. Subdivision Filed Map .. Lot ....... ?,..s..?M.. Permit No ...... Date Of Permit. .~. .... Applicant ........ Health Dept Approval . Underwriters Approval Planning Board Approval ........................ Request for: Temporary Certificate..' ......... Final Certicate ........... Fee Submitted: $,1~. ~,..~..~ ............................ : ..~.~ '.~.~.bj~.. CO ~-~ ")5 ~1 ~' ........ A~PLICANT .................... Town Hall, 53095 Main Road P, O, Box 1179 Southoid, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR '['OWN OF SOUTHOLD CERTIFICATION Building Permit No. ~-f3~ ~ Owner: ~7--1~ ~' (please print) Plumber: (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers ~ignat' - Sworn to before me this ~ day Notary Public, _ ,. ~066 .,,~LEi'~ M. KENNEDY h~ff'CAR'~ PUBL C, State of New No. 52-4656758 Co~si0n Ex~i[~rch ~30, LONG IS.L~.~ .t~.,.., ELECTRICAL INSPECTION ~SERVICE,, INC, 670 M~ddle Country Road · Sa ntJames{N?,t 17§0 · Tel: (631) 265-3075 ~& i'1~21/00 ' ~,~O.~F~~ 100~3 ~,~o. ~5~3~2 ~o. 11/20/00 ' ' ~ fo~ to ~ in t~l~nce wbh t~ c~rt~ ~fion of t~ Nati~lElea~ C~. ' , ',. ' 1 I 5 ~ag 1 ~ 30A ' ~.0, BOX 61 ST. JA.ES, NY 11780, W~ffE - ORIGIN~ ~ BUILDING OWNER'S NAME FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important: Read the instructions on pa~les '1 - 7. SECTION A - PROPERTY OWNER INFORMATION BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. CITY ,~O0 ~/~ Old STATE )t~~ ~ O.M.B. No. 3067-0077 Expires July 31, 2002 For Insurance Company, Use: Policy Number Company SIC N~mbe. r CODE PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc,) /oo0 - 7/- 02 -O~- BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use Comments section if necessary.) LATITUDE/LONGITUDE (OPTIONAL) ( ~'~/°-~'-~WL~ or ~.:::.':;:.';:*) HORIZONTAL DATUM: LI NAD 1927 L._l NAD 1983 SOURCE: I.--~ GPS (Type): L_] USGS Quad Map LI Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2, COUNTY NAME B4. MAP AND PANEL B5. SUFFIX B6. FIRM INDEX B7. FIRM PANEL B8. FLOOD B9. BASE FLOOD ELEVATION(S) NUMBER ~ DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AD, use depth or, flooding) BI0. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Bg. [._~ FIS Profile ~:~ FIRM [._.1 Community Determined [_--I Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: [~[ NGVD 1929 I._1 NAVD 1988 LJ Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? k_l Yes .E~ No Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: I__lConstruction Drawings* I__lBuilding Under Construction* Iz~lFinished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 2_.. (Se~ect the bui~ding diagram m~st similar t~ the bui~ding f~r which this certificate is being c~mp~eted - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph,) C3. Elevations - Zones Al-A30, AL, AH, A (with BFE), VE, VI -V30, V (with BFE), AR, AR/A, APJAE, AR/Al-A30, AR/AH, AR/AD Complete Items C3a-i below according to the building diagram specified in Item C2. State the datum used, If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation, Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum Conversion/Comments Elevation reference mark used Does the elevation reference mark used appear on the FIRM? I__lYes I~;~'~No - Q a) Top of bottom floor (including basement or enclosure) Q b) Top of next higher floor D c) Bottom of lowest horizontal structural member (V zones only) D d) Attached garage (top of slab) ' CI e) Lowest elevation of machine~ and/or equipment servicing the building O f) Lowest adjacent grade (LAG) I~ g) Highest adjacent grade (HAG) r3 h) No. of permanent openings (flood vents) within 1 tt. above adjacent grade I::]1 i) Total area of all permanent openings (flood vents) in C3h ~ E~ . '?_...(m) /$ . ~___ ~t.(m) .~ . ._~ ~.(~) /I .?Z_it(m) sq. in. (sq. cm) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the Mformation in Sections A, B, and C on this certit~cate represents my best effods to interpret the data available. I understand that any false statement may be punishable by fine orimpdsonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME I . i , LICENSE NUMBER ~ TITLE , / ~" / / 1/ COMPANY NAME . -- ADDRESS .-~ -- ' ~' \ CITY ~, -- STATE ",., ZiP CODE SIGNATURE ~.~_~, DATE ,/Z - /~-OO TELEPHONE ¢~,~/_ FEMA Form 81-31, AUG 99 ~ SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS ? IMPORTANT: In these spaces, copy theI corresponding information from Section A. ~ For Insurance Company Use: BUILDING S.T~EET ADDRESS (Including Apt., iUnit. S~te, and/or BTdg. No.) OR P.O. ROUTE AND BOX NO. I Policy Number SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificat~ for (1) community official, (2) insurance agent/company, and (3) building owner. COMMENTS I--I Check here if attachments SECTION E - BUILDING ELEVAT ON NFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A 0NITHOUT BFE) For Zone AO and Zone A (without BFE), co~npleta Items E1 through E4. If the Elevation Certificate is intended for uae as supporting 'nformati'on for a LOMA or LOMR-F, Section C must be completed. El. Building Diagram Number (Selec~ the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accu~tely represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is LI_I ft.(m) Ll__lin.(cm) L_l above or I__1 below (check one) the highest adjacent grade.l E3. For Building Diagrams 6-8 with opening~ (see page 7), the next higher floor or elevated floor (elevation b) of the building is I_1_1 ff.(m) I__l__lin,(cm) above the hilghest adjacent grade. E4. For Zone AO only: If no flood depth nurgber is available, is the top of the bottom floor elevated in accordance with the cemmunity's floodplainmana~ementordinance?l_l!Yes I_lNo I~lUnknown. The local official must certi~ this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community-Issued BFE) or Zone AO must ~ign hera. PROPERTY OVVNER'S OR OVVNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE I DATE TELEPHONE COMMENTS i ! ]--I Check here if attachments SECTION G ~ COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or~rdinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevafiqn Certificate. Complete the applicable item(s) and sign below. G 1. I I The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, -- engineer, or aJfi~itect who is authod~:ed by state or local law to certify elevation information· (Indicate the source and date of the elevation data !?~:x.Comments ara~ below.) G2. L] A community offlcia~mpleted Sectlon E for a building located in Zone A (without a FEUA-issued or community-issued BFE) or Zone AO. : \\ I G3. J J The following informat dr) (terns G4-Gg) s prov ded for community floodplain management purposes G4. PERMIT NUMBER ! G5. DATE PERM T SSUED G6 DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ~" SSUED G7. Th~s permit ha[~ been ~ssued for: L--I i~ G8, Elevation of as-built 1~3west floor (inciudin G9, BFE or (in Zone AO) depth of flooding at LOCAL OFFICIAL'S NAME COMMUNITY NAME ew Construction L._I Substantial Improvement basement) of the building is: lhe building site is: . __ ft.(m) Datum: · __ fl.(m) Datum: TITLE TELEPHONE SIGNATURE COMMENTS FEMA Form 81-31, AUG 99 DATE Check here if attachments REPLACES ALL PREVIOUS EDITIONS 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] ROU~HPLBG. [ ] FOUNDATION2ND [ ] INFLATION [ ] FRAMING [~/FINAL INSPE~ ,~ 76S.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ]~LATION [ ] FRAMING [ ~'~ FINAL [ ] FIREPLA~C~CH.~IMNEY jDATE__ COMMENTS ~DATION (IST) ~NDATION (2ND) FRAM~ g PLUMBING ,,qS'ULATION PER N. Y. STATE ENERGY ADDITIONAL COMMENT~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSULATION [ ] F/I~A~ING [ ] FINAL [~/] FIREPLACE & CHIMNEY REMARKS: INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ].,~JGH PLBG. [/,~ INSULATION C~ [ ] FINAL ] FIREPLACE & CHIMNEY REMARKS: /~'/~~ ~' ~' ~¢-..~ r~ INSPECTOR ~ ~~/~INSPECTION J [ ] FOUNDATION 15T [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSULA~ [ ] FRAMING [ ] F~ ~~~ ~ [ ] FIREPLACE &CHIMNEy~ ~ /,y~ ~~ DATE ~f~~ INSPEC~~~~ 765-1802 BUILDING DEPT. INSPECTION [ ] Fo~U~IDATION 1ST [ ] ROUGH PLBG. [//]' FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY DATE INSPECTOR 76S-1802 BUILDING DEPT. SPECTION [ '~] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY INSPECTOR JOHN R. BRACCO, Registered Architect 10 Hill Street, Blue Point, N.Y. 11715 Phone (516) 363-2714 Fax (516) 363-2714 To: Town of Southold Building Department Attention: James Richter August 4,1999 Re:THE STICKLE RESIDENCE 415 HARBOR LIGHTS DRIVE SOUTHOLD, NEW YORK 11971 sec. 71 block 02 lot04 Dear James, Here are the amended plans, removing the basement in question. If you have any*fUrther questions, please do not hesitate to call Very T~l:uly Yours, John R. Brffcco, R.A. JIyDITH T. TERRY TOWN CLEILK OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD 't'ow~ Flail, 53(195 Mare R.o~d P.O, Box l l?g Soulhold, New York I Iq7 I Fax (5J6) 765-1923 Tclcphone (516~ 765- IROI THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 2ti, 1993: RESOLVED that the Town Board of the two (2) new forms to be used under the of the Code of the Town of Southold: Application" [FDP(93)], and "Certificate Special Flood Hazard Area [C/C(93)]. Town of Southold hereby adopts Flood Damage Prevent regulations "Floodplain Development Permit of Compliance for Development in ' iii Southold Town Clerk August 25, 1993 TOWN OF SOUTHOLD APPLICATION # PAGE 1 of 4 FLOODPLAIN DEX?ELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SE{~TflON I: GENERAL PROVISIONS (APPLICANT to read and si~n): 1. No work may start until a permit is issued. 2. The permit may be revoked if any false statements are made herein. 3. If revoked, all work must cease tmtll permit is re-issued. 4. Development shall not be used or occupied until a Certificate of Compliance is i.~ued. 5. The permit will expire if no work is commeuced within six moutks of issuance. 6. Applicant is hereby informed that othe[ permits may be required to fulf'dl local, state and federal regulatory requkemcnts. 7. Applicant hereby ~ivcs couscat to thc Loc.~l Admk~strator or his/her rcpr~cntadvc to ma,kc ieasounbl¢ ~uspecfious rcqukcd to vcri~ compllanc~. 8. I, THE APPLICANT, CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO (APPLICANT'S SIGNATURE) J ~'"~-"~'~ SECTION 2: PROPOSED DEVELOPMENT {TO be com¢leted by APPLICMxW) NAME BUILDER ADDRESS TELEPHONE 7 ENGINEER To avoid delay in processing the applicatiosa, please provide enough information to easily ideutify the project location. Pro~fide the street address, lot number or legal description (attach) and, outside urban areas, the distance to the nearest intersecting road or well-known landmark A sketch attached to tl~ app, lication showing the project location would be helpful. FDP(93) APPLICATION PAGE 2 OF 4 DESCRIPTION OF WORK (Check all applicable boxes): A. STRUCTURAL DEVELOPMENT ~it New Structure r-I Addition [] Alteration [] Relocation r-/Demolition [] Replacement TRUCTURE TYPE ~l~Residential (1-4 Family) [3 Residemial (More than 4 Family) [] Non-residential (Floodproofing? [] Yes) [] Combined Use (Residential & Commercial) [] Manufactured (Mobile) Home (In Manu- factured Home Park? [] Yes) ESTIMATED COST OF PROJECT $ B. OTHER DEVELOPMENT AC~fl'WITIES: [] Fill [] Mining D Drilling [] Grading [] Excavation (Except for Structural Development Checked Above) · [] Watercourse Alteration (Including Dredging and Channel Modifications) [] Drainage Improvements (Including Culvert Work) [] Road, Street or Bridge Construction [] Subdivision (New or Expansion) [] Individual Water or Sewer System [] Other (Please Spec'fly). Alter completing SECTION 2, APPLICANT should submit form to Local Admin~trator for review. ~ECTION 3: FLOODPLAIN DETERMINATION (To be comvleted bv LOCAL ADMINISTRATOR) The proposed development is located on FIRM Panel No. , Dated The Proposed Development: rn Ia ~IQT located in a Special Flood Hu?ard At'ca (Notify the applfic~,~t that the application review ia complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). [] Is located ia a Spedal Flood Hazard Area. FIRM zone designation is lO0-Ycar flood elevation at thc site ia: Ft. NGVD (MSL) El Unava/lable [] The proposed development is located in a floodway. FBFM Panel No. Dated [] See Section 4 for additional instructions. SIGNED DATE Alber~ J. Krupski, President James King, ¥ice-President Henr~f~ Smith Artie Foster Ken Poliweda To~ Hail 5~o95 ~a~ P.O. Box 1179 Southold. New York 11971 Telephone (516) 765-18~2 Fax (516) 765-1823 January 8, 1999 BOARD OF TO~NN TRUSTEES TOV~N OF SOUTHOLD Catherine Mesiano Inc. 12 Mill Pond Lane East. Moriches NY 11940 RE: ROBERT STICKLE SCTM ~71-2-4 Dear Ms. Mesiano, The Southold Town Board of Trustees reviewed the survey dated and received in our office on December 22, 1999 and determined that the construction of a proposed house, to be out of the Trustee Wetland jurisdiction, under Chapter 97, of the Town Code. However, any activity within 75' of the Wetland line, or any project seaward of the Coastal Erosion Hazard Line would require permits from this office. This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. Sincerely, Albert J. Krupski, Jr. President, Board of Trustees AJK/djh cc. Bldg. Dept. New York State Department of Environmental Conservation Bui{ding 40 - SUNY, Stony Brook, New York 11790-2356 Telephone (516) 444-0365 Facsimile (516) 444-0360 John P. Cahill Commissioner TIDAL WETLA~'D LETTER OF NON-JURISDICTION Mr. Robert Stickle 62 Lakeshore Blvd. Massapequa, NY 11758 November 20, 1998 Re: 1-4738-02053/00001 Harbor Lights Drive SCTM#1000-71-2-4 Southold Dear Mr. Stickle: Based on the information you have submitted, the New York State Department of Environmental Conservation has determined that: The property landward of the bulkhead greater than 100 feet in length, constructed prior to 8/20/77, as shown on the survey prepared by Joseph Ingegno dated 8/11/98 revised 9/3/98, and confirmed by Department technical staff.to be evidenced on Tidal Wetland Map#718-546 and IR/BW#724, is beyond Article 25 (Tidal Wetland) jurisdiction. Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6NYCRR Part 661) no permit is required under the Tidal Wetlands Act Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be f~.r~.her advised thgt this ~etter does not rel~ the responsibility of obtaining any pecessary permits/~r approvax~ from other agencies. ~i//erely,. / -~ (7. LJS Admln cc: . esiano, nc. d. d File PARISH DR ZONE COASTAL RARRIER IDENTIFIED 11--16--90 (SEE COASTAL BARRIER LEGEND) ZONE AE (EL 8) COASTAL BASE FLOOD ELEVATIONS APPLY ONLY LANDWARD OF 0 O NGVD :ONE X ZONE X T~)wn of Southold 360813 BR ZONE X ZONE X ~01~1 NO. TOI~t OF $OUTHOLD UUILDING DEPARTIgENT TOI~tlL&LL $OUTHOLD, N.Y. 11971 1)isapprc~ed a/c .................... ~IOTIFY: CALL.... ............. · I~IL TO: .................... INSTRUCTIONS a. 'Ibis applicatim mast be ~r~,le~ely filled in by typ~riter or in B ~s of pl~, ~ate ploC pl~ ~ ~e. F~ ~i~ ~ ~le. b. Plot pl~ ~ l~ti~ of lot ~ of ~ildi~ ~ ~s, ~lati~ip .w ~join~ p~s or ~lic ~is a~li~ci~. d. O~ ~ of ~. ~ ~ildi~ all ~ ~i~ or ~' i~ ~le or i~ ~ ~r ~ ~ ~er ~il a ~nifia~e of aI~ IS Mldi~ ~ ~ of ~ T~ of ~ld, ~folk ~, ~ Yo~, ~ o~r ~li~le ~s, ~i~es or ~ati~, for ~ &~ri~. ~ a~li~C .... ................... (Si~ o~ ..i...H ......... ¢ ....... ................. Slate M~r ~li~[ ~ ~ - ~,,~ 'X. ¢~¢% ........................................................ ......... a~...~ .... Z ................................ - --- ~ oi ~r of pr~s .................................................. If aBli~[ is a ¢~rati~, si~ of ~y ~ri~ offi~r. (Nmre and title of corporate of[icer) ~ture of ~ork (check Mdch applic Repair ............ }~mwat ...... If dwelli~, rs~ber of d~llt~ t~ If garage, nmi~r of e/~rs ....... ble)l tt~ Bulldiug ..~ ..... ~{dition .......... Mteration .......... ....... Iimolition ............ Other Work (~scrtption) (to be Hid on Etltug this application) ~lts .....~ ...... fischer oE d~lliog [mits on each flonr ................ If histr~ss, ccm~'ctal or 1/[la/ (Iccupe~7, speat~-~ nabr~ ~ ~t~t of ea~ ~ ,of ~ ........... ~ ........... Bi~si~s of ~stt~ st~s~ If ~: ~t ................ ~ ............... ~pth ................. Iki~t ......................... i~r oe Stories ...................... ~tb .................... ~i~t~ ..................... ~r of ~tories ............... ~i~t ......... ~ .............. ~r of St~ies ..................... ~ 0 ~ lO. ~te of ~am ......... t .... ~ ................................ I I. ~ ~ ~ district tn ~i~ O~6,,l~s ~ st~t~ ...... ~ ................................................. 13. ~ill lot ~ ~ ...~ .... ~ ........~111 mss ~{11 . { ~1~ ~r ~ ~scrtpii~ ~i~ to ~, ~ ~ st~t ~s ~ i~icate f,~a Im~party li~es. ~{~e street ~tetJt~r interior or comer lot. (~ of indlvidual si~ulu~ coutract1 I~ is the ....................... ~-]:~- '" e." ......... ......... .... .... NO. QUALIFIED IN 8U~O~ ~OUN~ TERM ~PIRE~ SURVEY OF LOT 46 MAP OF HARBOR LIGHTS ESTATES / SECTION T~O FILE No. 4681 FILED JULY 26, 1966 SITUATED AT ~ BAYVIEW ,.f// fl/ S.C. TAX No. 1000-71-02-04 SCALE 1"=40' / AUGUST 11, 1998 SEPTEMBER 3, 1998 ADDED PLOT PLAN OCTOBER 31, 1998 REVISED PLOT PLAN NOV. 19, i998 REVISED SEPTIC SYS. LOCATION/ DEC. 8, 1998 REVISED PROP. HOUSE / MAY 17. 1999 REVISED PROP. SEPTIC SYS/ / AREA = 20,000.00 sq. 1K)R APPROVAL OF CONb'TRUCTION ~,-~ FAMILY IIE$11)ENCE ONLY'" TEST HOLE DATA (TEST HOLE DUG E~'~(~J~ ON JULY 28. 1998) I FOR SANITARY ~Y~TEM ~ BY HEALTH DEPARTMENT SEPTIC TANK (1) Joseph A. Ingegno Land Surveyor PHONE (516)727-2090 ~ (516)722-50~ Fox (516)722-5095