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HomeMy WebLinkAbout25144-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26402 Date: 04/23/99 THIS CERTIFIES that the building NEW DWELLING Location of Property: 970 WATERS EDGE WAY SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 88 Block 4 Lot 14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 14, 1998 pursuant to which Building Permit No. 25144-Z dated AUGUST 31, 1998 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 COVERED PORCH, AND TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to JOSEPHINE E. PETTIT (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-97-0065 04/14/99 ELECTRICAL CERTIFICATE NO. N485411 04/12/99 PLUMBERS CERTIFICATION DATED 03/12/99 MANORVILLE PLUMB&HEAT. - "4 �, ;� - zat il5ring Inspector 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. 25144 Z Date AUGUST 31, 1998 Permission is hereby granted to: MATTHEW RYAN, MD 1021 WEBER CT CHARLOTTE NC, 28211 for CONSTRUCTION OF A TWO STORY SINGLE FAMILY DWELLING WITH COVERED PORCH AND TWO CAR GARAGE. at premises located at 970 WATERS EDGE WAY SOUTHOLD County Tax Map No. 473889 Section 088 Block 0004 Lot No. 014 pursuant to application dated JULY 14 1998 and approved by the Building Inspector. Fee $ 662 . 00 Application Fee + 75.00 737.00 ZL e Bu' ing Inspe for ORIGINAL Rev. 2/19/98 V Form No. 6 �— c?7K-F��{3 TOWN OF SOUTHOLD APR 151999 i1 BUILDING DEPARTMENT TOWN HALL _ 765-1802 BLDG.DEFT. TOWN OF SOUTH(2L,D a APPLICATION 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 17 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. r 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - 45p. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . Apri1, 15,,, 1999, , , , , , , , , , , , , , , , , , , , , , , , New Construction. . . .PC. . . .. Old Or Pre-existing Building. . . . . . .. . . . . . . . . . Location of Property. .970.1datersedge.Way. . .. . . . . . . . . . . . . .. . . . . . . . . . . .Snutb61dr. XY . . . . . . • • • • • House No. Street Hamlet Onwer or Owners of Property.. . . . .Ryan. . . . . Pettit . , . . . . County Tax Map No 1000, Section. . . .$$. . .. . . ..Block. .. . . 04 . . . . . . . .Lot. . ,I . . . . . . . . . . . . . . . . . Bay Haven 291037 Subdivision. . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lo ta . .. . . . . . . . . . . . . . . . . . . Permit No. . .?51442 , , , ,Date Of Permit. . .8031 8 , , ,Applicant. Matthew Ryan Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . .. . . . Q . . . . . . . . . . :�. . . . . . . . . . . . . . . . . . . . . . . . C o -� a6 ya APPLICANT Theodore C. Martz Jr. live/ o Fax(516)765.1623 Town Hall,53095 Mairylaoad -� ) ;,:x+ , Telephone(516)765.1602 P.O. Box 1179 Southold,New York 11971 'y •,:,, ^p � ,.,,In OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: March 12, 1999 Building Permit No. 251442 Owner: Josephine E. Pettit (please print) Plumber: " Manorville Pluinbing and Heating (please print) I. certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Oz (Plumbe Signature) Swo n to before m this � day of 19u Notary Public, "�� County ARY PUBLIC,Stets of No Vc Itlt��591690 Qualified In Suffolk 01404 f.,r�nv3;ioh�ItpiYBB i �`�./ N (T) / ° CL I m a. 17 o OD fl- Gj Leos V L Z.� p,cc itra LA,)\ s - as MIA41 - f O Print Key 019, Gy Page 1 5769SS1 V4R2M0 980228 0= D 05/13/99 11 :31 :56 Town Hall,53095 Main Road y Fax(516)765-1823 D�is�pyl��)Aop"V Ce . . . . . Telephone(516)765-1802 T,} �'Sd'lltl Id, New'Yotk 1'1971 ' 473889 88 . -4-14 --- ., O OSEPHINE E PETTIT NUMBER# DATE TYPE C O # USE/DESCRIPTION 25144 8/31/98 PERMIT -2�QL2DI GDEF�I�rAWRTFLING Ti OFSOUTHOLD 25720 5/12/99 PERMIT ADDITION 0/00/00 0/00/00 0/00/00 0/00/00 0/00/00 0/00/00 0/00/00 0/00/00 F1=More F7=Permit Detail F8=C0 Detail F9=Preco F12=New Swis/Parcel F3=Exit • ,_•� /rte • 1 � • . I-��II�°tom LI L �S.iii.�r..�� .�1 ��►A�i t /WI/L./' / —� i / \ / W-11- J t ted- �..rz sf ir/! � - r � i W l.r.��ri � � � r�i a►•ham i 1 '�� ' /� _ice"i .i". .�j'/�/�_> /�"' - . • v LAW OFFICES RICHARD G. HANDLER ATTORNEYS AT LAW 101 IRELAND PLACE P.O. BOX 554 AMITYVILLE, LONG ISLAND 11701 TEL. (516) 598-1400 RICHARD G.HANDLER FAX. (516) 598.0952 CRAIG D.PAVLIK cOw�i &07 .���� 2 y/ AL1 Z d*y �� �, 1qj9 CRAIG D PAVLIK Notary Public. State of New York No 02PA5024137 Qualified In Saffolk County Commission Expires February 28, ram JUDITH T. TERRY 1. +—: - '� Town Hall, 53095 Main Road P 0. Roc 1 170 TOWN CLERK ' �['�,i,.., '" 1` Southold. Ne,,, York 11071 REGISTRAR OF VITAL,S'TATIST'ICS ��- Fax (516) 765-1923 MARRIAGE OFFICER Telephone IS 161 765-1901 RECORDS MANAGEMENT OFFICER jib FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24, 1993: RESOLVED that the Town Board of the Town of Southold hereby adopts two (2) new forms to be used under the Flood Damage Prevent regulations of the Code of the Town of Southold: "Floodplain Development Permit Application" [FDP(93) ] , and "Certificate of Compliance for Development in Special Flood Hazard Area [C/C(93) ] . DEFT. TOWN OF SOUTHOLD Southold Town Clerk August 25, 1993 APPLICATION #_ PAGE l of 4 TOWN OF SOUTHOLD FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SECTION 1• GENERAL PROVISIONS (APPLICANT to read and sign): 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 until permit is re-issued. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. 5. The permit will expire if no work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local, state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections required to verify compliance. 8. I, THE APPLICANT, CERTIFY THAT ALL ST TEMEN ' ER ATTACHMENTS O THIS APPLICATION A13E TO THE BES F Y O E, ACCU E. c io z, 98 (APPLICANT'S SIGNATURE) DATE SECTION 2• PROPOSED DEVELOPMENT (To be completed by APPLICAIN"n NAME ADDRESS TELEPHONE APPLICANT �l./'/.? BUILDS —aY"5`3. ENGINEER PROJECT LOCATION: To avoid delay in processing the application, please provide enough information to easily identify the project location. Provide 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 this application showing the project location would be helpful. FDP(93) APPLICATION # _ PAGE 2 OF 4 DESCRIPTION OF WORK (Check all applicable boxes): A. STRUCTURAL DEVELOPMENT ACTIVITY STRUCTURE TYPE ❑ New Structure O Residential (1-4 Family) ❑ Addition ❑ Residential (More than 4 Family) ❑ Alteration ❑ Non-residential (Floodproofmg? ❑ Yes) ❑ Relocation ❑ Combined Use (Residential & Commercial) ❑ Demolition 0 Manufactured (Mobile) Home (In Manu- ❑ Replacement factured Home Park? ❑ Yes) ESTIMATED COST OF PROJECT S B. OTHER DEVELOPMENT ACTIVITIES: O Fill ❑ Mining ❑ Drilling ❑ Grading ❑ Excavation (Except for Structural Development Checked Above) ❑ Watercourse Alteration (Including Dredging and Channel Modifications) O Drainage Improvements (Including Culvert Work) ❑ Road, Street or Bridge Construction ❑ Subdivision (New or Expansion) ❑ Individual Water or Sewer System ❑ Other (Please Specify) After completing SECTION 2, APPLICANT should submit form to Local Administrator for review. SECTION 3• FLOODPLAIN DETERMINATION (To be comFeted by LOCAL ADMINISTRATOR) The proposed development is located on FIRM Panel No. . Dated The Proposed Development: ❑ Is NOT located in a Special Flood Hazard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). ❑ Is located in a Special Flood Hazard Area. FIRM zone designation is 100-Year flood elevation at the site is: Ft. NGVD (MSL) ❑ Unavailable ❑ The proposed development is located in a floodway. FBFM Panel No. Dated ❑ See Section 4 for additional instructions. SIGNED DATE APPLICATION # PAGE 3 OF 4 SECTION 4• ADDITIONAL INFORMATION REQUIRED (To he completed by LOCAL ADMINISTRATOR) The applicant must submit the documents checked below before the application can be processed: ❑ A site plan showing the location of all existing structures, water bodies, adjacent roads, lot dimensions and proposed development. ❑Development plans,drawn to scale, and specifications,including where applicable:details for anchoring structures,proposed elevation of lowest floor(including basement), types of water resistant materials used below the fust floor,details of floodproo£tng of utilities located below the first floor and details of enclosures below the fust floor. Also, ❑Subdivision or other development plans (If the subdivision or other development exceeds 50 lots or 5 acres, whichever is the lesser, the applicant must provide 1170-year flood elevations if they are not otherwise available). ❑ Plans showing the extent of watercourse relocation and/or landform alterations. ❑ Top of new fill elevation Ft. NGVD (MSL). ❑ Floodproofing protection level (non-residential only) Ft. NGVD (MSL). For floodproofed structures, applicant must attach certification from registered engineer or architect. ❑ Certification from a registered engineer that the proposed activity in a regulatory floodway will not result in any increase in the height of the 100-year flood. A copy of all data and calculations supporting this finding must also be submitted. ❑ Other: SECTION 5• PERMIT DETERMINATION (To be completed by LOCAL ADMINISTRATOR) I have determined that the proposed activity. A. ❑ Is B. ❑ Is not in conformance with provisions of Local Law #_, 19_. The permit is issued subject to the conditions attached to and made part of this permit. SIGNED , DATE If BOX A is checked, the Local Administrator may issue a Development Permit upon payment of designated fee. if BOX B is checked, the Local Administrator will provide a written summary of deficiencies. Applicant may revise and resubmit an application to the Local Administrator or may request a hearing from the Board of Appeals. APPLICATION # _ PAGE 4 OF 4 APPEALS: Appealed to Board of Appeals? ❑ Yes ❑ No Hearing date: Appeals Board Decision --- Approved? ❑ Yes ❑ No Conditions SECTION 6• AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance is issued The following information must be provided for project structures. This section must be completed by a registered professional engineer or a licensed land surveyor (or attach a certification to this application). Complete 1 or 2 below. 1. Actual (As-Built) Elevation of the top of the lowest floor, including basement (in Coastal High Hazard Areas, bottom of lowest structural member of the lowest floor, excluding piling and columns) is: FT. NGVD (MSL). 2. Actual (As-Built) Elevation of floodproofng protection is FT. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. SECTION 7: COMPLIANCE ACTION (To be completed by LOCAL ADMINISTRATOR) The LOCAL ADMINISTRATOR will complete this section as applicable based on inspection of the project to ensure compliance with the community's local law for flood damage prevention. INSPECTIONS: DATE BY DEFICIENCIES? ❑ YES ONO DATE BY DEFICIENCIES? DYES ❑ NO DATE BY DEFICIENCIES? DYES ❑ NO SECTION 8: CERTIFICATE OF COMPLIAN E(To be completed by LOCAL ADMINISTRATOR) Certificate of Compliance issued: DATE: BY: Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA (OWNER MUST RETAIN THIS CERTIFICATE) PREMISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: ❑ NEW BUILDING ❑ EXISTING BUILDING 0 VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HE, CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW #_, 19 SIGNED: DATED: B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # 19_, AS MODIFIED BY VARIANCE # DATED SIGNED: DATED: C/C(93) THEODORE C. MARTZ, JR. BUILDING CONTRACTOR (516) $78-8443 145 Ryerson Avenue - -- Manorville, New York 11949 SEP 8 1: :. oo:tw;r , September 23, 1998 1— Town of Southold Building Department Main Road Southold Town Hall Southold,New York 11971 Att: Mr. Gary Fish: RE: Matthew Ryan, permit #25144 Per our recent discussion, I am enclosing an additional $100.00 fee due on the above mentioned permit as it falls within the Coastal Flood Plain Zone. Thanks, 1 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: 91 / d DATE[ INSPECTOR vq� M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY REMARKS: e DATE INSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IULATION [ ] FRAMING [ C]/FINAL [ ] FIREPLACE & CHIMNEY REMARKS/. Z,44 S Al t� DATE f d INSPECTOR , .�.. G� p4CW � W � 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] R GH PLBG- [ ] FOUNDATION 2ND INSULATION [ ] FRAMING [ ] FINAL [ ] FIREP CE A CHIMNEY REMARKS DATE INSPECTO M-1802 BUILDING DEPT. INSPECTION ._ [ ] FOUNDATION IST [ ROUGH PLBG. [ ] F DATION 2ND [ ] INSULATION [ VFI"REPILACE G [ ] FINAL S CHIMNEY REMA S: ��� DATE INSPECTOR M-1802 BUILDING DEPT. SPECTION [ OUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ INAL [ ] FIREPLACE & CHIMNEY REMARKS: �-✓'i ` 1�� DATE L�/ d'`/INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1001105 BUREAU OF ELECTRICITY F 40 FULTON STREET, NEW YORK, NY 10038 Date APRIL 12,1999 Application No. on file 17556'799/99 N 485411 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of JOSEPHINE PETTIT, 970 WATERS EDGE WAY, SOUTHOLD/BAYVIEW, NY in the following location; ❑ Basement ® Ist Fl. © 2nd Fl. GAR/ATTIC/OUT Section Block Lot was examined on APRIL 07,1999 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS I INCANDESCENTI FLUORESCENT I OTHER AMT. I K.W. AMT. I K.W. AMT. I K.W. AMT. I K.W. AMT. H.P. 39 81 54 39 1 1.2 2 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERSSPECIAL REC'PT. TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K.W. OIL H.P. GAS H.P. AMT. NO A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS 4 F 1 SERVICE DISCONNECT NO.OF S E R V 1 C E METER NO.OF CC COND. A W.G. A.W.G. A.W.G.- AMT. AMP. TYPE EQUIP. 1 0 RW 1 0 3W 3 0 3W 3 0 4W PER D OF CC COND NO.OF HI-LEG OF HHLEG NO Of NEUTRALS OF NEUTRAL r OTHER APPARATUS: WELL PUMP-1 3 1/2 TON AIR CONDITIONERS-2 WITH 2 GOA DISCONNECTS-1 SHORE DETECTOR:-S WILDWOOD ELECTRIC LIC.#1563-E PO BOX 808 / 4th STREET GENERAL MANAGER WADING RIVER, NY, 11792 Per 1 This certificate must not be altered In any manner;return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 77 C.M.B. 67-00ELEVATION CERTIFICATE Expires May31, 1993 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to provide elevation information necessary to ensure compliance with applicable community floodplain management ordinances,to 'determine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE • BUILDING OWNER'S NAME POLICY NUMBER Josephine E. Pettit STREET ADDRESS(Including Apt.,Unit,Suite and/or Bldg Number)OR P.O.ROUTE AND BOX NUMBER COMPANY NAIC NUMBER -97OLTdat-ers_a gray— OTHER DESCRIPTION(Lot and Block Numbers,etc.) 4 CITY STATE ZIP CODE Snttthol rl n1V 1 1X71 SECTION B FLOOD INSURANCE RATE MAP(FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1.COMMUNITY NUMBER 2.PANEL NUMBER 3.SUFFIX 1 4.DATE OF FIRM INDEX 5.FIRM ZONE 6.BASE FLOOD ELEVATION (in AO Zones,use depth) 360813 0166C May 4 , 199 AE E1 . 8 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): Ox NGVD'29 ❑Other(describe on back) 8. For Zones A or V,where no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate the community's BFE: feet NGVD (or other FIRM datum–see Section B, Item 7), SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level 8 . 2(a). FIRM Zones Al-A30,AE,AK and A(with BFE). The top of the reference level floor from the selected diagram is at an elevation of L1_ J__1J. feet NGVD (or other FIRM datum–see Section B, Item 7). (b). FIRM Zones V1-V30,VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from 1 the selected diagram, is at an elevation of ❑feet NGVD (or other FIRM datum–see Section B, Item 7). (c). FIRM Zone A(without BFE). The floor used as the reference level from the selected diagram is U?J.0 feet above© or below U (check one) the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is ILL111 feet above❑ or below❑ (check one)the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor(reference level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No 0 Unknown i 3. Indicate the elevation datum system used in determining the above reference level elevations:2 NGVD'29 ❑ Other(describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on the FIRM ]see Section B, Item 7], then convert the elevations to the datum system used on the FIRM and St R equation under Comments on Page 2.) D IS 4. Elevation reference mark used appears on FIRM: El Yes No (See Instructions on Page 4) 5.The reference level elevation is based on: LX7 actual construction ❑ construction drawingspp�"" Q�ppRj (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in ld to Wh/bY 5 '��9 case this certificate will only be valid for the building during the course of construction. A post-construction Eie alio Cenificate ��� will be required once construction is complete.) BLDCI DEPT, ), T WK C� �CIUTHOLD 6.The elevation of the lowest grade immediately adjacent to the building is:IJ��J.0 feet NGVD (or other FtiRi Mt O4 B, Item 7). SECTION D COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 is not the "lowest floor"as defined in the community's floodplain management ordinance,the elevation of the building's"lowest floor"as defined by the ordinance is: feet NGVD (or other FIRM datum–see Section B, Item 7). 2. Date of the start of construction or substantial improvement _— FEMA Form 81-31,MAY 90 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION r SECTION E CERTIFICATION „ This certification is to be signed by Ilya land surveyor, engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones Al—A30,AE,AH,A(with BFE),V1—V30,VE,and V (with BFE) is required. Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AO and A(without a FEMA or community issued BFE), a building official,a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6, 7 and!!8- Distinguishing Features—If the certifier is unable to certify to breakaway/Ron-breakaway wall, enclosure size, location of servicing equipment, area use,wall openings, or unfinished area Feature(s),then list the Feature(s) not included in the certification under Comments below. The diagram number,Section C, Item 1, must still be entered. I certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER(or Affix Seal) John T. Metzger. 49618 _ TITLE COMPANY NAME " i President Peconic Surveyors , P.C. ADDRESS CITY STATE ZIP > ,( P.O. Box 909 i Southold, " NY 11971' ,' SIGNATURE p0P N V ___ _ _ - //'10/IGt.— 04/ 6/99 ( 516 ) 765-5020 Copies shc/u14 be made of6104irtificate for:1)community official,2) Insurance agent/company,and 3 tiding owner. 9i COMMENTS: o F M —=vw ON WITH ON PILES, SLAB BASEMENT PIERS.OR COLUMNS , A v A A v ZONES ZONES ! ZONES ZONES ZONES ^ — REFERENCE REFERENCE LEVEL REFERENCE LEVEL ! BASE LOGO LEVEL ELEVATION Y_.i5 J 5k ;ff 11'x11,6�4 Qfl! {' I :'• r I PQM 1 BAS[ BASE fLOOD ADJACENT :b rj}' flEFERENCE FLOOD 1 ELEVA110N - REFERENCEI ADJACENT GRADE "".R1 , LEVEL ELEVATION LEVEL GRADE V�.I D EN S; ,p'i'• 'ADJACENT GRADE The diagrams above illustrate ffhe points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. 1, `Y BOARD OF HEALTH . . . . . . . . . : . . . . . JUL 14 1998110 I 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF t TIIOIX SURVEY .. .. . . . . . . . . . . . . . . . . . . . . El' RTHENT CHECK . . . . . .... . . . . . . . . . . . . . . "tr BLDG.DEPT,• IIAi SEPTIC 7?ORM 1rr TOWN F S UT 10 11971 g, y. r . . . TEW: 76180 NOTIFY: . . . . . . . TE; Jc •- I:xanined......4!..�.!/...., 19. `�,(� y� 1''.`.�,... MAIi. TO: . . . . . . . . . . . . . . . . . . . . /jJ.... 19. V. I'ennit No. ..o<S I 1 G• ................................... . Al nureval.....:... . Disapproved a/c .................................. ................................... , ............................................. Z:I'nsl')ector) ..............•••.f APPLICATION FOR BUILDING PERMIT Date. . . . . . . . . . . . . 19. . . . iNSTRUCTIONS a. 'Buis application moat becenpletely filled in by typewriter or in ink and submitted to the Wilding inapec:tor wi 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plat plan slowing locatioui of iot and of buildings on prenises;!reldtioasliip. to adjoining premises or p blic streets or areas, and giving a detailed description of layout of property must be,dram on the diagram whirl is part pf this application. c. 'Ilse work covered by this opplicat,ion,may.not he cmmenced:before issynnce of Building Permit. d. Upon approval ofIthis,Opp].igation,J.1,4 Iwild Ing Inspector w(lt'issue a Building Permit to the applicant. nch permit shall be,kept on the premises available for inspection throughout the work. e. No building shell be occupied or used in whole or in part for any purpose whatever until a certificate of Occupancy shall have been granted by dhe Wilding inspector. APPLICNrIM IS IL'REM MADE to the Wilding Department for the issuance of a liuilding Permit pursuant to the liu}�lding Zone Ordinance of the 7bwcn of Southold, Suffolk County, New York, and other applicable ]ass, Ordinances or Reguhtions, for the construction of buildings, additions or alterations, or for removal or demolition, as herein E}P cribed. the applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and T9, M14 to admit authorized inspectors on premises and in builds for necessary inspections. (Signature of applicant, or tune, if a corporation) w ..,p, .. (2 1 111', ........................................... (Mailing address of applicant) a 6,2_0 Slate whether applicant is ower, leasee, agent, architect, engineer, general contractor, electrician, plu her or Wilde QW.N. .........p........................I......................................................... Nae of owner of premises <1 AiV./ li4dlW1wuO /1, R,n.o ...... ...................................... 4.... ............... as on the Lax roll or latest deed) if applicant is a corporation, signature of duly authorized officer. ......................................................... (Name and title of corporate officer) Builders License No. ......................... Plu:bers License F0. ......................... - . Electricians License No. ..................... Other Trade's License Nn. .................... I. iocation of land on widdmli�roposed work win I be cone. *••••• .................. ` ................ Iisulet ................. (louse Nunluer Street 1`� County Tax I Section ....1BOB....... Block ................ ..� ..... not ........ " Subdivision ...... ... .................... Filed Map No.`.I1O....:...... Lo s. _ _ .... (Nate) Z. State existing use and occupancy of premise and intended use and occupancy of proposed1c9nstnotion. a. Existing use and occupancy ..v ...'." 1:...... ...................................... 11e+v� .w Il b. intended use and occuparxy .. ..... ... ..........�. .................. o�� A. ]. 141Lure. of work (dleck wAiidl er„,•��,ljieabla)s New Building ......... Ackd'Ition .......... Alteration .......... Ilelwir ............ Rennval i.......... befrolItIon .......... Oi:�lelr Work �— J."* scription) 4, I:atbiated Coat ... 0M ........ fee. ..r.,:.. ....., ..: Y fl oto be paid on,filing tbia application) 5. if defiling, uulx3r of dwelling Invite Maimr of d ellin8 units on each floor t Ifgarage, n fiber of care ., ............................. 6. If Ixraluess, mm eccial or mlmr occ pancy, speci 7�turee and extent of enc, tyke of use....... ............... 7, Il,n � enatone of existing structures, If any: Pront..,••,.I.,...... Rear , ��r.�....... [kpfh ��b� ..p..... . .. Iluiglu: ..................... .. Mailer of Stories ..Z^.................. Dimensions of ones structureIlt, alterations cr 'uklitionar Front ............... ilea: Dept, .................... Ileigilt .................... Maim of Stories .............. . S. Di nenalona of entire new const'ruct'ions PrOnt ................ hear ............... nepth ....... ... .... Ileigile ..... ............. Midler of Stories ..................... 9. Size of dols lhrnt ........ .......... Rear .................... Depth ............... .... . ID. Dare of Pur luise ............ .......I Min of Forcer (Mier .....,..................... ............ . II. Zone or use district In w,idllprentees are situated ........................................................... ... 12. Does proposed construction vi Ste any zoning low, ordinance or regulations ..................... 13, Will lot be regraded ....:1 ' .. Will excess fill Ila ed from premiseas YES No 14. Nares of Owner of prrT!W �,� t.....te6$.iA(klres��I.............................. �psl.-� 1✓�y •� pp_' Male No. Nn1e of An111teCL' J fin.. 2;7:.,. Addreae +nil26 .l• � � 171one No. Mitre of Con lector •�' .....•..... Address ��,p,,,,'��J,.II�t�.gq.41 No. , �/�'a Pv ,of a tidal wetland? * 1 .Vane 15. is t111irproperty SMIi M 1a 1 tR+l38 =alum my M. IRM A � r Ber � X ftEO. PLOT DTAGRAM - locate clearly and distinctlylall buildings, wlletller existing or proposed, aril indicate all set-back dimension:; front property lines. Give street and block minter or deacriprion according to deed, aryl alxxr street rueren and indicate IArelller Interior or corner lot, F �o2A 6k9,oL!•l�`� NiMeAN MP '01 "MO-, MINN (Mr .ije�kletq bulz ......M. tie�!... !�:........ �•. .beinns ll duly sworn, dele8 slxl says Lint be in the appl.iunu: (Porn of Onfivickuli 818111118 caltra•t) elxnre uni ed, Ile in the ...... :....O WN.....�.... .. (C itractor, agent;corpornte' oMeer, etc.) of said (owner or owners I and is duty aulilorized to per.ronn or have perrortind the said work nrxl to make srxl file this aln)l icntiou; dint all sLatenents cdtltalned in this spiAlcatiom are tom to'llle Ileet of ,is krxx+ledge and Ixillef; nixl 111nL the work will Inv performed in 411e tivintler;set fors, in the application filed tiferewidl._ , Sworn Lo before me Ulla f p 1i..�.l.....day if .......19..!. .. Notary I'rbtic SI rv1 .. .. .............•........ My Commis Expifo$JuIY ,200 (' s .. / of Al 2 4 5 6 i 8 G •.O .I 12 13 14 15 16 I-7 • K PLUMBER CERTIFICATION ulalmonm CERTffICATE ON LEAD CONTENT BEFORE REQUIRED - IFICATE OF OCCUPANCY lqLDER USED IN WATER J EoioroNNOTOCCUPANCY ORi 4CFUSE IS UNLAWFUL BRI! j �I Pw�aE�NG WITHOUT CERTIFICATE H Au.PutsINGWAsre OF OCCUPANCY s w�►TER un>Es NEEo NOW 77� I t SI � sEwcau8xua ® 1 B 7 � "MS. B�cPPer tubi Is used BUILDING D.PE.S �ngSENl yT c- AT 1= for ter distributing 7B ISM B AM TO 4 PM FOR THE - - - - - -- - - -- - --- - --------- - system;Piping shall be FOLLOM1MNG INSPECTIONS: -------------- - - --- - --- --- —- - — - - -- - - -- --- - ----------- - - of types K or L only t FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING DO NOT PROCEED WITH 3. INSULATION PROVIDE ANTI-SCALD AND/OR 4. FINAL - CONSTRUCTION MUST FRAMING UNTIL SURVEY BE COMPLETE FOR C.O. F R O N T E L E V A T I O N OF FOUNDATION LOCATION THERMAL SHOCK PREVENTING ALL CONSTRUCTION SHALL MEET DEVICES AS TO PART. 902.6(x) THE REQUIREMENTS OF THE N.Y. HAS BEEN APPROVED. N-Y. STATE BUILDING CODE. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS PROVIDE 1% NR. FIRE RATED SEPARATION TO G — PART. 717.3 (f) (1) OF top N.Y. STATE BUILDING CODE" `Odmmatnryi� ZE 43F rim PROVIDE OPENINGS FOR w*o J oqr A EMERGENCY ESCAPE AS — REQUIRED BY PART.714 OF Y(tNi11 tilH� N.Y. STATE BUILDING CODE, e 6 J I --- -— -- -— — - - - - — - ---- - — - - - -' ------------------------------------------------------------------ [NO. DATE: I REVISION: BY SHEET TITLE i0 ELEVATIONS PROJECT P ETTITRESIDENCE ^ S OUT NO LD,NEWTORK R E A R E L E V A T I O N O _ R_ P . DESIGN COMPUTER AIDED DESIGN 10(VANS Rp SNFLiFR 19pNp,NY if%t 516-J19-J316 I 2 3 4 5 6 7 8 10 II 12 13 14 15 16 17 i K � i i J O ' P 7FED Il Ili , .-------- ------------- -- E — T 5 1 D E _ — V A - 1 0 R O N S I DE _ L - `J AO N t s= • = s •bITN r` A 1 I I I NO. DATE: REVISION: BY SHEET TITLE "^ i ELEVATIONS �nrz I PROJECT PEiTIT RESIDENCE �°•® ' ` SO V THOLD,NEW YORK O . R . P - DESIGN COMPUTER AIDED DESIGN n\\ 5Nf?fl ISLAND.VNT 11%. A6-)a9-SS.6 I 2 3 4 5 6 7 8 0 I I 2 13 14 I S 6 17 1 K ' F! f m o j-------—-------------------------—---— 11, ; �a — ---� ----------------------------------------------------------- — — -----------------------------------------------------------—----------- '16' /Iao IAF' T- - _ - --- T ----- _ CRAWL S-A6 sa.ce tics - - < o .1TI./ e. ' e.., nwEo _ mL ! b ----------------------------------------------- L i AEVA]iONea.00 rv, ! ! J •I o'. _�F _______________._-- . _-_______________________________-____________�- ____________________ _�,____—______________-_-__-- _ ------------------------------------------__ .:ftf{3{iiffp;h �«�:J Citi�I •J�' . pr ow�rsnce oU _ S � C�•:•:TS w I s 3� ._. ___ i I - I N0. DATE: —REIISIONr BY -�- SHEET TITLE ^ FOUNDATION PLAN PROJECT vEi2ii FESIDENCE SO UTXOLC.NEW YORK , I P _ ED E S I G N a pp COMPUTER AIDED OESIGN T 10'VANS ND S.ILlliYAN0 NY I'H. j 516-1+9-33K 2 3 4 5 0 8 Ci !O II 2 13 14 15 to 17 K AL lb'-3 VS' 55'22' 20'.T +3/H' _ H-c'.H' :2-:• x'.(� 2b' a4. 5�' I 1 1 ii0 3 a 0 e UTIL WORC SHOP X00 I ! N ry Izo 3/a' ry :T-i 3,a' >aslrr ! o'ai la.l•3:rz' Ir21rz' m BATH � a ! q m _ $ SII ry1 !js�nuwTMs ww /., of 3-O ! m � ryyx I I ill ^ ------------ nll I a — — 1 NO. DATE: REVISION: er SHEET TITLE '0 E�OOR PLAN PROJECT 'ETTIT a[SI D ENCS 59ULiOL9 AEW YC RK ' o _ r . P . ED E S i G N • COMPUTER AIDED DESIGN 3+EacR IS+xp�vim• nSb+ i'6-i39-3345 (3 14 15 16 A; I 2 J :09 VY � 2.11 I f � ��� m� .,_e IY . II 'a arb.l 1 rc f o Iso+/e• � - _ I `° I a o n n SII �- F•• �I• j JO Ilei �i �. �- I I q • • _ _. ,--_-�— _� ______ - ___' ���}i<�V�I Hyl �'.J� I _ s a� I �I I I, REVISION: i BY SHEET TITLE w FLOOR PLAN PROJEC- F ETT• PSSI DENCE SOU'•IOLD.•4EMY0" p - RP . � E� tGN�.-.nK COM.PUTER AIDEO DESIGN / 'C [nEL�5Lh'•D 4 Y `�b+ .e-]-9-i3•fi 2 3 4 5 6 8 G 10 II 12 13 14 15 16 17 =RAnING NOZES 3 x 12•RI0.4 TII Monlry^ 1.2er tv Ma`t�fgeM DLVAPS FIR- LaA aGUC WpI yA,.cce 2 NI vree<neg(c Ee TSA.ptetl txoozFa'.5/B'mn Wktreas pIgSE ygli �. 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NGcpe cs a uwn PSI Y vo's¢tls sbtl^:celve 5-IOD rags M:sill mC — 5F1F vEYINs sNIF_iiurL ple.e P erterbr rolls zroll'y?elvmlxep. GR�R 3gLK yLE O'�IT 0 PNwoop s -atFNO tM 1z r�clleM.JCi D DAll 7F 5R A,P35 c� ej[Jes mp 6 D p 12'o, nterk[e z z cum sAce,Ns bl ,x<nn¢<: `"5°,e wwervrMMN..y ernl, � _ tlaa^�lce vlad a c.Ba m[ro vlMw ane swp w<n 0'A. \ _ -� wrticare:fe warx,o•sMG o app-weM Pr CB M1[Mcare c Ks a[A, I<!a to rer�`vb^IM Ca~X sM1c.Me 6ewolo PMclib 69 ser+es %4-R31M _ � �i a e-2'olreare rmbel rbac-�Mms a:lp_/L ar:wc:a ar°gINJI AI'ioKts,9rc z z •Iz'FnaceR _ .a-r oc F , —/ •N Nn moa'+Sem oua xo 5:li:eye-°a ;z--��r:a o`rMil�x � y=.gypgy,l nAtl be¢ntt oamb ME araeprum A 'ryle 3/�i.vL nm a ss sM1cll yM AN, on vwLs \ .�xl^ee at Noor penman pvnq.:t>MgM M,a'e.o<E'cn or X 53%EiORATNEEW N6 c Pof+ra sFMll x«y_-rcnuract,rcrs recernenm[vre Tx4•-Ie•Oc SMXi \ i/W'058=JEATMIM6 .IXVIS C 9 \ m� -�LRAo Z-IpEN-iAL c£NE¢PL IYJFZ 5H'Xb'SiC ]'X �Aj,ilI1pu.hobre CsMraJBX yeiJaIBsn rWM IIG^BMwm�reb'tNewnLrs ao^fIsN[.Y1, b- 1l,OOAAILL PLA' 0' AOA 3/4i(64FLm /].DIA - RRMr AyI616'CmyMe5tb m. be reouVA re"y oy wcY. 3 X 61R9ER ___2EV.8m YH q�R -eGu.•eme+ta rvlfA EM Ix r E_•iq0 z rese o'rns[O vytl m � tlrn u1N M p.!,me-zscs s __ iOp CF sN ryyL ,"ryan apvbep' • �. m A -� Assv+eo Lro,�cr'nc 61aa'11. ..�.cA ll `-'Qy9IM191NT�0N Conc2te r0 CICIn- BrieniOYx2I=- i0t PL 2.X0-Ib"OL irvB p, -!B do, test 'f •' -� - E r•P v 3c I Ex 'T3 NO DATE REVISION: BY -Th EfT TITLE SECTIONS PRCJ_CT _ T RESIDENCE —14; 50L�H CLD.NEW YCPK CO.PUTER AIDED DESIGN �4c Tesf Boring Na'l ! O Br. Ci yey Loo OLBr. Loomy Clay CL d "moi EXCAVATION INSPECTION REQUIRED �0 s O� 9 Y FOR SANITARY SYSTEM 3.51gr. FGre to e! BY HEALTH OEPARTMEW 3.8' 6r. water Medium Sand 6 SP SURVEY OF Br. Flee to ;' Coarse Send NOTE ANGE(S) LOT 37 13 SW fAyDe pf rvites _ / R u�° 0V eA to "BA Y HA VELA" Pg �"•`•,,` w .� -" / SAX oftA Ifc e F Y� ICe FA•Nr^ s FILED hW 22,1959 FXE NO. ,910 �x = ;.�r " '� 's ti °D`{ AT SOUTHOLD TOWN OF SOUTHOLD q SUFFOLK COUNTY, NY 1000 - 88 - 04 - 14 Scale: 1"= 30' Mar. 20, 1997 k�° :a ��Q"c. f � ``S -fuwE r� 199 devised`• sepfic-� (✓ n teh "S hsr ��' 1 June 3o /9)7( � AJ � t s \ SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES cr ,, 2a PSIMTP FOR APPROVAL OFCODiST):pOp FOR A AMiLY RRSIDENCIt ONLY , NOTE= all MSF SUBSURFACE SEWAGE DISPOSAL DAYS JUL 1998 S (Z 10 - g SYSTEM DESIGN I �GS ro 89 30• °/S� Tes/B,, 3� �V BY, JOSEPH FISCHETTI, P.E. APPROVf,D 7 c� s o W any d� HOBART ROAD ru • P ` SOUTHOLD, N.Y. 11971 FOR OF 3 (516) 765 - 2954 < TMU YEARS FROM DATE OFAPPROVAL A APRroved ih Wbrdance with'a d of ireterminatfon dated 3 14 geview Lu a�3v'/fy o y h ( 0 = Proaase coo- e,pv tiP„ !$!F✓}y llf� FLOOD ZONE, 4 (E �COMMti ZOO PA O� SUBJECT TC COVENIANTS&gi«^TR!^v110Y.S U'.^�. P._. l. _' � —�"AREA = 18,019 sq.ft. ti" i S- 3608!3 0079 a- PAS -- ANY ALTERATION ORF ADDITION O THIS SURVEY IS A N LA LAW ON 1 am fa /Bar with the STANDARDS FOR A ROVrAL The /ocofions of wells and ces ools r a9`g ' OF SECTFOl1 7209 OF THE IOW YORK STATE EDUCATION LAW so Y LIC. N0.' 498/8 EXCEPT AS PER SECTION 7209-SLWIWSION 2. ALL CERTFF/CA�bONS AND CO STRUCTION OF SUBSURFACE SE AGE shown hereon are from fled observations HEREON ARE VALID FOR TICS MAP AAV COPIES THEREOF ONL Y/F D/SPOS SYSTEMS FOR SINGLE FAM/L Y- - SIDENCES and or from data obtained from others. _ WHOSE MGMT�PPEARRS HER O�ssED SEAL OF THE SURVEYOR and will bide by the conditions se/ 1br1h Ther and on /he CO ' P.C.C f5f6I 765 - 5020 ADD/TA NALLY TO COMPLY WITH SAID LAW TH£ TERM ALTERED BY' Permit 4 construct. P. 0. BOX 909 MUST BE USED BY ANY AND ALL SURVEYORS UTILONG A COPY 1 1230 TRAVELER STREET OF ANOTHER SURVEYOR'S MAP. TERNS SUCH AS INSPECTED' AND ELEVATIONS ARE REFERENCED TO hLG.V.O. SOUTHOLD, N,Y. 11971 �OLAO tT-TO-DATE•ARE NOT qJ COWLMNCE WJTH THE LAW. well 97-143 251442 L Q i Test Boring Br. Clayey Loa �Ji� oL \ o \ l hP I Br. Loamy ' Cloy CL o `O� y . S `9 Br. Fine to el 3 S �� 3.8' _ er r 2 �wn S S SS„ Meand 7 SP � 6' 0� .6 SURVEY OF C Coarse LOT 37 13 sw "BA Y HA VEN" �0,x j. FILED JAN. 22,1959 FKE NO. 2910 �G11�p9 '�a ' AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N Y. 1000 - 88- 04 - 14 s4� Scale: Y'= 30' Mar. 20, 1997 N0 ti oa ; Ss JUNE l9, 1.497 ( revised septic J / •h mss. n �� _ JUNE 30, 1997 trellised septic J NOV. /O, 1998 fi cont. foundation O �• a `tea 02' c. % 9p4 2 F o7 ro NOTE= . N, 6 aPt 3S SUBSURFACE SEWAGE DISPOSAL SYSTEM DESIGN 6�493p. J T°SryB \ BY, JOSEPH FISCHETTI, P.E. HOBART ROAD SOUTHOLD, N.Y. 11971 v (516) 765 - 2954 f It 31 Fz� = pr`apose - C'",�Q✓rP I w FLOOD ZONE. 4 t6L. OF NElyy� C- TY- L,Iwo. Mfr2c Y AREA = 18,019 sq. �� 3soBl3 0079 '6,- el. a� D n, ANY ALTERATION ORADDITION THIS S &X IS A V/OLATKNJ U. OF SEc7lON 7209 OF THE NEW YORK STATE TE EDUCATION taw lam /omiNor with the STANDARDS FORA OVAL The locations of wells and cesspools o" EXCEPT AS PER SECTION 7209-S(SD1V/SION 2. ALL CERTFICZ-10N5 AND CONSTRUCTION OF SUBSURFACE 5 WAGE shown hereon are from /te/d observations ,9e� 1C. NO. 496/8 HEREON ARE VALID FOR R T MAP AND COPES THE ONLY lF DISPOSAL SYSTEMS FOR SINGLE FAMILY RE&Ii3mCES and or from data obtained from others. ECONI B48 C. SAID MAP OR COPES BEAR THE IMPRESSED SEAL OF THE SURVEYOR WHOSE SIGNATURE APPEARS HEREOM and will abide by the conditions set forth thereln and, on the (5161 765 - ADDIT/014ALLY TO COMPLY WITH SAID LAW THE TERM ALTERED BY' Permit to construct. I P. 0. BOX 909 MUST BE USED BY ANY AND ALL SURVEYORS UTXIZM A COPY 1 OF ANOTHER SURVEYORS MAP. TERMS SUCH AS INSPECTED'AND 1230 TRAVELER STREET NOT W COAPL44NCE WITH THE LAW. ELEVATIONS ARE REFERENCED TO NL,, 1230 TRA N.Y. /1971 BROUGHT-TO-DATE'ARf G.V.D. well c.a /sem t ' 97-143 cQ SCDHS Rel. # RIO - 97- 0065 Test Boring - L Q44a fit' f,Icp� ;Jf �, t'i J�v£Si!rE}':'y� g'`••� e' O B!. OLa y.By LOO \ \ �'PJ k i,:.:.;,:. .....M...«........�.......w•.,. +..,-:.,,+... Br. Loamy . Clay CL ,9 Br. Fine to el `�'�. --'--�-» - - -- - /4 3.8' -Gr. Water Z a Mediam Sand SP (00, SURVEY OF co �eesond LOT 37 13' SW "BA Y HA VEN" p9 <'Otea` F2ED JAN. 22,1959 FILE NO. 2910 AT SOUTHOLD '00, ; TOWN OF SOUTHOLD � � o / SUFFOLK COUNTY, N. Y. - 00 - 88 - 04 - 14 Y 10/ Scale: 1" = 30' o Mar. 20, 1997 0% A s JUNE l9; 1997 ( revised septic J i JUNE .30, 1997 (revised septic 1 41 zio. l°- � o NOV. iO 1 a 3�^s�g3.5sP j 9- 1• , 998 P cont. foundation 1 �• ���a A �ti '; Mar. 11 1999 (final) SUFFOLK CCtDt�tY D�s4R3swa'r�+i1°t37 !.pt'4�� i,'Y;�F,� E=/ NOTA Si�VAVpr 53D €:C ,y I I `� as ���' SUBSURFACE SEWAGE DISPOSAL ES q9 �I V SYSTEM DESIGN lSata Fss.taz Yao.l 6- L �Q �S V r BY: JOSEPH FISCHETTI, P.E. s o 3O./Y / ��/ .\ +11 J HOBART ROAD The a d' t�d weir su , . • . .. , SOUTHOLD, N.Y. 1197/ �FY a zaf�3se� t.:a_« ac„x•.tss?12"beep 0 icsp€eted thtctlae Pied 6v t3a sGx c nt or er r xe:s =r a f=na to 1516! 765 - 2954 fsesa feYez�PD op £sem.Ak .3r a ��. Qr� zs, / 5 Q�Q' }' R,. �313t�oi5VatcrsrrhPf> tecvar z£&nsgr . .�iry4�if 7$ ' PrOPOSe� ru,q ean/!' /Vu� FLOOCOMMU,ZONE �4 P o_h� .. 8)360813 0079 6PMVE11AREA = 18,019 sq.tt. ti� a , MFr��o� ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION ' g I am familiar with the STANDARDS FOR APPf�9VA.- The locations of wells and cesspools s OF SECTION PER C THE NEW YORK STATE EALL TION WRTLAW 1/CM�n•. 'If EXCEPT AS PER SECTION 7209-SL/BD/V/SION 2. ALL CERT/F/CA�TYONS AND CONSTRUCTION OF SUBSURFACE SEWA,-E� shown hereon are from /le/d observa/io � GO �1F19aR15g HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF DISPOSAL SYSTEMS FOR SINGLE FAMILY,Rf^fDEN ES and or from data ob/alned from others. - P n ro on SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR - -0 - , RVE, WHOSE SIGNATURE APPEARS H REOM and will abide by the conditions set forth therein artd o.-Y the ADDITIONALLY TO COMPLY WITH SAD LAW THE TERM ALTERED BY' Permit to construct. 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