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HomeMy WebLinkAbout22705-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24357 Date MAY 13, 1996 THIS CERTIFIES that the building ACCESSORY Location of Property EAST END ROAD FISHERS ISLAND, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 3 Block 2 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 5, 1995 pursuant to which Building Permit No. 22705-Z dated APRIL 27, 1995 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 ACCESSORY NON-HABITABLE POOL HOUSE AS APPLIED FOR. The certificate is issued to PETER & SUSAN CHAPMAN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R-10-94-0120-MARCH 6, 1996 UNDERWRITERS CERTIFICATE NO.-N-365090 & N-365091-OCTOBER 2, 1995 PLUMBERS CERTIFICATION DATED MAY 8, 1996-MARIO ZANGHETTI, JR. L < -E P6 n Inspector Rev. 1/81 COP FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMU MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date... . .7 19..7.. / N 22705 Z Permission Is hereby granted to: 4~ ? W~ ~..........~.1+~1 ....:........a.. ~9a 6 . at premises located at....... . -10 U`• rri..... County Tax Map No. 1000 Section -a......... Block Lot No. .......5 pursuant to application dated 19.1!'~s~...., and approved by the Building Inspector. Oz7 Fee $...3~~~ S e~= ilding I Bunspector Rev. 6/30/80 ' Form No. 6 TOWN OF SOUTHOLD p k LS `r BUILDING DEPARTMENT ~"Me TOWN HALL A~OV 6 !995 ~ ' M-1802 81 _ APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. 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. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. '2.' Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .1i/2/95 . ~ Construction....3%..... Old Or Pre-existing Building ation of Property.. East en . d road House No Street Hamlet er or owners of Property... Peter & Susan Chapman . my Tax Map No 1000, Section.... 3........ Block.. Lot...s.................. division ....................................Filed Map............Lot.. . mit No.? ........Date Of Permit..4;?~~95......Applicant.Z&S, Contracting Inc Ith Dept. Approval.- .......................Underwriters Approval...... „ „ nning Board Approval uest for: Temporary Certificate........... Final Certicate...1{....... Submitted: ..........Pres........ APPLICANT co ~ ~N3 5 17 ly;;S,`ECON' JJDA7E COMi1ENr ~s 1' ° I m,~ a O FOUNDATION (13t) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING H 3. x INSULATION PER N. Y. 1.r STATE ENERGY y.~ CODE a~ 4. FINAL 2 ADDITIONAL COMMENTS: m x m ' x H (~1 9 O m ,I m y o~OgOFFO(,~cQ o~ Gym H a Town Hall, 53095 Main Road p • Fax (516) 765-1823 P. 0. Box 91971 Telephone (516) 765-1802 Southold, NewYork 1 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD December 4, 1995 Mr. Charles Brigham Board of Health Dept. Riverhead County Center Room #N204 (North Wing) Riverhead, N.Y. 11901 Re: CHAPMAN HOUSE & CHAPMAN POOL HOUSE Suff. Co. Tax Map #1000-3-2-8 H.S. Ref. No. R10-94-0036 & R10-94-0120 Dear Charlie: Please expedite this application for a final board of health approval as soon as possible. If there are any problems, please contact me at once. Please send final approvals to this office. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Thomas J. Fisher, Sr. Building Inspector TJF:gar encls. 1 i TEL. 765-1802 FOLk~oG TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR' o ; P.O. BOX 728 u' TOWN HALL SOUTHOLD, N.Y. 11971 1 C E R T I F'I C A'T I.O N Date May 8, L996 Building Permit No. 227052 (pool house) Owner Mr. Peter Chapman (please print) Plumber Mario Zanahetti Jr. (please print) I certify that the solder.used in the water supply system contains less than 2/10 of lead. „ (plumb 's ignature) Swar to before p}e this day o f /~G)ivJ 19 Notary Public Notary Public County, Cpl®M~R A~w~ww+ a~i. 'wotary public Staia of Ngw York Na, ABOS550 ()ual,1160 In iros 12,3 our)ty Term Ezp COUNTY OF SUFFOLK ®R"we") ROBERT J. GAFFNEY SUFFOLK COUNTY EXECUTIVE DEPARTMENT OF HEALTH SERVICES MARY E. HIBBERO, M.D., M.P.H. COMMISSIONER JPER.MIT THE ATTACHED PLAN, WHEN DULY SIGNED BY A REPRESENTATIVE OF THE DEPARTMENT, CONSTITUTES A PERMIT TO CONSTRUCT A WATER SUPPLY AND/OR A SEWAGE DISPOSAL SYSTEM FOR THE PROPERTY AS DEPICTED. CONSTRUCTION MUSTm(~ONFORM WITH APPLICABLE STANDARDS INCLUDING THE STANDARDS FOR CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES AND STANDARDS AND PROCEDURES FOR PRIVATE WATER SYSTEMS. THE PERMIT (PLAN) EXPIRES THREE (3) YEARS AFTER THE APPROVAL DATE. ANY MODIFICATIONS WHICH MAY AFFECT THE PROPOSED SEWAGE DISPOSAL SYSTEM OR WATER SUPPLY REQUIRE SUBMISSION OF A REVISED PLAN AND ANY ADDITIONAL FEES, PRIOR TO CONSTRUCTION. NO INSPECTIONS WILL BE PERFORMED BY THE DEPARTMENT ON EXPIRED PERMITS. PERMITS MAY BE REISSUED UPON THE SUBMISSION OF NECESSARY APPLICATIONS, PLANS AND FEES, AND WILL BE REQUIRED TO MEET THE STANDARDS IN EFFECT AT THE TIME OF REISSUANCE. A PERMIT MAY BE TRANSFERRED INTO ANOTHER PARTY'S NAME UPON RECEIPT OF WRITTEN PERMISSION FROM THE ORIGINAL APPLICANT AND THE RECEIPT OF ANY REQUIRED TRANSFER FEES. IN THIS CASE, THE PARTY PAYING THE ORIGINAL APPLICATION FEE WILL BE CONSIDERED TO BE THE ORIGINAL APPLICANT. L~ "C`d,iE IN 91 ;,._...,a:. WWM-05 8 T` PAGE 1 OF 2 DIVISION OF ENVIRONMENTAL QUALITY COUNTY CENTER RIVERHEAD. N.Y 11901-3397 852-2100 18-380..12/92 INSTRUCTIONS FOR FINAL APPROVAL OF CONSTRUCTED SYSTEMS It is the applicant's responsibility to call the Department to arrange inspections of the sewage disposal system and water supply facilities prior to backfilling. These include inspections of the soil excavation for the sewage disposal system and inspections of the water supply well, well lateral, public water supply line, disposal system, piping and final grading. Other inspections may be required. Following satisfactory construction and inspections: L The applicant must submit 4 prints of an as-built plan (up to and including 11 "x17"), by a licensed design professional, of the subject property showing the following: a. the lot location and dimensions; b. the lot number(s) and the none of the subdivision, if applicable; c. permanent structures (i.e., buildings, driveways, walkways, swimming pools, decks, etc.); d. the exact location of the private well, if applicable (give at least 2 dimensions measured from the corners of the building); e. the exact location of the public water line, if applicable; f. the exact location of the septic tank and leaching pool(s), if applicablf. Give 2 dimensions from the building corners to the covers of the septic tank and each leaching pool; g. the exact location of the sewer line from the dwelling to the street; if applicable; and h. have a clear area at least 3"x5" for the Department's approval stamp. 2. The applicant must submit a certificate from the sewage disposal installer attesting that the system has been installed according to the criteria of the Suffolk County Department of Health Services, when applicable. 3. If a well has been installed as';:the potable water supply, the applicant must submit a current well water analysis (within one year) and a well driller's certificate. If the well or water quality does not conform to standards, proof of corrective measures will be required. Refer to "Standards and Procedures for Private Water Systems." 4. In those cases where public sewers are utilized for the dwelling, the applicant is also to submit one (1) copy of the sewer line inspection approval from the public sewer district. In districts operated by Suffolk County, two (2) copies of Form S-9, duly executed by the Suffolk County Department of Public Works, are required. 5. In those cases in which the installation and connection of the public water service line has not been inspected by the Department of Health Services, a tap letter from the appropriate water company is required. HEALTH DEPARTMENT REFERENCE NUMBER MUST BE ON ALL CORRESPONDENCE OR DOCUMENTS SUBMITTED. ~I SUBMIT ALV NECESSARY FINAL PAPERS AT THE SAME TIME. PHOTOCOPIES OF DOCUMENTS WILL NOT BE ACCEPTED. WWM-058 PAGE 2 OF 2 18-380..1 2/92 ,',,•I\IIIOI41,11j e 147 n~nn . I ~lr fGf i o ~ii,~ YOgK + I z ~ ~ I I ryOull ISO N b I I ~ I ~ ~ I i i p ~ I ~ I y I I ~ s ~ I I ~ I E A i I II I l i l I ( < I I i 00 no tA %A tAH y •-z~ ICI t4 !It $$s p~ ZED 12`-`fu o00 n ny Coo ~ ~ •'~nM~sti F~.- @N O OnC C TA I ~'v ~ o I ~ p rr C 'i'~ n Q ry ut 'A 8$° r~ x / •\•\\\\11111111111•, ~ , m i.. ZS v' o• 1 ••01 ~1\IIt TO ITI I I I 11. 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G (aD 8 51 H Q 0 H w m 0 r rGr rt CD '.0 (D z to H E H ~ to a P. 0 w a ~ o Y• z 0 0 tv rq p H co a w x r w n,a 19 p a m O o a Y• p Y• g Y- E ro O G H. 0 W E O (D (D M CO 0 W H 0 w w O rt O R w ct O a 4 r P x" H w a W W m r r 0 Y• O P. W 0 1 z rt N O N O 0 O O m G pr r W 0 w 'd ct (D (D p X m co m 0 rb N O r rt F,. w p, a 0 1y m m ct m ro p (D 0 rc 0 N H 0 c ro fr a' m m Y• m En F-• H O M H Y- Y• w 1.,. Y- -0 0 O (D r d 4 w 0 W (D co H. ID p . fr 0 w p ro 0 0 P. rt O 0 W H p m H (D a W O ID W 14 m 4 m 0 v rr rr Y• ct H w (n i4 0 ¢ d ~ w b w O G r p p M a W o W a m Y• C w m rr 0 m m I H H co P. O N 4(D W O H qa m M C p W H hl m rr Y• G 0 p N W r O ro m m r a H P. fr H 1 rt Y• H O w O W 0 £ rt C m P. m O m W 0 r H H m w co r m rt H a Y• P. I w w 14 H 0 W rr r X M r E w co O O O rr ti W Y• W M O z w w p G 0 O p (r w P. P- 0 O r W M m M O m r ro ro G w 0 O W W P. O I a o a I rt cr m a co m a o 0 o m G I H (4 Y• N W lQ ro P W E x m cr rr m rt 0 O p r G ~ • P- H 0 r m o a (t d cr 0 m ro m x w w o r m m H a a -`6 'sum THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 r1000856 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date OCTOBER 02,1995 Application No. on file 88049495195 N 365090 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the abbe application number in the premises of PETER CHAPMAN, EAST END OF ISLAND, FISHERS ISLAND, N.Y. in thefollowing location; ? Basement ® Ist Fl. ? 2nd Fl. OUT Section Block Lot was examined on SEPTEMBER 26,1995 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLE$ SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K. W. AMT K W. AMT. KW. AMT K.W AMT. H. P. 10 7 6 10 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS MAT. K. W. Olt H. P. GAS H. P. AMI. NO. A. W. G AMT AMP AMT. AMPS TRANS. AMT H. p SYSTEMS AMT WATTS OF FEET 2 SERVICE DISCONNECT NO.OF S E R V I C E AMT. AMP. TYPE METER I 1 A. 3W J 9 3W 3,e' lW NO. OF CC COND A. W. GNO OF EOUIP. HbIFG OFA.HbLEO G. NO. Of NEUTRALS A. W G. PER .9' f CC. COND. OF NEUfRAI 1 150 CB 1 x 1 a./0 1 1/0 OTHER APPARATUS: ELEC. WATER HEATERStil-4.5 K.W. G.F.C.Ir-5 Z & S CONTRS. INC. LIC.#924-E P.O. BOX 202 FISHERS ISLAND, NY, 06390 GENERAL MANAGER 11 Per ertificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. ® PY FOR BUILDING DEPARTMENT THISCOPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS PACE 1 x1000656 BUREAU OF ELECTRICITY 83 JOHN STREET. NEW YORK. NEW YORK 10038 Date OCTOBER 07. ,1995 Application No. on file 87100495/95 N 3650791 THIS CERTIFIES THAT only the electrical equipment as described belour and introduced by the applicant named on the above application number in the premises of PETER & SUSAN CHAPMAN, EAST AND PRIVATE ROAD, FISHERS ISLAND, N.Y. in the following location; It Basement ® 1st FL ® 2nd FT. Section Block Lot tvas examined on SEPTEMBER 27,1995 and found to be in compliance with the National Electrical Code. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K. W. AMT K. W. AMT. K W. AMT. K W. AMT. H P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIALREC'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 NOSYOFSTEMSFEET AMT. WATTS . SERVICE DISCONNECT NO* OF 5 E R V I C E METER NO. OF CCOND A. W. O A. W G. A. W G. AMT. AMp. TYPE EQUIP 102W t%3W 303W 304W PER! ' OF CC.COND ~'~HIIEG OF HbLEG NO. OF NENRAIS OF NEUTRAL OTHER APPARATUS: ALARM BOX PANEL-1 SIRENS-1 SMOKE DETECTOR t-5 Z & S CONTRS. INC. LIC.#924-E P.O. BOX 202 FISHERS ISLAND, NY, 06390 GENERAL MANAGER Per 11 Y_ 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. BOARD OF HEALTH FORM N » 1`jp15 O.1 3 SETS OF PLANS JAN i TOWN OFSOUTHOLD SURVEY l~I~! BUILDING DEPARTMENT CHECK _ ~r i V 5t0U N HALL SEPTIC PORPI lki," f` SOUTHOLD, N.Y. 11971 ~_.....-.NTOW' OF TIW-1, TEL.: 765-1802 t:OTIFY CALL a . Examined .7...7.w.,.w.... 19v ry HAIL TO: ~ Approved 199t5. Permit No. . . Disapproved, a/c r (B r din n ector) APPLICATION FOR BUILDING PERMIT Date 11-5 19f. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public sheets or areas, and giving a detailed description of layout of property must be drawn 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 permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. >LS...~it+ocd[c. (Signature of applicant, name, if a corporation) (Mailing address of applicant) State wl?etlier applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (J•fe'°"S e 'aw "rte[-; . Name of owner of premises SsG?. • • . . . . . . . . . (as~tax roll or latest deed) If applica t is a cor oration, signature of duly authorized officer. (Na and title of corporate officer) Builder's License No. f3. aS!a NS Plumber's License No. ...Spy- Electrician's License No. 9.~?y Other Trade's License No. 1, Location of land on which proposed work will be done. I-louse Number Street Hamlet County Tax Map No. 1000 Section 3.......... Block 07 Lot F . Subdivision Filed Map No.' , , Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction`. a. Existing use and occupancy , , , , , , --45 b. Intended use and occupancy ...'Synf// pr 3. Repair ature of work (check which applicable): New Building Addition Altiiiation , . Removal . . Demolition 14Other Work,.,wl.ibt<ryeFr 4. Estimated Cost (Description) c Fee rSi!>D . wellin (to be paid on filing this application) 5. If dwelling, number of dwelling!: B, nu gi units . Number of dwelling units on each floor garage, number of cars . 6. If business, commercial or mixed occupancy, specify nature and extent of•each type of use . 7. Dimensions of existing structures, if any: Front , , , , ' Rear . . Depth . . [[eight Number of Stories Depth dditions: Front . . Rear . Dimensiams of slime structure w ith Height alterations or a... . . Number of Stories , , 8. Dimensions of entire new construction: Front , • , ' ' ' ' ' ' ' ' ' [[eight Rear . . Depth r • • • • • • • . Nutlber of Stories . 9. Size of lot: Front Rear . . . ...Depth , . , , , . 10. Date of Purchase . , . . . . . . Name of Former Owner , . 1. Zone or use district istrict in which construction •premises viol ate any are situzoningated 12. Does proposed law, ordinance or regulation: 13. Will lot be regraded 14. Name of Owner of premises , • . ' ' ' ' ' ' • • • • Will excess fill be removed from premises: Yes No Address Phone No. . Name of Architect . Address Phone No.............. . Name of Contractor,,,,,,,,, 3,Address.................. . Phone No. 15. Is this property within Yes........ No.. 00 feet of a tidal wetland? ~ *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all (buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. 1 r STATE OF NEW YORK, COUNTY OF S1S • • • • • • • • , • . being duly sworn, deposes and says that fie is the applicant (Namedividual signing contract) above named. / fie is the . . (?enCu~ct....... . (Contractor, agent, corporate officer, etc.) of said owner or owners, and A duly outhorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner et forth in the application filed therewith. Sworn to bef re a this r- .......J............ day of 19.j Votary Public, . . County / , •C~~ THdhtAA•K; At1w@w •ammt~ • • 62~ . . N4161ryt70118 41g1o of New (Signature YorNo. 4000600 of applicant) QuflllileM In Rnllolk Cnuniy z OGo ®--i ei 7~ pp by r-i N V1 N O cC m in -ot CCia °'c p ti ~v U w wog "ao Ooc I ~ 0 i ' I Al' xG `NTEgeee°a ~y % p F~ `:ya 3 ~ X 1~ SO o~ ~J I I ~ • O Q I I `r~ ' _ ' I I Ise•rrrrlroUl t ~ ao-;mot I I ~ ~i n! 4i p ~ I ~ y ~ I! i j r3 _ I X d 0 (n - LJ 7v I I I I r "tL ' I fill o N I I ~ Imo- a 10 Q. 5"T SZ Z! A C a a Yrt tt b' r""4 A A.° )69 u W W CC w C 4 f a` kv_ F,y s J S9y:I V X. N Jr .3 us» .k? gdd zO n® °p a as N U Lr, k' (J W J ry ti d = - s3 ~`3 tn. U 8r ' ~1 r ~.3 f.b y~~ O {.b 5 V W cue, La, r1 0 Ljj t4 to ~j p1 d F 4t a a t y x b' + W G6 V~ pC ',~GW <`'Q~ A o 7 r *!31 ) Jug 17,Ya. 0. 1 c Gh. to of p v s a) a a U¢. kLj Z COI ~y! Y 4+ F 0 ~I 9t R F h ~Dd Z E Q a( E.. wJ G Y/ C' O p CL k:a..r 1Fy-~C i t t f, r eS " 2. 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Q O r fC - t~ I~Ir o. 3J. . x,777 do ~ \ \Wk. \ V M ~•6 r' 11 a ~ , V V ^ t o ~ p ~ t, t pia ~ ~ -3 / t i ~ iz '°I" .....~...y\ r r...qw«. ....,i. r n..o-. of '-:sfP^. t,l - J,v v., f WJ. 'i~,pv I i ~ i ti Tn^ t F 1 a 5>m' o y tip.: r 1 a i r I v t 1 f, qr' nF~ 0O© a Q 1N ~'.1 • v~ a o j V o aoooo •,~I Si-oGl-. I--? Lc 19 Lo r9 je. 51ti1(ol..E FA.MII.Y F Fa.MII..Y 2E51DEIJ C~ ' ' OU ~ ~ i k14Tel~. PfGOJIOEh F3 2oJIOEh p.31' NILU.JIG.IF36,L - 1 I SYSTl=M SI llcr! .00 'No' jA`Ibfyd,.! rMOO gym. LOCATION :400 22e " 0 wo 1 41 ~G y A~ o GRAPHIC 5OALE IN,,FET' 'QCi1CH MACK TOP - IW aNUm F,AlT EL.EVZY.o4 \\o % 'TKSr ~r _ I. . I ~ I NOTES:'` 1. COORDINATE DISTANCES ARE MEASURED FROM U.S. COAST AND GEODETIC SURVEY- TRIANGULATION i STATION "CHOCOMOUNT 2" aryl _ 4 24 2. SITE IS IN THE TOWN OF SOUTHOLD, COUNTY OF A6 M~ IYrn ,yl ' I Y rnr+~v. S OFF,QkK,,,TAX' MAP 1000, SECTION 003, BLOCK 2, „ LOT 5. yl: 1 \ l F 42 i 3. STE,IS TO BE SERVICW BY ~ MUNICIPAL WATER . ~ ' ANp+' QM' SITE SEWv 0tf D}$POsA( SYSTEM IN ~I I COM~'~.IAN E WIT, l THE $fANp'ARQS. AND REQUIREIMENTS'OF THE SUEFOLk COUNTY' r -..:f ~ PfIG ATE r J,g LOGATC}J DEPARTMENT OF H5AI-JH . 4. SITE IS IN R-laQ ?ONE E~~ &'N R III'Mrs,,P4tt r Chaprn4n., #'6 4~fIIG'w FCOaq'. I'v 7 6 OS7 6. TOTAL AREA: 4,9' AQRE$ - ell, k]ELL- (a3.o lnl.0"~ t J ILY.V'h~l.) Ll f{.S$:'e't1G.4i{ t", PPY u n 1- 7+:~.~~,'~S5~t11 t °u..a ruk p ! { tai , / \ c aw roe LA 'TLO CTitiLIK) leo.b' i t't9'~ ~ {ufi'v ' is 1z3 Vii. 1. 9.n:a h - LFA',1'. ?nl:?i {4`p/S .CljeNe{~:':$ ] ' ati~d f 1 ~4.. ~ T O, ir{~e u7:9R Fn'i. S.n Q .r r r 1 wewwaroffr . Z7." r' 15n."V-.ur awmeu~~~ i aster d I ~.rct~-aE. '~YPIV. OF NCI4 ~ t''N ~!47hq~~i 'k• n S 7q o`er„ \ 3 F 414L7g 4=/$°9810^ F ~ WJO x1605 5.~9LCn0 ~p L-109.54 1-7 kl z:S~14. 15 Oi~ _Ilr\//l 40- so . a. . 40 GRAPNIC sLAU51, W'}'EV All L,q v~Siar~s 'REVISIONS i SiUGL ~ FAMILY Alc~ DATE DtkD ],?Tlt DESCRipTION +yd 9d.10~.95' F<i~ any Ya,Fe SY-~~E ~N(L?E~ ~ESfO~ M Prr MW icf~F-. LIU~Ia3LtY~1Gi L~1'1{+1"f'IBYa R3 .F')t'. Fig^^+TrogA1_ J r SCA4E: 1" - 40' , r k x 44% 8'-6" KNOCKOUT INLET AND OUTLET OPENINGS _ RIBS INSIDE + + 'U :r 0 000 ~O 00000 JLTJ O c? 1'OI Lo r CAST U~ - (~4'~ 51tilErL.~ Fr4.MILY 1 Fr4.MILY 1irE51T„~EIJCE - CONCRETE COVERS 0©00d, ~v0 ~ i kJATgiZ pR,oVIGE4 fl 'R.oVlcmlzp E'~ Mur.dtu EL& SYS'Tr=M ®1 ® 1 4 x 4 12.6/12.6 GA. WIRE MESH 8 x 6 6/6 GA. WIRE MESH 17 1/2• 4" . ~ ICaIa.,Gly' -C INLET 3• VENT~3• VENT OUTLET LIQUID 'LEVEL r CORPNUUUs HOT t'4 OURET O~ or" ap ASPHALT SEAL BAFFLE WTH NIDP4C MRNi~ONa a SCHEDULE ,#40 /4" PVC INLET BAFFLE eP' OAS j. DEFLECT06 4• •5'-8" I I LOCATION tl~AF ROSS SECTION ' 4 R4C a zoo t^ GRAPMIC SCALE IN 'FEET ;Ooh QN Mo1JU1GF-A1T F=L=v. za.o4 $~'P`hG TANK \yR NqT TO SCALE ~~`J"/R ~4a ' O'1LSr I ` . o "v v o ovvo a q~ntT~... o 0 o v v 4" DIAL KNOCKOUTS ' / PZ ¢.al. b v v o v c v v d I , ~ ~ ~ e v vv o e o v v - ,t-\ ~ ~ e o0o vvu - NOTFS- ' v v v o 0 o v v 1. COORDINATE DISTANCES ARE MEASURED FROM 8'-0* DIA U.S. COAST AND GEODETIC SURVEY 'TRIANGULARON STATON "CHOCOMO,UNT 2" MMPOOL 2. SITE IS 'I& THE TOWN OF SOUTHOLD,' COUNTY OF - W ~ F SzR gg SEGTfON SUFFOLK, TAX MAP 1000, SECTION`603,'BLOCK.2, O-etc; NOT TO SCALE l LOT 8 Xg~ I PROYOR CONGReTE CHIMNEY 3. SITE. IS TO BE SERVICED BY MUNICIPAL WATER f AIND"COAR To 1' PRoM 1cINISHM OR,AZt. AND ON SITE SEWAGE' DISPOSAL ',SY$TEM' I'N COMPLIANCE WITH THE STANDARDS AND' REQUIREMENTS OFITHE SUFFOLK' COUNTY 1?T~I~~ p i DEPARTMENT OF; HEALTH 4. SITE IS IN R 120 ZONE 5, OWNER: Mr k Mrs. Peter Chopmah ~a o-~ C TE5T HOLE DATA (CHANDLF-R, PALMER s IN6) Iq$q 641116w Ro}ttl E'> w s, q$q RNeroide. GT 06878 jd F~'" C9mm Gl O" - b TOP50IL 8. TOTAL AREA: 4.9 ACRES ffq`/fp b" - 24" 51156011- (BANDY) m rr 24" - 15' PINE SAND J NO WATER, NO MOTTLING G<q~ s rsTE - / SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES L N"~ II FOR APPROVAL OF CONSTRUCTION OF S p C of n[W yopy \ SINGLE~FpApM~ILY RESIDENCE ONLY pPO . s a ~ VN1, I DATE DEC 2 0 Wi HS REIr, 0. -9 ai~o R, E APPROV ! ~ c y f c p_ ap~ EXPIRES THREE YEARS FROM DATE 0 APPROVAL ~f F" `R 9fFO S~ lion„"\~ nq i 4 SITE PLAN! POOR P06L' Pl,kmlT / ~ C.^ 141.9<y Iti °g Lc109. ~ .'W! 'S 5~11,CnO W 2.!.')4.15 I 40 24 0 40 4^mly %ALE'1 'IN FfE7 ~ '~Q~ FISH"* I$LANP,.k F,'lt~lRi!K REVISIONS' )NS' 5J4 EMP~~~Eb I am familiar with the standards for approval and DATE DESCRIP1I'0N C7M A.N'CF'LI¢lir. F?'.~iLMER Ae.1C7M Si SC~IF T'ON AYr McxIIGI,~_ \ construction of subsurface sewage disposal systems for single family residence and will abide by the Archlt.ctura ~~dqI WjA~ and Su"onq 1La MMOMj1'YM1111MpR Ab''7~? ~ptry.~.~4=tYf1111-t.o1 conditions set fbrth therein and on the permit to - construct, APPLICANT--- DATE cVwm5ia= 8.1^+'14 c 8.1'+'14 SCALT: Y" = 4 SHEE 1 OF 1