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HomeMy WebLinkAbout23000-z 4 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 8-24561 Date AUGUST 8, 1996 THIS CERTIFIES that the building NEW DWELLING Location of Property 1720 INDIAN NECK LANE PECONIC, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 86 Block 4 Lot 6.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 30, 1995 pursuant to which Building Permit No. 23000-Z dated SEPTEMBER 7, 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 ie ONE FAMILY DWELLING WITH ATTACHED GARAGE & REAR DECK AS APPLIED FOR. The certificate is issued to RONALD & ELIZABETH HITZLER (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-94-0110-AUG. 7, 1996 UNDERWRITERS CERTIFICATE NO. N-391054 - JULY 12, 1996 PLUMBERS CERTIFICATION DATED AUGUST 8, 1996-MIKE JACOBI PLUMB. & HEAT. din6 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) Date.......................f. ......................, 19..f...�.. NG 23000 Z Permission Is hereby granted to: .... .. �s....................................... ........11 .;71...................... J S„i to . ... .... i/�u.G/.............. ........ .... ........ ..... ���. .. � ..'f. �1m........ rr ... ..... 7 :4 ........../.....©.... -c......:� / .... �f��........ 2............ �................................................................................................... .................................................................................................................................................................. ..................................................................... _....................................................................... �'E ..... ./. ............................. at premises located at............�zz ��...✓✓'" ........................... .E ��1.rli County Tax Map No. 1000 Section ....&0........... Block......�(�........ Lot No. ...,fP. ............. pursuant to application dated ....,. �lll�f�.�.... 1 ' ...... 19...l`S and approved by the Building Inspector. Fee$....... . ............... .. ✓..•:✓•....................................... Building Inspector Rev. 6/30/80 C-Az Form No. 6 ING TOWN OF SOUTHOLD J ' C 0 Yoe? �t)� G IIUILDTOWN DHALLTMENT 765-1802 N r G � 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 iustall.ation from Board o£ 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. 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 unusualnatural 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. 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 Building - $100.00 3. Copy of Certificate of Occupancy - .250 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential J$15. 0, Commercial $15.00 Date . .U.! .� . �. . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . �7 Location of Property. . . . . . . . . . . . ..� �f.. . . .ING�/C . . . G�}�(/G" . . . . . ezLC- 6N i . . . . . . . . . . House No. Street Hamlet Onwer or Owners of. Property. p�pCu/ ��. .t.`.�'Gf /N / TZ LEn County Tax Map No 1000, Section. . . ©.Q.� . . . .Block. . . . . . . G` }q7. . . . .Lot. . .(`. -2, . . . . . . . . . . . . . 12 Subdivision. . . . . . . . . d .1 . . . . . . . . . . . . . . . . .Filed Map. .�4 / . .Lot. . . � �(nn q (� � . . . . . . . . . . . . . . . . aitzpInej Permit No. Qk?��. 2 . . .Date Of Permit. . .! 1?A! . . . .Applicant. ./. .��t.EuG�'�. . .�. . . . . . HealthDept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . v , . • ' . Fee Submitted: $. . S . - . . . . . . . . . . . . . . . q,Ao St�Sb rirG %�i�. .� . . . . . . . . . . . . . . . . . . . . . . C0-E c2LISG! APPLICANT TEL. 765-1802 �oc�vFFQLt LOIS, TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR G +r P.O. BOX 728 7 Y TOWN HALL I SOUTHOLD, N.Y. 11971 BLDG.Dear. TOWN OF SOUTHOLD C E R T I F I C A T I O N Date Building Permit No 2 O 0Cj :2, O is 6 u r Owners LL1 Zvi r5 (please print) M6 Plumber— FO1K TOWN OSTFOLD (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. p� l (plumbs s signature) Sw n to before .c this gz�kday of 19 �� C / Notary Publi tlotary Public , ({ ! County CLAIRE LGLEW Notary public,State of New York No.4879505 Qualified in Suffolk Courtly Commission Expires December 79—� i=CII THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1000484 BUREAU OF ELECTRICITY F Iliad; i'1^'t6rC. 85 JOHN STREET, NEW YORK, NY 10038 SLILY 12 Date ,1996 Application No.ojlJf1, 10852695/95 N 391054it _THIS CERTIFIES THAT =,onl the electrical equipment as descn:bed below and introduced b the y eq p y applicant named on the above application number in[he premIt TORKELSON BUILDERS, 1720 INDIAN NECK RD. , PECONIC, N.Y. Illlillr ip ul .ia theJotio¢in/T location; 08oaen[ent ® fat Fl. ® 2nd Fi. GAR/ATTIC/OUT Seetiun26 BlocA4 Lut 6.21._.yf= 1996 and '. was examined on JULY 09 t found to be frt compliance with Me Nakano!Electrical Code. -,�E�r. --+�'FIXWRE FIXTURES i RANGES lCOOKING DECKS I OVENS DISH WASHERS EXHAUSV TANS 7-OUTLETS KOTACLES SWITCHES 1NU msctM FLCE UORESNT OTHER AMT. K.W. MT. K.W. 'AWT, K.W. AMT. N.W. AMi �' ;i. III:H PAIn „i.40 53 47 40 1 1.2 3 I{ 1—_ 11i DRYERS -:"FURNACE MOTORS - FUTURE APPLIANCE FEEDERS SPECIAL RIC'PVj TIME CLOCKS EEU I UNIT HEATERS MULTI-OUTLET L DIMAIERfIIf SYSTEMS AMT. K.W. OR-; KP. GAS H.P. ' AMT. NO. A.W.O. AMT.' AMP.' "T.' AMPS. TRANS. -AMT, H.P. NO.OF FEET ' it 'I1 30 l .- !<r;SERVICE DISCONNECT NO.OF - SE R V - -1 C E ` j AMI. AAV. TTTF jQUD. 1A2W 1,r3W 3X3W 3,i AW NO.OPR/GONG. fA.W.OND, NO.OfIibLEG A'MI:lEO �.OfNEUiRA15 A u�iIAm=I 1 200 I CB 1 % 1 2/0 1 2/0 -_I,:!I OTHER APPARATUS: WELL PUMP-1 MOTORS[1—F H.P. G.F.C.It-5 SMOKE DETECTOR:-2 RICHARD KLEINFELDT LIC.#665EE '�ws..w—. l_. r�L 114 CARLTON AVE ISLIP TERR. , NY, 11752-2904 GENERAL MANAGER 515 Per r . 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. rili�,D�iN*PrcCroN Rrrv,tT UA VF Cor1ims 170 INDA_I'rON ( IS_r) FDMNDATIUN (ZED) _____ n _ ` >T------- ------ - - ->- ---- <- -- ---------- --.. - -- --- IMUCH FRAM f, Al 4W -=------- ------------ ------- _ ------------- ----_--- -_-_-- - I NSMI,AT rON PER N. 7 . STATE ENERGY '--- CODA n r• rNAi, ADUI NAr. CONHINTS: M H �i O 7, _---------- ------- ._-__-__..____.�_. a r trt TEL.765-1802 TOWN OF SOUTHOILD f :'c OFFICE OF BUILDING INSPECTOR L — P.O. BOX 728 u' may' TOWN HALL i 0 Nr 1� SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N Date zC? Building Permit No. � SC50 d'Z-- Owner !/y( r �' MVS 14 1 � S jv (- (please print) r Plumber (please pr)-nt) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber;''p signature) Sworn to before_�rmc this day of 19�. Notary Public Notary Public , County CLAIRE L.GLEW Notary Public,State of New York No.4879505 Qualified in Suffoik County Commission Expires December 8,18 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ROUGH PLOG. [ } FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: L -i- ,-,-� �C DATE 3 Loi/� INSPECTOR /' 765-1802 BUILDING DEPT. INSPECTION [ ] F0 NDATION IST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACES CHIMNEY REMARKS: k., \12 DATE �/ f INSPECTOR / 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ } FRAMING [ } FINAL [ ] FIREPLACE & CHIMNEY REMARKS,: J DATE INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST ( ] ROUGH PLBG. [ ] FO DATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: -� DATE INSPECTOR 6 �,3 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING [6, FINAL [ ] FIREPLACE & CHIMNEY REMARKS: �C DATE INSPECTOR ;3 cnmo� 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IId�SULATION [ ] FRAMING [` ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: evILI DATE A' 4 INSPECTOR A�_ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [i rfNSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE 3-INSPECTOR ,XA.4, 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1STW- INSULATION UGH PLBG. FOUNDATION 2ND [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: r DATE INSPECTOR BOARD OF HEALTH . . . . . . . . . FORM NO, 1 3 SETS OF PLANS . . . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . AUG 10 1995 BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORN . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NOTIFY [ LL ; 7Z J h.- � t� y � CALL i- J. Examined . . . . . .l,(. . . . . . ., 19 . . . NAIL TO ; Approved . . . . . . . �3ott0� Disapproved,a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . r dinb Inspector) APPLICATION FOR BUILDING PERMIT Date . . . . . . . . . . . . . . . . . .. 19 . . . 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 streets 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 ins etions. FLYS/ . . . . . . . . . . . . ( ignature of applicant, or name, tf a corporation) (Mailing address of applicant) Slate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. GLS /. . .. . o .. . . ..0.4,1!T!� 02. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises �D��G b -W jf/T2G 1 �. 1/zig/3L 7 lo�, lfl.Fz;l(>l L . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (l. ('�.. . . . . . . . . (Name and title of corporate officer) Builder's License No. NJ: v Plumber's License No. . . . .•... . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. i 14i� aF./yo�rotti .NLrGGt LI�. . .a? y�.t `�3.+. .!r! : .G.�sCss . . Rr�Ay . . ��crwi � .. . . . . . . . . . . . . . . . House Number Street Ilamlet County Tax Map No. 1000 Section . . . : . . . ©ft . . . . Block . . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . Subdivision . . . . ( x!, ! d OATS. . . . . . . . .'. . . . . . . . . . Filed Map No. . . . 9,331. . . . . Lot . t'Lr. . . . . . . . . . . . (Name) , 2. Slate existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . .(�4 a/g'-T. . . . . /- 7. . , . V"•' . . . . . . Vtt l;: ;,flR 61 ,-. b. Intended use and occupancy .'�. . .- 'l` �}`. 'C's� S Oki !Cf :fE wr":'sit;r3 ts�tini. . . . . . . . . . . . . . . . . . J. Nature of work (check which applicable): New Building l 5 . . . . . Addition . . . . . . . . . . Alteration . . . . : . . Repair . . . . . . . . . . . . . . Removal . . . . . , . . . . . . . . Dernolition . . . . : . . . . . . . . . Other Work . . . . . . . . . . . . (Description; 4. Estirnated Cost . . .j �O.G' . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . `` (to be paid on filing this application) 5. If dwelling, number of dwellin units y, F!9 rN AL1. . . .. Number of dwelling units on each floor . . . . . . . . . . . . . If garage, number of cars . . t r! . . c(d(Z. . . : . . . . . G. If business, connnercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . 7. Dimensions of existing structures, if any: Front . . .4?7 . . . . . . . . . Rear .4 7 . . . . . . Depth ..?.V . . . . . . . . Height -.-?0.'. . . . . . . . . . . Nutrtber of Stories . ..Z.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . Depth . . . . . ... . . . . . . .I. . . . . . . . height . . . . . . . . . . . . . . . . : Number of Stories . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . .? . . . . . . . . : Rear A:7 . . . . . . . . . . . Depth '?V . . . . . . . . . Height _3P.. . . . . . . . . . . Number of Stories . .o2. . . . . . . . . . . . . . . . 9. Size of lot: Front i411:7 .. . . . . . . . . . . Rear . . .4J?. . . . . . . . . . . . . . . Depth 1; :�p . . . . . . . . . 10. Date of Purchase /q�/a ( . :+. 1.9. `�.Y. . . . . . . . . . . . . Name of Former Owner WZA:Y0:$ . </<H,9.r 0 . . iCZ 11. Zone or use district in which premises are situated . . , , , , , , , , , , , , , , , , , , , , , , , , , , , 12. Does proposed construction violate any zoning law, ordinance or regulation: . .tiP. . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . , ! ' . '. . . . . . . . . . . . .... . . . . . . . Will excess Fill be removed'from premises: Yes <r 14. Name of Owner of premises ( q? v + Address Yy S 7.sY!fiAi.,6• , Phone No.o4f=?- k4-77kr Name of Architect �.'. ?. "..rqA. . . . . . . . . . . . . . AddressJ,1,3? FP.a.ftY.G.R4'�'vPr»ehone Noyyy. �o Name of Mr. • Address 7gn.c4irp4jepoe- r PhoneNo�bS - 317f% 15. Is this property within 300 feet of a tidal wetland? *Yesp'0'AOri s . . . Na. , Jl�t�. . *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 frc property lures. Give street and block number or description according to deed, and show street names and indicate whetl interior or corner lot. A ) a � 4 i � r� y2 , y3 STA'L'E OF NEW Yg S.S COUNTY OF . . . . � . . . . -TZ7x'CG(l r1 1 , . . , being duly sworn, deposes and says that he is the applic. (Name of individual signing contract) above named. lie is the . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent,corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file t application; that all staternertts can tained in this application are true to the best of his knowledge and belief; and that work will be performed in the-manner set forth in the application filed therewith. Sworn to before me this t . . . . . . � `. . . . . . . . . day Of . . . ... .. �. . .�.�, Notary Public, . . . . . . :� Cour tv ROBERT 1. SCOTT,JR., - / . . . . . . . . . . . . . . 1. . . . . . . . . . . . . . . . . . . . . NOTARY PUS[1C,State N.Y. (Signature of applica No.4725085,Suffot uu*g�t Term Expiry May t. 19-T(O ii H. S. No. I I n VACANT .._. ��E� -3 �' -.�_.___�."• I \V STATEMENT OF INTENT �f THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL 2$ . CONFORM TO THE STANDARDS OF THE . SUFFOLK CO DEPT OF HEALTH SERVICES. .'.C1Mt"10N ^CCJ.�. IS. LIRIVEWd:Y 1Y 2`+ APPLICANT a _- - - -� - f - SUFFOLK COUNTY DEPT. OF HEALTH 1 SERVICES — FCR APPROVAL FOR ` CONSTRUCTION ONLY DATE ul u I _ H- S. REF NO 1 ; Q � APPROVEDIt - , i . . : SUFFOLK CO. TAX MAP DESIGNATION: A f RSA' t'1�' t �' . Q11L DIST SECT BLOCK PCL uli s ^ OWNERS ADDRESS ' ' CONCR ' Fouw QA cd AP ti I u " lG Ems? Y DEED L- F /A P. tV �& t. NQ'S. 2EF4c MRF ^r �nllt.{ _l TEST HOLE ' S7AMP +4 OA' a Fil �G t!^: THE SO e if'Y I A 2At 5.66001 W. 2SG.O ,� Z 3�FKr 1 '+ P 1? 3 ! w�fts"y *�lak _t _ ( SeWn TAB W 010 N6w vo*stm h I nr rr r- mi�,vr as Q t G.t C !ti� ,t.,ar�a >.rr L..._. . •..�� �� FeOcelwn ta'K I . G �N I I PPOP El1 Lh ux ww" - r>=- iAmp:"1T ujmea via iE, on an0 { �jh (� ( ( (� `� PSZOQ.HO) p MAS' WF-t4f)CP OCT, 12,1 A � j IA ',.-1" PROPEFf.T T I-^ —._ ___._ t ins ia•r..emfn. ��� 5::rd,b11M0100n1� v FQL1NDA-LO -f WI_") QS fT - _ t SEAL I gni- , sUAC rIpEL#TY NATIQ`JAL?ITLE3NS I<AD.iCECU, w_ } / l ✓ AMC--, K4wFzrtAMF'I�N NA7S, IAI. Sil1Nk SEP 26 0: "—f, RODERICKVAN TUY PC I b',�a�r LICENSED LAND SURVEYORS i {I —� (I LAND 5° GREENPORT NEW YORK �NE"V yOiYN _ EXPIRES YEAR$ FROM DATE OF APPROVAL H- s. No. I I AUG 3 0 PJ95 1 Zzu fflc-, .. -- STATEMENT OF INTENT SHE NATER SJPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL 25 CONFCP.ti± TG THE ST aNDAP.DS OF THE - - - SUFFOLK CO DEPT OF HEALTH SERVICES. c St — .-.'M^IOA. ��'✓' i-a-C.d FX ��. d 2•- AP. iCArjT I Ci27V EWA.Y t ---- - - - - -. SUFFOLK COUNTY D OF HEALTH 41 < ' SERVICES - FOR APPROVAL POR ; - CONSTRUCTION ONLY �� DATE } �._?( :mac P20P.WELL-� J1-- r--- - -- �- - - ---� - : .._I � H S. REF NO � �O- ^ 01/D .APPROVED - j _ _ SUFFOLK CC TAX MAP DESIGNATION- 1 Q. .. ls�• t'C_C:- HO Y Q Alc_Eti-' Qui,..`, r_, ;•�y �- n, iLj _ DIST SECT BLOCK PCL =EvT I, - - OWNERS ADDRESS iw� _ ! Ap7. H a 45s - v CdQt� DEEC L P I 77 NO'S. MAP `F WI ._t} TEST HOLE STAMP 9k,THE TUFF 01 :' :n Z` 4k bbn >C W. c5^ O 'x) i33'. Ju 6 r F' FVA ti tiS IZE E.._ M - L! SEA _EV L P2OP.NEL!_, �� 0. I F;' '+ A A,'7 w w A D . 994 LL ;`li-\�' '`F PMPE !< Y:.' ti MAP AMEN [? OCT. 12 1 - - - SIJ <vUyEftD FCf� N ui j FIDELITY NATIQNIrLTiTLE 1NSU2ANCECO: i f 6 L ANC BRIG�EtAhtPT nF NATIO SENhtJv lk. 7L?6, i t X7 RODERICK VAN TUY PEC CNIC "-"-- LICENSED LAND SURVEYORS GREENPORT NEW YORK 1 DYNE b5T NSQ3 -- -zA- I ": L4tIr' : - /UI'�I"4R 1•. V/'1ir f'T�J�t,, GR�v10Esrill FFOLK it�FY{ ,1(MD , H. 5- NO. P-10-94 -01hQ \fib + { ` � 4 ,�d � �. Il0 A, cF� ay{ 7 1996 tt -� ✓:'Adros�% k044 /� S 1Y41fd'�{nri!, x,.ui�'Y4tV I *41 4914 Y ur STATEMENT OF INTENT + am I "i°�' '� 4�r� �� j THE WATER SJPPLY AND SEWAGE DISPOSAL ,.�,r..fS p f" J___ ' SYSTEMS FGR THIS RESIDENCE WILL — CONFORM TO THE STANDARDS GF THE , rySfqPt 1 /,' SUFFOLK CO DEPT OF HEALTH SERVICES. NL. 6 JO + a�01 YVNOr tu>d 250.0 +y ,S; o z�' zAPPLICANT 4_2_ 7 y �� _–_ v _ s // F SUFFOLK COUNTY DEPT. OF HEALTH —"F" SERVICES — FOR APPROVAL FO Lu R ; t / ^ 2 I CONSTRUCTION ONLY � i . / DATE. p 113 1 , wx n d. H. S. REF NO . Q10'94-0410 U f i APPROVED Q h CL W t n 4Q,• I I r — SUFFOLK CO. TAX MAP DESIGNATION WELL , 2 - 101 COh=PAD C" SEPTI < AREA= 400 C' K h T. DIST- SECT BLOCK PCL u —r Z —PIPE 1000 Cab 4 6.2 o , OWNERS ADDRESS- i ' u PrP 3 E.87 fH. STEE' kq�I AP7. 6 _ "SMS — eN a IST.FLOOR RpCF1 IN NC7TE5 , DEED L. %I/A P 1.L0NO'S. F�CLTO MAP CJF Wf�TD { TEST HOLE STAMP \�s OATS ,FILED 1),4 THE 7208� SUFFCLQCLE!2k'"_5,66,00 w. 250.0 a j OFFICE nor MAP NO 9331, Seotp,f I anNey"savinlo1 Bttt pg of mn New Y«k&xM EcNaelgn L8Y4 i 2.ELEVATIONIS IZEFEZ TO_MEII�N I j Copies olD is suM14ymaDnmbeadn4 I ' C SEA LEVEL- ( rewmanaem+ewedeea« I I 'PROP.WDLL I �. I roee.wmbeavdamsnaanawea,eeidrwnc aweaarc I "w I ` I py�pe�}6pekAlpoenenas _. onhWmeD�t«Mnmme sunwr I ' I —i I I � kprepend,anaan Nsuquero d+e I tl� CS W"e cempeny,gowosd«dal eYN'<Ya,., W PMT J til lmdmg mNamwnlisted nempo end (pROP.HO.) _j W Me e,,igneos of Me landing lns4 MAP WEN OCT. 12 199 , ' 1`y W:cn.Gua�mecsarenolmslambie MAP OF PQQPE'rT`�' y^ _ � —y—j y ��(�C i eraaese�e _____.. __ - - - -.._ l'fl • ___._Y. �' �'.}�+�i. III.k�9rY Lu c,nor5 5UfLVEYED P02 N i1A}�AhtTIrE_ CIiAt#tF T�t, o'�' r-- ..� �� � t=1t?L'LiTY t+fl4'I'f '{17tEAND To il�.+U4.tf-1GE�, H 1 i SURVEY —_. . SEPT,2fa,1 rr �7 RODE.^^��R' IC�K/VAN TUY P.C- y� 1 I I nF ZO•Ls2562p�'y J4,♦ 1/ l.+s��'-.+.N'>^.'1e �n LAND SrJL� TCWN OF SOUTHOLD N.Y. LICENSED LAND SURVEYORS GREENPORT NEW YORK 's W. kl pop f4lli e ENERGY COOL CALCULA'T'IONS (For Non-l:leclric Ileal) Ueslyu Crttoria G , Ooo negree' nnye ,� //O.A. JVP J . A. IVF Olt! 7 7< 2 �el- PER: /-enrH uns'ru! SUBSYSTEM AREA DESIGN 'rll RRMCL REMARKS L1A'1'1NG :xterior Wa Lls (Opaque) �lazlny �— 7- 57 3/ - 5 Qw r.7 ours :e Lliug/Iloul: (Opaque) 72 Z+q 0/vs kyl LyliLs 'lour — 123 ' v5 O 'auuiLatlon I lab Jllsal.a Llon -- - 'f0'1'AL toles : fuLLd.Lny Envelope Systema to meet requirements of. 7815. 2 IVAC Gquipemenl: to meet requirements of 7815. 11 IVAC SysLems to meet requirements of. 7815. 12 _ mcL. Systems to meet requirements of 7815 . 13 icutil.nlious Systems Lo meet requirements of 7815. 14 Insu LaLLoo of 1'lp Lug SysLems to meet requ.1remenls of 7815 . 15 ;crvlce Wa Ler Iles Ling SysLems 6 Equi.pmeul to meet requirements of '11115 . 21 ilectvlcal F LLghtiug Systems F Equipment to meet requIremeu Ls of '7815. 31 '1'o Lite best of lily knowledge, a pF NEIy�•, belief, 6 professional. .�pj -E-- 0 judgement, these plans nre Ju > 1 comp.LLance with Lite code. 9pFE5Siq{1 J`� _ „ - `—, r. .� . AILLI,PWMBINGi 1 �. - �•,.... -�--`^ --' — — - T _ IEEEmm covat ►0 _LV , :�,. .. PV�EADCpAlj• C /ON ;., AT ON RT/ CERT/f/CATE'OFOCCUP ARECY SOLDER USED//y SUPPI SYSTWATER ` �©s EXCEED 2/10 of %EM CANNOT 1 � LEAD. IF � 1 M1 w+—+•,.. aJy_ r :,,,`� y - aI r s * fl 1! _ - ,,, a w,ay.h:. 'f'"^;.•r- •W r-m,ae l .^ 'R i`. A �,r::x` rK ,, �: , M +Pii� s •nv.:� _ _ _ _ -- , , _ _ _ _ _._ _ •_ _ i '1 IT ,, ibE APPROVED AS NOTED e, JJIM N11Ei, 4' IT I IT .rt ° - ''.DATE:. q & A- P,C•cQ NEW yds . �'a "'i� ': r /, I / A / , �� TESTINSa RPtCt11E .• 6 . '. t ` - I '° ., _ � '� wce ' r0 1- : I-Till ., -N DPp�t1.IW _ �y�y� _ � y�y (�/ UP Y p NOTIFY- BUILDING 'DEPART y ' a Ig's,' Mfllll•T�Ci Ct 3'f', AYOSM d1Ek'Ib118 - �'T ', `r►�N��pc_R�Ow�� *"�£OlY{/.UfT1�1t;1 :OF\ . , � ar � 7fi5-1803 9,AMNO 4 PM,FO THE _ C�; 'r w , . NOT,PROCEEO r C; R V'!,NP R•T. N.Y. 11944 - .� D; I V�TN /: FOLLOWINGINSPECTIONSi rn v�`� ay. av�umf ptainc eh'4U be IIkIR1�Nt iM EI�D1G!lQA1 IAl , ISE IS,UKAWF �, _ _ . *Mpy� y��yyj,„.�/ 'IIIT (}� F�" /�[' A7'r: FRAMING UNTILSURVEY' ',,:1, 'FOIINDATIGN'• TWO REQUIRED ' .A �2z4,yi U ,OD 'A ��!�1N„y\!�!!yF' ', rM ,I�Ps'1v'�wr�}�!�OF 'YY,I 1 �I OUT I-� 44: �IC;I�A'IiL: F f FOfiPOURED CONCRETE - de' �.4� �”)�'7 � N L,tTATlUItDINh l ,'�!�r�.�FATE wwlnwR (�,F.,, _ (,A PAN �/ - U UUNUATION�LOGATiUN 2. ROUGH FRAMING 6' PLUMBING,: ., Ok_ESS70NP _ _ t BIRO pg.. `a.;_ 'q ' V7'I OIi PAN 1' r '.M S. INSULATION _ w 1 ...,-.+ .:`•.. �71yT�*p,`q ,r, ,', , ...a 'r - ..1r s ; a�� . - , ,r,� HAS SM '"''FMOVER ':NF1 � ',QJ - - , '-r'^+-ti., _ •��,.. .s 4.. NAL , ' CONSTRUCTION, 'MUST - /)-L� ✓ 'DNN;' i'. {. _ z f 1 e - :BE COMPLETE FOR C .� PJ/ - '.4++ 1r I'•�JAi HT1 C»!I 's _ •T _ r 1 a -'.�;�Rg r :,''y "�4'? •Nj,, } ALL CONSTRLCYION SHALL MEET' ( "� P FRE!hE0U1PEME S 'OF E '�P. �""”' �.. kE.' �`, fVT .TR ,.N.Y. , . h A' 'SI'TA ".CONSTR TIO". NEG ,i '-, '[4 .. .^: -.,'d r 4 -1, / '.•,A/` s ai+ .. ,. <: i.,5 r :� A 1< -r, -!:: !' - T,UC Nr;&� S. R Y• ' „_„ J x -Yr�: ..r" . ''' .•.: :.:� rYI�� s s-.: � -ra]'; 'i P'r aa '` HY.';;* , - (,: ,,s . . .,-.. , :-: �:r(!�.� ,',..�r., �.�' ,r ;:CC10Efi N,OTp{ AESPONSIB_LE . FOR^.,, , L IT -ti' ,LJb r n :;r., rn.t • >,.' ,•r .d- ,�„ .r , L. 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