HomeMy WebLinkAbout23204-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-25428 Date DECEMBER 16, 1997
THIS CERTIFIES that the building NEW DWELLING
Location of Property 4552 PECONIC BAY BLVD. LAUREL, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 128 Block 4 Lot 19
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 20, 1995 pursuant to which
Building Permit No. 23204-Z dated DECEMBER 28, 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 ONE FAMILY DWELLING WITH ATTACHED DECKS AS APPLIED FOR &
AS TO CONDITIONS OF ZBA #4343.
The certificate Is issued to FAIRWINDS LTD.
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL SEPT. 3, 1997-R10-95-0091
UNDERWRITERS CERTIFICATE NO. N-415847 - MARCH 31, 1997
PLUMBERS CERTIFICATION DATED APRIL 15, 1997-DAVID A. KIRWIN
< �f
it ng Inspector
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-25429 Date DECEMBER 16, 1997
THIS CERTIFIES that the building ACCESSORY
Location of Property 4552 PECONIC BAY BLVD. LAUREL, N.Y.
House No. Street Hamlet
County Tax May No. 1000 Section 128 Block 4 Lot 19
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 20, 1995 pursuant to which
Building Permit No. 23204-Z dated DECEMBER 28, 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 ACCESSORY GARAGE AS APPLIED FOR & AS PER CONDITIONS OF
ZONING BOARD OF APPEALS #4343
The certificate is issued to FAIRWINDS LTD.
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-415847 - MARCH 31, 1997
PLUMBERS CERTIFICATION DATED N/A
//ui1 ing 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) p
Date ../ ....................................... 19..47.....
NP 23204 Z
� co s -�
Permission is he by grant d to;
....................... ..............
toy""'"%"'
dam............. ... ... ..... ........ . ... ... .. . .A
.
f...:»: ... ................... ..... . .....
,. .. '. ........................
,
„ . . ....
at remises located at... .. .YyJ _,.............. ....... .... ....... ... .......................
.............................................. .�.� pp .......................... ........I............................
County Tax Map No. 1000 Section .....�cr�Cl........ Block ...........T��//............. Lot No. ...... .............
Pursuant to application dated ......�� '................. yc
....................... 19. and approved by the
Building Inspector,
Fee
t .. ...............................
Building Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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 12 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.
J
C. Fees
1. Certificate of Occupancy New dwe lin $25 0 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 Buildina - $100.00
3. Copy of Certificate. of Occupancy - _ .25�,
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Resident4l�$1500, Comercia�l $15.00
1.q.9.
.�. . . . . . .Date . .
New Construction. . . . . . Old Or Pre-existing Building . . . . . . . . . . . . . . . .
Location of Property. . . .1./
'I� . . �. . .11LN. bl . . . . . . . Fvkln�.. . . . . . .
House No. Street Hamle
MKW/NDS W G/a �N . c 25 �,� VO,�MAIn)
Onwer or Owners of Property . . . w6w; P.
//�� I G / �
County Tax Map No 1000, Section.) Y.�. . . . . . .Block. . . . . . . . . . . . .Lot. . ./. . .{PI . . . . . . . . . . . . . . .
Subdivision. . . . . . . . . . .+.J. . . . . . . . . . . . . . . . . . . . 11 .ffFiil�led Map. . . . . . . . . Lot
1. . . . . . . . . . . . . . . . . . . . . .
Permit No.'An .QZ"Daate Of Permit.��l.�: /`�6.Applicant. { 4'
Health Dept. Approval.i JP-: 15:. Do'. . . . . .Underwriters Approval. . . . . . . . . . . . . . . .. . . . . . . . .
Planning Board Approval. . . . . . .. . . . . . . . . . .. . . . . . `y'
Request for: Temporary
LCCertificate. . . . . . .. . . . Final C t}cate. . ./`. . . . . .
Fee Submitted: $. . . ✓. . . . . . . . . . . . . . . . . ,
�;as yas APPLICANT
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
4 TOWN HAIL
765-1802
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:
L . Final survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
^_. 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.
3. 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.
J
C. Fees
1 . Certificate of Occupancy New dwe lin $25.0 ' Additions to dwelling $25.00,
Alterations to dwelling 525.0 Swimming pool $25.00, Accessory building S25.00,
Additions to accessory building 525.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - S100.00
3 . Copy of Certificate of Occupancy - .25v.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residenti '1 $$1515.20000,, -C^ommercial ${155.00
n u Date . . •. ... J��(. . . . .r . L. . l �.�. . . . . . .
New Construction. . . . . . . Old Or Pre-existing Building . . . . . . . . . . . . . . . .
Location of Property. . . � . . . .(tlP. . . 1/�!bl. . . . . . . . . V. . . . . . .
House No. Street Hamle
�n12WIId4�S � �aQMAI Ij �F
Onwer or Owners of Prop rz:,7
County Tax Map No 1000, Sect--'on. . . . . . . .Block. . . . . . . . . . . . .Lot. . ./. . . . . . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . Filed hap, . . . . . . . . . Lot. . . . . . . . . . . . . . . . . . . . . .
Permit No.� <. ..0 J. ._11 �Date Of Pemit.121 ��/16.applicant. . . .J
ealth Dept. ApprovalQ !v._,1 .vnn .`1
. . . . . .Underari:ers Approval. . . . . . . . . . . . . . .
Planning BoardApproval. . . . . . . . . . . . . . . . . . . . . . . .
Reauest cor: Temporary Certificate. . . . . . . . . . . Final C rcicate. . . . . . .
i
Fee Submitted: S . . . . . . . . . . . . . . . . . . . . . . . 1 n
t3A-c S 3 T) . . . . . . . . . . . . . . . . . . . .
:. . . . . . . . . . .
c o_�S v �2 p APPLICANT
NPR 15 '97 01:00811 SOUTHOLD 701411 HALL 516 765 1823 P. 1
��o�oSy�FotK�oGyd
Town Hall, 53095 Main Road y as Fax (516)765.1823
P. O, BOX 1179 ++� Telephone(518) 785-1805
Southold, New York 11971 y Ob
dol 41 �a
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
C E R T I F I C A T I O N
DATE: l 5— Cl 7
A
Building Permit No. Z 3 Z O 4� .Z
Owner: HCNvt q— 1-1WOO SEaF1= ,IUS
(plea a print)
Plumber: uRU116 A KIPQWIw , ✓J✓3R COOLU-ttl /�Lvv ,rsc� t (fl
(please print) /
I certify that the solder used in the water supply system
contains less than 2/10 of 18 lead.
(Plumbers Signature)
,•::-wtmYork
Sworn to before me this
day of aO1A 19ckq
Notary Public, OILIMIA County
DONALD A. DENIS
A H C H I T E C T E
Aquebogue Square
Route 25/P.O. Box 565
Aquebogue, New York 11931
(516)722-3511 FAX:516 722-3859
Donald A. Denis,A.I.A.
Frederick R.Weber, R.A.
December 2, 1997
Town of Southold Building Dept.
Main Road
Southold,NY 11971 4, 5 W n
RE: HENRY& LINDA STEFFENS tt SEC 5 IM t
4522 GREAT PECONIC BAY BLVD. =14d
LAUREL, TOWN OF SOUTHOLD,NEW YORK
SCTM#1000-128-4-19 {OWN OF SOUTHOLD
Dear Sir/Madam:
Attached herewith please find a application for Certificates of Occupancy on the garage
located at the above address. We have also enclosed a check for $25 to cover the fee. If
you have any questions or require further information, please feel free to call.
Ve ruly yours,
X70 i'A.'�N!),I.A,,
DAD:dmh
Enc.
cc: Mr. Henry Steffens
APPEALS BOARD MEMBERS "Jq3� -�t•fL,
y`^�*� ��`'V Southold Town Hall
Gerard P. Goehringer, Chairman '. 53095 Main Road
Serge Doyen, Jr.
P.O. Box 1179
James Dinizio, Jr. ' Southold, New York 11971
^ � ;� '-- x.A
Robert A. Villa Fax (516) 765-1823
Lydia A. Torrora" � = Telephone(516) 765-1809
- 4 BOARD OF APPEALS
TOWN OF SOUTHOLD
October 20, 1995
2 ,
Mr. Donald A. Denis, A.I.A.
Aquebogue Square
Route 25, P.O. Bos: 565
Aquebogue, NY 11931
Re: Appl. No. 43413 - Henry and Linda Steffens
Dear Mr. Denis:
Please find enclosed a copy of the determination rendered by the
Board of Appeals and filed today concerning your variance
application. A copy of this determination has also been furnished to
the Southold Town Building Department pertaining to your pending
building permit application request.
You should contact the building department at 765-1802 to
determine what other documentation may be necessary to complete
your building application file. Also, due to the proximity of this
project within 500 feet of a waterway, State or County Road, we have
transmitted copies of the variance file to the Suffolk County
Department of Planning for their determination as required under the
County's Administrative Code. No further action is required on your
part. It is expected that the county will refer the matter back to
Lis wlthoul the recd for couiaty action for approval or disapproval_
If you have any questions, please feel free to call either our
office or that of the Building Department at 765-1802.
Very truly yours,
Linda Kowalski
Enclosure
cc: Building Department
APPEALS BOARD MEMBERS SSL
Southold Town Hall
Gerard P. Goehringer,Chairman c E s 53095 Main Road
Serge Doyen,Jr. P.O. Box 1179
James Dinizio, Jr. _ -��.Y Southold, New York 11971
Robert A. Villa = �',jl ���' Fax (516) 765-1823
Lydia A.Tortora Telephone (516) 765-1809
TBOARRD FST
OFAPPEALS
FINDINOGS A�D D� At IWTION
DATE OF ACTION: October 11, 1995 APPL. #4343.
APPLICANT: HENRY STEFFENS.
LOCATION OF PROPERTY: 4522 Great Peconic Bay Blvd. , Laurel.
COUNTY TAX MAP DISTRICT 1000, SECTION 128, BLOCK 4, LOT 19.
BASIS OF APPEAL: Notice of Disapproval issued by the Building Inspector
dated 9/14/95. "Under Article IIIA, Section 100-30A.3 and Article XXIII,
Section 100-239.4B , respectively, proposed construction will have
insufficient total side yard setbacks and will not have required 75 ft.
setback from a bulkhead."
PROVISIONS APPEALED: Art. III & XXIII, Sec. 100-30A.3 & 100-239.4B.
RELIEF REQUESTED: The August 15, 1995 updated survey map shows a
proposed setback at 49.9' from the outer wood bulkhead, and maintaining a
similar nonconforming setback established at the southeast corner of the
existing house at 23+- feet. The side yard setbacks will be reduced by nine
feet to 20.8 feet at the westerly side and maintaining the same
nonconforming setback of 10.4 ft. at the easterly side. The additions
proposed are for a 24.6+- setback from the 5' raised entry to the proposed
deck in the rear yard.
MOTION MADE BY: Lydia Tortora
SECONDED BY: James Dinizio, Jr.
ACTION/RESOLUTION ADOPTED: Approved as applied for.
REASONS/FINDINGS: Property has a narrow width of 73 feet, widening out
to 91 ft. along the Great Peconic Bay. The parcel is shown to be. created
by deed in or about 1963. The actual buildable area of the property is
limited and restricted based upon the location of the one-story frame house
which was built prior, to 1959 (according to assessment records) . The deck
additions are not unreasonable due to the variable contours of the land and
the substandard size of the property, and it is not substantial in relation
to the requirements. There will be no benefit afforded the applicant if the
variance were denied, and a grant of the variance as approved will not
cause a detriment to surrounding properties regarding environmental or
physicial conditions. (Note: The other addition and new garage proposed
as shown on the plan. are not under the purview of this variance application
as written under the Building Inspector's disapproval.)
VOTE OF THE BOARD: Ayes: Serge J. Doyen
James Dinizio, Jr.
Robert A. Villa
Lydia A. Tortora
Gerard P. Goehringer, Chairman
This resolution was unanimously adopted. ZBA:lk
DONALD A. DENIS
A R C H i T E C 1 5
Aquebogue Square
Route 25/P.O. Box 565
Aquebogue, New York 11931
(516)722-3511 FAX:516-722-3859
Donald A. Denis,A.I.A.
Frederick R.Weber, R.A.
September 4, 1997
Town of Southold Building Dept.
Main Road
Southold,NY 11971
RE: HENRY& LINDA STEFFENS
4522 GREAT PECONIC BAY BLVD.
LAUREL, TO WN OF SOUTHOLD, NEW YORK
SCTM#1000-128-4-19
Dear Sir/Madam:
Attached herewith please find two applications for Certificates of Occupancy on the new
residence and pool located at the above address. We have also enclosed the Underwriters
Certificates, surveys approved by the Suffolk County Health Dept. and Plumbers
Certification for the house, as well as two check for $25.00 each to cover the fee. If you
have any questions or require further information, please feel free to call.
(�I
V truly yo s, �. 1
I � .
I�
DO ALD A. DENIS, A.I.A.
DAD:dmh
Enc.
cc: Mr. Henry Steffens
* i
•t
r � .ate I< / /✓�_�_. _ .�� - _
Y
�. �� ! r _.... i• .!t -.. -. / ,..asp -
i�
A- , r -��� � 0O1" 2 31445
4 ^
APPEALS BOARD MEMBERS �O�OgUFFO(� coca Southold Town Hall
Gerard P. Goehringer, Chairman y<Y 53095 Main Road
Serge Doyen, Jr. y x P.O. Box 1179
James Dinizio, Jr. 5 �v Southold, New York 11971
Robert A. Villa Fax(516) 765-1823
Lydia A.Tortora Ol �O Telephone(516) 765-1809
BOARD OF APPEALS
TOWN OF SOUTHOLD
October 20, 1995
Mr. Donald A. Denis, A.I.A.
Aquebogue Square
Route 25, P.O. Box 565
Aquebogue, NY 11931
Re: Appl. No. 4343 - Henry and Linda Steffens [
Dear Mr. Denis:
C
Please find enclosed a copy of the determination rendered by the /
Board of Appeals and filed today concerning your variance
application. A copy of this determination has also been furnished to
the Southold Town Building Department pertaining to your pending
building permit application request.
You should contact the building department at 765-1802 to
determine what other documentation may be necessary to complete
your building application file. Also, due to the proximity of this
project within 500 feet of a waterway, State or County Road, we have
transmitted copies of the variance file to the Suffolk County
Department of Planning for their determination as required under the
County's Administrative Code. No further action is required on your
part. It is expected that the county will refer the matter back to
us without the need for county action for approval or disapproval.
If you have any questions, please feel free to call either our
office or that of the Building Department at 765-1802.
Very truly yours,
Linda Kowalski
Enclosure
�/ cc: Building Department LZ
a3ac
Asbestos Technology Corp.
P.O. Box 761 Skip Rooney
Shoreham, NY 11786 (516) 744-3400
April 9, 1996
Re: 1) Henry and Linda Steffens
Right-of-way off Peconic Bay Boulevard
Laurel, Town of Southold, New York
2) Suffolk County Tax Map # 1000-128-4-19
3) # 4980
To Whom It May Concern:
The formentioned property was inspected and there was no visible
Asbestos.
F.J. Rooney
Inspector
AH 90-08226
ACMLTR24
.TOS O G,�pT 1
S�UTHOr,n
s
"The Asbestos Specialists" Asbestos Removal . Testing • Consultation Licensed &Certified
o��gUFFO(,I-co
0
N g
Town Hall, 53095 Main Road p • Fax (516) 765-1823
New York ox 9 11971 A�1�1 �.a�l� Telephone (516)765-1802
Southold
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
TO: Donald A. Denis, A. I .A.
FROM: Thomas J. Fisher - senior Building Inspecto
;?91��
RE: Building Permit #23204-Z - H.S. Steffens
DATE : January 2, 1995
As per our conversation this morning, enclosed with the
building permit is a notice pertaining to asbestos.
You were correct about the garage framing being indicated
on the plans . We will need a plumbing diagram.
Also, as a reminder, disconnection of all utilities;
electric, gas and water, and provide protection from any runoff
into wetlands .
-Z7
77� �z .
rortm no.a
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TowN CLERK'S OFFICE
SOUTIfOLD, N.Y.
NOTICE OF DISAPPROVAL
Date . . . . . . . . . . . .. 19l.f/
TO
P•Qt .r� . ' . . . . : . . . . . . . . . . .
PLEASE TAKE NOTICE that your application dated . . . . . . . .. 19 i's r
for permit to ^ ��CC!CG! Gi!n ,v,L . . .��r�! C .tW4Cr
Location of Property 42A.
. . . . . . . . . . . . . . . .
House No. / p Str et Hamlet
County Tax Nlap No. 1000 Section . . . ./. . Q.
. . . . pluck . . . . . . . . . . . . Lot . �.�. . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . . . Lot No. . . . . . . . . . . . . . . . . .
is returned herewith and disapproved on the following grounds A. . . . . . "' •
¢. . . . . .�. . . . . . . . . . . . . .
7 W-
. . .. . . . . . . .
. . . . .
Building Inspector
RV 1/Bo
DONALD A. DENIS
A R C H I T E C T S
Aquebogue Square
Route 25/P.O. Box 565
Aquebogue, New York 11331
(516)722-3511 FAX:516-722-3859
Donald A. Denis,A.I.A.
Frederick R.Weber, R.A.
December 4, 1995
Town of Southold Building Dept.
Main Road
Southold,NY 11971
RE: HENRY& LINDA STEFFENS
4522 GREA T PECONIC BA Y BL VD.
LAUREL, TOWN OF SOUTHOLD,NEW YORK
SCTM#1000-128-4-19
Dear Sir/Madam:
Attached herewith please find the following:
1. Application for Building Permit
2. Three (3) sets of Plans. -
3. One Survey.
4. Suffolk County Dept. of Health Services Approval.
5. Southold Board of Appeals Approval.
6. Check to cover fee.
7. Application for Construction of Septic Tank/Cesspool.
If you ve any questions, please feel free to call us.
Very {y yours,
NAL DENIS, I.A.
DAD:dmh
Enc.
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 ULATION
[ ] FRAMING ( FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: L /[l�-t ,�c ✓�
DATE �� �� INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] F G [ ] FINAL
[ IREPLACE & CHIMNEY
REMARKS:
DATE / C' INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST ( L-t3�OUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
( 1�J FRAMING [ ] FINAL
[ FIREPLACE & CHIMNEY
R MARKS:
r .
DATE �i� INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST ( ] ROUGH PLBG.
[ j FOUNDATION 2ND CvrfNSULATION
[ ] FRAMING [ ] FINAL
REMARKS: �i},7c�✓
DATE / INSPECTOR
M-1802
BUILDING DEPT.
IN PECTI®N
[pr FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ l FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE INSPECTOR
G
f� M-1102
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]
FOUNDATION2ND [ �LATION
I 1 FRAIMIlIO ( ] FINAL
[ ] FIREPLACE d CHIMNEY
Ilk
REMARKS: /7!/ i�iGE1���rn� �,✓
A jo- 7 2
DATE 10131 1�L INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] i1SULATION
[ ] FRAMING [ V]/FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE 29 /�� INSPECTOR
765-1802
BUILDING DEPT.
I NISPECTION
[ ] UNDATION IST [ ] ROUGH PLBG.
IV FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: ��
R
DATE �/ INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ FOUNDATION IST [ ] ROUGH PLBG.
[ j FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACES CHIMNEY
REMARKS:
DATE 1,4 INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ k,14INAL (�
t
[ ] FIREPLACE & CHIMNEY
REMARKS: rZ
r
DATE INSPECTOR ta
,.
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1195100 ISURe of ELECW4Mcmr 1
85 JOHN STREET, NEW YORK, NY 10,038
Date MARCH 31,1997 Application No.on file 12073296/96 N 415847
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named an the above application number in the premises of
HENRY STEFFENS, 4552 GREAT PECONIC BAY BLVD. , POLE 59-5C, LAUREL, N.Y.
in thefollo:cing location; FX Basement ® 1st Fl. ® 2nd Fl. GAR/ATTIC/0UP Section Block Lot
was examined on MARCH 27,1997 and found to be in compliance with the National Electrical Code.
MXTURE ACUS SWITCNK X RA COOKING 0=5 O WASH NAUST'FANS
OUTLETS RICIPTINCANNSCINT1 FLUORESCENT OTHIR AMT. K.W. AMT. K.W. AML K.W. AMT. I K.W. AMT, N.P.
128 89 69 126 1 2 1 8.5 1 3.4 5 F
DRYERS RJRNACE MOTORS PUTUM APPUANCR PNORRS SPACIAL RIC'", TIMET CLOCKS "LL UNIT MRATRRS A"TMWTL1T DIMMIRS
STIM
AMT. K.W. OIL N.P. GAS N.P. AMT, NO. A.W.0. AMT. AMP. AMT. AM►S. TRANS. AMT. X.P. NO' MT AMt. WATTS
4 F 1 - 12/2 2 - 18 600
SERVICE MSCONNltT NO.00 S R R V I C E
0.
AMT. AAV. TYP! MRTRR1 X rIV 10 SW S X SW 130 4W NO.OF CC.COND. A.W.0. NO.OF HMIEG A•W NO.OF A.W.TR
WLN►. R C. OF NF 6 OF U AL
1 200 CB 1 X 1 2/0 1 2/0
OTIMR APPARATUS:
WHIRLPOOL BATH-1
2.50 TON A/C-1
3 TON A/C-1
3.50 TON A/C-1
MOTO RSt3-F H.P. ,1-2.5 H.P. ,1-3 H.P. ,1-3.5 H.P.
PANELSOARDS:1-14 CIR. 100,3-1 CIR. 60
�.F.C.Tt-16
� r
«< Continued on Page 2 >s> :,
aENNAt AAANi►oEl1
` Per
ctrI ficato mot nat ba'R1N►ed in any manner; return to the Board if. incorrect. Inspectors may be identified by their,credentiah
COPY FSR,.BUILDING DEPARTMENT. THIS COPY OF C,ERTIF ,Y,�W$T NOT BE ALTEIIEI� IN ANY w4NNR
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2
1195100 BUREAU OF ELECTRICITY
F— 88 JOHN STREET, NEW YORK,,NY 10038
Date MARCH 31,1997 Application No.on file 12073296/96 N 415847
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premi"s of
HENRY STEFFENS, 4552 GREAT PECONIC BAY BLVD. , POLL 59-50, LAUREL, N.Y.
in thefollowinglocation; ® Basement T It Fl. ® 2nd Fl. GAR/ATTIC/OUT Section Blo,* Lot
was examined on MARCH 27,1997 and found to be in compliance with the National Elecbfcal Code.
FIXTURE RX RA ES COOKNVO DECKS O DI WASH AUST FANS
OVT�ETS AM SWITCHES NCANNSCENT NUOKESCENT I OTHER AMT. I K.W. AMT. I K.W. AMT. I K.W. AMT. K.W. AMT. M.,
DRYERS FURNACE.MOTORS FIITUN AMUANCE MEDERS SMCIAIREC'IT TIMRChOCKSmy,FMATM Liff DIMMERS
AMT. K.W. Olt M.P. GAS M.P. AMT. NO. A.W.O. AMT. AMP. AMT. AMPS. TRANS. AMT. H.►. NO.OFFST AMT. WATTS
SERVKN DISCOI+INHCT #40.OF S e R V 1 C E
AMT. AW. TVN E l X 3w 1,f 3W 3 0 3W 3 X ew NO.OP c�c.coNo. OF cc c' NO.oP Mi•tec �'M�t4� wo.or NEUTKAts NeuTciiAt
OTHER ARMRA W
SEATUCK/KELLEY LIC.#3631
LAURA CT.
P.O. BOX 335 OENIRIAI MANAGER
SPEONK, NY, 11972-0335INN 11
Per
This eertifiotft must not ba altered in any manner; return to the office of the Board if incorrect. Inspectors may be idyl'. by C"ntiols.
COPT( FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT 'BE ALTEREDfM ANY .NAliit.
e,:
BOARD OF HEALTH
W FORM NO. 1 B SETS OF FLA. . . . . . .
TOWN OFSOUTHOLD SURVEY .
BUILDING DEPARTMENT CIiECK . . . . . . _ . . . . . . . . . _
TOWN HALL SEPTIC FORM _
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 1:DT i PY I y (
CALL f.l. +
Examined . . . . . . . . . . . . . . . .. 19 . . . MAIL TO :
Approved . . . . . . . . . . . ., 19 . . . Permit No. .
. . . . . . . . . . . . . . . .
Disapproved a/c .�f
. , };f
• • • • . • -(Building Inspector) . • • • • • .
AUG 1995 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, witl
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 strer
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app
cation.
d. 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 peri
shallbe 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 Occupan,
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 tl
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c
Regulations, for the construction of buildings, additions or alterations, w for removal or de ition, as herein describes
The applicant agrees to comply with all applicable laws, ordinances, bu ing code, hong od , and regulations, and t
admit authorized inspectors on premises and in building for necessary s e tions.
{J� A Signature of applicant, o name, if a corporation)
(Mailing addre?s of applicant)
State whether ap Iicyn-t yis, owner, lessee, agent, archite engineer, general contractor, electrician, plumber or builder
. . . . . . . . . • - ' v `' . . . . . . . . . . . . . . . . . . . . : . . . . . . . .
jz45
Name of owner of premises ?1 •1• . . . . . . . . . . . . . . .
(as on the tax roll or latest deed) Uv
If applicant is a corporation,signature of duty authorized officer.
(Name and title of corporate officer)
Builder's License No.
Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . .•.
Electrician's License No. . . . . . . .. . . . . . . . ...`. . . .
Other Trade's License No. . . . . .
Location of Sand on which proposed work wi e on
. . ,�tG. . . . . .
House Number q Street Hamlet /
County.Tax Map No. 1000 Section . . . 1 /. .lsljp . . Block .. . . . . . . . . . . . . . . . Lot . . .1. . . . . . . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . ... . . . . . . . . . . .
(Name)
State existing use and occupancy of premises and inten�d}e)d use and
�7occupannc}yy of proposed construction:
a. Existing use and occupancy . . • // -/ �. . 1.►. 7:'.1, �. . . . . . . . . . . . . . . . . . . . . . . .
b. Intended use, and occupancy . `v. . . � . . . . . . . . . . . . . . . . . . . . . . . . .
1- r'
3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteration . . . .+. . .
kepair Removal . . . ... . . . . . . . . .. Demolition . . . . . . . . . . . . . . Other Work . . . .if . . . . . .
• (Dcscripgion)
4. Estimated Cost . . .� 9.0. . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . .
//•�� �!, (to be paid on filing this application)
S. If dwelling,number of dwelling units . . . .V Y. . . . Number of dwc[ling units on each floor . . . . . . . . . . . . . .
_ If garage, number of cars . . . �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6. If business, commercial or mixed occupancy, specif nature and extent of each type of use . . . . . . . . . . . .
7. Dimensions of existin�structures, if any: Front . . �1 r Rear -3.2,A � . . . . . . Depth �j�j,�1 . - , , ,
Height . . . . .�y( 1. . . . . .Number of Stories . . . .ONS/. . . . . . . . . �. . . . . . . . . . . . . . . 1. . . . . . . . .
Dimensions of seg stt�tcture with alterations or additions: Front . .VJ, �. . . . . . . . . Rear .9 . . ... . . . . .
Depth . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . .
8. Dimensions of entire new construction: Front . . .`"'� Rear . ^ . . . . . . . . . . Depth.. . . . . . . . . . . .
Height . . . Number of Stories . . . . /� �. ,
� . . . . . . . . . t r. . . . . . . . . .
9. Size of lot: rout . . . . 3..�.t . . . . . . . . . . Rear . . . �V. 1. . . . . . . . . . . . . Depth .1.�!•. . . . . . . . .
10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NaTM••(,1p/( of�-�Q�I er Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11. Zone or use district in which premises are situated . . . . . . • \ ^ . • . . , . -
12. Does proposed construction violate any zoning law, ordinance or regulation: . .-1.6!3 . . . . . . . . . . . . . . . . . . . . . . . .
13. 1Vi11 lot be regraded . . . Q . . . . . y Will erpe fl, e e o e m premises: Yes N
14. Name of Owner of premisest7, S.IL�`�"". . . Address G � Ar Phone No.90 c�J.�79r:
Name of Architect .Address l�
���l �,.�� S.��IS : . . . . . ��� ig31. Phone 30.'�e`�'��. . . . ,
Name of Contractor . . ,J"_0 F . . . . . Address . . . . . . . . . . . . . . . . Phone o. . . . . . . . . . . . . . .
15. Is this property within 300 feet of a tidal wetland? *yes:. . . . No. . . . . . . . .
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAG RAM
Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all set-back dimensions fro,
property lines. Give street and block number or description according to deed, and show street names and indicate whethc
interior or corner lot.
�p� �/
;TATE OF NEW RK. . S.S t
:OUNTY OF ff
. . . . . . �� 4�. . . . . . . . . being duly sworn;deposes and says that lie is the applican
(Name of individual signing contract)
bove named.
e.isthe . . ... . .
. . M . 14 !ly. . . . . . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Contractor, agent, corporate officer, etc.)
said owner or owners, and is duly authorized to perform or have performed the said work and to make and file thi
)plication; that all statements contained in this application are true to the best of his knowledge and belief;and that th
ork will be performed in the manner set forth in the application filed therewith.
v0m to before me this,
• . . . . . . . . . . / . . . . .day of. lxk kst_. . . . . . . ., 19
County / 1
ata Public,,. . . - /,F"
� L~ LIZNBETH qNN k9VAIL E . . .
. . . . . . . . . . . . . . . . . .
Notaryry Public, 0, te Suffolk
lk York tgnature of applicant
No.52-8125850.Suffolk Cot�n�,
Term Expires October 31, 18,L�
_ IOAFO OF HEALTH �. . . . . .
f - _ FORM NO. t 3 SETS OF PLANS . . . . . . . .
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CIIECK . . . . . . _ . _ . . . . . . . . .
— 41995 1 TOWN HALL SEPTIC FORA . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971 722-3511
TEL.. 765.1902 1:0 1 F' .
t
CALL . . . Denis. Architect
Examined . �� La, , ; , • ,, 19/. ,lJ MAIL TO : • - • • • • • -
. . .�/ �3;L Donald ilenis,.9xch�tect.
Approved
. . . . ., 19 ... . Permit No PO Box 565
Disa AgtteA6gu2, -NY, x1932
e�Eig/OL. . . . . . . . . . 4
. .fFy Gie-6o ���� . . . . .
,l�aG�Ta,r/ olid g Inspector) `
APPLICATION FOR BUILDING/PERMIT
Date . . . 11/20/95. . . . . . ., 19 . .
�jj'S G�,dd�G
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with
sets of plans, accurate plot pian to scale. Fee according to schedule.
,b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public street
or'areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app)
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 permi
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 Occupanc
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 th
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein e 'bed
rhe applicant agrees to comply with all applicable laws, ordinances, building co e, housing code, and regul o a d ti
admit authorized inspectors on premises and in building for necessary in
7
(S'anature ant, or name, if a r ration)
225 Mountain enue, Ridgewood, I J 07450
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Owner
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
~lame of owner of premises . . .$@11x:3? & Lin. .da. . .Steffens
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(as on the tax roll or latest deed)
f applicant is a corporation, signature of duly authorized officer.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Name and title of corporate officer)
Builder's License No. .N9t,selected
Plumber's License No. N9t. Selected. . . . , • . . , ,
EIectrician's License No.Not, selected
Other Trade's License No. . . . . . . . . . . . . . . . . . . . . .
Location of land on which proposed work will be done. . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4552 Great Peconic Bay 'Blvd, Laurel, NY
lous . . . . be . . ... . . . . . . . . . . . . . . . . . . . . tr.ect . . . . . . . . . . . . . . . . . . . . . . ai. . . . . . . . . . . . . . . . . . . . . . . . . . ..
House Number Street Hamlet
4 19
County Tax Map No. 1000 Section . . , 128 • • • „ • • , , , . Block . . . . . . . . . . . . . . . . . • Lot . . . . . . . . . . . . . . . . . . .
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 , ,Single Family Relaidence
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . .
b. Intended uscandoccupancy . .Same. . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
31 Nature of work (check which applicable): New Building . . . . . . . . . Addition . . . . . . . . . . Alteration . . . . . . .
Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . .. Demolition . . . X. . . . . . . . . . Other Work . . . . . . . . . . . .
(Description'
4. Estimated Cost . . $. 375,444. . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(to be paid on filing this application)
5. if dwelling, number of dwelling units . .QIX. . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . .
If garage, number of cars . .Three • • " " " N/A"
6. If business, commercial or mixed occupancy, spec y2 mature and extent of tach type of use . . . . . . . . . . . I . . . . . . .
7. Dimensions of existing structures, if any: Front . . . .'. . . . . . . . . . . Rear . . . 32.5. . . . . . . Depth .53,5. . . . . . . .
Height . . . . . . . . . . . . . . . Number of Stories . .One . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . .
Depth . . . . 2Q.. . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . .
8. Dimensions of entire new construction: Front . .37. . . . . . . . . . . Rear . . 28 . . . . . . . . . . Depth . . . . . . . . . .
Height . . . 29.. . . . . . . . . Number of Stories . .`�r. . . . . . . . . . . . . . . . . . . . .
73.61
9. Size of lot: Front . . Rear .91.41 . . . . . . . . . . . . . . . . Depth . .368.43. . . . . . . . . . . .
1959 . • . . . . . . • . . . . . . . . . . . Name of Former Owner . P . P.
10. Date of Purchase Christo her, Cam e
11. Zone or use district in which premises are situated . .13.4Q. ... . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12. Does proposed construction violate any zoning law, ordinance or regulation: . No, , , , , , , , , , , , , , , , , , , , , , , , , , ,
13. Will lot be regraded No. . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: 'MM I-
14.
14. Name of Owner of premises Henry,Steffens. . , _ , ,Addres 225 Mountain Ave.Rici
Name of Architect Donald A. Denis, A.I.A. , P.CAddresN Box 66,el AqueboguePh e No. : . . . . . . . . . . . .
Not Selected . . . . . . . . . . . "
Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . Phone No. . . . . . . . . . . . . .
15. Is this property within 300 Leet of a tidal wetland?'
etland? *Yes. . . . . . . No. . . . . . . . .
*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 fro,
property lines. Give street and block number or description according to deed, and show street names and indicate whethi
interior or comer lot.
See attached survey by Young & Young dated August 15, 1995.
��kS Jay
;TATE OF id> fi f@RK, S.S
:O(J Y OF . .
. . . . . . . . . . . . . . . being duly sworn, deposes and says that lie is the applican
(Name of individual signing contract)
bove named.
Owner
eisthe . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Contractor, agent, corporate officer, etc.)
F said o%vncr or owners, and is duly authorized to perform or have performed the said work and to make and file thi
)plication; that all statements contained in this application are true to the best of his knowledge and belief;and that th
ork will be performed in the manner set forth in the application filed therewith.
vom to before me this
• . . . . . . . . . . .� yJ . . . . . .day of. J �OV^C M��a 4 �. . . . . . .. 19
atary Public, . . . . . . . . .. 5�. ?. . . . . .:: /� . . . . County
YONA DUSWEIe
7 NOTARY P!BUC OF NEN 112SEY ignature gf::pplioint
My COMMiSSt9N 9PIP0 UEC. 13, 1996
i
I
0 La
Young & Young, Land Surveyors
400 Ostrander Avenue, Riverhead, New York 11901 B�
jouIn'ng n11� 616-727-2303
pill
Alden W. Young, ProfessionW. nagll Engineer & Land Surveyor 666�e
Thomas C.
Howard
Walperka
ProfProfeeol EnLand gineer
m
rye `1v Kenneth F. Abrasso, Land Surveyor
E•pAvrtNe Ov \
tinegb� 7
o
7 '0
c o
Zo Ff� o NOTE: a=MONUMENT FOUND ❑=MONUMENT SET o
ELEVATIONS SHOWN HEREON ARE FROM ACTUAL [l
SURVEY AND ARE REFERENCED TO NGVD (MSL 1929).
ff ` to
v ♦ E
2
T zxi 3r p
> X
°
4� 7
Ipill
RA
7 Ao
o ° 71
it
c'y as O ax• . sz -211
0 ?4
CP 91
a
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a 3
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v
nt
m�
m "'c"GF- y36
If
i
pN�\T3 6o n 4
'N
= 2,3
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a o
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cf ,'e W 1 2• i 4
k
e N B
(711. .1 ,4agR N•V z✓ � <P` u ?, N. p
of SP O,/ dztJp6•o \\G::L4 q,'.�I f A M 0 LZn jN c
f `4R Of. TP•' r, fl.1 Cm0 S�
O �^ � `vb ♦M x =i
n • f o
m a� OUgO o
O tO ° 4
fJI
\T' { ' n x go,'. ,
oLm
P�p\'C� ,f\ e, ;at '%lova;''•
9i a - � .�. ' • MRs / �b
• k" $IA°F X CUM DEPARTMEW OF HEALTH OERVICi6 Q�e�
T
wooo aft."
FOR APPROVAL OF CONSTRUCTION OF °
SWOLE FAMILY RESIDENCE ONLY
G' oa ,i. ,
Pvo`�`O'' (i?''' g'• DoaEAU6 22 1996 60 I g��e
Y ',; N;''
41
/mak EfPEIE!THREE YEARS FROM DATE AFFNDVAL
� •FI d' /per r a.
W000 ARJIN
TEST HOLE /s' SURVEY FOR
FROWN 0.0' ao „/ c � �ab `v
*AMC 20, °^ ., ,\ •,yo O2 HENRY STEEPENS & LINDA STEEPENS
/ c a
4LR Q At: LAUREL Town of: SOUTHOLD
FIM, To
BROWN
CO>R!R Suffolk County, New York
9PND
r Suff. Co. Tax Map: 1000 12B 4 19
NO WATER 10.0' t - alet,icl SLetlen 01.0 Lot
P
NE�'Y
JULY 6,199 ■■
{ �4 OCT. 13,19944 Y� R
1c O DATE ;OCT 8,1994 R I
SCALE :1'= 40� ab
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LAND JOB NO. :94— 0607gls
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Young & Young, Land Surveyors ON
400 Ostrander Avenue, Riverhead New York 11901 E
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Alden W. Young, Profaseioal Engineer k Land SurveyorHoward IF. # �
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HENRY STEFFENS a LINDA STEFFENS
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Q At: LAUREL Town of: SOUTHOLD
Suffolk County, New York
Suff. Co. Tax Map: 11000 128 4 19
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AUG. 15,1995 ��
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JOB NO. :94— 0607 €�R
® �,, LA14C SHEET NO. :1 OF 1 O 3�Q
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Young & Young, Land Surveyors till
400 Ostrander Avenue, Riverhead, Now York 11901
'ljuuttf 0111 516-727-2303 tl
Valmi g AQ.O Y Alden W. Young, Professional Engineer & Land Surveyor �g
Howard A. Young, Land Surveyor
Iv Thomas C. Walperf, Professional Engineer
�tevNe (V Kenneth F. Abrusso, Land Surveyor
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SUFFOLK COUNTY DEPARTMENT 01'Nn11 }'.c1-RV''":"•
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�$ ac8 tr n leao~y rff, sea\Ne end The sewage dlsposcl end water supply facilities at this location taw..been 5 tl�
inspected and/orcarified by WS0eper ctoro;hcroganc:eo�ldfound eo !
be satisfactory FO � lisp
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NOTE: office of Water and Wastewater Msnegemert
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'b ' `(� SURVEY FOR
HENRY STEFFENS 9 LINDA STEFFENS
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Q At: LAUREL Town of: SOUTHOLD
Suffolk County, New York
Suff. Co. Tax Map: 1000 128 4 19
t oletrinl sentlrn elnnk Lot
P^ f N AUG I6,1997
JULY I, 1996
MAY 30 996
*O MAY 21, 1996 s'K�
_ 0 APR. 17,1996 ep�
AUG. 15,1995 �R
I JULY 6,1 995 a
'V OCT. 13,1994 Ig
in O DATE :OCT. 6,1994 0
SCALE :1n= 40 Ertl
SHEET N0. :1J08 No. :94—F607
® 19J5777E �