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Home My WebLink About21200-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22408 Date JUNE 21¢ 1993 THIS CERTIFIES that the building Location of Property 2200 HOBART RD. House No. County Tax Map No. 1000 Section 64 Subdivision ADDITION SOUTBOLD, N.Y. Street Hamlet Block 3 Lot 4 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 27, 1993 pursuant to which Building Permit No. 21200-~ .... dated JANUARY 27¢ 1993 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A GEORGE & FLORENCE LOEHR /u/ding/Inspector Rev. 1/81 leOl~M NO, ~1 TOWN OF $OUTHOLO BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-°N? 21200Z Permission is hereby grgnted to: · ~.~.~ ...~....~... ~ ~ /~-~/ ~ _ ...~~~..~.~...~ ........................ ~o ~~~..~...~~......~~~....~~~ ........ .............................................................. at premises I~ated at .~.~.~~...~...~/ ................................................................. ~.....~..~ Rev. 6/30/80 Form No. 6' -' APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~65-1802 ~his application must be filled in by t~pewriter 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-Risposal(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 i% 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. 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 - $5.00 over 5 years - $10.00 .4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ;~../..~-7 ~. ~ ..... New Construction ....... · .... Old Or Pre-existing Building.~..~ ........ Location o~ P~opa~ty " ' House ~o. S~ee~ Ham~e~ Onwer or Owners of Pro-ert,,~'F~< ~f~~ ~.~ Coun,y Tax Map No 1000, Section...~.ff ....... Bio-uk..$ ............. Lot...~ ......... Subdivision .................................... Filed Map ............ Lot .................... .. · . pp ..... ~ ............... ~ .... Permit No.g.(~.~.~.~...Pate Of Permit~.~!~S..~ licant~ Health Dept. Approval ....................... ... Underwriters Approval ....................... . . Planning Board Approval.ff.~.g.~./.~.~ ....... Request for: Temporary Certificate ........... Final Certicate.~' ....... Fee Submitted: FOUNDATIO:~ (2nd) 2. ~OUGH FRAME & -PLUMBING ] " iNSULATIOn! PER N. Y. STATE ENERGY CODE FI:;AL ADDITIO~A'L COMMENTS: INSPECTORS Victor Lessard Principal Bt~ik~i~g [~spector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gar',/Fish Building Inspector Vincent R. Wieezorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD JUNE 18, 1993 GIIORGIg & FLORENCE LOEItR 2200 HOBART ROAD SOUTHOLD, NY 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: ~ An application for Certificate of Occupancy is not on file. (Enclosed) 'No Underwriters Certificate on file. The check is ~u~not on file.)$25.00 No Health Department Approval on file. No final inspectioh has been made. No Plumber Solder Certificate on file. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 21200-z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. TRUSTEES ' '~-2 John M. Bredemeyer, III, President Albert J. Krupski, Jr., Vice President Henry P. Smith John B. Tuthill William G. Albertson Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR SCOTT L. HARRIS Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 October 23, 1992 George Loehr 2200 Hobart Road Southold, NY 11971 RE: Waiver for deck SCTM #1000-64-3-4 Dear Mr. Loehr: The following action was taken by the Southold Town Board of Trustees on Thursday, October 22, 1992: RESOLVED that the Southold Town Board of Trustees~grant a waiver to construct a 10' X 24' deck attached to existing dwelling. , :to co If you have any questions, please do not hesitate t this office. Very truly yours, John M. I President, Boa~ of Trustees JMB: jmd cc: Bldg. Dept. 95.20~b (10/90)-- 25c 1-4738-00624/00001-0 FACILITY/PROGRAM NUMBER(s) PERMIT Under the Environmental Conservation Law (ECL) January 20, 1993 EXPIRATIONDATE January 31, 1996 ~]N~w j-]Renewal E~Modlflcation E~Perm,t to Co.struct E~Perm,t to Operate Article 15, Title 5: Protection of Water Article 15, Title 15: Water Supply Article 15, Title 15: Water Transport Article 15, Title 15: Leng Island Welts Article 15, Title 27: Wild, Scenic and Recreational Rivers 6NYCRR 608: Water Ouagty Certificati0n F'--~ Article 17, Titles 7, 8: SPDES I----q Article 19: Air Pollution Control ["--~ Article 23, Title 27: Mined Land Reclamation I---q Article 24: Freshwater Wetlands [-~--] Article 25: Tidal Wetlands [-----1 Article 27, Title 7; 6NYCRR 360: Solid Waste Management ~'-~ Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management ~-"] Article 34: Coastal Erosion Management -'--'-]Article 36: Floodplain Management ['-~ Articles 1, 3, 17, 19, 27, 37; 6NYCRR 3BO: Radiation Control ~'---~ 0ther: PERMIT iSSUED TO George & Florence Loehr TELEPHONE NUMBER ( ADDRESS OF PERMITTEE 2200 Hobart I~d., Soutkold, NY 11971 CONTACT PERSON FOR PERMITTED WORK JTELEPHONE NUMBER NAME ^nD ADDRESS OF Pro)ecT/FAClUTY ~De]~' Property · 2200 Hobart Rd. LocAr,oN OFPROIECT/EACILITY Southold Suffolk Southold Town Creek E__ - N4 , _ DESCRIPTION OF AUTHORIZED ACTIVITY Construct 10' x 24.8' deck. Ail work shall be in accordance with the attached NYSDEC approved plan. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Condjti0ns sp. ec,!fied (See Reverse Side) and any Special Conditio~ns ipclud, ed as part of this permit. , D~v~d DeRidder January 20, 1993 Page 1 of 4 New York State DepaHmentof Environmental Conse~ation Building 40--SUNY, Stony Brook, New York 11790-2356 (516) 751-1389 FAX (516) 751-3839 Thomas C. Jorling Commissioner January 20, 1993 George and Florence Loehr 2200 Hobart Rd Southold, NY 11971 LS/nw RE: 1-4738-00624/00001-0 Dear Mr. & Mrs. Loehr: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are'enclosing your permit. Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Very truly yours, Laura Scovazzo Y ~ Sr. Environmental Analyst enclosure 9S-20-6a (10/90)-- 25¢ ADDITIONAL G~NERAL CONDtTtONS [:Og, ARTICLES 15 (.Titie 5), 24, 25, 34, 9. That if future operations by the State of New York require an al- teration in the position of the structure or work herein authorized, or if, in the opinion of the Department of £nwronmental Conservation 13. it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused 14 thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fdl, excavation, or other modification of the watercourse hereby authorized shall not be com- pleted, the owners, shall, w~thout expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteraUon. 16. 10. That the State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused 17 by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. 11. Granting of this permit does not relieve the applicant of the responsi- bility of obtaining any other permission, consent or approval from 18. the U.S. Army Corps of Engineers, U,S. Coast Guard, New York State Office of General Services or local government which may be required. 12. All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any 36 and 6 NYCRR Part 608 ( other environmentally deleterious materials associated with the project. Any material dredged m the prosecution of the work herein permitted shall be removed evenly, without leaving large refuse piles, ridges across the bed of a waterway or floodplai~ or deep holes that may have a tendency to cause damage to navigable channe{s or to the banks of a waterway. There shall be no unreasonable interference w~th nawgat{on by the work herein authorized. If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. If granted under Article 36, this permit does not signify in any way that the project will be free from flooding. If granted under 6 NYCRR Part 608, the NYS Department of Environ- mental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301,302, 303, 306 and 307 of the Clean Water Act of 1977 (PL 95-217) provided that all of the conditions listed herein are met. All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or his agent as part of the permit application. Such approved plans were prepared ~y J. TT~qec~O on 1 ~)/24/RR , SPECIAL CONDITIONS During construction, no wet or fresh concrete or leachate shall be allowed to escape or be discharged, nor shall washings from transit mix trucks, mixers, or other devices be allowed to enter tidal wetlands. Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands. The storage of construction equipment and materials shall be confined to within the project work site and/or upland areas greater than 50' linear feet distant from the tidal wetland boundary. Supplementary Special Conditions (A) thru (J) attached· DEC PERMIT NUMBER 1-4738-00624/00001-0 PROGRAM/FACILITY NUMBER Page. 3 of 4 Type of Permit Tidal Wetlands Activities for Which a Permit Is Necessary (See footnote for major/minor project explanation) Major Projects Dredging affecting 5,000 square feet or less Filling of 100 cubic yards or ~ess At~ other major projects Minor projects Those minor projects requiring a variance of 10% or less from standards in 6 NYCRR Part 661.6 Development Restrictions Those minor projects requiring a variance of greater than 10% from the standards in 6 NYCRR Part 661.6 Development Restrictions Installation of two or less pilings per currently existing principal building All accessory structures less than 100 square feet in area, adjacent to a regulated tidal wetland whether or not requiring a variance All other minor projects Mining Excavation of 1,000 tons or 750 cubic yards of soil, sand, gravel and other minerals from the Fee $400 $400 $9OO $400 $900 $100 $100 $200 No foe earth or more than 100 cubic yards of minerals from or adjacent to certain bodies of water within 12 successive calendar months for commercial, industrial or construction use. (Mining does not include the excavation, removal and disposition of minerals from most construction pro- jects or excavation in aid of agricultural activities.) Solid Waste Management Facilities For landfill permit applications other than landfills used exclusively for disposal of construction and demolition debris: (i) to construct (including initial permit Io operate) by municipalities serving a population of 3,500 or greater and by private individuals, organizations or corpore'~ibns; $400 (ii) to operate a facility which does not receive any industrial or commercial wastes: RENEWAL Serving population of more than 10,000 $100 Serving population 3,500 to 10,000 $50 (iii) to operate a facility which does receive industrial or commercial wastes $100 Waste Transporter Hazardous Waste Management Facilities Floodplain Managenent Collection and transportation of industrial/commercial, Iow-level radioactive and certain other wastes including sewage, septage, waste oil, etc. Waste Collection Permit Application Fees: For first collection vehicle $25 For each additional vehicle (total fee not to exceed $300 for any one applicant) $5 The construction, operation and siting of facilities which treat, store or dispose of hazardous waste, including hazardous waste incinerators, energy recovery units, land treatment demon- strations and facilities proposing to utilize innovative and experimental hazardous waste treat- No fee ment technology, Any development in flood hazard areas. No foe Wild, Scenic and Recreational Rivers System Coastal Erosion Management Conceptual Review Certain land uses or development in the river area of, or watershed above a designated wild, scenic or recreational river. Major projects except construction or modification of erosion protection structures greater than 100 linear feet Minor projects Appeal of erosion hazard area designation A conceptual review of the substantive consistency of a project or any component of a project with current state environmental policy and standards. No fee $5u $100 $25 $50 $5OO Minor Project-Major Project Explanation Under Uniform Procedures a minor project is one that, by its nature and with respect to its location, will not have a significant effect on the environment. A major project is one that is not specifically defined as minor. To determine whether a project is major or minor, refer to the specific permit program in Section 621.4 of the Uniform Procedures regulations. 14-18-1 (11/81)--9d NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION UNIFORM PROCEDURES APPLICATION FEE SCHEDULE Type of Permit Stream Disturbance Dam Construction or Repair Activities for Which a Permit Is Necessary (See footnote for major/minor project explanation) Fee To change, modify or otherwise disturb the course, bed or banks of protected streams Major projects $25 Minor projects $10 To construct, reclonstruct or repair any artifical obstruction, temporary or permanent, in or across a nature stream or watercourse, that witf impound more than one million gallons, will be more than ten;feet above the stream bed, or will have an upstream drainage area greater than one square mile. Construction: Class "A" Hazard $50 Class "B" Hazard $100 Class "C" Hazard $300 Reconstructior) or major repair (activities involving structural integrity): Class'A" Hazard $25 Class "B" oi "C" Hazard $50 Dredging and Filling of Navigable Waters SeCtion 401 Water Quality Certification Any excavation br placing of fill in the navigable waters of the State or their adjacent, contiguous wetlands. Major projedts $50 Minor projects $10 Any activity thai affects the quality of federally navigable waters and requires a Federal permit or license. No fee W';ier Supply Long Island Well Transportation of Water by Vessel State Pollutant Discharge Elimination The acquisition, bonservation, development, use or distribution of water for potable purposes by, or proposed bY, any person or public corporation; or Any groundwate( withdrawal in excess of 45 gallons per minute on Long Island. Major projects Minor projects Transporting mo~'e than 10,000 gallons of water from any freshwater lake, brook, river, stream, or creek in this State except ballast taken for normal activity of vessels. Any proposed oi existing discharge of sewage, industrial wastes, ballast, or other wastes to either surface Waters or groundwaters, except an individual discharge to groundwaters of less than 1,000 gallons per day (gpd) of sewage effluent without the admixture of industrial $50 $10 No fee System or other wastes.; (SPDES) VOLUME SOURCE Discharge in gailons per day 1,000 or less 1,001-10,000 10,001-100,000 Greater than t00,000 For ballast discharge from vessels Non-Municipal-- Industrial Municipal Non*Industrial $10 $10 $10 $100 $75 $50 $2OO $15O $75 $300 $250 $100 No fee Air Contamination exhaust or ventilation systems), Permit to construct a major source Permit to cbnstruct a minor source initial certiticate to operate Renewal ofI certificate to operate Exception: No Iee is charged for open burning permits issued under the authority of Article 19 and 6 NYCRR 215. To construct, modify, or operate any stationary source of air pollution (incinerators, process $500/source $50/source No fee $10/source/year Freshwater Wetlands Draining, dredging, excavating, filling, erecting any structure or roads, placing of other obstructions, polluting or any activity that impairs natural functions in e wetland or its adjacent area. Major projects Minor projects $50 $10 765-1802 BUILDING DEPT. INSPECTION [ ~FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ;ZND [ ] INSULATION FRAMING [ ] FINAL 765-X802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [~]I~L DATE INSPECTOR ,,//~ ~ '~x~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL,: 765-1803 APPLICATION FOR BUILDING PERMIT BOARD OF~HEALTH .~..~ ........ 3 SETS ~PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORM ................ NOTIFY CALL ~.'.~ ~ .~ .......... MAIL TO: Date ................... 15... INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets df plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing lo~ation 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. e. 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 Pennit 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 aoy 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 ~:emoval 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 ilkspections. .~ ~// i' lic~r~(, or name, if a (Mailing address of applicant) /. )'ff 7~ ' State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. .... O..w.N. .................................................................................. Name of owner of premises ?..~.~..r/.~ ~..t~i,.,.q~. /~./.O.T ~.~.~.~..~.". Z~sa.t~ v- (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No...~.u-/.~.c¢.~f7 .............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be done ....... ' ......... : ................................. · .gL. a ................................... :4 .................. House Num her St rcet Hamlet County Tax Map No. I000 Section ... ,D, .~. J/. ......... Block .0.~· .............. Lot .0, .-~. ............... Subdivision ..................................... Eiled Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... b. Intended use and occupancy ...................... ~-~'- .¢. ,~, .... · .'~'..'.. '.."i. ....................... 3 Nature of\York (check'which 9pplicable): New Building ..... ' ..... Addition . . ,Z~..~eration Repot Re?ova, Demo.tion " ...... /tSd 0 ~ ~ (Description) 4, Estimated Cost ~.~ ........ ~ ................... ~ ..... Fee , ............................... (t0 be paid on filing this application) 5. If dwelling, number of dwelling units ............... . If garage number of cars ~ Number of dwelling units on each floor .............. . mensions of existing stmcm es, if any: Front Rear ............ De ' pth .............. Height ............... NuCber of Stories .......... Dim i f ~ith It ti dditi .............................................. ens ohs o same structure a era OhS or a OhS: Front Rear. D p~h ' tlei~t ................. ....................... Number of Stories .......... Dimensions of entire new construction: Front . . H igl · pth e it ....... ~r.&u~_ ~.. · ........... Rear ............... De ...... Size o lot: Front .............. Rear ..... De fp ................ pth Date o urchase ....... . , ' ......... "t ............... N fF p~ .. ame o o~erOwner ............. Zone or use dmtnct in which emises are situated.. ' ............... 01 g I .................................... ocs proposed construction w ate any zonin aw, ordinance or regulation, . W~l ot be regrade . ! x~ ~ ~ ' .' .... ,' .................... Will excess fill be removed from premises: Yes No ~me m owner oI premmes ........... Add.e~° . N fA ..... ....................... Phone No. me o rchitect ...... l ........... · .... , · ·. ' ' · · ...... Address ................... Phone No ............ , .... Nme of Contractor ........ ~ .................. Address ................. Phone No ....... - .... ~' 15.Is this property locCted within300 feet of a tidal w~land? *YES ~ .... · If yos, Southold Town Trustees Permit may be required. ....NO .... ... [ PLOT DIAG~M - · 8. 10. 11. 12. 13. 14. Locate clearly and distinctly al~ buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block~'number interior or comer lot. or description according to deed, and show street names and indicate whether STATE OF NEW YO~Ke,.c-- , COUNTY OF ......... .Xo ...... ..................... being duly sworn, deposes ~d says that he is the applicant (Name of individual signi~}g contract) above named. Itc is the ~ $.~ ' ' (Contractor agent corporate officer etc ) ........... of said owner or owners, ~d is duly~authorized to pe,rform or have performed the said work and to m~e and file this application; that ali statements contained in this application are ~rue to the best of his knowledge and belief; and that the Work w~l be perfo~ed in the m~ner pet forth in the application hied therewith. Sworn to before me this /~'~ [ ' ........... ...... " .......... ~/ ..... : ..... ? ¢ ~{ ~n~7';'-,~ County ...... .... : ........... ~ARY PUBLI~ ~ (Signature o[applic~t) TE. LINE ALONG BULKHEAD D H,W. M. ~,REA = 35,112 SQ. FT. ~r' 8061 ac. to tie line ~Y.S. LIC. NO. 49668 . I I',1 ROAD J~HOLD ~ N,Y, 1197l ND-JIFY BY:. _ .... _.~ _ FY BUILDING DEPARTN~3= AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1.FOUNDATION TWO REQUIRED FOR POURED CONCRETE 2.ROUGH. FRAMING-& PLUNIBING 3.INSULATION 4. FINAL CON~'~TR[.ICTiON ~UST BE COMPLETE FOR C.O, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS SURVEY OF PROPERTY AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. I000 LOT NUMBERS REFER TO , 'SUBD V S ON MAP OF FOUNOERS ESTATES"FILED MAY I0~ 1927 IN THE OFICE OF THE SUFFOLK COUNTY CLERK AS MAP NO. 834. - 064 - 03 - 04 SCALE I"= 30' OCT. 24, 1988