HomeMy WebLinkAbout20370-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-21175 Date NOVEMBER 24, 1992<
THIS CERTIFIES that the building NEW DWELLING
Location of Property 675 HALLS CREEK DRIVE MATTITUCK N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 115 Block 17 Lot 17.21
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 8, 1992 pursuant to which
Building Permit No. 20370-Z dated JANUARY 8, 1992
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for wkiich this certificate is
issued is ONE FAMILY DWELLING WITH ATTACHED GARAGE AND WOOD DECK AS
APPLIED FOR.
The certificate is issued to KEVIN CANDE & CATHY PUFAHL
(owners}
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NOV. 16, 1992 - 91-SO-97
UNDERWRITERS CERTIFICATE N0. N-256783 - NOVEMBER 11, 1992
PLUMBERS CERTIFICATION DATED NOV. 23, 1992 - MARK BAXTER
Buildi'' ng Inspector
Rev. 1/81
rosmt x®. s
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)
N 2 0 3 7 0 2 Date sl,:wss: ~!i~,...
~ 19~.~.
Permission is hereby granted to: U
n ,
...~....5~! .
i~- ,p a Ua:t_ y.?~1:!~.,... x.1.".1.9. ~.0 ~ n I
to ...~:1?r:'9:~M:S,..[::.....a4:...N..fra ~...........:~.d~A~:~~.. i.Ma~1...~lfAa.C..........
R.,...,~..
Vat premises located at ...~.~.....[.1.4X~.....1.14R.4./~......l..ise.W..'R.......~.RVk~~~4:..........
o.............................................................................................................
County Tax Map No. 1000 Section ......1.~.`4+........... Block ......I..~.......... Lot No... a:.......
pursuant to applicotion doted ...~~2:n.t:t.t~ .M. 19g~:., and opproved by the
Building Inspector, fVT'
Fee 5...74T.~::..
......1.~..5~?
u ding Inspector
Rev. 6/30/80
Form No. 6 1'~s~ - ~
v' TOWN OF SOUTHOLD
` ' BUILDING DEPARTMENT
• TOWN HALL
• 765-1802
APPLICATION FOR.CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building or new use:
1. Final survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept, of water supply and sewerage-disposal(S-° form .
3. Approval of electrical installation from Board of Fire Underwriters. )
4. Sworn statement from plumber certifying that the solder y;sed in system contains
less than 2/10 of 17. lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.'
S• For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existin "
g land uses;
1. 'Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2, A properly completed application and a consent to inspect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
• reasons therefor in writing to the applicant.
• Fees •
1, ertificate of Occupancy ew dwelling $25 OQ ~
n ~c.raq.ons to dwelling $25.0'b'-• Additions to dwelling $25.00,
Additions to accessor building ~wlmmang pool $25.00 Accessor buildin
Y g $25.00. Businesses~$50,00. Y g $25.00,
• 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
S. Temporary Certificate of Occupancy - Residential $15.J00, Commercial $15.00 '
Date ,l/„~~~.1~~
w Construction.. , Old Or P e ~ " " " "
r -existin Buil g,
cation of Property:.. Lf',T„ A7c>,. •Z~,,,lf!9;L~,:S dC',lt;£~/~. L
house No. ° ^ urs,-. ..~~:T~ :.TL' C:'~.•..
• ~ Street ..Hamlet
+er or Owners of Property„~,~~ 1 ~ ~ ~ w"~ '7~~~ •
mty Tax Map 1No 1000, Section „ ~/,,,,,,,,,,glock.....~ ~,,,,,,,,LOt„ ~ -•Z ~
~'A'fL~ ~I~v~ i~`~'..~~TI•'rUC~"r..Filed Map............Lot....~4..T.
alt No.:~.,~.:
'~^+~....Date Of PeCCr~~mi77t~~ ................Applicant..
Lth Dept. Approval..,l,~,'; S 6 ...l.l...
..Underwriters Approval... SJ; , ,`F~ 1'•~-
fining Board Approval.......{'.~~.~!~{"............
~~esC for: Temporary Certificate.....,, / •
Final Cezticate v
-
Submitted: ~
~~•,~s~c~~ ~ • .mot ° ~ . . .
m~~v`T` C
Y .d3:.
O~~F~~(~~`, TEL. 7G5-1802
Qom. _ O~, TORN OT' SOiiJTF~O]LD
1 ~ OFFICE OF BUILDIl~IG INSPECTOR
° ~ rn P.O. BOX 1179
v%~ e??~ TO1VN HALL
,~o`~p~' SOUTHULD, N.Y. 11971
C E R T I F I CAT I O N
Date {~~rR~ Z
Building Permit No.~~
Owner CGS ~n r
(please p int)
Plumber_(/U~q,,, I~ C.~ 1C~`Q v
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of to lead.
~ (plumber's signature)
Sworn to before me this
.9'l'c.cl day of /`~0.P~~ 1'I!-Qel'L_~r'
19 ~ L, ~ r ~ y-c9~Lc.~ J
N tart' Public
17otary I'ublic,,~ County
Sit LINOAJ. COOPER
Natary Pubfir., State of NeW Yo
Perm
Exp,ees50ecamffolk Counry~v
ber31,19_,_,
THE NEW YORK BOARD OF FIRE UNDERWRITERS FILc~
100d'9T1' BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
Date NOVC~HIIBR IR'2492 ApphcntionNo.onfile 77&0f49x19?. N 25h7E3~i
THIS CERTIFIES THAT
only the alectricaf equipment as deacri6ed 6ebw and introduced 6y the applicant named on the above application number in the premiaea of
KI;IIZN CANI)E, HALL';? CRlR!'sK B[tT~F~, FlAL"CIi'UCK, t1.Y.
in thefollowinK Inca 8 s@m ~ Ise Fl. ~ 2nd F'l. CAI?(A.TTSC~Q~.)fi Sertion Black Lot
~(~`~'FPtB~Ct ~Ir,~'~~32
was examined on andfoundWbe in emrtpliance with the requirements q(this Board. _
iIXTURE ECEPTAClES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS INCANDESCENT FIUORESCENi OTHER AMT. K W AMT K.W PMi N.W AMT K.W AMT. H P
~ b4 4i8 hx 6~! 2 f.5 1 1.2 ~ 3?
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS EELL UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K. W. Oll H. P. GAS H. P. AMT NO. A. W. G. AMT. AMP PMT. AMPS. TRANS. AMi N P SYSTEMS AMi WAiiS
x NO.Oi FEET
SERVICE DISCONNECT NO.Oi S E R V I C E
~ AMT. AMP. 1YPE METER ~ 1W ~ ~ JW 3 ~ JW ] A, AW NO. OF CC CONO A. W G NO OF HIAFG A' W G NO Of NEUTRALS A' W G
F EQUIP. PER 9 OF CC. COND. OF HI-LEG Of NEUTRAL
~ 1 2t~~ CR i X 7. 41N 1. 2/~1
OTHER APPARATUS:
,rA~HZZr.-?.
~o~~nr?51~-~ H.II.
G.~'.C.ls-5
5M01{E S3CTECTf)Ht -1 ,
I ~
i G & 5 COPITRA.CTOit i,?C.p5TEl°E
BQX 21a
Hi)H~IHOLB f FI'X r ~ 19'T S GENERAL MANAGER
11
Per--.{'~ t
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors mdy be identified y their credentials.
COPY FOR B LDING DE AR MENT. N13 CO F CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
I.
c'lcLD 1~:SC~~;iUN ~IJr.; I~ i;OC1i4ENT°
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7 . ~ 3 m o
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FOUNDATION "3Q
(1st)
a('p
7 Y
• c-
c
FOUNDATION (2nd) - m
2 .
P,OUGH FRAME $ _
PLUMBING _
~
M~
' ~
3. / y~
IIISULATIOII PER N. Y, m
H
STATE ENERGY !e
CODE
.
7 ~
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FIIJAL
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ADDITIOPI COMh1EP1TS: ~ ~ 'F
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INSPECTORS
Victor Lessard `D~~JFFD(r
.(n1~
Principal Building Inspector ~ q\. _ ~d~
Curtis Horton h~ w ~ SCOTT L. HARRIS, Supervisor
Senior Building Inspector c=am 1
rn ; ~ f':=5
~',ok' ~ Y Southold Town Hall
Thomas Fisher .=•..dro- =
Building Inspector d 3 Y~ P.O. Box 1179, 53095 Main Road
~~9.~~ t.~s~' !r Southold, New York 11971
Gary Fish O
Building Inspector Or 'fix Fax (516) 765-1823
Vincent R. Wieczorek ~'"s=~=~7~ Telephone (516) 765-1800
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTHOLD
NOVEMBER 16, 1992
REVIN CANDE 6 RATARYN PUFAHL
REMSEN ROAD
WADING RIVER, NY 11792
RE: PREMISES @ 675 HALLS CREER DRIVE, MATTITUCR, NY
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
becau e of the following reasons:
xltS An application for Certificate of Occupancy is
not on file. (Enclosed)
x>~ No Underwriters Certificate on file.
The check is not on file.)$25.00
gRR No Health Department Approval on file_
No final inspection has been made.
~ xxlt No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
' BUILDING PERMIT # 20370-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
_ .y
_ . ~ . F
765-1802
BUILDING DEPT.
INSPECTIAN
[ ]FOUNDATION 1ST [ ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ~MING [ ]FINAL
r
_/C~EMARKS: ~
r _ /1
`
l
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Gds-Ili ..G~~ GL2-~ _ /
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DATE ~ SPECTO / ~
~3~°
765-1802
BUILDING DEPT.
1 NSPECTION
[ ] FO DATION 1ST [ ] ROUGH PLBG.
[ FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
! REMARKS:
E
- -
i
DATE Y INSPECTOR '
~ •
~~~Zo
765-1802
BUILDING DEPT.
INSPECTION
[ FOUNDATION i5T [ ) ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [)FINAL
l
REM KS:
r
4
'1
I
DATE ~ -2~ INSPECTOR
zoo---
765-1802
BUILDING DEPT.
1 NSPECTAON
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[)FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ FINAL
REMARKS:
DATE ~O 7 1/ INSPECTOR
765-1802
BUILDING DEPT.
~ ~ - I NSPECTIAN
[)FOUNDATION 1ST [ ) ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: ,~J P
` ~ s
`
DATE INSPECTHR~ /
' BO,1FD OF HEALTH
PORMN0.1 J SETS OF PLANS
FI~?p~` TOWN OFSOUTHOLD SURVEY
BUILDING DEPARTMENT cltect;
~Ii~; JpN"8~~~2 TOWN HALL SEPTIC FORM
k
i'~~ SOUTHOLD, N.Y. 11971
k TEL: 765-1802 t:OT i FY ~ / /
if"",.~,~C__ ..~.z. > CALL ./.-..'~1~' ~~~F~'
Examined a.~w,.. ~ 19 q.?^ Mn I L TO
Approved 4!v+:cL°1!µS 199:Z Permit No..'a.4'.3.7 a ~ . . .
Disapproved a/c .
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date .....i..l.~........., 19 ~Z.
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 i spe tons
(Signature of applicant, or name, if a corporation)
.°..!to•zo g~~ac~wa.j~+-s CiJfz-I~~~y~?..~.
(Mailing address of applicant) 1 «l3S
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
w.~ .
Name of owner of premises ..F.-.'P.~) w1 , ,1`.•...l.(Pl,v. ~.2; , , , ~ , ,~Glt~')(Z; l,~,Y.~ , , , ,~UT;CI.~'L
(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 . .
Plumber's License No . .
Electrician's License No . .
Other Trade's License No . .
1. Location of land on which proposed work will be done. . ~/~e~ ~ ~{a.~~C,~
House Number Street Hamlet
County Tax Map No. 1000 Section l l ~ Block l Lot
Subdivision . ~a~. ~Jb U l'.~ Filed Ma No. Lot .
p
(Name)
Z. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy Q CCs.. l p .
p.~4 S~e.n ~.F
i ~._iRid
b. Intended use andoccu anc .~~lYY.1.a:~ ~Glv?'ll` r., p,~~ l~ E.sL, ~
P Y ~ • ~ x Y?, . 4. .
I
~t,iazol; ,
3. Nature of work (check which applicable): New Building Addition , Alteration . I........ .
Repair Removal Demolition Other Work .
df ~~-O p (Description)
4. Estimated Cost..........1 Fee..................................,...
(to be paid on filing this application)
we ~n num er of dwelling u
'G.
. If gara a number of cars r~ is ~
g g.....,..........................
6. If busines~ commercial or mixed ' ' • • Number of dwellin u ype of useh floor
,occupancy, specify nature and extent of each t , , , , , , , , ,
7. Dimensions of existing structures, if any: Front ................Rear , , . , Depth .
Height Number of Stories ,
Dimensions of same structure with alterations or additions: Front Rear , .
Depth Height Number o~toties .
8. Dimensions of entire new construction: Front ~ Rear Depth ..3. .
y
Height Number of Stories ....Z.
9. Size of lot: Front ~ ~ Rear . ~
• .SUY.?.~....... Depth ..?;20
10. Date of Purchase ~ g,~ .....................Name of Former Owner ...5.~?a.n ~ V f.C, h .
11. ,Zone or use district in which premises are situated .
12. Does proposed construction violate any zoning law, ordinance or regulation: ~ .
13. Will lot be regraded Will excess fill be removed from premises: Yes No
Name of Architect p~~hf~ll(~ , y~~t ~ 'Address ..5 f~!4~........ Phone No.'1.3W: Z . , .
14. Name of Contractor remises ~ ~ Address .+'e.~.1r1,~C1C.lne..~..... Phone No .
!~O C t~ ~Q„(„~ , ;j", , , , , ,Address .Phone o.
15. Is this property within 300 fee of a tidal wetland? eyes,,,,,,,. No..'......
*If yes, Southold Tgwn Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot. ,
@-~~
\
U l\,
~J
STATE OF NEW ORK S.$
COUNTY/
~O . ~ .
(Nam idual si in~ • ~ ' ' ' ' ' • • being duly sworn, deposes and says that he is the applicant
contract)
above named.
He is the ................~JC.t~Yi-P.~...................................
(Contractor, agent, corporate officer, etc.)
~f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
vork will be performed in the manner set forth in the application filed therewith.
iworn to before me~tjhis -j'~
.b~ .day ofv .G~ ?1 U Cd 19~
lotary Public, 1.. ~~i(~-(,'. , . County
CLAIRE 1.OtE1N', •r• : v`'~2" ' ' ' ' ' .(~.~~j}/."• • :'1 • . .
N~rYPubIIc,StataofNewyo* (Signature of applicant)
Qualifledoln
Suffo k County _
Commlasion Expires December g~ 18.,,~L--
K TEST HOLE
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~ 'f Lot 2g
~L • ~ Lit 'j7 (VACANT)
S N, ~ Area = 44460 s. f. 3
w i
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N. 85°08 04 'yy. EL ° I<.z
140.98'
TEST NoLE GG Lot 25 I
/ (VAC4NT) Lot
LOAM 1 2 4
AO' I VACANTI
SAND
10.0'
SINGLE FAMILY DWELLING NLY
EXPIRES TWO YEARS FROM DATE OFAPPROVAL
NOTE
TEST HO LE AS INDICATED ON FILED MAP
SURVEY FOR
KEVIN CANDE
SUFFOLK COUNTY DEPARTMENT OF HEAUM SERYICEa LOT N0. 27, "HARBOR VIEW AT MATTITUCK~~
FOR APPROVAL OF CONSTRUCTION ONLY AT MATTITUCK GATE. OCT 15, 1991
G1 TDWN OF SOUTHOLD SCALE I = 40'
DATE~V t S ~~t REF. r / SUFFOLK COUNTY, NEW YORK NO 91 - 0899
N U/MUTNdP12 E0 ALTf RATI ON OR 4001 TION ro TN IS
SURVCY 4 A VIOLATION OF SE CTIOM 7109 OF THE
4PPROVED NEw PORN STATE EDUCATION Law Sg OF N@h,
3 ~ ~3 RCOPI ES aF TNii SURVEY MOT GEARWG 7N[ LAND
SURVEYOR'S IMNEO SEAL OA EMEOSSED SEAL SNA LL § ~O
MGUARANTEES DINDI C4 TED NEREOMI SNALL ERUMPp/LT TO `SA'a® W Y 9r
THE PERSON FOR WMON 7ME SURVEY IS VREPARf0 ~
HEALTH DEPARTMENT-DATA FOR ROVkL TO CONSTRUCT ANO Or NIS GENALF ro THE TITLE COMPANY, GOVERN- ~ Z ~
N M[Mf3T WAT[II •AIN NI ! N30URCE Of WATfR PIIIMITE _PUELIC _ MENTAL AGENCT AND LENDING INSTITUTION LISTED [T
N EIiF CO. TA%MAp OIETT000 Sf GTIOM 115 EIACN 1L LOT 17_21 MERE011, AND TO THE ASSIGNEES OF THE LE NOINO ~
R TN[R[ ARE MO DWLL LIMEf WITNIM 100 fEET OF TNIS ?RO pf RTT INSTI7UTIOM GUARANT[ES ARE NOT TRANSFERABLE
OTNfR TNAM TNOEE ENOVN N[REON -~y TO ADDITIONAL INSTITUTIONS OR SUGSEOUEMT
R THE WAT[R WMLT Alp SEEEIG[ DIEFOEAL SYETfN FOR TNIf R[EIOENCf OWNERS
R DISTANCES SNOWN NCREON FROM PROPERTY LINE ~ NO
w11A CdFORN TO THE ETINOMROE OF TN[ SUFFOLK COUNTY O[?MTN[NT TO ExIETING fTRUC tUR[E AR[ FOP A SPECIFIC 8
W MGLTN E[IIVIC[E FUR 105E AMD APE NOT TO EE USED TO ES TAELISN ,{FD ~
ARLICANT~ r,. /~~~gV_ PROPERTY LI NEE OR FOR THE ERECTION OF fENCF3 lggp V~
ADavfsE 18 5 L ol0 ~p'UNT.2`( _ GL.A
ptluf.0~1'EyLD RL -~L~ 61ro~ YOUNG ~ YOUNG R~IVOERHEAD"NEW YORKE
NOTES ~ =STAKE • :MONUMENT ALDEN W. YOUNG, PROFESSIONAL ENGINEER
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK ANO LAND SURVEYOR NY.S LICENSE NO 12845
OF SUFFOLK COUNTY ON AUG. 21, 1987 AS FILE N0. 8377.
m HOWARD W. YOUNG, LAND SURVEYOR
n RTNELOGTpMnw4LIWI,aFPTICrANKUT14c[EEroa.E(nlaNOwNNU[oN N.Y.S.LICENSE N0.4S893
m ARf pROY HELD OpERWTIONE AND OR DATA OETAIN[0 FII'OY OTNERE
BRANDIS A SONS INC. ~ ,
WPtEa MP`N O~\` 1 ! ~ n
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2, e3, ~G ? UNOp(\O
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/ 26d o.,no _ 983'
I _ _ M
~ 26 I ~
~ ~ mot i -
I
2
' ~ ~ I
e
It 7 ~ I
' n ml Lot Lot 28
=1 2 7
S N i Area = 44460 s. f. 3
N", I o
I o
I v
°
I
N. 85° 08'04 "W.
140.98'
Lot 25 I
/ Lot 24
SURVEY FOR
KEVIN CANDE
LOT N0. 27, "HARBOR VIEW AT MATTITUCK~~ MAR, 30, Issz
AT MATTITUCK oarE: ocr I5, issl
TOWN OF SOUTHOLD SCALE- I" = ao'
SUFFOLK COUNTY, NEW YORK N0. 91 - 0899
R WMUTNORIZ CO 4L TERA TI ON OR 4001 TION TO TN IS
SURVEY 4 A VIOLATION OF SECTION 1209 OF THE OF ,Z;4y
MEW rORK STATE EWCATION LAw F.~
M COPI ES d< TN13 SURVEY NOT BEAR WG TNC LAND f
' SURVEYOR'S INKED SEAL OR EMBOSS ED SEAL SHALL ~PRD by ~ fl~°Y~"
NOT BC CONSIDERED TO BE A VALID TRUE COPY '
N GUIRAMTEE3 INOIU TED HEREON SHALL RUN ONLY TO P O ~e
THE PEPSON FOR WHOM THE 3.U RVEY IS PREPAR [D
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT AND a N1s BEHALF 10 THE TITLE COMPANY, GOVERN- ~ q
r N[ARCST WAT[II CAIN _MI ~ N30URCE OF WATER MIMTE _PUBIIC _ MENTAL AGENCY 4M0 LENDING INSTITUTION LISTED
R riRF CO TAX MA? pfT IOCO S[C TION Jl
.i_ BIDCR 12_ lOT 17.21 HEREON, AND TO THE ASSIGNEES Of iNE LENDING i
R TN[K ARE NO DWCLLIKf WITHIN 100 FEET OF THIS /ROPLRTY INS TI tVTIpI GUARANTCES ARE NOT TgAN SFER4 BLE
OTNCR THAN THOSE SHOWN N[REON TO 4DDI TIONAL INSTITUTIONS OR SUBSEOUE NT
OMNERS r
M TNL WAT[R !U?PlY AND SEMNBE DISPOSAL 3YSTCM FOR THIS RRIDC NCL R OI STANtEi SNOwN NE REOM FROM PROPERTY LINES 1 O. 4 $9
WILL CpifORM TO TN[ STAN DAROB Of TN[ SUfFOLX COUNTY DE?ARTMLN7 TO EXISTING STPUC TUBES ARE FOR A S?CCIFIC N /IL
0/ N[ALTN BLRVICLS PURPOSE ANO ARE NOT TO BE VSED TO ESTABIISN LAND S V
ANLICAMP PROPERTY LINES OR FOR THE ERECTION OF fEMCE1
ADOR[Sf
"L YOUNG Bt YOUNG R~IVOERHEAONNEW YORKE
NOTEI ~ =STAKE • :MONUMENT AIDEN W YOUNG,PROFESSIONAL ENGINEER
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK 4ND LAND SURVEYOR N Y.5 UCENSE NO 12845
OF SUFFOLK COUNTY ON AUG. 21, 1987 AS FILE N0. 8377.
HOWARD W. YOUNG, LAND SURVEYOR
rM IOCATIDN OP wLLLfwI, SEPTIC TAMKpTI• C[SY0Oli(C?) SNOwM NC11LOr N.Y 5. UCENSE NO 45993
ARE PROP FlELO OBlERMTIOMS AND OR DATA OBTAIMCO FROM OTHERS
BRANDIS A SONS INC. ~1
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~ S.C. DEPT. OF
~3'-' HEALTH SERVICES
SURVEY FOR
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES KEVIN CANOE Nov. s, Iss2
'~j 81NGLE FARIILY DWELLIPOG O&!LY LOT N0. 27, "HARBOR VIEW AT MATTIT UC K~~ MAY la, Inez
lUOtf ~S~t.S. ftEF. raO. ~L-.~-~-7 MAR. 30, 1992
DATE A7 MATTITUCK DATE ocr r5, 1991
Tha sewage disposal and water soppfy iaciirties for this TOWN OF SOUTHOLD SCALE. I " = no'
location fiave been inspected by this ISepartment and/or SUFFOLK COUNTY , NEW YORK No 91 - 0 899
4 other an sand and to be satisfae~ry.
~ RuNAU iNOR12E0 ALTCRATI ON OR AD DITION ro rNls CERTIFIED T0~
V' Chi of etlreau of Wastewl ter Management suRVfr a A vla AnoN OF SECrION Tz D+a of TNt KEVIN CAN DE
wEW YORK STATL EDUCATION LAW TRW TITLE WSURANCE, INC.
NEDPIES of rNU 3(MVEY NOT BEARWG tNf LAwO SUFFOLK ~,QUNIj~}: NATIONAL BANK
SURVEYOR'S INKED SEAL OR EMBOSSED SE4L SMALL ~~pp x~~dd`
NOT B! CONSIOE RE010 BE A VALID TRUE COPY X ~i UU~~ ®®®,p
K GU APANTfE4 Iw01CA TED HEREON SMALL RUN ONLY i0 00g3~oo W a°~
e~ 9
THE PERSON fOR WHOM THE SURVEY IS PREPARED ~ ~ 17V. p
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT 4ND a NIS BE NAV TO THE TITLE CONPAwY, GOVERN-
R N(AREl7 WATER •AIN MI V NSOURCE Of WATER PIII MTE _PUBIIf ~ MENTAL 4GENCY ANO LENDING INS TI7V TI OM LISTED
N Stiff CO. TAX MA? OIST=000 SCC TION 115 BLOCK 1L. LOT 2~ NEREON~ AND TO TNf ASSIGN E[3 OF iNE LENDING ~i2#1~~~'~?U
R TN[RT ARE NO OW[LLIIMiS WITHIN 100 FEET OF THIS ?ROP[RTY INSTITUTION GUARANT[[S ARE NOT TRANSFERABLE e p ,
TO AOOI IIONAL IN371TVTIONS OR SV BSE OUE NT i1
OTN[R THAN THOSE SHOWN HEREON OWNERS 9
N TN[ WAT[R SUPPLY AMD SEMMBE DISPOSAL SYSTEM FOR THIS R[31DE NCL R DISTANCES SHOWN HEREON FROM PROPERTY LIMES L&t®
W IlL Cp1fORM TO THE STANOIAROf OF TNf SUFFOLK COUNTY O[PARTMfNT TO Ex 13TpG STPUC TV RES ME FOR A 3/ECIFIC ~"ppE~}~E~y'q y
W NLALTN SLIIVICL3 PURPOSE ANO ARE NOT TD BE USED TO ESTABLJSN ~ -ogee a
ApUCANF ?ROPERTY LINES OR FOR THE ERECPON Of ffNCES ',F~~(NAN®
ABOR[ss
~L YOUNG & YOUNG'°E ~
",~wvoR E
NOTES ~ =STAKE a =MONUMENT ALDEN W YOUNG,PROFESSIONAL ENGINEER
SUBDIVISION MAP FILED IN THE OFFICE OF TkE CLERK AND LAND SURVEYOR N Y.S LICENSE NO 12845
OF SUFFOLK COUNTY ON AU G. 21, 1987 AS FILE N0. 8377
HOWARD W_ YOUNG, LANG SURVEYOR
N M LOCATd10f WELI(W),SEPTIC TANK(fTiB CEfSI'OOLSIC/) BIIOWN N[II[ON N.Y S. LICENSE NO 45893
AR'E FROM FIELD OBlERYMTIOMS AND OR DATA OBTMNEB FRYh1 OTHERS
BAANDIS i SONS INC.