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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-21196 Date DECEMBER 4, 1992
THIS CERTIFIES that the building NEW DWELLING
Location of Property. 255 ORIOLE DRIVE SOUTHOLD, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 55 Block 6 Lot 15.26
Subdivision HIGHPOINT MEADOWS Filed Map No. Lot No. 23
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 17, 1992 pursuant to which
Building Permit No. 20902-Z dated AUGUST 18, 1992
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 AS APPLIED FOR
The certificate is issued to DBM CO.
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 90-SO-88-NOV. 23, 1992
UNDERWRITERS CERTIFICATE NO. N-256222 - NOV.9, 1992
PLUMBERS CERTIFICATION DATED NOV. 18, 1992 - K&K PLUMBING & HEATING
Building Inspector
Rev. 1/81
WORM NO. f
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. T.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED) nn
N°_N° 20902Z Date .........l .0.:t... 192:
Permission is hereby granted to:
b ...h'~ ~
..3.... R!rn.... ~ Z.Q.x... v~?.40
to.. °u 3 1h~~S.? ....51tc...S2?5.4 ...j. . ....Qa .w?
- .....................Q...........~...................................
at premises located at ...and ...1,.~1Ge.l........c~~-!5 . .
.
County Tax Map No. 1000 Sec' C?.5 Block 0 ..LP....... Lot No..~.s.. rn......
pursuant to application dated k°...........1.7......., 19..42.; and approved by the
Building Inspector.
Fee S.•+~.•
Auiling Inspector
Rev. 6/30/80
{ 4 Form No. 6 7-
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL i
DEC I W2 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-disposel(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.
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 $15.00
Date „NovembeA 30 1992
:ew Construction..X Old Or Pre-existing Building
.ocation cf Property.. 255. Oxiote DX-Eve ...............................Soutto.~d...............
House No. Street Hamlet
)nwer or Owners of Property.. AAA Ca
:ounty Tax Map No 1000, Section. ?.~..........Block........6.......Lot.15:?b
;ubdivision.... ft-aI.O.4O !eAd,0~ ................Filed Map ........1.... Lot..23..................
ermit No...ZO.9.QZZ....... Date Of Permit. .~/1!!92........ApplicanE.$.M.... .
lealth Dept. Approval 90 50:8.8 ..................Underwriters Approval.........................
'lanning Board Approval
request for: Temporary Certificate........... Final Ce~rticate.. XX......
'ee Submitted: $..25:00 .....~,ti;-i'~~~:°.`:::
APPLICANT
'f
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1195099 BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
Dote DECEMBER 10,1992 Application No. on file 78973792/92 N 259916
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
DBM CO., ORIOLE DR., SOUTHOLD, N,Y.
in thefollowinR location; ® Basement ® /nt FL ® 2nd Fl. OUT Section Block Lot 23,
was examined on DECEMBER 07,1992 andfound to be in compliance with the requirements of this Board.
FIXTURE TANS SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K. W. AMT. K. W. AMT. K.W. AMT. K. W. AMT. N. P.
17 27 19 16 1 1 8,3 1 1.4 1 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SNICIALREC/T TIME CLOCKS SELL UNIT HEATERS MULTI-OUTLET DIMMERS
Mr. K. W. OIL H. P. GAS H. P. AMT. NO. A. W. G. AMT. AMP. AMT. Mrs. TRANS. AMT. N. P. SYSTEMS NO. OF FEET AMT. WATTS
I 2 F 1
SERVICE DISCONNECT NO. OF S E R V 1 C E
AMt, AMP. TTPE METER 10 2W 1 a 3W 3 a 3W 3,e AW NO. Of CC. COND. A. W. G. NO. o' NI LEG A' W. G. No, a NEUTRALS A. W.G.
EGW?. PER% OF CC. COND. OF HI-LEO 0 NEUTRAL
1 200 CB 1 % 1 4/0 i 2/0
OTHER APPARATUS:
MOTORSt1-F H.P.
G.F.C.It-4
SMOKE DETECTORt-1
SAGE JAMBS LIC,43635 E
P.O.BO% 38
GENERAL MANAGER
GREEMPORT, NY, 11944 11'Y
Per
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
SUILI)IM DEPARTMENT. TA IS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
ca'0 Fa
0~0 CpG~
JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK ° P.O. Box 1179
co
z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS O `r} Fax (516) 765.1823
MARRIAGE OFFICER y~Jp 0~~.y+f f516) 765-1800
RECORDS MANAGEMENT OFFICER Telephone
OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
APPLICATION FOR PUBLIC ACCESS TO RECORDS
INSTRUCTIONS: Please complete Section I of this form and give to Town Clerk's
Office agency Freedom of Information Officer). One copy will be returned to you
in response to your request, or as an interim response.
SECTION 1. p p
TO:~ tom. ~o~ ~ok _ -~e y C
(Department or Officer, if known, that has the infor ation you are requesting,)
RECORD YOU WISH TO INSPECT: (Describe the record sought. If possible, supply
date, file title, tax map number, and any other pertinent information.)
CIO
/s- u 64
Signature of Applican
Printed Name: h ~ lG-~-~ 1 \ y ~~Yf;
Address: cZSS by
Mailing Address (if different from above) :
Telephone Number: 76 is-- 3S 73 Date:
[ l APPROVED RECEIVED
( ) APPROVED WITH DELAY* [ ) DENIED* MAY 2 t 1596
Judith T. Terry ' (0WPdat Clerkelndthold
Freedom of Information Officer
* If delayed or denied see reverse side for explanation.
I
MAT:
s
TEL. 763-1803 1
'i r,~FFnIk~¢ TOWN OF SOUTHOLD
Ol FICEOF BUILDING INSPECTOR
} P.O. DOX 728
CA TOWN HALL
~-t SOUTHOLD, N.Y. 11971 j
Y
. tr OEC 1992 v
C E R T I F I CAT I O N
e,
ti I l~l~a- i
' Date i
n
j Building permit No..7C) 0 Z e2
Owner Z C r i
p ease print) 1
Ip ease print)
r, I corti£y that the sotdnr used in the water supply system '
!contains less than 2/10 of 18 lead.
1 f,
- (plumber's signature) '
Sworn to before me this
day of
1992 : Z
/p Notar ubLic v
170t4ry Vublict /C County SUSANNE J. PERRICONE
i
NOTARY PUBLIC, State of New York lip No. 4882799 -
Qualified in Suffolk County
Commission Expires Jan. 20, 1993 -
i
Y,
r J+1
INSPECTORS
Victor Lessard HO(~
Principal Building Inspector p
Curtis Horton ~ SCOTT L. HARRIS, Supervisor
Senior Building Inspector o -
Thomas Fisher a Southold Town Hall
Building Inspector- P.O. Box 1179, 53095 Main Road
s-- Southold, New York 11971
Gar Fish y
Building Inspector 1 a Fax (516) 765-1823
Vincent R. Wieczorek Telephone (516) 765-1800
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTHOLD
NOVEMBER 30, 1992
D B M COMPANY
443 MAIN ROAD, BOX 2130
GREENPORT, NY 11944
RE: PREMISES @ 255 ORIOLE DRIVE / LOT 23
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)
%%S No Underwriters Certificate on file.
The check is not on file.)$25.00
XXX No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 20902-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
HERBERT R. MANDEL
RICHARD ISRAEL
September. 30, 1992
Bui,r?ding Depahtment
Town oS Southotd
Southold Town HaU
Main Road
Southotd, N.Y. 11971
Attn.: Tom Fiahea.
Re: Lot #23 Highpoint Meadowa, buitding peAn('t #20829Z
Dean Alt. Fiahen;
PCeaae be advised that toe have omitted the &Uco door Unom
the 6oundati,on plan uon the subject phemises and eliminated one
pieA which we Sound to be unneceasany.
Vent' truly yoWc6,
i
6 andeP~
HRM/sp
443 Main Street • Greenport, NY 11944 • (516) 477-2223
765-1802
BUILDING DEPT.
114SPECTI®N
[ ] FOUNDATION 1ST [ ] RO GH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ Q] FINAL
REMARKS:
DATE l v INSPECTOR
765-i$02
BUILDING DEPT.
INSPECTION
[ ] FO A?TION 1ST [ ) ROUGH PLBG.
] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMAR S: l
DATE l_dlL /<~7,?ANSPECfOl?
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ I ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
REMARKS:
i
DATE INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ROUGH PLBG.
] FOUNDATION 2ND [ ] INSULATION
[,T'-F'RAMING [ ] FINAL
RE ARKS:
k,(4-/
G'
DATE SPECTOR ""mot
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
[ j FOUNDATION 2ND [ j INSULATION
[ ] FRAMING [ ] FINAL
REMARKS
- wo~r,
DATE C`i INSPECTOR t2
1ELD I:: S':ZCi jjJ 1ti•SLNT^
y
OUNDATION (ist) ]
c
OUNDATION (2nd) _ cV'r
OUCH FRAME & I ~/J
-PLUMBING G~
cn
3.
~
m
At/
m
INSULATION PER N. Y. I H t_
STATE ENERGY i
CODE
• I ~ LC
t
11 m
ZZ -3
FINAL
o V
ADDITIONAL COMMENTS: s
m
H
a v
b
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H
BOARD OF HEALTH
3 SETS OF PLANS
- FORM NO.1 SURVEY
TOWN OFSOUTNOLD CHECK
BUILDING DEPARTMFNT SEPTIC FORM
TOWN HALL
SOUTHOLD,N.Y.11971 NOTIFY
V t, TEL.: 765.1802 CALL
"..l . ~.Y. , 19!1.r- MAIL TO:
.
ExamintLn yy q 2 y~
Approvto o~ t 199 Y. Permit No.a.4. 1 . R Q U R.
Disapproved a/c .........................AN t T =
BlOti 1)EPL
T" 2f 8-00"M -!L I
hC
ing In spector)
APPLICATION FOR BUILDING PERMIT
Date ..Aug. 17,........, 15
INSTRUCTIONS
a., This application must be completely tilled in by typewriter or in ink and submitted to the Building Inspector, wii
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 str,
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this ap
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 per
shall be kept on the premises available for inspection throueltout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupas
shall have been granted by the Building Inspector.
APPLICATION IS IiEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and
admit authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant, or name, if a corporation)
P. U; Bax 2130r Gneettpoht, N:Y: 11944
..1144
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build
owneA
Name of owner of premises . , .D B M Co.
(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:
°25'x`' Sa itFto2d......................
[louse Number Street. Hainlet
6 15.26
County Tax Map No. 1000 Section ...5.5 . Block . . . . . . . . . . . Lot
Subdivision .Ujghpojkjt.Meadct0A Filed Alap No. Lot ..23.........
(Nauae)
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 ...QB0- •4"y. 4qqk~
y~...
OCT a~
- 6 lath
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ORIID~E DRIVE
3420 207.17
5.82° WR~40
IoOOd L's9 °o,
N.82°34120~E. •9s,
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Lot 24 Z
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Lot 29
I
SURVEY FOR
D.B.M. COMPANY
LOT NO. 23, "HIGHPOINT MEADOWS, SECTION TWO" OCr I, 1992
DE C. 16, 1991
AT SOUTHOLD DATE AUG. 13, 1990
TOWN OF SOUTHOLD SCALE 1"= 40'
SUFFOLK COUNTY, NEW YORK NO 90-0618
K UNAU THORIZ ED ALTERA'ION OR ADD' I ON TO THIS CERTIFIED TO.
SURVET IS • VIOLATION OF SECTION '209 OF THE
MEW rORK'TAT [ EDUCAr.ON LAr D.6 M. 07$;
~',ifq
II -OP-ES OF THIS SURVEY wOr KARWG THE LAND BR NAL BANK
SUR VF YOBS INKED SEAL )P E48 OSSEC SELL SNAIL s
NOT BE :0M 310EREC TC RE A vALIC TRUE COPy r
N GUARANTEES INDICATED HEREON SMAL'_ RLM ONLY TO S y~/ O i
RE SON SURVE IS ARED
HEALTH DEPARTMENT -DATA FOR APPROVAL TO CONSTPU; , AN MC C ORR HIS FOR SAL WFHOM TO THiNETITLE E Y fOMP T HANTREP GDOVEVILRN S
A HS ^ O~
aUh _ MEN iI AGE NCI AMC LENDING INST.TU YOM CIS*EO K A
R NEAREST WRTLII ~AIM.MI I NSOURCE OF WATER III
~
R III Co TAX MA? OISY 1000 SEC TION SS BLOCK 6 LOT M..U HEREON, AND TO TWE ASSIGNEES OF THE '.ENDING .~~F <
R THERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSiIiUi10N GUARANTIES ARE NOT 7qµ SFEAA OIE r
OTHER THAN THOSE SHOWN HEREON OMR OOIS IOMAI INS i!TUi5 OR SU RSE OUE MT ~ZN ;Eq
R THE WATER SOM,Y AND SEWAGE DISPOSAL SYSTEM FOR MIS /tprDE MCE R 0, STANCES SHOWN HEREON 'RON PROPERTY LINES • • 'v
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT TO EX I17IN6 STRUCTURES ARE POR A SPECIFIC F •YS
OF WEALTH SIENICES PURPOSE ANO ARE NOT TO RE USED TO ESTABLISH 106
APPLICANT, PROPERTY LINES OR FOR THE ERECTION OF FENCES -49SARAet
ADDRESS
nl _ YOUNG & YOUNG RIVERHEAD, NEW YORK
NOTE
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF ALDEN W YOUNG, PROFESSIONAL ENGINEER
SUFFOLK COUNTY ON MAR. 19, 1990 AS FILE NO. 8911. AND LAND SURVEYOR N YS LICENSE NO 12845
m 0= STAKE HOWARD W YOUNG, LAND SURVEYOR
No r THE LOCATION OF WEl L(W),SEPTIC TA0K(ST)B CESS OOLS(CP) SHDSIN HEREON N Y S LICENSE NO 45893
a ARE PROM FIELD O"ERNUIONS AND OR DATA OBTAINED FROM OTWERf
I.B.
BRANDIS III SONS INC.
(VACANT)
(WATER MAIN
- S-- EL** 3.4
EL -t&5 aR'iOLE DRI~E
R ;
0
S. • W. 207.+7
62°342
N S20'20 E' L=ES.'S 8S•
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Y PROPOSED , 1N1IJ MV
L SANITARY
1rl SY STEM
s.T. I es' _ N
1
D PROP, LDCATtON O C)_
NUR- OF HOUSE m
1
1
-13
1
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1 (VACANT)
1 rn
1
IN
rn
Lot 24 Z~(~
(VACANT) ( V)
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Lot 23 s.f. 1
Area =27364
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11101. EL` 'B Y ;
1 1
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_ S Z 8 16 AO W n:
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of 29 V[[VV////
vAQA"T) r`?1990
SINGLE FAMILY DWELLING ONLY
`
j3QkJI DATE - PPRC)VAL fir
EXPIRES nNO YEARS `
3o a 9~ 8s to ~aJr SURVEY FOR i ,
D.B.M. COMPANY
SUFFOLK COUNTY DEPARTMENT OF HEALTf( SERVK: LOT NO-23, COMPANY MEADOWS, SECTION TWO"
AT SOUTHOLD DATE. AUG.13,1990
FOR APPROVAL OF CONSTRUCTION ONLY TOWN OF SOUTHOLD SCALE I°=40'
AUG 241990 SUFFOLK COUNTY, NEW YORK NO 90-0818
IE,- HS REF " NUMAUTHORIZED ALTERATION OR ADOI TION TO THIS
SURVEY 5 A VIOLATION OF SECTION 7209 OF THE
NEW YORK STATE EDUCATION LAW 1'~E NFS{'
S I'
RCO IEs OF THIS SUIT VEY NOT GEARING THE LAND
~90VED SCAR MRS INKED SEAL OR EMBOSSED SELL SMALL Ft,ED W O
N GE CONSIDERED TO GE A VALID TRUE COPY
N GUARANTEES INDICATED HEREON SHALL RUN ONLY TO
HEALTH DEPARTMENT - DATA FOR APP 0 CONSTRUC T THE PERSON FOR WHOM THE SURVEY IS PREPARED Z O
AND ON HIS BEHALF M THE TITLE COMPANY, GOVERM-
R NEAREST WAY" MAIN-MI ! MSOURCE OF WATER PRIIATE PUBLIC _ MENTAL AGENCY AND LENDING INSTITUTION LISTED
M UFF CO TAX MAP DBT 1000 SECTION 55 BLOCK 6_ LOT_I i .1 HEREON, AMID TO THE ASSIONEES OF THE LENDING
R THERE ARE NO DWELLIMSS WITHIN 100 FEET OF THIS PROPERTY INSTITUTIO GUARANTEES ARE NOT TRANSFERABLE
OTHER THAN THOSE SHOWN HEREON TO ADOITION NAL INSTITUTIONS OR SUBSEQUENT
M THE WATER SUPPLY AND SEWWSE DISPOSAL SYSTEM FOR THIS RESIDENCE OWNERS
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY mVARTMEHT N DISTANCES SHOWN HEREON FROM PROPERTY LINES B9
OF HEALTH SERVICES TOEKISTING STRUCTURES ARE FOR ASPECIFIC D',
`
APPLICANT, ~ / ~ PURPOSE AND ARE NOT TO BE USED TO ESTABLISH 'AND 5119.0
yl 0W~ `O PROPERTY LINES OR FOR THE ERECTION OF FENCES
ADORED P-o ~l)X ~ )30
YOUNG a1 YOUNG RI VERHE, NEW YORK
E^~ W TIEL 41
NOTE
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF ALDEN W YOUNG, PROFESSIONAL ENGINEE
SUFFOLK COUNTY ON MAR. 19, 1990 AS FILE NO. 8911. AND LAND SURVEYOR N YS LICENSE NO 128 D Q un.
URVEYOR
HOWARD W YOUNG, LANDS
m A, THE LOCATION OF WELL(W),SEPTIC TAMI1(ST)B CESSPOOLS(CPI SHOWN HEREON NY S LICENSE NO 45893
ARE FROM FIELD G"ERIMTIONS AND OR DATA OBTAINED FROM OTIIEMS 7
B.
BRANDIS G SONS INC.
BLDG. DEPT.
tI§
,vov 20 1992
S.C. D P f. OF
r NL,1Lit~ EF1:'IDE
r ~yATER MA~ /ICS ~ S
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SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES SURVEY FOR
N L F MlLY DWELLING 6NlY GORDON TYRER & DIANE TYRER
pAT~QV 9 2H.S. REF. NO. 912=60=29 LOT NO. 23, "HIGHPOINT MEADOWS, SECTION TWO°
The sewage disposal and water supply facilities for this AT SOUTHOLD DATE . NOV. le, I992
tocatsonhave bee" inspected 5ythis Department and!or TOWN OF SOUTHOLD SCALE' C=40
other enc sand taund Fo he sat ry. - SUFFOLK COUNTY, NEW YORK NO 92 -0988
M~ .,.1 AUNAUTMORIIEO ALTERATION OR ADDITION TO THIS CERTIFIED TO: of hresu of WBSbewater Management SURVEY 6 A VIOLATION Of SECTION 7209 OF THE :
MEW YORK STATE EDUCATION LAW GORDON TYRER
*COPIES OF THIS SURVEY NOT BEARING TAE LAND DIANE TYRER
SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NORTH FOR
NOT BE CONSIDERED TO BE A VALID TRUE COPY
S *GUARANTEES INDICATED HEREON SHALL RUN ONLY TO CHICAGO OMPANY
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTFUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERN- W
Q' _µv • Y/Y
R NEAREST WATER B1AIN-IA1 I *SOURCE Of WATER INMATE __PUBL~- _ MENTAL AGENCY AND LENDING INSTITUTION LISTED
N SUFF CO TAX MAP DIST IOOOSECTION 5 BLOCK 6_ LOT J5.U HEREON, ANO TO THE ASSIGNEES OF THE LENDING
NTHERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION GUARANTEES ME MOT TRAM SFERA BLE
OTHER THAN THOSE SHOWN HEREON TO A001TIONAL INSTITUTI S OR SUBSE WEN7
N THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE OWNERS
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APPLICANT,
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veew TEL 977^222 YOUNG Ek YOUNG RIVERHEAD,NEWYORKE
NOTE:
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF ALDEN W. YOUNG, PROFESSIONAL ENGINEER
SUFFOLK COUNTY ON MAR. 19, 1990 AS FILE NO. 8911. AND LAND SURVEYOR N YS LICENSE NO 12845
ns = STAKE HOWARD W YOUNG, LAND SURVEYOR
o *THE LocAnaN orWO.L(W), SEPTIC TAHKIST)a CEBVOOLS(CP) SHOWN HEREON NY, S. LICENSE NO 45893
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