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HomeMy WebLinkAbout20414-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22475 Date JULY 26, 1993 THIS CERTIFIES that the building ACCESSORY Location of Property 2504 CAMP MINEOLA RD. MATTITUCK N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 122 Block 9 Lot 7.25 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 24 1989 pursuant to which Building Permit No. 20414-Z dated JANUARY 31, 1992 was issued, and conforms to all of the requirements o£ the applicable provisions of the law. The occupancy for which this certificate is issued is ACCESSORY INGROUND SWIMMING POOL WITH DECK AROUND The certificate is issued to MARILYN PYMM (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-24633$ - AUGUST 12, 1992 PLUMBERS CERTIFICATION DATED N/A uil ing Inspector Rev. 1j81 FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22073 Date DECEMBER 30, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 2504 CAMP MINEOLA RD. MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 122 Block 9 Lot 7.25 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore Filed in this office dated AUGUST 24, 1989 pursuant to which Building Permit No. 20414-Z dated JANUARY 31, 1992 was issued, and conforms tq ali of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH AN ATTACHED GAAGE & BALCONIES The certificate is issued to MARILYN PYMM (owner} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 87-$0-201 - DEC. 14 1992 UNDERWRITERS CERTIFICATE NO. H-029184 - JUNE 9 1992 PLUMBERS CERTIFICATION DATED MAY 29 1992 - MATTITUCK PLUMB. & HEATING B ding Insp ctor Rev. 1f81 Fosae< >Va 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 o 2 0 414 Z Date ....l~~J > 9.~'~ ~A~js~~~~38~ Permission is hereby rants to: a~ . . at premises located at ~ 7~ .1~...........<................................. . .............................~~1 .....v. . . i p. County lax Map No. 1000 Section ....l:.~..r~...'.~r....... Black .......rl~...........pp~~Lot No.....~.ae~.c„t...... pursuant to application doted .........~...%i ~ 19.EJ'/..., and approved by the Building Inspector. ~ Fee s..~,~7~ ~ Bu t ~ ~~P ` \ Rev. 6/30/80 ! ti ~ ~ Form No, 6 ti~~`; a, ~ TOWN OF SOUTHOLD S~ 1 ~ 1 i BUILDING DEPARTMENT ~ ~ TOWN HALL ~ C"~; 765-1802 ~ ef~~. ~ ~ ~q~~ ~.~..,4~m_., 0~ APPLICATION FOR CERTIFICATE OF OCCUPANCY YC1~41tV C}'~;+3+£S"~'E"' t d,,~,.,,t~ :,j 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 2/7O of 1~ lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect ox engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. Foy 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 $25.00. Busine$ses $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 15f00, Commercial $15.00 `~GOL' '~`~lz~k Date ~'!C..~. ~ . New Construction...... x. 01d Onr Pre-existing Buildi~nyg. _ Location of Property...~2~?t~_,~IVP~-. ~DCt,...,..~/i4rizo~i lP.~.......~?~:.... House No. ~ treet Hamlet Onwer or Owners of Property......,:,/~.°?~,~~~'nf„ ~!'?//';1 ........................vr~~,......,.._.. County Tax Map No 1000, Section.... ~~~......Block... g...........Lot.~p...~.'~........... Subdivision^^ ....................................Filed Map............~L?/ot.. ~ Permit No.+~:~~~.~y,~y,':....Date Of Permit ................Applicant.../.'~1~~+, Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate...J.4,..... Fee Submitted: $,,,c~;s„?~,,,,,,,,,,,,,,,,,, ~ c~s3 y ' PLIC ~o-~aa 4~5 THE NEW YORK BOARD OF FiRE UNDERWRITERS 10P~025S BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date 3117liUFi9' 12r1492 Application No. un file 03~S22~t!1".f{~~ ~ THIS CERTIFIES THAT only the electrical equipment as described 6elom and introduced 6y the applicant named on the above application number to the premiaea 4( WT.Gf~IAPt PY;'(fi, ;?tit311 (,A.4LI? tSTNBt?C,A RfI1~D, Y$~TTiTCC~ ULY,f:AGI~, N. Y= in thefo!luwing location; ? Basement U£1R /aC)'1' ? lst FL ? 2ru{ F'l. Sertinn 8[oek Lut fiUfilt~'1' Q'TI!!t'?2 was exurnined on and found to be in conrp{ionee with the requirements of Chis Board. FIXTURES RANGES COOKING DECK$ OVENS DISHWASHERS E%HAUS7 FANS iIXTURE ECEPTACIE$ SWITCHES OUTLETS INCANDESCENT fIUORESCENi OTHER AMT. K W. AMi. K W AMi K W. AMi, K. W. AMT. H P DRYERS FURNACE MOTORS fUTURF APPLIANCE FEEDERS SPECIAE REC'PT TIME CLOCKS gEll UNIT HEATERS MUlT40UTtET DIMMERS PMT K W. Oll H. P GAS H. P AMT. NO. A W G. AML. AMP. AMT. gMPS TRANS. AMi. N. P. SYSTEMS qMl. WAi(5 MO.Of FEET (~3 SERVICE DISCONNECT NO.OF $ E R Y 1 C E AMi. AMP. TYPE METER t,a' ]W 1 g 3W 3,9' 3W 3,a' 4W NO. OF CC COND q W G. NO OF HLLEG A W' G' NO OP NFUTRAlS A W G, EQUIP. PER% Of CC. COND OF HI-lEG OF NEUTRAL OTHER APPARATUS: ~WT.NM3FIC1 l'(10L-1. RLCL~P'CAC.L~:$'~11(=.B.f;.S..''1°2 "Iti4FTHP~IN(i E901',) Tixl& a€rGifil:r.,t.l* s:ov~ce itom~aiancc: zt the dote of irlslrr',i;tign only. &e,:auve of alfnaani. env3ronrar~nt.es 9t. i~ ndv3si~hle t.c hive feequent Ce~t~,/and o*; rep~ti[r, ~ftd~ by a gtutliPi[ata person. ®L!C.E~c'ac'a~ Et,f;CTRXCAL VF~RTUItP, LIt..>~II47 G!~~~~ p.0. k10B 1 31. GENERAL MANAGER C@1NTFR Hs71?LCHUS, NY, 11.93!1. Ped 1 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. I COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED iN ANY MANNER ~~D~ I;.~:'~O:iv;; (~Dn;E j~ ;;0.`fMENT~ FOUNDATION (1st) ~ ~r OY/ fM C~7 V FOUNDATION (2nd } ~ ffJb ~ 2. 0 4 z~ _ o ROUGH FRAME & ~ PLUMBING ~ _ • ti 3. - ~ II7SULATIOPI PER N. Y. _ H STATE ENERGY CODE s ~ a 4. y • S FINAL ~ ~ ADDITIOPJAL COMMENTS: V r 9 ~ ~ ~ ~ aid ~ l/~~d. ~ -r o P acv r? / f ~ m ~0 ~ ~ • r 1 ' x fn d d m ~ 'tl U w; :c~r - y~ DEC C1 '92 1524 TOWN OF 50lJTfriOLD ~~~...z"~ P.2i1 ~ ~ ~wi~ 3~ r ~ ' ~ BUIL27,L ....,~i., ~3 ~ - , 2 .n APPLICA'£ZO,H i'OTt C,~ ~ ~ ~ ~ ~ ~ . ' CAF OC,C,UYANC~I ~ r,, ~c ~ A. This application must be fillefl."in b ~ ~ ~ y ~R ~;nk`and submstked to the building inspector with the following .ypr new 6tfi~d~s new.u`sas 1. Final survey of property w2Gh acc}~r t ~ q„ ~ ~ of,axl buildings, property lines, streets,'and unusual natural;~or ,p~~ ~ ~ ~tur@S 2. Final Approval from Health D: pt; 01' lyt~n ~:seGrera e~-dis oral S-o form . ~ ~ ~ _ g P ( r 3. Approval of electrical a.nst 1lation~~rs~m;,~'` ~ of .Fi:re [Tnderwriters. 4. Sworn statement from plumber;eerti€yin~~~~~thessolder used in system contains less than 2/10 of 1% lead ~ ~ ~ ' ' 5. Commercial building, a.ndustrkal buiTd3,~g,~~ t~Ple r~esiilences and similar buildings and installations, a certificate o>i'Cod'e ~ y~nce "Frviri.:architect or engineer responsible for the building; 6, Submit Planning Board Approval of complet~d;'sCe,p],ap requirements. B. ~ For existing buildings (prior to. April:g~, 1957~~non'=conforming uses, or buildings and ~ "pre-existing" land uses: ~ ~ ~ ` 1. Accurate survey of property 'showing: ailYR~~Ci~a~rty ]Snes, streets, building and unusual. natural or topographic feat,l'rey~ ~ . " , 2. A properly completed appl~ca,£iost and, ~``CS~p.e~~~G to irtsp@,~t~ Signed by the applicant, if a Certificate of Occupancy° is denEd, "kk~~~,Sui'ldin~ `Lrispector shall state the reasons therefor in writing to tk)e,appl~,cant?„ Fees ~ 1 1. Certificate of~ Octupancy Now dwell,i,n~,,$25~;60, AddiE~,pn's to dwelling $25.00, Alterations to dwelling $25,00, Swim{uin~ 1?oq~L`~$25,00;~-Accessory building $25,00, Additions to accessory buil.di'ng $25OD, ; Bu~~,nesses~`~$'S0'.OD. 2. Certificate of Oceupancy~ori,,P-re-existing'P~iil~ling - $1.00.00 3. Copy of Certificate of 4ceu~iancy~- $~~,OU 4Yert,S`year§ - $10,00 4. Updated Certificate of Occupancy - $50 00 5. Temporary Certificate of Occu anc P y ReS~.deneial $1 00,, Commercial. $15.00 - -Date y~`~~~~.f°~,:..,. _ iew Construction.... Old Or Pr/~e-existing Suildsrig." . .ocation of Property.. r~b`~. ,'!:C L:~ , , "~/N~a~~ ~'F..... , J'/,~2/.~rd~k. House No. ~.StFseC• , Q Hamlet rower or Owners of Proper ty.....~~,~1L~;Q'... ~~/F?9/`t'/ 7~ ounty Tax Map No 1000, Section., ~ ,....Block ,r', / r Y / .Lat. f subdivision...... .Filed Ala p ,7aOt. J' r ermit No.~.~~,~~~,~„Date.O£•Permit.... ,:iApplicant .~~-f;/,~Y~?~y/~I!`1......... ayx._ ealeh Dept, Approval,..... .....,....,.,.;.Underwters:Approgal,.... Tanning Board APPraval ~.i-' equest .for: Temporary Certificate..;,,,..,,; Final=Certicate.,~,,,,, ee Submitted; lp~'es. <<~~ ,d,~ INSPECTORS <G~: , Victor Lessard .~;jF'~D(~ Principal Building Inspector ~di ~ Curtis Horton ~ c' SCOTT L. HARRIS, Supervisor Senior Building Inspector ~ ~ y xf~~- Thomas Fisher ' ' ~"~a'~a a Southold Town Hall Building Inspector t~l~, ' ~t ~ -tip P.O. Box 1179, 53D95 Main Road Gar Fish ~ `''%3 Southold, New York 11971 Y ~;;~1 `~~.;T° Fax (516} 765-1823 Building Inspector Vincent R. W ieczorek ~ Telephone (S lb) 765-1800 Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD e .1ITLY 14, 1993 ,iUie 2 3 l9J~ MARILYN PYlAI ~Lsv==;;j,'q,~r't.~ 2504 CAMP MINEOLA ROAD , MATTITUCR, NY 11952 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. g~x The check is not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20414-Z (POOL ~ D$GR) Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. INSPECTORS ~ Victor Lessard P'' ~1jFf0(~~ Principal Building Inspector ~~~'r'~ , ~ ~dG Curtis Horton ~ rc,'_ SCOTT L. HARRIS, Supervisrn Senior Building Inspector ~ - ~ ' .c Southold Town Hall Thomas Fisher `~t~ ~ nZi ~ ~ r + ~ P.O. Bax 1179, 53095 Main Road Building lnspectar ~ ~ ~j. Southold, New York 11971 BuilOding Inspector y'Jv,''~ 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 JULY 14, 1993 MARILYN PYMM 2504 CAMP MINEOLA ROAD MATTITUCK, NY 11952 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 not on file.)$25.00 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 # 20414-Z (POOL 6 DSC&) Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. ~ss-isaz BUILDING DEPT. 1 hlSPECTION [ ]FOUNDATION iST [ ~ ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ INAL REMARKS: t DATE INSPECTOR 07~29i1994 15: ~4 FF019 OHiJNE Y.-P.FiN60W ~ TO t516?651 $G3 P. 02 ~ N ~ ^n mT ~ "st O \ i7 rn rri ~ C7 ~ ~ C°u 1W ~ . m i9 'J` (/j 7CI ~7 P" l.) .yy rn ~d 1> ® O -~S C 'ca ~j ila m~ ~ G'i t'1 ej 3~ '9 W H m~rr+y r' Q ~ ~ Om~ ~ c~n~~<''~~a ci o m~ t, ~ ~ ~ 1~'' ~M ~w„~,.,~, ~ ~ , e~ ~ ~ ~ G~ ~ u r c ~ ,gyp k~~e+"' + .7 ~ ffi. _ sus 9 1 r' v e`: ~ ~m~c~~~ ~r!'1 .3~ ~ 'I h. ° ti 71 F2[ 1 ~ ! ~ ~ ' - ,x 'C ' G a I 1 • FJ ~ 5 ~ ~i 1 T 7l a ~ ~ y ~ ~R 4 Y `SwJ, it I(' h ~~h. ! a31e '~7rr4 ~ m • ~ ~ 'Nan t r~S~ ~ ~ ~ ~ Tr.y, ~ ~F, ~ .A`~dt y t 1 ~ , ppa vet" \Y 1~~ ~ ~mp$ {t ~`3 a'' t lsG.t b!~c}i p y 1 F} ` ~ ~ ~'.11' Nk ft{ ~ a t XP~ ~ -'~,~'j'lf, ire V~ - P,< p,~!~ - , , ~ f Cr: t d r J; § x~+~kl ~ t C,~ ' !rv 7 ~ 7~ ~ g . ~ Y t~T yr J ~ ~ ~ , a'~ w q~ y ~ z, t's~ `r~=. pp ~pp~++++ W.Y VTt ~'~Y ~ ~ A ~ ~ I"i~al~a.a.yn }='yrnm G°'I:ar°'t:. W~,~>t°~l.nrii':c:;n„ h1~Y. 11ij;_ir:r 'C'c;wrr cai' EdY:at.lt.hr..;:lcl }::'t1.a.i.7.c1:ir7irJ !:?f:?fit. 8n1..1"lc1'7ca:lt 'I"sawn 1•{<sa.:I. f.3aY..tthn:lr.:i, IV.Y., .{Y.'>'7.1. Fif:?:„ FIp~Y:la.r.,«ii::.i.ar-~ fr.:,r FYY!nY?vvsca. 13L1 .'1 :l i:1.7..n(:_~ }''i>a e•m.i. 1. #~t1i:3~::5i:i f:::r'rc.:ll:ar:rcl W7F+ta!,ea 'Pa.l°~t:i my c.t'ri±c:.k". :irs "tFre ~trrttaLtnt:. t:a-i ~El~t'7.:_;;.~ 'Pear- r•tarira?wa:l. ra'P' "l-Irr~ ,~Cac:rvr rr,:~fr?i~t:ar-~s:tai::l LiLt.i.trl.irit-y 6='t~rma't Wh.i.e:t-i :A. 1"Y (71..1 C: 1..1 ..li't. F:'iiHiii l! !5fe?nCa IPYE? ct f: f.:ir5 ~'.l r'iYift Y; :A. P.Sn t7'{' 1"i:?P'1 C:Wdt ssra 'i-. l'r~i. :I: rn<:a'y G:fal"i'!". a. I"t 1.l G? Ga:11"r !:a'IL I"4l i:f.'t:.l.l:al"t i:3!3 ECai:Jl'l ii!5 [3(:a5w57. 1:7 :1 t2?~ i'Ytrstr'rf: "/call :l.r'r atciv~ar'rr..:r~ •f car ycal..lr" g7r•c.;(nFY't. ejR.:i::e~r'rt:.i.r.,n t.ea 't:hi V'r::r"rm("y trt.l:l y yc:u..le"~; v i - / ~ - ~ INSPECTORS Principal Building Inspector p~~SpFFO~,~coG Curtis Horton y~ SCOTT L. HARRIS, Supervisrn Senior Building Inspector y z Southold Town Hali Thomas Fisher P.O. Box 1179, 53095 Main Road Building Inspector ~ • `t' d p! Southold, New York 11971 ~ ~ ng F p~t~, ~~l ~ 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 October 23, 1991 Mr. William Pymm 9 East High Road Port Washington, N.Y. 11050 Re: Premises: 2504 Camp Mineola Road, Mattituck,N.Y. Suffolk Co. Tax Map #1000-122-9-7.25 Dear Mr. Pymm: During a review of our files, it was noted that the above building permit has expired and a final inspection and issuance of the Certificate of Occupancy has not been done. According to the Code of the Town of Southold, (Sections 100-281 and 100-284), a building permit is needed for any construction of additions, accessory structures, alterations or new dwellings. We would like to bring to your attention that it is unlawful to occupy or use said structure until the Certificate of Occupancy has been issued for that building permit. Please contact this office as soon as possible so that we may clear up this matter. Thank you in advance for your anticipated cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Victor Lessard, Principal Building Inspector VL:gar - . y: TEL. 7G5-1 Hp2 ~O~~~FO~ ~Ol,, TOWN OIL' SOiU~'IIOd.D fa~~ . < OFFICE OF IIUILDIIJG INSPECTOR o P.O. BOX 728 • ~E~~~ ^r TOWN HALL ~ "O ~ ~ ~~~1 ~,~p'~' SOUTHOLD, N.Y. 11971 v~~ 0 C~'p C E R T I F I C A T I O N Date~~ Building Permit No. ~ C y j ~ •Z. (pl ase pr((i~nt) J Plumber~~~, , L I'/y~~U~'r, y~ rI ~•e wft„ (Please print) ~ I certify that the solder used in the water supply system contains less than 2/10 of to lead. i _ ~ (plumber's re) Sworn to befoze me this ~~`~~~~day of , 19 9,~-. <<~~ Notary is Uotary Public,~_XfffpG.~ County EQCM F..41p(gpN ~Y Pub6e. Stele of New York No, 4920756 T~A~edare Fb~~un~~/ ti S~FF~LS~C' TEL.7G5-1882 o O~ TORN OF Sf~~J'~II~~.D r?f ' . ~(r ~ OFFICE OF IIUILDII9G INSPECTOR o "tt' • rn P.O. BOX 728 TO1VN HALL v~\ Cp ~~rm~ , ~j~ SOUTHULD, N.Y. 11971 } f• " C E R T I F I C A T I O N • Date cry / q -g Building Permit No. d yI y 'Z owner j f~~PiL y,Y /y1(p1 ase pr(~n(t) J Plumber Y1 I ~ ~f t" ~u • ~t f Ivz lv;n ~ ~,~g~~., (please print) ~ I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. mac--=' (plumber's n re) Sworn to before me~i~fh~is 7cu~U - day of ~ _ i9 9,~. ~ ~u~-~ c± Notary 1c tlotary i>ublic,~X,/~~pC„~ County ~Y Rb1o, Mew Yak ~eN4ad InSu~tlolk Coum Tam Expires Feb,1G,f ~7 06/05/92 Marilyn Pymm 9 East High Road Port Washington, N.Y. 11050 Tom Fisher Town of Southold Building Dept. Southold Town Hall Southold, N.X. 11971 RE: Building Permit #20414 Z Dear Mr. Fisher, Enclosed please find Plumbers Certification for the above referenced new construction permit. Underwriters Certificate, and Health Dept. Approval should follow shortly. Very truly yo , Q, ? Marily2~~mm a0' ~~9~~ ~ b~~:a :C;CL} THE NEW YORK BOARD OF FIRE UNDERWRITERS 1'AGG ~ 90,t t'~1b9 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date JllNC 09,19!t2 ApplicotianNo.onfile 73021991/91 H 0241A9 THIS CERTIFIES THAT only the electrical equipment as described bebw and introduced 6y the applicant Homed on the above application number in the premiaea of MARILtiN lyYltM, REFINE; RVk~NtIE, a"P,C,~122.~9-9.2a, EtA'CTIY'tfCK, N,Y. in thefallowinq location; ? Basement ~ 7st F'l. ~ 2nd Ft. (`iAt~l ApT,I t;~~~~ .Sertinn ftloek Lot - was examined mt MB.C' 19 f 19 92 and found to be in wrrtplianve with the requirenxents of this Board. iIXTURE ECEPTACLE$ SWITCHES FIXTURES RANGES COOKING DECK$ OVEN5 DISHWASHERS EXHAUST FANS ~ OUTLETS INCANDESCENT FWORESCENi OTHER AMT K W. AMi N W PMT N.W PMi K W. AMT. H P. C 99 99 50 fib 6 1 12.7 2 1l DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REG'PT TIME CLOCK$ EELL UNIT HEATERS MULTI-OUTLET DIMMERS AMT K W OII H. P. GAS H. P AMi NO A W G AMT M1P. AMT AMPS. TRANS. AMT H P SYSTEMS AMi WATTS Np.OF FEET 4 F 1 2 1 "t, 1 SERVICE DISCONNECT NO.OF S E R V I C E AML. AMP, TYPE METER 1 9W L 3W 3 d' 7W 3It 4W NO OF CC. COND. A. W G. NO OF HbLEG A W G NO. Of NEUTRALS A W G. EQUIP. DER B OF CC. COND OF HbIEG OF NEUTRAL 2 laVi C'N 1 % 2 It@~ 7 1;0 OTHER APPARATUS: MGTORSTI-p H.C', G.I+.C.Sc•6 SMQKP. Hf;4'CC1'Otta-2 C!~%~~~~''l. YfIGLIRM PYftN 9 FA87' NIGH I{OA[t P,VtABNINGI'ON, Nkr 11090 GENERAL MANAGER Per11 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. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE M115T NQT BE.ALTERED IN ANY HANDIER. f ' ~ 4d~ 1 51992 F3LDG, ODEP"i. 6/11/92 Marilyn Pymm 9 East High Road Port Washington, N.Y, 11050 Tom Fisher a'; Town of Southold Building Dept. Southold Town Hall Southold, N.Y. 11971 RE: Building Permit #20414 Z Dear Mr. Fisher, Enclosed please find Fire Underwriters Certificate for the above referenced new construction permit. As soon as I receive Health Dept approval, and have remedied the discrepancies noted on your 6/4/92 inspection, I will contact you for final C of 0 inspection. Very truly ycyxrs, v Mari 1y Pyrca~l~~r~~~ 5)t 5 gyp, i n ^A "''J «f z T r ~ ~ ~ '.4 s ~ MI I ~q Q i Y ~ 1 v. '~'f? ' ~ r IdM ~~s.rt',~ - P -1. x,~~v pax s~~~t ~ 1'.. ~1 l~pp ~4 ~y,.~~ ~„~4~ r+. n ~ ~P1 t~ ~AI d ~ a f ,s+`~ ' 'W I w ~ ~ ~ ty~>. 6. ~ ~ J ~JS' ~ ~ Ir R ~ °b 9 c r , ~ .~y Ji: ~I m r,.` ' y a 2 t (L ~ _ ~`'yM9 1 • .APR ~.t(~ ~~S i ~p ~ T' O w ~ i W ~ ~ ~ _ ~ t~ ~ ~ ~ o `2 ~ ua a c~ r ~ ~ ce m ~ JAM ~ .J zW~~ ~ ~ CA rv i ,d„„ 5°-! 1A ;7^ f ~ ^z S'X3 ~ CAB! ~ ~y ~ ~ ^ p 4~ a G,^,9~ t~¢w°.' t1) Ei. +?S L31 lil f" Q ~ tae p , r.,. Ca r. ~ ~ U ni ~~f~,~w ar n.~~~.T_~ 3~ J.. , cap ~ ~ ~ _ ~ ~ g ~ O ~7)~, ci' dL f,~ ~ Q g{~ f3 w„ ~ ~ ~ 7~ .'K~"i ~ .~5 tk, ~ ~ '.g f,y COA ~ y ~ jv~ ~ C'~ It-:e?` F+ S6. s° shi i~'3 '+1` h fJ$ 63 ? i. Z6'd i~Z3 [531451 U1 ronyFl7 tl8-X3F+i°itl0 WOhd bSe^=[ ZE6[%bZ%LO ~ .T?; ;,x5`rt" . SS-20{ (9/86)-25c NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DI f PFRMIT NUMRFR ~ EFFECTIVE DATE J n-~,~-0914 tAf'II ITY/PROGRAM NUMOF R(s) PERMIT E ATE(s) Under the Environmental Conservation Law 4 rl/A 7(31/92 L~ _ r~~_~~_~ 32t8c1329: Aquat c Pest c des 27 ~ WaterROua~ty~ Certification N ~ Tidal Wetlands N '.~J P otect one of ltWat r N ~ SPDES 17, Titles 7, 8: ~ Solid Waste IManageme tRR 360: " - Article 15, Title 15: ~ Article 19: ~ Article 27, Title 9; 6NYCRR 373: Water Supply Air Pollution Control" Hazardous Waste Management Article 15, Title 15: ~ Article 23, Title 27: ~ Article 34: Water Transport Mined Land Reclamation Coastal Erosion Management 1 Article 15, TI11e 15: ~ Article 24: ~ Article 36: 1 Long Island Wells Freshwater Wetlands Floodplain Management 1 Article 15, Title 27: N-New, R-Renewal, M-Modification, ~ Articles 1, 3, 17, 19, 27, 37; J Wild, Scenic antl Recreational C-Construct ("only), 0-Operate ('only) 6NYCRR 380: Radiation Control Rivers PCRMIf ISSUCU 10 hti.11 am Py_rnm ,~,i ~s+F55 OF PCRM1T iSL 9 Eas~H~c~h_ Rd P W Y , AGLNi FOR PERMITTE E/CONTACT PERSON TELEPHONE NUMBER La.ncf 1~~ C- P 1.,.I ANU ADURL SS OI PROIECTIFACILITV (If different from Permittee) James Cre~k_,_f P B ' ; O(nTION OF PRO)ECTIFACILITY COUNTV TOWN/SQ3.KC~kk'~t'A9C UTM COORDINATES Ma"ttitf~ck DF U'RIPTION OF AUTHORIZED ACTIVITY I Cons r i ~~nstruct a ~'x1n' t a 4 ' ' 6'x2n' floating do k Al w r v GENERAL CONDITIONS sy acceptance of this permit, the permittee agrees that the permit is contingent upon strict compli- ance with the ECL, all applicable regulations and the conditions specified herein or attaehed hereto. 1 The permittee shall hlemthe office of the appropriate regional permit administrator, or other office designated in thespecial conditions,anotice of intention to commence ,vork at least 48 hours in advance of the time of commencement and shall also notify himlher promptly in writing of the Completion of the work. 2 The Vermitted work shall be subject to inspection by an authorized representative of the Department of Environmental Conservation which may order the work suspended if the Vublic interest so requues pursuant to ECL §71-0301 and SAPA §401(3). 3 Fhe permntee has accepted expressly, by the execution of the application the full legal responsibility forall damages, directorindirect, of whatever nature, and by whomever suffered, ansing out of the protect described herein and has agreed to indemnify and save harmless the State from suiU, actions, damages and costs of every name and descnp- non resulting from the said project 4 Tf,r Department reserves the right to modify, suspend or revoke this permit at any time after due notice, and, if requested, hold a hearing when: a) the scope of the protect is exceeded or a violation of any condition of the permit or provisions of the ECL and pertinent regulations are found; or h7 the permit was obtained by misrepresentation or failure to disclose relevent facts; or r) newly discovered infnrmaton or significant physical changes are discovered since [he permit was issued. ~ 1 h.~ nmmittee is responsible for keeping the permit active by submitting a renewal application, including anV forms, fees or supplemental information which may 6e required by ~Iw Department, no later than 30 days (180 days for SPDES or Solid or Hazarduous Waste Management permits) prior to the expiration date. G Fhn hermit shall not be construed as conveying to the applicant any right to trespass upon the landg or Interfere with the riparian rights of others in order to perform the p~~~nvtted work or as authorizing the impairment of any nghts, title or interest m real or personal property held or vested in a person not a party to the permit Th, permittee a responsible for obtaining any other permits, approvals, lands, easements and rights-ofway which may be required for this project. Isxiance of thrs permit by the Department does not, unless expressly provided for, modify, supersede or rescind an order on Consent or determination by the Commissioner shred heretofore by the Department or any of the terms, conditions, or requirements contained in such order or determination. Any moddication of this hermit granted ~ the e a e m in writing and attached hereto. FRMIT ISSUANCE DATE PERMIT ADMINISTRATOR ADDRESS ',_7(2R/B7 Alfred T, Kellar Bldg. 40 SUNY Rm, 219 Stony Brook, NY 117.4 nl!rIIORIZFD SICNATUNf ~ Page 1 of cc: C,T, Hamilton J06.r (11a6)-YSc • DDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (Title S), 24, 25, 34, 36 and 6 NYCRR Part 608 ( ) nl that d future nperatons by the State of New York require an al- other environmentally deleterious materials associated with the terz'~^n in the position of the structure or work herein authorized, or project. if. in the opinion of the Department of Environmental Conservation 14. Any material dredged in the prosecution of the work herein permitted it >hall cause unreasonable obstruction [o the free navigation of said shall be removed evenly, without leaving large refuse piles, ridges across waters or flood flows or endanger the health, safety or welfare of the bed of a waterway or floodplain or deep holes that may have a the people of the State, or cause loss or destruction of the natural tendency to Cause damage to navigable channels or to the banks of resources of the State, the owner may be ordered by the Department to a waterway. remove or alter the structural work, obstructions, or hazards caused ' 15 There shall be no unreasonable interference with navigation by the work thereby without expense to the State, and if, upon the expiration or herein authorized. revocation of this Kermit, the structure, fill, excavation, or other 16. If upon the expiration or revocation of this permit, the protect hereby modification of the watercourse hereby authorized shall not be com- authorized has not been completed, the applicant shall, without expense pieced, the owners, shall, without expense to the State, and to such to the State, and to such extent and in such time and manner as the extent and in such time and manner as the Department of Environmental ~ Department of Environmental Conservation may require, remove all or Conservation may require, remove all or any portion of the uncompleted any portion of the uncompleted structure or fill and restore the site structure or fill and restore to its former condition the navigable to its former condition. No claim shall be made against the State of and flood capacity of the watercourse. No claim shall be made against New York on account of any such removal or alteration the State of New York on account of any such removal or alteration. 17 If granted under Article 36, this permit does not signify in any way 11 That the State of New York shall in no case be liable for any damage that the project will be free from flooding. or injury to the structure or work herein authorized which may be caused 18. If granted under 6 NYCRR Part 608, the NYS Department of Environ- by or result from future operations undertaken by [he State for the mental Conservation hereby certifies that the subject project will not conservation or improvement of navigation, or for other purposes, and contravene effluent limitations or other limitations or standards under rio claim or right to compensation shall accrue from anY such damage. Sections 301, 302, 303, 306 and 307 of the Cfean Water Act of 1977 12 ~ Granting of this permit does not relieve the applicant of the responsi• (PL 95-217) provided that all of the conditions listed herein are met bility of obtaining any other permission, consent or approval from 19. All activities authorized by this permit must be in strict conformance the U S. Army Corps of Engineers, U.S. Coast Guard, New York State with the approved plans submitted by the applicant or his agent as part Office of General Services or local government which may be required. of the permit application. 13 All necessary precautions shall be taken to preclude contamination Such approved plans were prepared by of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, (eachate or any on SPECIAL CONDITIONS J., There is to be no disturbance of vegetation or topography within 50' of wetland 2, No disturbance to tidal wetland vegetation during dock installation. Supplementary Special Conditions (A) through (J) attached, I i I I I I I I I I I I DE~nE fJ ~1~B~R PR~IGRAM/fACILITV NUMBER Pd e 2 of 3 / S 4~l ,f F~C~~~°° ~~J ~ SUPPLEMESTTARY SPECIAT. CONDITIONS 11 ~tJr 2 - 666((141 4 19(3g ; The following conditions apply Co all permits: ~ a-•-~{ BLp ~t7E1a,A,x,.«...d A. If any of the permit conditions are unclear, the pe ~~064~~~ct i the Division of Regulatory Affairs at the address and telephone no'1~ m~ielgc~. B. A copy of this permit or approval and supplementary conditions shall be available at Che project site whenever authorized work is in progress. C. The permit si;n enclosed with the permit or a copy of letter of approval shall be protected from the weather and posted in a conspicinus location at the work site until completion of authorized work. D. At least 48 hours prior to commencement of the project,.the permittee shall complete and return the top portion of the enclosed 'receipt form certifying that he is fully aware of and undersCands all provisions and conditions of this permit. T•]ithin one week of completion of the permitted work, the bottom portion of that form shall also be completed and returned. E. For projects involving activities to be accomplished over a period or more than one year, the permittee shall notify the Regional Permit Administrator in writing aC least 48 hours to the commencement of resumption of work each yeaY. F. ~If project design modifications take place after permit issuance, the permittee shall submit the appropriate plan changes for approval by the Regional Permit Administrator prior to undertaking any such modifications. The permittee is advised that substantial modification may require sub- mission of a new application for permit. G. All necessary precautions shall be taken to preclude contamination of any wetlands or waterway by suspended solids, sediment, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other enviro~entally deleterious materials associated with the project work. H. Any failure to comply precisely with all of the terms and conditions of this permit, unless authorized in writing, 'sliall'~be treate3 as a violation of the Environmental Conservation Law. I. The permittee is advised to obtain any permits or approvals that may be required from the U.S. Department of Army Corps of Engineers, NY District, 26 Federal Plaza, DTew York, NY 10278, (ACtention: Regulatory Functions Branch), prior to commencement of work authorized herein. J. The granting of this perniC does noC relieve the pernittee of the responsibility of obtaining a grant, easement, or other necessary approval from the Division of Land Utilization, Office of General Services, Tower Building:. Empire State Plaza, Albany, NY 12242, which may be required for any encroachment upon State-owned lands under water. Regional Permit Administrator _ NYS Dept... of._Environmental.Conservation - Bldg. 40, SUNY--Room 219 ' Stony Brook, NY 11794 (516) 751-7900 nEC 11 10-87-0914" Page 3 of 3 _ I.~~yl~-'r~:cra~eb ~G p,r' 1~1~2Y~ T ~ zn~ Tn1et'~-tdQ1 ~R~ t't~ M.~ Q . J S-~._~..a c\~rnt lo«~ ..~~7own o~ .~+~I~s~~ f,c.l~k~.r).r,N~~`L~ ~ _ ' AIR _ 4 ~ ~ Su.FFo~K CouN~( ~ _ NAC~s~zom mr~Pa~l N `z ~'=3~co' A, ~2v ~ ba-k~vvi ~;:,-111ear~'~:S~u~''I.::.~ev+e ' ~ UPS/! purpo +2a. ~ , S,. ~riYa~2~ocki 12ecc~~ic~~ P' ~ p~l'Ccf~~' ~~'01~'oseb` .~to cor~S~uc-~ ~ i`~ V ~ ~ c~, KaG.-,~txec~.~;~ock~ ;whcc4., ul. S~ cell-b ~~uc:~ x-!-13 ~8 r ~7-p.~~; o.~s~~;o~, 1R,P~°~y~ Coi~rrl~ t?-~ Su.~-~o1k~~1e~,'~ofk ',.J,) ~ ~ Sec-4,Qn Vicew ' / 1 I ~ ~ ~~~~.e'~x~pDoc-k ~ ~ ~ ,,,,use. ap ~1~ .I Cns«3e Tm ~'r~~,enk~alT~~m 1 ~ ~Xis~rt+^~t at' i 'a cXf~ ~ TimhK~~e.`~"j~ ~ ' > ~ ~ ' . Scale., l`~;~ tQ . v1,D ~ ~ ~ SHEE T o~~. LAND USE CO , ~ WADING RIV,~~R, N. Y. NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION UNIFORM PROCEDURES ACT Date. .h -.~-1 ' ~ Receipt No. U + t~ 1 DRA - Stor>,y Brook Rryion No.: Office: Applwant: ~ ~ ~ Amount: $ _L ~ v~ Application Identification No.: '/L C']-Q~ 7 - Permit Type: 1 L.~-1 Check Money Order ? Robert A Greene DEPARTMENT REPRESENTATIVE Check or M.O. No.: Reg, permit Admin. 32-t 4-t 3 19177) TITLE AUG 2 Q 1989 r ~JL a' -.~.~,'T~U1fi~l ±?F^~ts'4)~ gal . 4/23/90 Marilyn Pymm 9 East High Road Port Washington, N.Y. 11050_x? TOWN OF SOUTHOLD ~ ~ ~ ~ Building Dept. Q ~ wQ,~ ~ Town Hal l ppR 2 ~ X990 ° Southold, N.Y. 11971 ATT: Gary Fish BLDG.UEPT. WN OF S U HOLD RE: Permit# 18438 Dear Mr. Fish, As per your request, I have listed below the contractors used on the above referenced project. Septic: Artco Drainage Corp. Mattituck, N.Y. Piles: James H. Rambo, Inc. Southampton, N.Y. Foundation: J & J Concrete Riverhead, N.Y. Framing: Pan/KUCk Contractors, Inc. Huntington, N.Y. Roof: J.P.HUnter Co. Mattituck, N.Y. Brick Mason: Hollybrook Contracting New Suffolk, N.Y. V r truly/y,0-gars, M~ 1~ ym////~ l' ~-~r~ c,UFFOL~-C;~ ~ ~ ~ C ~t ~ ~ i~l2~WK A. KUJAWSKI, JR., President ~a ~ AUG ~ Q'~ EPHONE .ALRF,RT J. KRUPSKT, JR., Vice-President tt? ~ (51) 165-1892 Oiled M. I3RCDEMEYER, [II ~ OLDG. DEPT. i ~ 4 nV L. BL',DNOSKI, JR. ~ ti ~~Qt ~ TOWN OF 50UTNOLD "'~"'~2Y P. SMITII ~ L' ~='7C7X!- BOARD OF TOWN TRLSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 May 30, 1989 William Pymm 9 E. H_i_c7h Road Port Washington, N.Y. 11050 Re: Trustees Permit No. 2314 - Wetlands Permit No. 417 Dear Mr. Pymm: Your recent request to extend the above referenced permit has been reviewed at the Trustees meeting held on April 27, 1989. Yoiat request has been approved by resolution, adopted at this meeting, for a period of one year. Your permit will expire on July 27, 1990. All other terms and conditions remain as written in the original permit. Very truly yours, Frank A. Kujawski, Jr. President Board of Trustees P'AK: j as 1 i. ' , ©~og~FFO(,~~oa iIP,NRY N. SMITH, Prosidmit ~ TELEPHONti '~)I".' M. UREDEMEYSR, Vice-Pres. ~ ~ (516) 765-1892 i'll]LLIP GOUDEAUD ~y • ALRI?RT KRUP5Ki, .JR. ` [![.Li?N M. LARSEN yI~O.~ I`~O~ [30ARD OF TOWN 1'RU51'EES TOWN OF SOUTHOLD ~j-° ~ Town Hall, 53095 Main Road ~ ~ ~""""`N~~ P.o. BoX 7za ~ 2 4 4989 ~w Southold, New York 1 1971 111 ~,jC July Z8, 1987 ~t:(ic"~[~ YOWR C}F 4tlUl`tULD,,,~ -a Mr. Glenn E. Just Land Use Company Route 25 A Box 2521 Wading River, New York 11792 Re: William Pymm -Application No. 539 Dear Mr. Just: The following action was taken by the Board of Town Trustees during their regular meeting held on July 27, 1987 regarding the above referenced matter. WHEREAS, The Land Use Company on behalf of William Pymm applied to the Southold Town Trustees for a permit under the 17rovisions of the Wetland Ordinance of the Town of Southold, application dated May 1, 1987 and 6VIIEREAS :.aid application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and WHEREAS, a public hearing was held by the Town Trustees with respect to ;aid application on July 27, 1987 at which time all interested persons were given an opportunity to be heard, and no objections were raised, and WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and VVIIEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, i10VV, THEREFORE, BE IT RESOLVED that The Land Use Company on behalf of William Pymm BE AND HEREBY [S GRANTED PERMISSION UNDER THE PROVISIONS OF THE WETLAND ORDINANCE OF THE TOWN OF SOUTHOLD TO: construct a single family residence, pool with decking and sanitary system. To <~.onstruct a 4' x 20' fixed walk leading to a 3` x 8' ramp and a 6' x 20' float dock. Property is located on Reeve Road, Mattituck. Board of Town Trustees - William Pymm Page 2. This permit will expire on July 27, 1989 if work has not commenced by said date. There are two inspections required and the Trustees are to be notified upon the completion of the work. Prior to the issuance of said permit by the Clerk, the applicant shall file with the Clerk a certificate that he has public liability insurance policies insuring against any liability which may arise in the performance of the operations pursuant to such permit in such amount as shall be fixed by the Trustees, which said policies shall name the Town as a name insured. Please take further notice that this declaration should not be considered a determination made for any other department or agency which may also have an application pending for the same or similar project. Please return to the Building Dept. for a determination on the need of any other Town Permits that may be required for this project. Please remit the Following fees for this application: 4' x 20' walk 80 sq. ft. @ $1.00 per sq. ft. _ $80.00 3' x 8' ramp 24 sq. ft. @ 1.00 per sq. ft. = 24.00 6' x 20' float dock 120 sq. ft.@ 1.00 per sq. ft. = 120.00 Wetland inspections 10.00 Trustee Application 25.00 Total amount due $259.00 Very truly yours, Henry P. Smith President Board of Town rTrustees HP5: ip cc: Robert A. Greene, D.E.C., Stony Brook Commissioner Henry G. Williams, D.E.C., Albany Stephen Idars, Army Corps of Engineers Thomas Hart, Coastal idanagement Conservation Advisory Council Bldg. Dept. Board of Appeals File A INSPECTORS ~~gUFFO(kcD (516) 765-1802 p VICTOR LESSARD, Principal G'L~ SCOTT L. HARRIS, Supervisor CURTIS HORTON, Senior y Southold Town Hall VINCENT R. WIECZOREK, Ordinance p ^x+ P.O. Box 1179, 53095 Main Road ROBERT FISHER, Assistant Fire d,~ ~ Southold, New York 11971 Building Inspectors O,( ~ ~,0 Fax (516) 765-1823 THOMAS FISHER Telephone (516) 765-1800 GARY FISH OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD May 24, 1991 Mr. William Pymm 9 East High Road Port Washington, N.Y. 11050 RE: Building Permit #18438-Z Premises: 2504 Camp Mineola Road, Mattituck N.Y. Dear Mr. Pymm: Please send a lettermit tolAugustc29reg991ting an extension of the above building p Very truly yours, SOUTTiOLD TOWN BUILDING DEPT. Gary J. Fish, Building Inspector GJF:gar ~ ~ VICTOR LE5SARD ~ Town Hall, 53095 Main Road PRINCIPAL BUILDING INSPECTOR , ~v ~ ~ r, , "1,~ P.O. Box 1179 (516) ~6s-lsoz /~;~'Y' Southold, New York 1197] FAX (516) 765-1823 `>1''~'~.~ ~ ~~SY > „r'P9 ~ -:.~77J1~-i OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD DATE: AUGUST 8, 1989 RE: PYMM RESIDENCE DEAR MR. AHLERS: In order to issue a Building Permit for your proposed construction, for buildings located on lots adjacent to tidal water bodies, we will need an in- spection by the Board of Town Trustees for determina- tion and a waiver of jurisdiction or a permit from the New York State Department of Environmental Conserv ion. Yours tr 1 , Buildin Inspector Phone Number D.E.C. 751-7900 Town Trustees 765-1892 i " t Dlovember 13th, 1989 ~ DEFT TOWN OI+ SOUT?JOLD T F~SOU~Fr.~:'..<___wa Building Dept. Town Hall Southold, N.Y. 11971 P.%: PERMIT ,',E18433 Dear Sirs: Enclosed please find three (3) copies of the Pile Driving Report and Pile Identification Plan in connection with the above referenced permit. Very truly yo~.ars , ~Gt' Ptaril~~ynt~~`y,~.. 9 E. High Road Pt. Washington, PI.Y. 11050 encl: (3) copies each PILE DRIVING REPORT w' FOR PROPOSED RESIDENCE AT w MATTITUCK, N.Y. D~~ '~'-`;!!1` NOV ~ ~ 1989 IS+a... uv~ ty ~.r~LEJ FOR MR. & MRS. WILLIAM PYMM OCTOBER 20, 1989 n 4 Npl Yp,~ .y CHARLES F. VACHRIS. P.E. CONSULTING ENGINEERS ~ WILLISTON PARK, N.Y. ~ ~fa~ TELEPHONE: (516) 747-5096 FAX: (576 741-9797 CHARLES F. VACHRIS, P.E. CONSULTING ENGINEERS ' 973 HILLSIDE AVENUE, WILLISTON PARK NEW YORK 71596-0330 PILE DRIVING REPORT PAGE 1 OF 2 Pile Driving Contractcr James H. Rambo, Inc. Structure Proposed Pymm Residence Location Mattituck, N.Y. Type of pile Timber Treatment CCA (1PCF) Pile Hammer Delmag D-5 Energy 9,100 Ft-Lbs Design Capacity 15 Tons No. Length Set Capacity Remarks 1 20 0.33 20 + 2 2U 0.33 20 + 3 20 0.30 20 + 4 20 0.30 2U + 5 20 0.40 18.2 6 20 0.3U 20 + 7 2U U.33 ZO + 8 2U 0.33 20 + 910 0.40 18.2 ~ 10 20 0.40 18.2 11 20 0.40 18.2 12 20 0.40 18.2 ~'~-n 13 20 0.32 20 + - 14 20 0.33 20 + ~ 15 20 0.33 20 + err 16 2 0 0.40 18.2 17 20 0.33 20 + 18 20 0.40 18.2 19 20 0.38 19.2 20 20 0.38 19.2 21 20 0.33 20 + k 22 20 0.38 19.2 23 20 0.33 20 + 24 20 0.40 18.2 25 20 0.40 18.2 TELEPHONE: (516) 747-5096 FAX: (5161 747-9797 , CHARLES F. VACHRIS. P.E. CONSULTING ENGINEERS 173 HILLSIDE AVENUE. WlLLISTON PARK , ~ NEW YORK 11596-0330 PILE DRIVING REPORT PAGEL OF 2 file llriving ConCractor James H. Rambo, Inc. Structure Proposed Pymm Residence Location Mattituck, N.Y. Type of pile Timber Treatment CCA (1PCF) Pile Hammer llelmag D-5 Energy 9,100 Ft-Lbs Design Capacity 15 Tons No. Length Set Capacity Remarks 26LO U.33LO + 27 20 0.40 18.2 L8 20 0.38 19.'2 29 20 0.40 18.2 30 `LO 0.40 18.2 3120 0.3220 + 32 20 0.35 20 + 33 20 0.40 18.'2 34 20 0.38 19.2 35 20 0.38 19.'L 36 'LO 0.27 'LO + 37 20 0.27 20 + 38 'LU 0.33 20 + 39 20 0.40 18.2 40 '20 0.33 20 + 41 20 0.40 18.2 4L 20 0.40 18.2 43 2U 0.38 19.2 44 20 0.35 20 + 45 20 0.40 18.2 46 20 0.38 19.2 47 20 0.40 18.2 ~ ~ 48 20 0.30 20 + 49 20 0.30 20 + ~ 5O 20 0.40 18.2 ~ \ <>~:NC' 4,,. ~ ~ .ate . 1 INSPECTORS Principal tBuilding Inspector O~~S~yfFU[,Y~,pG Curtis Horton ' y~ SCOTT L. HARRIS, Supervisor Senior Building Inspector o r Thomas Fisher y - Z Southold Town Hall Building Inspector O' ` A; .fie P.O. Box 1179, 53095 Main Road ' . O~ Southold, New York 11971 Gary Fish '~0,~' ' Fax (516) 765-1823 Building Inspector Telephone (516) 765-1800 Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF.BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD .October 23, 1991 Mr. William Pymm ~ _ ~ 9 East High Road Port Washington, N.Y. 11050 ~ ' ' Re: Premises: 2504 Camp~Mn~cila Road, Mattituck,N.Y. Suffolk Co. Tax Map #1000=122-9-7.25 Dear Mr. Pymm: During a review of our ,files,.it was noted that the above building permit has expired,and;a,final inspection and issuance of the Certificate of Occupancy%ha5not been done. According to the Code of the Town of Southold, (Sections 100-28,1 and 100-284),,,'.a building permit is needed for any construction of additions;,aceessory structures, alterations or new dwellings. We would"like-ta,bring to your attention that it is unlawful to occupy or use",Said structure until the Certificate of Occupancy has: been 'issued for that building permit. Please contact this office as spore as possible so that we may clear up this matter. Thank you in advance for your'anticipated cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Victor Lessard, Principal Building Inspector VL:gar J ti. 10/29/91 Marilyn Pymm 9 East High Road Port Washington, N.Y. 11050 TOWN OF SOUTHOLD Board of Southold Town Trustees Southold, N.Y. 11971 RE:-Request for Renewal/Extension ~rustees,Permit #2314 Wetlands Permit # 417 Bixl,ding Permit #18438 Dear Sirs, By this letter, I respect£uJ.ly request a one (1) year Renewal or Extension of the above referenced permits. Construction has been delayed due to ongoing financial limitations. And I sincerely hope I. will be able to complete construction by that time. I have attached a copy of the 'previously granted extension which indicates that it-Was the final extension to be given on this permit. Since I have initially paid a substantial permit fee, I ask the Board to reconsider this previous decision, and grant my extension request. Or in the alternative, consider establishing a general policy of minor processing fees.;fpr;permit renewals, which do not penalize homeowners in my. situation by doubling their permit costs. I would like to thank you-in advance for your consideration in this matter, and await your favorable reply. Very truly yours, Marilyn Pymm encl. ~ ~ ~~V ° Q a~~{ TRUSTEES o ) ~ SCOTT L. HARRIS John M. Bredemeyer, III, President tf~ , ~ Supervisor Henry P. Smith, Vice President yQ'r Albert J. I{rupski, Jr. 0 , Town Hall, 53095 Main Road John L. Bednoski, Jr. ~ P.O. Box 1179 John B. Tuthill Southold, New York 11971 BOARD OF TOWN TRUSTEES Fax (516) 765-1823 Telephone (516) 765-1892 TOWN OF SOUTHOLD Telephone (516) 765-1800 May 25, 1990 Marilyn Pymm 9 East High Road Port Washington, NY 11050 RE: William Pymm - #41.7 Dear Mrs. Pymm: ° The following action was take~,,l~y;the Southold Town Board of Trustees on Thursday, May 24~,~:',~~.90:= 3""" " RESOLVED that the Southold Town,tB9ard of Trustees grant an extension from July 27;-1990.tp, July 27, 1991. ,Please note that this; is the final .extension to be given on this permit. If you have any questions, please da not hesitate to contact this office. V y truly yours, G~~ John M. Bredemeyer, III President, Board of Trustees JMB:jmt - • ~ l t £a t .,1 f )r -'i < t.•', ~ ~r ~ i , ; ~ . ~ J.;~.7t January 5 , 1990 ~ 2' ~l ~ ,~ar~ - s Aso ; TOidN OF SOUTHOLD ~ ~,fi~% 4 ~ Buildin; Dept. Qi-cc. oEi~r: Town Hall Tt~wty o~ seturw~it_u Southhold, N.Y. 11971 RE: PERMIT ~~18438 Dear Sirs: Enclosed please find survey ammended Dec. 21, 1989 which details tha actual location of subject foundations. If any additional information is required please advise. Very truly urs, Y4~~ ly~Py~~~~?t~+'L 9 E. High Road Pt. ~dashington, N.Y. 11050 encl:(1) ~ ~1~~ I lJ~ Tss-1802 i~~~ ~ulri BUILDING DEPT. 1 NSPECTION ]FOUNDATION i5T [ )ROUGH PLBG. i P~[) FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL ~ ~ n ~..a-r~ c~ REMARKS: ~1 /~r~.iaG~l~ ~ 1 J tom' elf - ~ DATE ~ ~ INSPECTa~ ~~~3~ ass-isoz BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ FRAMING [ ]FINAL REMARKS: ~ - ~,v.,~~c,/ DATE ~ ~ ~ INSPECTO sj T65-1802 G~~ p BUILDING DEPT. v( NSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. (]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING ( )FINAL REMARKS: ~ - ~jr~~~ 0 i ~ , DATE INSPECTOR ~ ~~~~p~Q ~ ~ © Nom- ~~r,~:,~ ~ C/~~'~C. rsS-zso2 ' BUILDING DEPT. INSPECTION [ ]FOUNDATION iST [ ] ROUGH PLBG. [ ] FOU DATION 2ND [ ]INSULATION [ FRAM{NG [ ]FINAL REMARKS: __L~~ _ / Get o y < ,f _ c~r- 4/ _ ~ p~ t Gf~ ~ i DATE D INSPECTOR i 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATIO 1ST [ ] ROUGH PL G. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~ I DATE ~ INSPECTOR G l~ ~ ~ r _ 7SS-1802 BUILDING DEPT. INSPECTION ( FOUNDATION 15T ( J ROUGH PLBG. (]FOUNDATION 2ND [ ]INSULATION (]FRAMING [ ]FINAL ~ ~ REMARKS:. ~~V/ DATE d r d INSPECTOR ~ l ~ ~f65-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 15T [ }ROUGH PLBG. ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ }FINAL REMARKS: ~ mss- L,?.rr~ DATE Q 1 SPECTOR 1~~~ T65-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 15T [ ]ROUGH PLBG. [ ] FOUNDAT{ON 2ND [ ]INSULATION ' [)FRAMING [ INAL REMARKS: t~~~~~ R ' DATE INSPECTOR 765-1802 BUILDING DEPT. 1 NSPECTION [ )FOUNDATION iST [ ) ROUGH PLBG. F NDATION 2ND [ ]INSULATION [ FRAMING t ~ [ ]FINAL REMARKS: V Q" ~ S`'~ ,~~~c~ ti DATE ~ ~ INSPECTOR ~e i, BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLB [ ]FOUNDATION 2ND [ SULATION [ ]FRAMING [ ]FINAL REMARKS: %~C~ i~~~ a 5' DATE l~ ~ 1 NSPECTO ` > . . ~ ` x n r- 9 ~ m (1 m p m N~ m n N a (f m ~ a o tf m f1 ? ~ _i rte' '-"Y~ n n y A• m m N m m m m m m Z N N A m m m m m m m m m m m m m m m g m y $ - ~o w ~ m m m °o m m m m m m m m m m m ' m ~ m a titi a°. m ~ ~ cc n-Wi 0o N o: ~ ~~E p-_~~-A nv $aQW ~ •*eyqy A Do of N ~ N D; ~ Y@ to m v; L p 55 m 5 _ p l I I I I I I m pypl - N N N N m - O N N m;g=s ~ m m n m m ape 1 1 1 1 1 1 1 1 1 I l l i i l l l •y= o x o m W i[ , ~Ni O m O p N P 0~ x < -1 O m O A N m x o R i m a W Z A D N x W~ ~ r r o m m Z R~ N N A N r r O m T m D D D m r r O N~m frill 2 Z A 3$ r= 9 p p W r 1+~11 pg I c 1~ I tNI~ nI I I I ~ O m N 2 2 2 ~ 9 m m m D ~R Z D 2 .p N ~ 1j ~ -i mO 0 0 A p m H [ V n r fM' r m r S b O r r m m O W 2 n P fmtl ~ x I27A~Inn31 n D D O m p W Z N N N N ~ m O N m m ~ A O m{ ~1 ~ r r ~ O m umi ~ m 9 A> 0 0 m 61 A D O C m W m m A ti m m 9 0 9 m N N -I m m A< !11 m m f211 ~ K t m ~ p n N A° n z~ z x 9 a m x m n m m m~~ m ~ mmrm- -mac r ^Im.x~ q 1m~~ F1 ~m K7 m z N v m N -i -1 x m cc ~ m -1 m = ~ ~ m m a ~ ~ A m ~aR@ ~ ~ m ~ E ~ 8 N A ~ §pgp R ~ N . g.g ~ ~ s R omm m m 8>L~ ~ ~ ~ ~a~ ®,I1III~ x K m § Y P ~.~1 ? m w W jf O A N pd% !s omm mn M m ompnl ~~i~ ~ '9 0~~ nwWwm @@g CD NJ ~ULN, ON W W W W S 19F ~1 Ns~~ AAAAO tl5 qq ¢q a S d ~ i ~lYO wm II ~ N ~ C G ~ N' j' m m ai = ` d AA, ~~ss~' w 2 ~ ~ ~ ~ ~ mmasm`- n n y ~ _ s~ ~~~II °~~s~ fC~ Z C7 0 ~ mm v-Is 1~. I 5 ~ 0 8 ~ N ~ N a a o r ~ -1- ~ N m m m' 111 ~ { 3 ~ o ~ ~~~9~2. c1D A INSPECl"ORS PrincipaltBuilding Inspector O~pS~EFO(~COG Curtis Horton 'fj~ SCOTT L. HARRIS, Supervisor Senior Building Inspector y a Southold Town Hall Thomas Fisher v- P.O. Box 1179, 53095 Main Road Building Inspector ~ • ~ y Southold, New York 11971 Bui ding Inspectar ~ ~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 October 23, 1991 Mr. William Pymm 9 East High Road Port Washington, N.Y. 11050 Re: Premises: 2504 Camp Mineola Road, Mattituck,N.Y. Suffolk Co. Tax Map #1000-122-9-7.25 Dear Mr. Pymm: During a review of our files, it was noted that the above building permit has expired and a final inspection and issuance of the Certificate of Occupancy has not been done. According to the Code of the Town of Southold, (Sections 100-281 and 100-284), a building permit is needed for any construction of additions, accessory structures, alterations or new dwellings. We would like to bring to your attention that it is unlawful to occupy or use said structure until the Certificate of Occupancy has been issued for that building permit. Please contact this office as soon as possible so that we may clear up this matter. Thank you in advance for your anticipated cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Victor Lessard, Principal Building Inspector VL:gar 4/23/90 Marilyn Pymm 9 East High Road Port Washington, N.Y. 11050 TOWN OF SOUTHOLD ~ ~ 14~ Building Dept. '"__'_,".",_,._..~..~._'_°i~~ Town Hal l i Southold, N.Y. 11971 Lj! Eau;` j F' ~Q6'' ;aJ ATT: Gary Fish BLDG. DEPT. TOWN OF SOUTHOLD RE: Permit# 18438 Dear Mr. Fish, As per your request, I have listed below the contractors used on the above referenced project. Septic: Artco Drainage Corp. Mattituck, N.Y. Piles: James H. Rambo, Inc. Southampton, N.Y. Foundation: J & J Concrete Riverhead, N.Y. Framing: Pan/Kuck Contractors, Inc. Huntington, N.Y. Roof: J.P.Hunter Co. Mattituck, N.Y. Brick Mason: Hollybrook Contracting New Suffolk, N.Y. V r trulyvyo~rs, M~ly Pym~~ . 3. Nature of work (check which applicable): New Building , Addition Alteration Repair Removal Demolition . Other 1Vork . 4. Estimated Cost .~,Q',CJ, ,C,~ (Description) C.?~.Q . Fee . 5. If dwelling, number of dwelling units ~ (to be paid on filing this application) • • • • • . • . Number of dwelling units on each floor If garage, number of cars ~ • • • • . 6. If business, commercial or mixed occupancy, specify nature and extent of each t 7. Dimensions of existing structures, if any: Front YPe of use , h.~S..~;l" Heigl2t ~ Rear Depth . Number of Stories , • • Dimensions of same structure with alterations or additions: Front • ~ ~ • ~ • ' ' ' ' ' ' ' ' Depth........... Rear ...........Height Number of Stories . ' 8. Dimensions of entire new construction: Front . Height Rear..:.:.,:.._......Bepth ...Numbe>;ofStories......... 9. Size of lot: Front .......4v GP Rear ....C.o...:.t........•. , . . : ..:....:....t....'....... . 10. Date of Purchase G°• • • • • • • • ~ Depth ~v, , , , , • I°.It~~ .....Name of Former Owner .•G : ,A4-4•c~!-~•........ 11. Zone or use district in which premises are situated , , .~^,CLc~, I~.~SIta~~,1~~ • • • 12. Does proposed construction violate any zoning law, ordinance or regulation: ~ ; , , ; , , ~ • ~ • ~ ~ ' • 13. Wili lot be regraded ...`~Fr.S , , , , , , , , , , , • • , ,Will excess fill be removed from premises: Yes 14. Name of Owner of premises'l~/.1,V!-; tppt!1, ,p-`~• Address , .?~.~C.-t~;~`~, . , , ,phone No. P.~ Name of _t ~~~1,i0~...J: IL ; z?,y.11.•EYLS ' Address 7~~' ;l,-c?~1/ . Name of Contractor r,.?,c~1,sE.~F.G rO ~1 • • • • • Phone No...-. , • , , , , , , • • • •r'~•4 • • .Address .......Phone No. ' IS.Is this property located with in 300 feet of a tidal wetland? *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 from ' property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. G 1 r7 l r~ I( ~Ci~ ~c~ , l.~~G ~~1 11 \~/t c..,c._.t .z~,.t-~1 i~~t't~'1 tom( °I 1=AS~[' t-~t ~ 1--1 ~,~r..~ ~l CP - °l co42 p`~+2-°7 ~~~t-I1~.~ i~a~.l,~ ,-•1,~' l t c~ ~ c:~ 5 t ~ - -7 Z 2 - Z 2~"7 ~e~ >e ~l A~ ~ ar~t~-~ . STATE OF NE1V YORK, COUNTY OF .$t?, k~0t;1!• , , , • , S.S (Name of individual sip • ' ' ' ' ' • • • • being duly sworn, deposes and says that he is the applicant ,nin„ contract) above named. He is the ...~F..yT./~.,h1,G).trv~F_EfZ. (Contractor, agent, corporate officer, etc.) • • ~ ' ' ' • ' ' of said owner or owners, and is duly authorized to pe~rfc~-m or have performed the said work and to make and file t119s aPPlication; that all statements contained in this applicat)'on are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this day of.... Notary Public, ....~~:5-!LN! ./.1.:.!x!3,-,(Jb~....... County , / HfLEN K Df VDE ` ~~2?~ ~~•~irr~° . NOTi1BY PUBLIC, State of New York • ' ' ' ' . . i ruExpires7Mirch3019u~~~ (Signature of applicant) 1 Q~Wpr+aG BomKD 'I , P ~ ~g t~'~ BOARD OF HEALTH _ _ W~ 3 SETS OF PLr)~NS j-•--° ~ ~ I FORM NO. 1 SURVEY D.• 1C d TOWN OF SOUTHOLD CHECK ~ //.3~ o Ili BUILDING DEPARTMENT SEPTIC FORM ,J,•~,•, , , , , , TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY TEL.:765.7802 CALL Examined 19 ~ MAIL T0: P 6. y~~yt~~, . Approved ...~1~.7'.~/........, 19~~Permit No.~~~c~,rl~ 4v~- Disapproved a/c ' . , R n wldind~. for Y o .t-.tie,~eQ,1>,. ` J7" d^eTQ Imo" te,_, ) 1 ~ LICI~TIO FOR BUILDING PERMIT ~ ~ ~ Date 19 . i INSTRUCTIONS a. Tlus application must be corjtipletely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to sdale. 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 availab~e 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 Builditg Inspector. APPLICATION IS HEREBY Mr1,DE 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 o(' buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply wiY~h all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorzed inspectors on premises and in building for necessary inspections. (Signature at" applicant, or name, if a corporanon) ' (Mailing address of applicant) (1~~,r~ State whether applicant is owner, lessee, agent, architect engineer, general contractor, electrician, plumber or builder. Name of owner of premises M.~:. ,\~t,l,.!Z..~I ,d,'h!~, , , .P~ T.`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. , . , , I Plumber's License No. 'd' ; Electrician's License No. , . , ,Ill A"' Other Trade's License No. i : 1, Location of land on which proposed work will be done . . . , . House Number i Street. ~ Hmnlet r/ County Tax Map No. 1000 Sectign ?r. Block , , , , , , , , , , , Lot , , cn t,.Jn ~'C. • Subdivision ~ ;.E;•,d1~I,,~El,~.1 Filed 1<la t No. . 4 Lot.. (game) 2. State existing use and occupancy', of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~.T . b, Intended use and occupancy •;I' p•~'"1.T( ~ C7n~(~ ~,Ia.M,t, , L.r D I o~,, a a, o ~ ~ , e ~I ~Q ~ ~6i ~ ~ ~ ~ , ; , a: _ S ~ ~ ` ~ ~ o ~ ~ o~ , ~ 'r ~~~.1 ~ i 1 ~ 'h. , j. 15 ~i~ r I ~ ' ~ d ~ r ~ ~ i ~ ~ ~ i• ~X ~ i ~ i /I ,y~ + ~ f T` f J \ ~ + ~a}'n ti ~ ~ . ~ _ . i ~ ~ ;S ~ III 1/ ~ i ~ r J ~ ~ ~ ~ ~ A~ ~ r Y 1 ~ N V :'I i~ _ ~ r~ ~ ~ yl I?" ' ~ ~ ~~~~'~i• ~ b F i>^ .Yr _ ~ , r n y,)~ 4.~ .t 1 ~f ~ y } ~ r ~ ~ ~ ~ ~ ` _ r 1 {A ~ x i ~ ~ ~ ~ r.. s, I~ ~ , ~ ~ ~ ~ Y i I((r 1 r r ~ ~ 1 a' 4a ~ P ( . ~ s, a j~ rD~mm h ~~'J~~ „ ~~IP~y^~~ , ~l Ala a.<,r f 1 r~ on W a . j _ •._4 _ . ~ ,M._.P.Y_..~. _ , I r ~ k~' 1 i I t~3' I/J/l ~ ~ ~ ~ r' I r' d, i ~ i i i ~ I - - - f f~ ~ ~ ~ z. ~ , s p ~ r ~ ( t. f ~ if yz ~ ~ H 8 a1 .~-7 s"?l s~ Z _ I R l"' l.. ~qY O it '`tom ti ~ ~ "y. ~ ~ ~ ^~c . - .s _ _ s n \ ~ a ~ , F i ` , ~ j ; k,,,. ~ ~ ~ ..5'~, r C ~ ~ ~t'T7ti'r'l QX.f_ ~ ~ I ~ tr ~r r S 6 . ` ~ ~ , ~ ~ 1 ~ ~ ~ ~ ~ ~ rn ro ~ ,t, of @ ~ ~ ,cam ~ M ~ , . r ~ C ~ ~ ~ ~ ~ b ~ b ~ ~ . ~o~ ,Rr k, 1' _ r "Y v i.~ b ~ G co fi, _ i'~ ~ ' f ' ~ - ~ ~ ~'r (~{y p ~ ~ f. I~ ~ ~ ' ; ~ P„ - ~ i~ ~ ~ ~ III cx1 ~ z' ~ ~ T i I y, ~ ~ ~ ~~n Q ' ~ i S ~ .'~F~, f~ N '~,o Ala v p t~ `~a,; a t^ ~',S ~ Q lL f~ f ~ r~ ~ ~ ~ RJ _ T ii ^~7,~ ~ s ~i'1 P Al ti! 3> N ~ - i ~ . o R ~ ; to '~A s Q ti _ ~ X " ~ a ~ iii . ~ y..~ ~l ~ vs' iq, ~,O ~ ~ 3 ~ app ~€tlG`=~ l~ 'i ~ t~ ~ l~ ~ i~ ~ ~ ~ ,i~ ..1 ; „"r"1+1~J ~As+"r~z'l., tb'i e..- ,r ~ t~A 0.5 ri.~ a;, iw--_ - ~ ~ i - N. M' 1 a p¢ E{ 41 . ~ ~ ~ CC{z` i' ~1 4r y r R - „j ~ *~.U~Y ~ ti ~ 1'61 r ~_.~S ~ ~ TI ~ 0 ~ ~ 1n ~ ~ t31`, ~ ~ f~~ n © p r ~ O O ~ > p sf-,'~, r ~ ~4 ~ ~ :5 ~7 a ~ W ~ _ ~i~ o ~ ^I 0 a z x ~ ~ r RQ r~~t~`~~@ a m o ~ r 'i ~ ~ c ` ~ ~ ~ ~ D 'mV. 'Z ~ ~ N ~ ~ ~ t ~~mc+ ) °o © ~ ~ ~ s ~ *t ~k a-pe~ 7• s tf6 m m a~ 3 7 d ~ ~ ~ 1h _ ~ ~ ' 'T+ ~ .TJ +r-1 'li p D 1'R ~ ~ 4~\'~,fl ~f A~ m/ m ~ ~ ` > tf m ~ ~ ~ ~ GS O ~ x .Cl m ~Zi F h?5'ys 'I~~Y r y°''v~ ~s moo 'k. ~3 ~;y ~5 ,'~~y p ~ n'a U 4 )\'tr ~ a c 7 ~ ~ i ~ ~~"'3E w"'S r .7. .~~6 ~ Q m i%~ ~ ~ x m r r Y Y S _ _ _ _ o-i..: ~ • ~ SUFFOLK CO HEALTH DEPT APPROVAL m . .iri' - H S NO. r ~ t i >r I o„ . ' °~c . t~ I ~I / o,n f L I. .v~ ,t r';' p I ~ h STATEMENT OF INTENT v~ Z' b S ~ b ~ t ~ THE WATER SUPPLY AND SEWAGE DISPOSAL ~ ' 09 yI. lsr- ry ~ SV STEMS FOR THIS RESIDENCE WILL ' i/ `m'~: .,t 3 f~' i~ CONFORM TO THE STANDARDS OF THE ' .Lryj •LI ,VI' ® pV''Q~ SUFFOLK CO DEPT OF HEALTH SERVICES. APPLICANT / J' ig ~..1'~Ilr i ~ 251.$L'+ Jt ttal t:~i _ ~ i SUFFOLK COUNTY DEPT OF HEALTH I _ ~~~~x:" p N. n7r'f"~~~ SERVICES FOR APPROVAL OF (1 ,r e't~~t ~ jet; Y'l~ I CONSTR UCiION ONLY _ I'~' I ~ ~ , I DATE I ,r ~~t r H.S REF NO APPROVED _ ~ph~~ ~ _ • i; I,, c ~ ~;~I ~ N ~ SUFFOLK CO TAX MAP DESIGNATION D '~1L .1 - ~ ,3 DIST SECT BLOCK PCL NN •-T ~ t(D ? t' I ' ~ e%L,i k' r Y Fr i// OWNERS ADDRESS a 'a y~i I tile. ~~irl/ i Lr :r. y „ / ,rc;=:;' -i; NIa~ ~F~(T UC.; Ki DEED L P - ~ ~ r TEST HOLE STAMP ~ e 3G.9L@ - Li U~-, a n e S w ~t1J IG+eJ r' v. f~. f - _ _~.R firer arm++r r~nrp mm r,-rE:, (r Fe - .(nur~cnor'm ink~6 eanfx V Haul sY.elf not Ilo mmeMan~E ~ml ~ (,pr IrN fur ,f~r)1LA~ (I'Vnt ~I l! IL O. ` 1 1%, ~a ~~5 rzcptl nun c~qt I - ~i I ne nr Ac, r ~ arv rv ('~l: v.~f~. sntesa lniMxnm hmeane !s•~n j.` ~ - ~ 1 „ bLRn nnrron lorwhnmfi ` .-L7 -vc*d .~rl ~ r `;J tDn - Y+ rtl nne nn heb tl yn It n n I. r r. L' r ~ ~ I artMnicielh c d ' -'r'an:. Va".5 CJY C i A f ~ ryi n+ r POL+rO S(%6" of th i - - r t tr ~ ~ J ! nna na '6 - I - -r (/11//.419/1 i~Ir'N./!rJ i?!eT •9C for W. i. %r f111, e.. ..il rnau.AOn~ au1v..,uuan ~ t I ~ ~ ~ / J/ - ~ - ~ SEAL ' cicA7 r1. CE'c~':? /~i tl7Ei h:dt! I *L~: .p .r--~~-~ ~ 77 >'~f..' it:R(h':rl?: F.' C: d. dC~ r I I ~ / ~ :3N1e. rr,._.., ' ..ru~~j rr"."J/ F'!."%'. F1', I ISB ~ 1 _ ~ n ~ , , s ~ ~ - 1 i L3 L~ RODERICK VAN TDYL, P~. Id ~ - I c r.C D rl 1 - rF. Y` N'I-n 1 I9~ J - , , \r - LICENSED LAND SURVEYORS - GR EENPORT NEW YORK ~iELEOVNf IO51 N]V]9 'Z ~ G. b ~ ~ ~ T ~ Q ~i S l~ F~- o t ~ , ~ ~ ppq,, II ~ jj'•~ry ` ~ ~ W ~ ~Z ~ ~ _ It ~ Y a - ~ ~~7 F~ L ~ F W Z ~ ~ ~ > ~ ~ q ,.,t ~~;a J 1 M~ i. //P!.y 's' F ~ 7: tTy G~ 3` US Q O LL N U Y'~ ~ r~in ' ~ 1'irr'. P~v~\'~s~ tv 4 tt1 Z~ `(J L kn~ ~ ~ 8 y uJi ; ~ ~ i.. • VI W ~ W h- ~ ~ O 'Vr` ~ ~a .~s ~ '3at'".'Iy Sf m ~ ~b c~ n: a a ~ ~ s ~ u w, av,0 ~ Y ~ ~ ~ l=. 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