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HomeMy WebLinkAbout20034-z {S FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCOPANCY No Z-24436 Date JUNE 14, 1996 THIS CERTIFIES that the building NEW DWELLING Location of Property 54455 COUNTY ROAD #48 GRSSNPORT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 52 Block 1 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL il, 1991 ureuant to which Building Permit No. 20034-Z dated JIILY 19, 1941 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued ie ONS FAMILY DWELLING WITH GARAGE DNDER AS APPLIED FOR. The certificate is issued to VARIIJAN & LINDA ARSLANYAN (owners) of the aforeaaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91-SO-0042-MAY 8, 1996 UNDERWRITERS CERTIFICATE NO. N-291154 - OCTOBER 1, 1993 PLUMBERS CERTIFICATION DATED FEB. 5, 1996-PSCONIC PLDMBING & HBATING ing~ector Rev. 1/81 1081[ NO. A 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 ~ ~ ~ b1' ~ ~ Z Date ......~..9........, 19..9.x. Permission is hereby grant to: ~d~_ cam...... of premises located at s,.~..........~~....~$........47...P.i~ ...............................................................................111................................................................................. County Tax Map No. 1000 Section Block .......4?.~........Lot No......4`~...~.......... pursuant to application doted ...~~rS%F~4.IkS.J' l.l 19.t1:..~.., and approved by the ~V f Building ~I[nspector. Fee S.~.LD:..:~- E i k . Bui ng Inspector I k I Rev. 6/30/80 k Form No. 6 y n R Y~~ TOWN OF SOUTHOLD U ~ ~ ~ O ~°°°'"Y L5 ~ BUILDING DEPARTMENT [J TowN HALL ~ ~ APR 9 1996 JUP.i 131996 ,6s-lsoz ' BLDG. DE . BLDG. DEPT. ~ TOWN OF SOUTHOLD M_,., TpWN OFSOUTHOLD APPLICATION FOR CERTIFICATE OF 000UPANCYr- A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the fallowing: for new building or new use: 1. Final survey of property with accuxate 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. G. Sworn statement from plumber certifying that the solder used 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. r If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Pees 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 - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 / Date New Construction....~1......//Old Or Pre-existingg(1BuildiCng Location of Property....Jr,.!~F7S~r......:.~:1°...:7:p,.....JDI;~.'t,~p~~y..1'~~.l~q.~.~ House No. StreetYy Hamlet Onwer or Owners of Property.. v.~.~~.~~~. ~.G:I.~.~~...1! 121-.1~Ny.~~ . y7.3~g~ s2. -1-g County Tax Map No 1000, Section ..............Block................Lot...................... - Subdivision ....................................Filed Map............Lot..............,./..,,./. Permit No..~~P7.~~.: ...Date Of Permit ................Applicant. ~~~{41:~~1~.A:R~`~~Z~'".... Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate....K...... Fee Submitted: tt y~ "SI ~ l~ APPI,IGANT ~o ~ a~43b THE NEW YORK BOARQ OF FIRE UNDERWRITERS eAGf. 1 1@01071 BUREAV OF ELECTRICITY BS JOHN STREET, NEW YORK, NEW YORK 10038 OgtP CICT06Ex @4,1913 Application No. on file 770b6&2192 N 291!54 THIS CERTIFIES THAT only the electr{col equipment as described below and introduced 6y the opplicgnt named on the oboee opplicotion number in the premises of VAl?UJAN Ax3LANYAN, 54435 COUN9'S' x0A(7, 30UTHOG[1, N. Y. in thefollowinq Incotion; ~ Basement ® lac Fl. ®2nd Fl, GAx / AT'TTC / QUT .Section B[cek Lqt woa examined on ~ fi p T F N (3 G' R 4 , 19 9 ~ and found to be in compliance with the Nationgt Electrical Code. iIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTAClES SWITCHES INCANDERCENL FIUORESCENl OTHEfl AMi K. W. AMi. K. W. AMi. K W. AMi. K W. AMi. H P. 123 a2 81 123 z ~ ~.s ~ 1.4 a F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS ggLL UNIT NEATERS MULTI.OUTLEf DIMMERS AMt. K. W. Oll N. P. GAS H. P AMT. NO A. W. G. AMT. AMP. AMT AMPS. TRANS. AMT. N. P. SYSTEMS qMi. WAiia NO.OF FEET I 1 $ 1 3@ 1 2@ 1 SERVICE DISCONNECT NO.Of 5 E R V I C E AMi. AMP, TYPE HiUEp. 1.0'1w 1,R 3W 3,a 3W 3A'4W NO. OPER a'COND OF CC.CONp.~ NO. OF HLlEG OP M lEG NO. OF NEVTRALa Of NEUTRAL 1 2@@ CB 4 1; 4 4/@ 7. 2/0 OTHER APPARATUS: ancuzzr-~. star@x3:1-s H.F.,I-3 H.x,,7_x II,E. eAN~I~ooAxnslz-~ ezx. s@ G.F.C.It-18 TRACK LIGHTTNf31-88 _ -t'~ G & S CONTRACTOR I,LC,#578••1; BO~t 215 30UTHOGD, NY, 14971 GENERA/ MANAGER f 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 plOT BE ALTERED 1N ANY MANNER. . 7 - y>., 7 i\ Ny _ Town Hall, 53095 Main Road ~y+ ~ ~Y Fax (516) 765-1823 P. O ©ox 1179 ~ 1 Telephone (516) 765.1802 J Southold, New York 11971 ~ ~ - - S OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE : .S--S~6 i Building Permit No. ~ ~(~~`~L ' Owner: 1~Q-.41 ll I=FS ~ QU~,~ (please print) ` / r Plumber: ,~'OI?/(' /'./~/17`J71~1'6/7~JgT/N~i (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1~ lead. (Plu~ibers Si nature) Sworn to before me th/is day o f 19 ~ ~~~~f-e t,-„ ~--y~~~ ~j SKI ' Notary Public, ~~L County N~~y ~ I~s.lN~6g44752 pua`iG4d i<S Cull C°u3MO9'g~ / Commisaa71:>'~)rox S~~ i o~~g~FFO~,~co o~ Gym H ~ Town Hall, 53095 Main Road p • ~ Fax (516) 765-1823 Southold New York 911971 y'flpl ~ ~+a~! Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD January 16, 1996 Mr. Varujan Arslanyan 1055 River Road Edgewater, NJ 07020 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: t/ xx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. f.~xx--:-:._ The: cfieek~.is....not .on-.file. $25:~~ xx No Health Department Approval on file , - -_.___..--___~_.e____.__....___, No final inspection has been made. xx No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20034-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. I . aJr~; ~w ~~i•~•5~~ ~i t,~r APPEALS BOARD MEMBERS ,G r. . "yip ~ ` ~ ~ Southold Town Hall Gerard P. Goehringer, Chairman ~ v `s ~ ~ 53095 Main Road Serge Doyen, Jr. k P.O. Box 1179 James Dinizio, Jr. ~ z, ,;~5°s'~ Southold, New York 11971 Robert A. Villa ~a , Fax (516) 765-1823 Richard C. Wilton Telephone (516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD June 7, 1994 D iy Mr. and Mrs. Varujan Arslanyan 1055 River Road Apt. PH 11 South Building Edgewater, NJ 07020 Re: Your Inquiry -Change in Shape of Spa Within Deek Area ZBA Conditions under Appl. No. 4072 dated 6!22/93 Dear Mr. and Mrs. Arslanyan: This letter is sent in response . to your inquiry and letter received yesterday by our office concerning the pending Building Permit -for a 10' x 14` spa. within the 18-ft. attached deck, and your request to change the shape of the spa•to a 17' x 7.9." The conditions set by the Board in its June • 22, 1993 resolution would not be violated if you locate the prefabricated spa, as proposed, with a size of 17' x 7.9" and at the designated depth of 51". We have provided the Building Department with a copy of. this letter for their permit file and records. Very truly you~rs,/~ GERARD P. COEHRINGER G' CHAIRMAN cc: Building Department . i _t. 1 ~ ~ " ' ~E W 2EPLACt AY Ox. ! ~ DEC CU. Y6S. rJr^ L,QST ~NST.~L,L Appp~X ~ ~ EMBANKMENT 9y' FT. OF = ' _ - - ~ J - ' ~ i ~ -r F~-.I34LF~ _ 14 C.C.A. P1L tNC,~S P20P ~ -_``'FLAC~STONg~ 46 tv O. L. (1' ~p'~ ~ IoSPA 4 ~EEP ~7 LANAI N[` 9' t tNFOR'MATION KECEtvEp , -~iAT_ NEw OWNE2 ~ P~zoP. ~-ANS 7p REOJES7 TD ~ T 1 EGK~ ~ tai I ' NSTRUCT C.ONNEC"riNG ^C` ~ y I / 1L1G4\Eq0 CDC 4' i ''-i \G': ~ ~~,0 yr,~~,^;1' - ~ _ - ~ fa~~P ROOM P2~ f.~t VY r _ `J~~ CEL L A? w4Y C O f`1~ t5 sNZU~ APF'R~ `,Z. ST RY. FR, gY TC HSE. TRUS I ia AAp p~~,~~o ON®~ _ _ t9 / E,v,vO ~RE~~Pj~~, ~ I T AT 'THE ~a''xL~ iiRED r'~ L'fNG ~ `e N~~4"+G~ ~ ,rte , RUST ~bCyt~•,~~~'S•vV,J~ :'1~LD I;:SP~C,iU;! ~~U6.;, NT° -bb )J Q 1. m ,n: a ~ 0 ~ ~ W _ y ~ FOllt1DATION (1st) r ~ L FOUNDATSOr1 (2nd) ~ ~ h b 2. I z o P,OUGH FRAME & ~ a,,,~,, ~ LUMBING ?aP-9s~ _ N 3 . ~ ~ ~ " 1r 8 / m ItJSULATIOt! PER N. Y. ~ ~ :y ~ STATE ENERGY CODE 4 . d li m y ~ c.~ FI;JAL _ Csh 8 _ H ~ O f z L ADDITIONAL COMMENTS: x -c a L 4 C ' r [x) ' x ' H ? ~ . y H .p ' O W Z m ~ • A r ~ • y ~ _ j' ~ . • m ...d ^o - H "I}qs Rtickund dd, ' SGcenman ~ ~ r r 1180 Pine. PJeelt Road P.O.Box 1002 ~ •~~f ~ Sou.thov.d; 'New Yonlz 11971, r .,e~`~,"'~ ~~,`~dt~ w r 1 ysr @, < pr~y4 i' I r~ f 4 v i } r G ~ Man ~25, 19'91 r{ sr~>ct ~ ~Cf1,1'#~~,€~;~f~~t`~~+ ~ r ~~Xr~ ~ , ~ ~r ~~1 ~t aF `~'taf~sf?}'~da ~~r ~ ~ ~4] r f r A ~ 'i ~P 1~ e ,,~TOWVI O~) .ySU U~'~20Ad s F,r~ ' } r .'ai a ~ fit rf 1~.N+r ~r~ ~5~33u~~r ~'M1y a~ 2(i'. Buti2d.cng Depan.tmen.t r ~ ~ ~ ~F(r 4 ~ er~~~~~ rv~~rM kr' ~ 1 E r ~ r fnNt r i tr o ~'4 A A A ~ /,rar ~ 'a 1 oGUYl ~a.~;4 ' i ~r~lr ~ v ~ 7 tjrrpfyt r ~r'~a~ ^rf ~ ^„~t { tir"!M'^`v iv rie~ Soa~th.o2d N ~~V.~ 11971 'le r r t,ff ~ ~ ;r " rra~n} e~ti~„~~t~#~r~~r~'~~~5~~a~} s ; r. 7F d s uh yk.~~i4, s d ~ ~r~S ~fa f V r r i d Fa~ r . r i~ r~ Ise x 1 R a'~~r kp~.~y~"d. ~t~~F4f,~~r t ~ 'y5 Doan S~.n ,~~z a~,,s~~ i, rnnr 11 ~ ti rr D ~t~q }rry f A l r i' ~pxhF ~r y qi y~. e f?~, r r , ~ f y ? ~ " ri 3" rah itas~~tdi-~SVi Sj n~ rw+~{!~f r~~4~~a. Vkz r~ ~L..yr~¢. 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'~a'~.,~ R°.. t, ~ r x a a ~ Y x ~ fx''~1'~ 4 s ~Xxa ~T+NId e ~ 3 ~r~W , ~ i~T r _ r 2 .x t 4 S r~.yxy ~ N i 4n~ 'M1R `~+~'v" 4'h ~n r , ' R<, ' ~ ~ , _ .~~n s~rtiu~ va.r~'r/r~.~nx '~+aaYf4k+ ~s ~~$a'~"~'a.~V.rc...~~,~ _ e 3~ t o 765-1802 BUILDING DEPT. 1 NSPECTION [ ] FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ] FRAMING [ ~NAL [ ]FIREPLACE & CHIMNEY REMARKS: .~1 DATE_~~~INSPECTOR ~ ~ BUILDING DEPT. INSPECTION ~ ~ [ ]FOUNDATION i5T [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION (]FRAMING [ FINAL ~ o~~ R MARKS: ~ sS~~ ~ D ~ t,~i ~ ~ - a.~ '~i.a~ . ~ DATE /~i~~~'INSPECTOR~`/i e~~~ . ~ , i . ~~1~~' Crss- oZ BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. ~ [ ]FOUNDATION 2ND [ ]INSULATION I [ ]FRAMING [ ]FINAL , J REMARKS: ~~rr i s ~ ~o ; ' h ~ DAT D INSPECTOR ~ ,G~~ . s ~ P T65-1802 % BUILDING DEPT. 1 NSPECTION [ ] FOUNDATION 1ST [ }ROUGH PLBG. [ ]FOUNDATION 2ND ~-j°'(NSULATION [ ]FRAMING [ ]FINAL t REMARKS: ~ f ~~°l ft I E ~ i DATE INSPECT Q ~ _ e o ~ _ _ r 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ROUGH PLBG. [ }FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~j~, R i j Ift ~t` iF F E ~ DATE ~ INSPECTOR c ~3 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. ]FOUNDATION 2ND [ ]INSULATION [ FRAMING [ ]FINAL ~i REMARKS: l ~ E t I E DATE ~ ' ~ INSPECTOR l ,f (~C~CI~~L~~ BOARD OF HEALTH FORMNO.1 3 SETS OF P1:.1YS/.~ ~r.'~ ~ TOWN OFSOUTHOLD SURVEY ~I BUILDING DEPARTMENT CIICCI: •~----~~~"~~~«~•-~I--~°" TOWN HALL s E r r 1 c F o Rrt . BLOT. Derr. TOWfV CAF SOU°ft,Ot_e~ E SOUTHOLD, N. Y, 11971 TEL: 765-1802 r:oTZt:Y; CALL .c~~~:~Z7~.~.~•ty~.A[-~fiM• Examined p~, 191. MAIL TO: I Approved ...~iM~.~G!-l , 19~). Permit No..;~aQ.~.`~'.~+ ,i J Disapproved a/c . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . ~f~~--~.G.. 19 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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 ~r areas, and giving a detailed description of layout of property must be drawn on the diagram which-is part of this appli- ation. ' 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 {hall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pazt for any purpose whatever until a Certificate of Occupancy jhali have been granted by the Building Inspector. t APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the l,urlding 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 demolition, as herein described. the applicant agrees to comply with all applicable laws, ordinances, building cod o o and lations, and to admit authorized inspectors on premises and in building for necessary inspections (Signature of applicant, or name, if a corporation) . ~O.~ox~9a,.~s.~G,~~ou~,~. ~?,~rr~~c,~~f! ' (Mailing address of applicant) /19.s Z ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................CN~a!~~~.~.......................................................... Iameofownerofpremises e ~ji?1~~~...~r',~'.l!<i~!t/l'~~,,,,,,,,,,,,,,,,,,,,,,,,,, ' (as on the tai 3.011 or latest deed) `applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. .....~~i~~ou%~ Plumber's License No . . Electrician's License No . . Other Trade's License No . . Location of land on which proposed work will be done . ...:344.s~ ~a~s,~~i',~~,~v f8 ..........~.:~'~!/~ry/~irr.9q~r~'......... . House Number Street Hamlet County Tax Map No. 1000~~Section .....O-`'.Z........ Slock Lot , B........... . Subdivssion .~'~/~~f ,y~~!~!~ ~/Cf{~1~.;~L~~, , , , , , . Filed Map No. , , , --?8~~, , , , , , Lot . (Name) . State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy r~~`~5~~~~CE k , ' ,,'T • . 1F+~ 1~ 4 ~ .RC b. Intended use and occupancy ~~fi ~ . "~`i~~ `v ~re+ ~,4ra~ ~~~t~Ft~ s ~n4 ~ ~a~6 ~"~'S'itz ~~c 1 ~ zd~~ ~~1~-~.i.u.4,Rxusu~*vw.wsasY ear new.-d L. ~~J~ c t s yv-- d §,y~i q~?s'm ~',_6, '~b <e is ~,•r,.. ,a,..k=•.~. x. . 3. Nature of work (check which applicable): New Building Addition Alteration ePah' • • • • • • • • • • • • • • Removal . , , , . , Demolition , Ot er Wor ,U,~~xE T(~ i~G'^ BC//4r' Ortl ~'X/s~%c!/~.' ~o!/.r~d.•~r~ Goi~s~-.~rrcTE~"~ a~Je.P`?o~-?~uT~/ 8 ,~Yzw4'" 7~ Y`l""`(Description) 4. Estimated Cost r~.f.,~0~.~ Fee , 5. If dweilin number of dwellin un,~ (to ba paid on filing this application) g. g its , , Number of dwelling units on each floor . If garage, number of cars ' r. 6. If business, commercial or mixed occupancy, specify nature and extent of each t YPeofuse 7. Dimgensions ofexaisting stru Numbe f any: Front , ,(pQ, ; , , , , ,Rear , , . , 1rrQ,~, , • , De' th= , , > p 3 Hei ht r of Stories CPur>v.4PirnrJ f~~!tiY . Dimensions of same structure with alterations or additions: Front , ./F;4. , , , , , , , , Rear ~ . P g • • • • Height ....~'1. ~ l..............Number of Stories . 8. ~em~nsions o~~ ti~new cNumbe'tion: Front .....cY,Q Rear ....•~4.~ , .Depth r of Stories Z.. . 9. Size of lot: Front d. w. 1 Rear • , ......Depth ~7.v ~i41~`~1,....... . 10. Date of Purchase , • , ~ , , . , , , , , , , , • , , , .Name of Former Owner , ] 1. Zone or usa district in which prcm~ses are situated , . ,/~~'-~'Q• • • , • • • • • • 12. Does proposed construction violatg any zoning law, ordinance or regulation: . 13, Will lot be regraded . (;.~;s?~/t~SC.QP,,~b) ,Will excess fill be removed f o re uses: Yes 14. Name of Owner of premises 0/1~.~~~!~~S.l/fiNJi~?/Address1a:'~ r~'!~!~!~-~v~.~y'~No ~/z_ 7/~~ ~/o¢' Name of Architect , 1a?n/,.4.~D, ~/LGr,~.. , , , , , , Address ~4?.?~B!~?'~~• (~+~77; ,phone No.. Z~~-:5"~'S0, . Name of Contractor l~iLL'~!~/otv;~ .Address . .Phone No. . 15. Is this property within 300 £eet of a tidal wetland? *yeS,~,~ No ? ~ • ~ ~ • ~ ~ ~ • • ~ • ` • *If yes, Southold Tojun Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all b'aildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to dead, and show street names and indicate whether interior or corner lot. , i~ p ' ,a ~rlNrd,~/~' ~~°r'~ yr/A' ~ t~-~Cisi //u9. r~A2,e C{,,lt~G~/ 1"' , i~~ f~,~oPos~D xlc~~ DES/D~~c~ o,d L~~kisi /n>G ,~'Orrvb.4~iv,J 10,.3' - - - ~19,~ i~ ~0T~7 ~ ~ /n/TL~,+'-ial~'~DT 5~r/G'"m° I ~ ~oTkB tiic3! fora>y y-~9u mFF=~i~ /000 - 05'2 ~ ~ ~ - - ~~7it~~1,~~~;- ~-'aszg ~ STATE OF NEW YORK, COUNTY OF . S•S , (Nam~~di~ual~gni~~~/~~ • • • being duly sworn, deposes and says that he is the applicant g contract) above named. 3e is the .........~?.Fr.G~?T,.:.. . ' (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 contairied 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. >wom to before me this ~ .......day of. i. .~~`~~q~"""'.... 19.~>.( Jotary Public, ~:Y :v; K'`"`; , County . t4 r JdY6E M WILKiN~ ~ ~ , ' , , ; ~ 4~" p~~ PuWie, stste o} NgwYork 4 No Za62?+48, SuffolkCou_~yp~ (Ssgnatare of appticarit)~ tern, F.~+pire~ Rune t;t, h e:1~J ~ , aMwou` ~,o. ~es i 3k„r~ao,4,m ..a.4~f~.4 3alxE,+cew5s.r9s:r , ati ~ i~e++,a .e«f..1nn.3..•dx~x.~ ~ r ;~d~&, `i~P~ i„~ u ~A. ~ .r.-..... 1 ~ ~ ?d ~ } ~ f ~ i ~ ° ~~Y _ 4 ~ ~ ~ . , ~ .1 ) S ~ ~ . ,y~ # Q ~ III111 I i I ~pp ~ r 9.. ~ . _ l yy, ~y„ ~ t ~ E ~ _ k:. ~ ; „ a . a T.__ t ,y ~ ` ~ ~ ~ ~ 1 ~:a~, \ ~ ~ a" n t _•g ~ i S _ { .i i re t' ; i ~ y i e ~ a 7F k s ~ s ; ~ _ x ~n b 3 ~Y I <3 S L Y ~ ~ s _ _ ~ y nG a~ ~ q~ ~ . ~~.r a ~ ; i o ~ x ~ ! i ~ ~ ~ s : ~ i1 Rte' p ~ ~ Nr s ~ r r~ ~ . _ 4/ jIX~1 .I F,~y ~ ~ F /2 7C~lr f . ~ t ~,`~~,~„~cc. c f e~ ~ ~ ~ ~ ~ _ ; ~ ~ ~ 'r s ~o t<x X,iS„.b.~i~... cp w„n'"r€ ~ ~x 'ks v' ~ ~ ~~x ~r ru.~:+ckq. 9k7 ~~~~Q,X~;:... k t t, ti~'~` 'a.;hr v. 3z_..~:.aaK-i. a...,, tip .,~.~.~~'sl3 - . H S~~- ..--t*''rcfY+ ' r Y V~ dl F tr +`~~F -~..a:.-. ~ _ • ~ ~ PLEASE N'OTE' r LC?n1~ ISL_L-1lVL ~C.Y.JfVD It is the applicant's responslblhty to, maintain adequate sanitary distance' f1~ir-;r=' '3F" - star supply and sewage Frigli wafer ~sr filarar era, O Ct ltleS. I ' ~ r"r-",._ ~r-a!"~ ~ ~%(~~1L7r~ r'a_Cc::~r'__~r~J4~=~i'~1 ~ presFnf ord. hi9A wvfer ntarL- !-di f-{~.7(urJ(y/~.~.~ilf~ - T d, r I~w~ .JF= :'GtJ-Tr-IOC_Lil c,. ~ , , (1 c l-1 =ii ~n er, ii: eneoss.e ss3i .jai i ...tl I am familiar,wlth the Standnrde f nne.e°.°°ai°m~e~~,c n.,.°-., -~..i. Ul Coneh'uctien~of Subsurface Se A royal and °mvnm° e.,e°,. m~ w°•..° ~ e is sal Sv¢[e m °reumm, a°e °n nis o~~ „in N bult: bend for Slnele Famly n18 ,ni°°°mn=°aa°~er°mr~~.m°, ,v fe of 0~= - ._..=~Y R, s esfdznces a wdl irie by the rona~n, m°,n~n~°° ee~,e o~,~~.~~~, _ [ r - - conditions svt Forth therein and o ~y~~ '°""-"'9"°"'°"ne 1ontli'°'~"`- % ,Q ptl armit to ,°:m°. e°.,enree: „re„°, r.°~~„~:; n.._ e 1 (d.Id~tt9 J t1] eOntlirUCt. / rp eWln°nel lnctlcu,inm nr suteaquenr-• v:or:. Signature ' O tru ap~E o.=. w. 0 " SUF#rG11Ut~1~'!)EPI~RTMENi Oi HEALTH SERVICES ' j m ~6$~5 ~~ti~~aw ~r`r• fFY1R'%'FNRdVALtOFCONSFRUCTION-0F I /y.. ~ - - _ ~g?T%T~t.er~ ~1J Sin¢le Family Residence Onl d- oEV_r_.rewnv ti~ ~ ~ 0~9 S ~4~0 ~r ~ 5 'Z 'DATE JUN 1 1 ~ A~' EF. NO ~ I r ~OrJC7Z. wUWCA . ~ 1} ~ ! ~ r pPPR0YE0 i '1 ~ ' _ ~ ~ EXPIRES 1W0 YEARS FROM ~ F APR AU• I ~ i", ti7 °a•tM1 v~ ~ p r I' I r•-. rq'~--i ~ ~ o' q4_~ x CJof~:: L<s>< tturr <ber sko~ _ wu ~ ~~y, . ~ ~ i- I a .q•i, 'Mph, o-G Your-r~ .E Gaodale+," fr1AnP d o J "y`yi,~- o (r/ -N,e ; ~.aff'olk ~ou;-rir~,~IarnF~•a 1. 'I / Zo F ` ~ ~p• ~ ~ R I ~y <s;'25sti°>° off(~a:r Ma~ fJO. Sf3S per, ~ ~ ~ ~ ~ ~ E1~CAVAilOEI ~E ON REQUIRED "~I,~t~ i ' I © i IE r -1 i rear N04S 4 M 99~ r~ ~ ',..,q l ;y AY ~ m: _ ~ _ ~ ~ ~ ~br' /oanry Clod i"`•-•~ 1~- ~l-. @ ! t~ I i brown t/<e~ ~ ~ i3FPT. 0~._ I - V i,. r C n Test N - - - d' Suffol4 C,bcvrrf±~ Tax Mcvf6;l~I~4{~a~r. F ! 1 q ~ Hole ~ r` fine r`o 'Jisf.fCX.'JO, S~acf.AS~', ~ilkr. f,ffi 1. 8, l met/ Sagrti _ r i - - Q,+~et+i,,,^-- ~'~'•4,. +,r:xCd e ~.hac-: ratle+~ ?u_~ vr,/;38£+' ~ ~ " ~4^ I seeds ~ ~ r on'y - qO..w~ ~ i~ J.auHr{ a/a c~Gr~ dnrtd ~I}'ure ~''Cr _ _ ~ 11 k4S-.. ~ytiJ~l, /rrr~o - ' ~S:,y i~ ~ ruled. ?o _ ~ Dpc_ 7 t95~=r { ' F~ ` i ~ 'y ecarae deed ~ _ - SE NOTE _ ~ ~ I ~ ro% mra?~/ i Guarr^arrfaed r•~ -_y__ MA2'S,Irjcfl T'he T'FI ~•~ar YrT{+.>- wm~an< K!? l6, 141f7. PLE~t~e 7; .;r'i ~ _ - zo--- . _ I r r_ - - 1 - --y---- Sanitary system Way are~~ , ~,r-~F,/mod c~~.:~3,raar. d under drive ~ ~ IGCJC'E=F'K::k_ ~~A!.I TJY(_,:'-:C:'. place - c. ra _ - Licensed t.arrd :;urve,:ors - - ~ t.,r~tr~or^f lVew Yorf- __.r___,-- _ . _ _ ~ _ _ _ ~ ~ r P - ` f~` r ~ z ~"~='"+.:~t-^.rev:,i'""Y~*t+.%f'^'.""r,~ea*^`^'-.~..._'YV r~~~~ ~`}~~j Ii~)'~ . , , . _ . , - Pc ter='~~ -r~~ ~ ~ae^ f i!F':~ trtrv~, `Uh:. _-l' l= F ~a.~ !s - . 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H'r _-~ij~ 1 . , I~i ~ n- ca vrn ~ ~6, y np 1 I / .e ~ ~ ~V m~ L~'Y„rvf: rFt~rr:r Win' .`e 1°'! N~r.r,- I oOl --a,.~ i"~~ ~ I t~+"~ I~ir ;aurNy molar ;Z, I~. t / ~ ~5 y jUjn'~:L 1h_Irv `-I i6r' P-'('Y~ -l•a, •_l.. l ,1 ~ I j'm,~ r 1 { frrte. fo 'CIS f h~~, " I ii ..u alal6 I y mro'r1 id.9.i { 1 B' : J:r9.~ :'.f zT elr.'.~ ~m, r ]'t7t_ ~ ' ~i ~ ~ Al'p~ r ~ sYIXiIL{ ~ ~ r- ~ _ R ~ i j gr'.ve?NC i,v~ E~ J.ixti i"d,' - - - n 'OWE ~ y D^_ I i F' 1 ~ ~ t~S' .5~ rrlu~e~. D ~ ~ ~I . c' ~ I i~'~; -Irr7 - ~ 3S _ ~ i-r.:'rrarrf^e-t h' - r fn /9 " I v.•r.'C( 41 ~ ` ~ 4 - ~i- ! ~ ~1 !O ~'j Yt1E Tf{-IC U'IdrYl'[F•:9 ~..VYF. ~y"/ ~ - ~~~c I. li I LO r r ~ ]v SurV°LKJ -kr~. Jtt ar-gy~ ~pF Np ~ ~ _,~r_ t ' ~a.~f-( - - Pbr c' ' ~ i j - ~ r P~Q~GK VggT p9 t ~ ApY 8 !9°~ i U r~ o G'A ;t - 'S' - '7x~ _ * ¢ Lic.era ~d I.y~r~ Y;ur1c. ~e~ Gr~'n~r-i ° fJe~w Sr~t-6_ b Ro 5 P 7 r_ A ' n ,nl : . , "35d ..?~.iw ":way.. ~..,~.+.....:-~~.,.sw_~'~,:.i~a~._..6.><,:w~ay:,...:.,...,eti,.._L .~.~_~„ra_. u~.._.7:~_'_ ~v-,