HomeMy WebLinkAbout19709-z
tr w. FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20633 Date APRIL 9, 1992
THIS CERTIFIES that the building NEW DWELLING
Location of Property 505 GROVE ROAD SOUTHOLD, NY
House No. Street Hamlet
County Tax Map No. 1000 Section 135 Block 3 Lot 49
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 28, 1991 pursuant to which
Building Permit No. 19709-Z dated MARCH 13, 1991
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 SINGLE FAMILY DWELLING WITH GARAGE UNDER AND ATTACHED DECK
AS APPLIED FOR.
The certificate is issued to GERARDO MASTRONARDI
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 89 5066 MARCH 30, 1992
UNDERWRITERS CERTIFICATE N0. N 221975 JANUARY 27, 1992
PLUMBERS CERTIFICATION DATED APRIL 7 1992
C
uilding Inspector
Rev. 1(81
Foam 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°_ 19709 Z Date .10i a.......... ~ 19. 1
/4
Permission is hereby granted, too:
)l~rl?i....... f
l...y.f al - .......P:...
to
at premises located at
.........................................................................../..L.~~'a...................
County Tax Map No. 1000 Section ..fJJ......... Block ..4f ....3........ Loot No.......l....d~.......
pursuant to application doted .ss~ ..............I 19.V. 1, and approved by the
Building Inspector.
Fee S•••.:1. yL.aS
Building Inspector
a
Rev. 6/30/80
Form No. 6 ° 'TOWN OF SOUTHOLD;y
BUILDING DEPARTMENT APR ®7
TOWN HALL '
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-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 2/10 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.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C.' Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ~~eh l9 9a
New Construction..... Old Or Pre-existing Building....
Location of Property.... r5: ®.4; Q
~1? ~Y. ..~4-!'!`d..........................
House No. Strcet Hamlet
i
Onwer or Owners of Property ..64Rf9lz .~v.....~~~7~D~~h.~/
County Tax Map No 1000, Section..... 1.315 ...Block..bb ' o3...... Lot..
Subdivision.. ..........................Filed Map.......... .Lot......................
Permit No.. 1 Q J ~.I . .Date Of Permit pq
~ .I.R I I Applicant. VlviceAf
Health Dept. Approval ........Underwriters Approval....
Planning Board Approval......
Request for: Temporary Certt-ifi((caat~t))e........... Final Certicate...........
1~2 J5, Fee Submitted: . . !
APPLICANT
INSPECTORS : .
Victor Lessard ~c 1FFUjc?~
Principal Building Inspector } n1)~ pG
Curtis Horton r SCOTT L. HARRIS, Supervisor
Senior Building Inspector r=te 1
sn F Q Southold Town Hall
Thomas Fisher w ) •t iy P.O. Box 1179, 53095 Main Road
,j
Building Inspector r =9 r~4,c.,4f Southold, New York 11971
Gary Fish 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
MARCH 4, 1992
VINCENT MASTRONARDI
149-01 95th AVENUE
JAMAICA, NY 11435
RE: GERADO MASTRONARDI
To Whom This May Concern:
We are unable to complete your Certificate of occupancy
because of the following reasons:
ffi 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.
~j x>a1 No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 19709-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
I
THE NEW YORK BOARD OF FIRE UNDERWRITERS pAGK I
2 BUREAU OF ELECTRICITY
85 JOHN STREET. NEW YORK, NEW YORK 10038
d+. M34;791/91 N .":1475
Date Applieation No. on file
i
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the 4111RU ant named on the above application number in the premises of
V uI'-(. ~.Ar~ re a,r';. 1t 0.tN ,J'. Gki'd F, WA.f), $(IUTH00, N.Y.
in thefollowinp location: er~E nt, GAR/ATTIC/OUT
~x Bea J !s[ F!. 2nd Ft. Section Block Lot
was examined on and found to be in compliance with the requirernen Is of this Boord.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS u
OUTLETS EPT ACLE$ SWITCHES INCANDESCENT FLUORESCENT OTHER "T. K W. AMT. K. W. WT. K.W. WT K.W. NAT. H I
24
- I F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SMIAL REC'PT TIME CLOCKS ELL UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMr. K. W. OIL H. I. GAS N. P. AMT. NO. A. W. G. NAT. AM1. AMT. NA15. TRANS. AMT. H. P. NO. Df RET AMr. WADS '
SERVICE DISCONNKT NO.OF S E R V I C E
AMr. AMR. irlE 1A tW 1BTA' ]83W 3F Kw 40' nR.jOND. OFC COND. NO. OF HI-LEG O'H:LM NO OF NEUTRALS OF NEUTRAL
1 zoo CA is ; i/o 7 2/n
OTHER APPARATUS:
- d TON A/(7-1
FRACT- AIR HANDF,HR- 1 r
F SMOKE DETECTOR:-l
M.T_H. ELECTRIC LIC.3700-E G!/~
- 89 E'i.OitER HILL DR.
NO. SHIRLw , NY, 11967 *BOOM MANAGER
1.1
Per.
This certificate must not be ahered in any mcumer; return to the office of the Board if incorrect. Inspectors may be idenfifw6 by their credentials. _
COPY FOR BUILDRNO DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
TEL. 765-1802
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728TOWN HALL
FQI~, ~
SOUTHOLD, N.Y. 11971 APRP"? 1992
C E R T I F .I C A T I O N
Date ZZ
Building PerdmtittY //No..
Owner l1 C
(please print)
Plumbe r
(pl ase print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(plumbe 's signature)
Sworn to before c this
_day of
Notart Public
Ilotary Public, County DORIS A. ROBINSON
too. 4
U/? NOTARY Smote Of. New Yom1
No.46al27 31276, Nauru County
Term Ezpim May 31,19 QRi
COUNTY OF SUFFOLK
p',
ROBERT J. GAFFNEY
SUFFOLK COUNTY EXECUTIVE
DEPARTMENT OF HEALTH SERVICES MARY E. HIBBERD, M.D., M.P.H.
COMMISSIONER
NOTICE
PRIVATE WELL
The attached permit has been issued by the Suffolk County Department of Health
Services for the premises shown with the utilization of a private well for drinking water
supply. It has been determined through a comprehensive water analysis and/or the
installation of treatment devices that the water quality of the well was within minimum
New York State drinking water standards and/or guidelines at the time of approval.
However, please note the following facts and recommendations regarding this well:
1. The WATER QUALITY of a private well is subject to change.
2. APPROVAL by the DEPARTMENT does NOT guarantee that the water quality will
always meet drinking water standards.
3. The DEPARTMENT strongly recommends that the owner have a periodic
comprehensive water analysis performed to monitor water quality to prevent the
unknowing consumption of contaminated water.
4. Should water quality deterioration occur, it may be necessary that public water
mains be extended, or treatment devices be installed for the water quality to be
restored.
Under provisions of the Suffolk County Sanitary Code, it is the responsibility of the
owner/applicant to provide a copy of this Notice and Permit to the Buyer of the premises
prior to sale or resale.
WWM-056(Rev. 2)
DIVISION OF ENVIRONMENTAL QUALITY
COUNTY CENTER
RIVERHEAD, N.Y. 11901-3397
852-2100
1.•,.t 1.. u. ~V'. IIDA E II
_ ~v:1MLNI {I
! ~ Icy
FOUNDATION
a
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FOUNDATION (2nd)
e7/J
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'OUGH FRAME &
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-PLUMBING
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I!lSULATIO!! PER N. Y. ~ ' ` - • • y
STATE ENERGY
CODE
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FINAL
o
ADDITIONAL COMMENTS; m
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965-180
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST ( ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING- [ ] FINAL
REMARKS. Az g
f -
ell
--j- All
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'ov
DATE a INSPECTOR
I
M-1802
BUILDING DEPT.
INSPECT' N
[ ]FOUNDATION 1ST [ ROUGH PLBG.
[ ] FO NDATION 2ND [ ] INSULATION
[ FRAMING [ ] FINAL
REMARKS:
/~J' L
DATE ~JJ INSPECTOR
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
S TION
[ ] FOUNDATION 2ND [ ;;INAL
FRAMING REMARKS;
Wit' ~Fn Cam, cl
°d
r
t
DATE INSPECTOR 240~t-v
i
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] RO PLBG.
[ ] FOUNDATION 2ND [ INSULATION
[ ] FRAMING [ ] FINAL
e
REMARKS:
Al
Ale- t o p
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,e
DATE INSPECTO
v J
ass-1so2
BUILDING DEPT.
1 NSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:.
L
DATE T INSPECTOR A41AA
y wtat s.w.a rt t.a r.u.rww asN .n.r....,yu.......~.«n..,.-a..,.•..d.r.~.s..cw.w..ari.*.»-• ~ : t v
"idkta Y ~a'YAj
jy osNNee ?eM tatayN /wwW SM OO "F" -""DUA wn-nM M11W W W MPN~ Mom ell MMMMt N b +xy~ v .
1 3
fiaa te(=9520 n~t1"3 24507
THISMOtxi17H4m,., the 6th day al February , +rrtnn hutdred std eighty-fCnr, .9
ii ~L: ItE1,rvEFJ'I AFRODITR KAPSALIS, JOHN KAPSALIS, and ANA.''TASIOS KAPSALIS,
residing at 14-76 160th Street, Beechhurst, New York,
i r
,.fry (the bra iw•t, ant -.ER' ^1)0 NASTRONARDI,
residing at 92-60 218th olace, queens Vil. get New York, " -
ynry of the ernead pate,
wTiNGtSC?H, that the prty a the Sew pen, fn "n6ileradon of ten doatn and other wahabie ataaldaeallol 4
paid by the pang of the ettotd pan. don hereby Crap and "lease into the parry of the seeond poet, the bthai
M as t i taea urd au" althe parry N the aaond put foresee,
ALL thet certain plot, Piece or panel of land, with the baleasp and iaprotameou thereon uettetl, aketaa,
rynglodar4Keethe Town of Southold, County of Suffolk,arid State of New York,
i BEGINNING it a point on the easterly line of Grove Road at the
.4f1\•1y1 northwesterly corner of land of Simons; `
Imo. RLRRIING THENCE along the easterly line of Grove Road. North 32
degTeec 04 minutes West, 113.40 feet to other land ` P. Orlowski;
t THENCE along last mentioned land the following 2 courses and distancest ~
(1) North 57 degrees 56 minutes Eas'., 48.9 feet;
i , - (2) North 55 oegrees 06 minutes East, 43,14 feet to land now or formerly'
of Gordon-Smith;
THENCE along said land now or formerly of Cot for Smith, the following
2 courses and distances: tr«.
i (1) South 32 degrees 04 minutes East, 40.52 fee dear
;:Set- (2) North 57 degrees 56 minutes East, lb feet;
THENCE along the said land of Gordon Smith en. tow or formerly of
Hnvenrt, South 32 elogiecs 64 ninutea EA it, 751ea-. to thL said land of + Simons;
V'.NCE along the said land of Simons, South 57 degrees :6 minutes
3 West, 110 feet to the easterly line of Grove Road at the point or place
of dLGINNING.
Said premises bp:nq the same premises conveyed to the parties of the r
first part by deed to them dated October 15, 1981 and recorded Novem-
ber 24, 1481 in Llbrr 9105 of Conveyances at Page 413 and lying in
Section 135.00, Blo•k 03.00, Lot 049.00, Suff.ilk County rierk'o office.
z' JV' Epan L ESTATE _ t
2 9 f9~it
NSF" 7Av fi
TOGETHdR whh as right, title sal intellect. ;f any, of the parry At rite n me
slFeeta s ad r~
toad, ht mot tk abn.t dettnbed premircr at k renter fines thereof; I'MFTHER with Me a xt
and all if* elute and rig' of the Party of the hen pan fn and it, old prawdrn; TO HAV AE ND~7'O
HOLD the ptemfw- herein noted onto the party of the aerewd pan, the n or foenasora and aatigta of
y
the party, of the second ,rn are,ler.
A\D the Nor of the Ara raft, in comr6lietcr with Seetiat 13 of the lien Law, toreNrns that the party of
the A o pan wdl Tern, the vnvderatinn for thn tooreyar,ce and win h••M the right to trceire well eaald•
, e- a to,a1 fold to te ~fed fir , l,r the pw•pmr of pa,ine the ro of the imprMenwa sod in apply
eat to tF, ryynxnl n the a of IM imprnrrrwnl Miner Wring +ty pan of the sail or the ame C
the .toe h a
,nr rr Mr rnrpow.
The -o d "Pa" j- -hall be cmtwnwd as it it trial "pa. fn" of , ee , the steer of IM, iadnwa a so rpn to
t N1 %Ts JE^ MMEREOF. the piny of the Ara rant hat data eeeewl.1 A
ed Ili t deed the day and Yale Ant ahoat tn sa is
r-'
S f ~a
4 P 0~7 f 71( n)~y yq 4l yyni +i + of fi y t l?
d^ ~ ,j,Y, ~ s a~r~ ,n ai_ r~~ ~tl ~Y'iJt {¢FF99 H~ ird'yi `.''i'+(~C ~'dE ~p i rv } ,y geg!I ~~p~e°
, ,~,i , ! qq hv~ t( t, P&; + ~~F i rY (3'i, r r'
~1 i7 r +i ,t
H:. V• P ) e 1~ J ~ 3 IP ~ hf. k fin,
111H U%Tr v tnaa ,a,`s tnwq rto /w? .wh ..a.•.• •
nave se moat few. tens 4 w Qualm. M
' ~'T" '~i•. I. r a ~ , r
y . , kls+w
01111101! 6th dy el February, 1984, Mme r 1011(1* 1q of
pertsdly coat
'I fit" Wy o""eAFRODITI KAPSALIS, r
TORN KAPSALIS and ANASTASIOS KAPSALa
at eta kaawa M he ew 4.%Wwal a deantwd in and who ro me kitowtt ro k the ntdnidrl described w Mad *M
e eMed Tile lotgana itatrta na. and acknnwkdted that tauat.d the krexoiK watrwttant, tad oltttowhdRcd thx
r. they eeerad tM tawr. eatcww the sore.
K6 T IWII(V"q
MahrY Wtoe:'•.. aN. rak
No 3046tdf.82
QMMw(I in ~ 't 'a Caaar
CStarwaen 6pw Mwtn 30L 1066
i
as
~ aeaw M IreV w,raa. Caelstee M w I nwve M MW ,rOaa. gWaeel' tas
19 . t• '.rr ,m On the day d 19 . Mme wa
On tM M 1
n nme f1°"e
t~m~e kt•-+~n. wM. btiM by me duly ^"'rn. M Arpa+c and t~MerlNeq[ witnna to tM fineReht9 MMrtaaMl• sill
sy that M reside. A No. wlaa, 1 am prrsmwny attptaixed. who, briM by the dttA
awaen, did depme am say that he tealdo x Na
that M is the
ht M kttaws
°I . the cvmorxnat de.cnTwd
t) be the inditidoal
in and which eaecmrd ,M I : ithat 0nt • ant he
km,.. ehr wal d u.d rmpnatton that rte W. tt +wt that be. std who e+ecvted nrf wIMellJiteS am Y
I. to uni ,.nenarvnt i. nrh emprnaa seal; that it w was ro that he. 'A a MmM It-: tkx
.M.c,d b, order a the NArd d dn. ' •n d rid corpar+- satire kt wTnnt jtherele.
....11 'a
tan. am that t. +ivwd Is newe theMO by the adn. at the rrane tine atrbarrhed It
, r
00 1
•araaln ana Yale #rrD tecTto+ 135/0419.00
Wtow, r Cm .NT M:uaar (:+•Nan+w Arn nat itrte leo `5 co cmmn q AFRODITI KAPSALIS
, JONTI RAMALIS
and ANASTASIOS RAPSALIS T.
VITICFNZO NASTRONARDT •,-,d Flat' wG£RARDO NASTRONARDI wrrr+ res. a w .e„ ro.w a ,.u wew.. w L31, ESQ.
.
35-39 Northern Blvd.
rinl Amrriraa Trllr Inearnnrc !'nmlNlnY i 'f
of..VrrYork Flushing, N. T. 11354
.ta~L1? zw w
r
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r• = t
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il~ t~j ql;~: ~~~'~e °ertilic ~r~~s i Y1h4plt rA l ~Jf+1t ~ t ~
W r r, t r{b,~; 777~,'i 5T)i lr~~ r~i ti.4'ryrflA~i 9. ,f~hl li ~alri• t ~i ~ ~ a'I. ! C
c e
ea tt i. e V~ 1 r t Nr. A,Y4A .ln
, # {t q < { w r ~ ~ r)t f I ~~gp r tk{~ d A Ytl
Alai
.P i ~ r 4 I i ~lr J. r A la/t er~f f)~eF el~j Y9 •iYO e, ,^I~> ~E~~, 1 r ~ir 'y
d xt' ~ r)
~(03 3 SETu r• n. . n w: : rya s rw u
3 5 'f S O F P L kA,)J 5 ~ .
yBa~ D q y FORM NO.I SURVEY .
iQ W9~ TOWN OF SOUTHOLD CIIECK - . e. •
i W BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL
IN SOUTHOLD,N.Y.11971 NOTIFY -A n
TEL.: 755-1802 1111001111110 . • . . . t . ..6t/ ..l.. .
MAIL TO: 0 Or a AZ4-, e CZv-2
Examined Approved ~/(,~r...., 1 9~ ~
/ q GJ lr~Ce'+x-ear ~ (17?~
• 4 1, 19 ~F. Pernti NO..~.
Disapproved a/c
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date M 1.~41 19~.
n _ INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation,
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied.or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances on
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
Tire applicant agrees to comply with all applicable laws, ordinances, b ding code, housing c dc, and regulations, and to
admit authorized inspectors on premises and in building for necessary it spcctions.
rgna4 re of appnt, or name, if a corporation)
I4,~-U1 , ,°,~,?Ke4Vtry. J~•NfFIG,A,r.~ 114•
(Mailing address of applicant)
State whether applicant is, owner, lessee, agent, architect engineer, general contractor, electrician, plumber or builder.
Eti1T
Name of owner of premises .....~I~YL~? . ,Mfg T RI~tJAsl~ll~l .
(as on file tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST.BP•r SUFFOLK COUNTY LICENSED
Builder's License No....... \
0
Plumber's License No. ,r........
Electrician's License No. . . .
Other Trade's License No.
1. Location of land on which proposed work will be done .
C QVE.... . . . ...............•T~-IOL(?.....................
pause Number Sheet llandet
County Tax Map No. 1000 Section .......13~J....... 131ock.......Q.~>>......... Lot
Subdivision . Filed Map No. Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy VIAC^~T .
b. Intended use and occupancy ~jll.lCl , , CAF 1 r~(. .{.J~!
*AN woo to
YWMN
iru S e. NA
Ygnu~+~toatrl~ ni bbai8
! ,:S x~arafi aa'xrprd at:-•,< .,v-+r„x'~
i
(checl
R}P
r l amok able): New Building • , Addition Other Work .t.w,,. . . . .
ui work ;v! • • , • • , • _ . , • • • Demolition JJ !
Repair • • . . . . .
4. Estimated Cost Fee
' (to be paid on fling this application)
5. If dwelling, number of dwelling units . t Number of dwelling units on each floor ...N h.......
If garage, number of cars
6. If business, connnercial or mixed occupancy, specify nature and extent of each type of use .......I AIA..........
7. Dinensions of existing structures, if any: Front KV,.\ Rear Depth `
Height Number of Stories .
Dunensions'of same structure with alterations or additions: Front , • • • , • • , Rear
-Depth . Height . , Number f Stories .
8. Dimensions of entire new construction: Front .....CjQI..:.... Ijear , ,4........ Depth
Height , Nunnbgr of Stories 5I'U.T...I. 12: .
9. Size of 10. Date of Purchase Front . . .tl a Rear ltq: r............ Depth .....lS~i
, • • • • • , . Name of Former Owner
11. Zone or use district in which premises are situated tip.~51 TJA(-
12. Does proposed construction violate any zoning law, ordinance or regulation: . • Wo............... 13, Will lot be regraded Y.(J Will excess fill be removed from premises: Yes No
14. Naine of Owner of premises )~71 RQIJAKQ) , , Address .>)a I II Q, , , n
N Y ..Phone No.'71.I °J
Name of Architect . n:4,......... Address Phone., No.
Nanie of Contractor Address Phone No............... .
15. Is this property located within 300 feet of a tidal wetland? *Yes No .X
*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 dinnensions front
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot. _
/ now or formerly -
V I S
PwI0.8Joyca E. Stusvick 1 +IP
•e sJZ°oq'e TOO' /
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GROVE \ROAD
Qi.
)o~ v
i
STATE OF NEW YORK,
COUNTY OF SIS
, ...YI t > tJ ( ..MfTr7 L(ZD.tJ < 13~?l being duly sworn, deposes and says that he is the applicant
(Naive of individual signing contract)
above nanned.
lie is the ~ tN T...............................................................
(Contractor, agent, corporate officer, etc.)
of 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 statennents contained in this application 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 19.9/
Notary Public, Su~~~.... County I 4. (!!!;f (Signature of app (cant)
KA
OnelNbp M
CommissionEvinOW Ms"
1M!
CHICAGO TITLE INSURANCE COMPANY
877 East Main Street
RIVERHEAD, NEW YORK 11901
COUNTY OF SUFFOLK) TITLE NO. 9008-02765
)SS.
STATE OF NEW YORK)
THIS is to certify that Gerardo Mastronardi
is (are) the owner(s) of record of District 1000, Section 135.00
Block 03.00 , Lot 049.000
THAT he acquired title
thereto by deed dated 2/6/84 recorded in Liber 9520 cP 143
on 2/29/84 that I have made a search of the records of
the Suffolk County Clerk and/or Registrar's office, and that said
search shows that neither the said owner nor any predecoasor in
title of the said premises owned contiguous property at any time
since 1957 except as follows: NONE
THAT the applicant herein does not own any contiguous property
except as follows: NONE
This certification is made with the intention of the reliance
thereon by the Board of Appeals and/or Building Department of the
Town of Southold
~ O
LAW DEPARTMENT
Sworn to before me this
(3~ day of March 1991
Notary Public, Suffolk County, N.Y.
NOTARY ON'4i~D 9'A 14 A
N0.52-7 )53235 S me of NowYofj
Commissio S .2u
ri FJCOires
Page 1 of 4
Title no. 9008-02765
Subject Premises: 1000-135.00-03.00-049.000
Henry J. Smith DEED
to Dated: 5/12/53
Paul Harry Orlowski Recd: 5/13/53
Bertha Orlowski Liber 3514 cp 215
Paul Harry Orlowski DEED
Bertha Orlowski Dated: 1/29/72
to Recd: 2/3/72
Paul R. Forestieri Liber 7100 cp 371
Kathleen L. Forestieri
Paul R. Forestieri and Deed
Kathleen L. Forestieri Dated: 10/20/73
to Recd: 11/7/73
Jerome Hurwitz and Liber 7525 cp 67
Patricia Hurwitz
Jerome Hurwitz and DEED
Patricia Hurwitz, his wife Dated: 10/15/81
to Recd: 11/24/81
Afroditi Kapsalis, John Liber 9105 cp 413
Kapsalis and
Anastasios Kapsalis
Afroditi Kapsalis, John DEED
Kapsalis and Anastasios Dated: 2/6/84
Kapsalis Recd: 2/29/84
to Liber 9520 cp 143
Gerardo Mastronardi
LAST OWNER OF RECORD
PREMISES TO THE NORTH: 1000-135.000-03.00-048.001
Paul Harry Orlowski, DEED
Bertha Orlowski, his wife Dated: 8/4/56
to Recd: 8/10/56
Frances E. Simon, Sarah Simon Liber 4159 cp 548
Leone Hayes, tenants in common
Paul Harry Orlowski DEED
Bertha Orlowski, his wife Dated: 10/7/81
to Recd: 10/16/81
Francis J. Dirscherl Liber 9086 cp 280
Marian T, Dirscherl
LAST OWNER OF RECORD
Page 2 of 4
Part of Premises to the EAST: 1000-135.00-03.00-045.000
Henry J. Smith DEED
to Dated: 1/14/52
Raphael M. Baratta Rec'd: 3/3/52
Hazel S. Baratta Liber 3326 cp 49
Raphael M. Baratta DEED
Hazel S. Baratta, his wife Dated: 12/1/60
to Recd: 12/5/60
Alta Gladys Schnepf Liber 4916 cp 476
Alta Gladys Schnepf DEED
to Dated: 10/19/63
John F. Havens Rec'd: 10/24/63
Mary to Havens, his wife Libor 5439 cp 31
LAST OWNER OF RECORD
Part of Premises to the East: 1000-135.00-03.00-046.000
Henry J. Smith DEED
to Dated: 1/14/52
Albert R. Gordon Smith Rec'd: 3/2/52
Mae L. Gordon Smith, his wife Libor 3326 cp 52
Albert R. Gordon Smith DEED
Mae L. Gordon Smith, his wiife Dated: 3/13/72
to rec'd: 3/20/72
Edward V. White Liber 7125 cp 530
Jane H. White
Joyce Stusocik as executor DEED
Edward V. White Dated: 7/24/84
to Rec'd: 7/24/84
Paul 0. Stusoick Liber 9607 cp 50
Joyce Stusoick
LAST OWNER OF RECORD
PREMISES TO THE SOUTH:' 1000-135.00-03.00-050.000
Henry J. Smith DEED
to Dated: 8/28/51
John Fiore Recd: 8/29/51
Elizabeth Fiore Liber 3257 cp 248
Page,3 of 4
PREMISES TO THE SOUTH CONTINUED:
Frances E. Simon, Sarah Simon DEED
Leone Hayes, tenants in common Dated: 12/14/73
to Recd: 12/26/73
Achilles Stachtiaris Liber 7557 cp 451
Achilles Statchtiaris DEED
to Dated: 10/15/81
Afroditi Kapsalis Recd: 11/24/81
Anastasios Kapsalis Liber 9105 cp 415
Afroditi Kapsalis DEED
Anastasios Kapsalis Dated: 2/6/84
to Recd: 2/29/84
Vincenzo Mastronardi Liber 9520 cp 134
LAST OWNER OF RECORD
Premises to the West: Grove Drive
Page 4 of 4
~.6'•~t 19~oY
i~~ GREED
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= 39.27 •o
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SURVEY FOR
GERARDO MASTRONARD/
MAR 28 1991
1999
MAR 15 :1991
_ AT SOU7HOLD DATE MAR 29,1989
TOWN OF SOUTHOLD SCALE 1"=30'
i.
APR - 81991 SUFFOLK COUNTY, NEW YORK NO. 89-0305
Iu~ NUNAUTHORIZED ALTERATION OR ADDITION TO THIS
SURVEY 9 A VIOLATION OF SECTION YEOS OF THE
1G1'.'!iti l~IF':OIJ F{D NEWYORK STATE EDUCATION LAW Ptg OF NE
*COPIES OF MIS SURVEY NOT WARMS THE LAND St W r
SURVEY011S INKED SEAL OR EMBOSSED SEAL SMALL
NOT BE COMSIOEREOTO BE A VALID TRUE COPY P(lD Yy ~.P
MGUARANTEES INDICA TED HEREON MALL RUM ONLY 10 3T /'p •r
ME PERSON FOR WHOM THE SURVEY 15 PREPARED G
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT AMD ON HIS BEHALF TO THE TITLE COMPANY, GOVERN-
M NEAREST WARM EAIM-MI • RSOURCE OF WATERS MIMTC ! PUBLIC- MENTAL AGENCY AMC LENDING INSTITUTION LISTED Q
IS BUY, C Y"MAP KNEW OARS NO OWELLI1MS WITHIN SECTION 100 FEET O OF THIS PROPERTY INSTITUTION GUARANTEES ASSIGNEES AR RABLE
TO ADDITIONAL INSTITUTIONS ORNOT TRANSFER SUBSEQUENT
OTHER THAN THOSE SHOWN HEREON OWNERS
M THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RSIOENM K DISTANCES SHOWN HEREON FROM PROPERTY LIMES R'O y
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT TOERISTIMG STRUCTURES ARE FOR A SPECIFIC (Y 4! a9
OF HEALTH SERVICES. PURPOSE AND ARE NOT TO BE USED TO ESTABLISH
APPLICANT- PROPERTY LINES OR FOR THE ERECTION OF FENCES - "RAND \11\y<IO
ADDRESS
RL. YOUNG & YOUNG RRIIVO _ERHEAD, NDER
NEW YORKE
E=MONUMENT p. STAKE ALDEN WYOUNG, PROFESSIONAL ENGINEER
AREA. II,BGB B.P. AND LAND SURVEYOR N Y.S LICENSE NO. 12845
HOWARD W. YOUNG, LAND SURVEYOR
*TIE LOCATION OF WLL(W),SEPTIC TANK)F)BCESMOCLS(CP) SHOWN HEREON N.YS. LICENSE NO 45893
ME FROM FIELD O MTIONS AND OR DATA OBTAINED FROM OTHERS
BRAX015 6 SJNS. IN4. IS'.
iI.SAARAWR
AVATJDN INSPECDON RE IRED f EASE NOTE
1Yt1T HaLB
Sanitary system is not to be
awNPY e..lq
CRE placed under driveway area.
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R= .00; O
~ I= 39.9.27 f q
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cR ,f,~ARwVAL wAT0.Ne gYvfF.M (5 Prlw~ wYyTeAn)
J dPtorminatitm dates!
SURVEY FOR '1613
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVK'F• GERARDO MASTRONARO/
FOR APPROVAL OF CONSTRUCTION ONLY AT SO[/THOLO DATE: MAR. 29,1989
TOWN OF SOUTHOLA SCALE: 1"=30'
DATE Z L•101 H F. NO. D-66 SUFFOLK COUNTY, NEW YORK NO. 89- 0305
THOR
ALTERA
TJOM SURVEY, 4 AAI VIOLATION OFT SECT OM 7209 OF THE IS ~pTE OF ryF~
11
APPROVED N[W YORK STATE EDUCATION LAW S r
NCOPIES Of THIS SURVEY MOT SEARING THE LAND P,pD W O
SURVEYOR'S INKED SEAL OR EMSOSSEO SEAL SHALL ~O~ FOG 7r
MOT SE CONSIDERED TO SE A VALID TRUE COPY !
IIGUARAMTEEB INDICATED HEREON SHALL RUN ONLY TO =
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED
AND (IN HIS BEHALF TO THE TITLE COMPANY, OOVEAN-
M MEARE3T WNfER MIN ML I aSOURCE OF WATERA ~1tIMiE PUSLIC~ MENTAL AGENCY AND LLMDING INSTITUTION LISTED
M BUFF CO. TAN MA? pSTt~-SEC TION IUS SLOCN l LOTS, i NENEON. AND TO THE ASSIGNEES Of rNE LENDING
tieft ARE NO DWELLINGS WITHIN 100 FEET Of THIS 001OPEMY TUSADGI TI
too. ONAIUtAINRS T,TUT1pU ORNIUS! pstflp SLE 1.
OTHER THAN THOSE SHOWN HEREON. OWNERS
M THE WATER SUPPLY AND SEWAGE OISFOSAL SYSTEM FOSS THIS all IDEMC[ N DISTANCES SHOWN HEREON FROM PROPERTY UN[f
WILL CONFORM TO THE STANDARDS Of THE SUFFOLK COUNTY D[PARTMENT ~QID
OF HEALTH fLRVICEf. TO EXISTIMS STRUCTURES ARE FOR A SPECIFIC TAND SO 4
PURPOSE AND ARE NOT TO GE USED TO ESTABLISH l
APPLdCAMT• PROPERTY LINES OR FOR THE ERECTION OF FENCES
ADDRESS
TEL.. YOUNG a YOUNG 4000STRANDER AVENUE
RIVERHEADD,, NEW YORK
• • MONUMENT Q. STAKE r A"'", .I-j•
AREA-II,G24 S.K ALDEN W.YOUNG, PROFESSIONAL ENGINEER D IIS5 (5 !'{y`/ S• II tlal~
91.11/.
. ARE R6FItIteNLEy7 7a MhL DAITUA% AND LAND SURVEYOR N.Y.S.LICENSE NO. 12845 -•,,.,.k, 7 p} j
HOWARD W. YOUNG, LAND SURVEYO
N THE LOGIE 010SERVA I SEPTIC MS R C SHOWN INERLOM N.Y. S. LICENSE NO.45893 rfAr~
ME E fRdi FIELD IA OBSERWTIONS A AN0 DO OAP DATH ATA OSTA&ME tA1MEDF FROROM DTN[RS 14 R ~p 1f; dl+~ll7
ORANUIS 6 SONS, INC. 1616
ORIJE
GREE1~ ~
R= 25.00;
I_= 39.27 O
re<\ ~Gi
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-
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5 61056 lloa
e
Jc~
SURVEY FOR
GERARDO MASTRONARD/
MAR 28 , 1991
MAR. 15 , 1991
i RR~ AT SOUTHOLD DATE MAR. 29, 1989
lj TOWN OF SOUTHOLD SCALE i"=30'
RI . t APR - g 1991 SUFFOLK COUNTY, NEW YORK NO. 89-0305
!1 }'i
i~G~ .Ymm yam, it UNAUTHORIZED ALTERATION OR ADDITION TO THIS
BLDG. SURVEY M A VIOLATION OF SECTION 7209 OF THE
w NEW YORK STATE EDUCATION LAW
TOWN OF SOUIr,4OLD _ THE LAND SE OF NF
*COPIES OF THIS NOT INEARNIG
.A,.e..~ S
URVEYOR'S INKED SEALYOR EMBOSSED SEAL MALL S~P A,
NOT 89 CONSERED TO BEA VALID TUE
NGUARAHTEESIDINDICATED HEREON SMALL RUNPONLY TO ~PRD w' THE PER
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT AND ON PE NwHISN B H E WHOM THE SURVEY IS PREPARED rO
FOR WHOM TO THE TITLE COMPANY, PREPARED
GOVERN-
III P'
NEAREST WATER MAIM-MI. ! N SOURCE OF WATERS PRIVATE ! PUBLIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED
M SUFF CO. TAX MAP DIST(QM SECTION 136 BLACK 0 LOT 49 HEREON, AND TO THE ASSIGNEES OF THE LENDING
MTHERE ARE NO DWELLIMS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION. GUARANTEES ARE MOT TRANSFERABLE
OTHER THAN THOSIr SHOWN HEREON. TO ADDITIONAL INSTITUTIONS ON SUBSEQUENT
M THE WATER SUPPLY AMO SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE OWNERS
WILL CONFORM TO THE STANDAIN)S OF THE SUFFOLK COUNTY DEPARTMENT *DISTANCES SHOWN HEREON FROM PROPERTY LINES Q NO
TO EXISTING STRUCTURES ARE FOR A SPECIFIC CF. 4 9
OF HEALTH SERVICES, PURPOSE AND ARE NOT TO BE USED TO ESTABLISH . C
APPLICANT, PROPERTY LINES OR FOR THE ERECTION OF FENCES y D t4RD SOV01
ADDRESS
TEL. YOUNG & YOUNG RIVERHEAD, NEW YORK
¦ =MONUMENT 8- STAKE
AREA- II,826 S.F. ALDEN W,YOUNG,PROFESSIONAL ENGINEER
AND LAND SURVEYOR N.Y.S. LICENSE N0.12843
HOWARD W. YOUNG, LAND SURVEYOR
*THE LOCATEM OF WELL(W), SEPTIC TANK(ST)G CESSPOOLS(CP) SHOWN HEREON N.Y. S. LICENSE NO.45893
ARE FROM FIELD OBSERVATIONS AND ON DATA OBTAINED FROM OTHERS
BRANDIS d SONS, INC. 1618
ICAVIATION INSPECTION WIS pR~~E PLEAS E QTE
E~.=10.0 O.O
Sanitary system is not to be
planed under driveway area.
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PENik6v \vrDF 1096 [N,1vC1-
wATeK 4.b
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9012.2
o a,4%"°4N~ ~2c11EV ~EGTIaid VF_WACU>GTTI~P.'hAL APPS 'n accordanre with olTanf of Refii+Y
.to 114RaVrl WATE.R
(arF l ~.5 t'.voL (~TeM) drhoratinationdated
SURVEY FOR
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICF~ GERARDO MASMONARD/ .
FOR APPROVAL OF CONSTRUCTION ONO AT SOUTHOLD DATE: MAR. 29, 1989
j~ TOWN OF SOUTHOLD SCALE /"=30'
OATt • HS-M. NO., St~'~6 SUFFOLK COUNTY, NEW YORK NO. 89- 0305
.i *UNAUTHORIZED ALTERATION OR ADDITION TO THIS AE OF ry
SURVEY p A VIOLATION OF SECTION ?209 OF THE
APPROVED SAP Ffy `
NEW YORK STATE EDUCATION LAW
*COPIES OF THIS SURVEY NOT SEARING THE LAND ~pPD W ` oy
SURVEYOR'S INKED SE41. OR EMBOSSED SEAL SHALL O
NOT BE CONSIDERED TO BE A VALID TRUE COPY ! J)} t G
NGUARANTEES INDICATED HEREON SMALL RUN ONLY TD =
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT ?ME PERSON FOR WHOM THE SURVEY IS PREPARED W
AATT(ERR pR AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERN-
% BUFF CO. TAX M pt(U1DIl. SECTION( ISB MACH _4.~M10T~-~ IC HEREON, AND TO THE ASS 8HE[S OF THE LLEND N8 D
LATHER 'ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE A,
OTHER THAN TMOlE• !MOWN HEREON. TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT
OWNERS THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM MR THIS RESIDENCE EII *DISTANCES
a
WILL CONFORM TO THE STANDAIROS OF THE SUFFOLK COUNTY DEPARTMENT TO EXISTING STRUCTURES THEREON ARE FOR A A FROM PROPERTY SPPECECIFI IFIC LINES
OF HEALTH SERVICES. TO EXISTING tARD SU VE
APPLICANT, PURPOSE AND ARE E NOT T TO BE USED TO OESTABLISH
F FENCES SINES OR FOR THE ERECTION OF fENtE!
AOORESS
TEL. 400 OSTRANDER AVENUE
YOUNG a YOUNG RIVERHEAD, NEW YORK
¦ - MONUMENT Q: STAKE ALDEN W.YOUNG PR
AREA: 11.826 S.P. OFESSIONAI ENGINEER
GL2v, AR£ F2£ffF V f-NIC9-V to MhL voru/ % AND LAND SURVEYOR N.Y.S. LICENSE NO. 12845
HOWARD W. YOUNG, LAND SURVEYOR
*THE LOCATION OF WfLL(W),SEPTIC TANKISTIB CESSFOOLS(C?) SHOWN HEREON N.Y. S. LICENSE NO.45893
ARE FROM FIELD ONSERWTTIONS AND OR DATA OBTAINED FROM OTHER!
BRANDIS 6 SONS. INC. 1618
OR~~E
R= 25.00; '
L = 39.27 q
e~\ 4Gi
~0
o~ o~\ oo0
„ s
vW AD`S Qp \ UO 0 F
o S^0~
OP•~a A3)h Os 1
41
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~ 056 \s~ Ga No
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cY' Y c?~ CTi p 491
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0 51 0 56 n1 C X06
0 0
5. coe
J~
AMR 5 1992
4
k
S•C. DEPT OF
I HEALTH SERbICES
4 SURVEY FOR
I
SUFFOLK GOUtl?Y DEPAi Th1ENT OF HCAL'CN SERVICES 6ERARDO MASTRONARDI DEC, a , Isst
MAR 28, 1991
SPIV"LE FAMILY MFLUPIM, ONL q MAR. 15 , 1991
ok0R..~ ~.~z... N,S. REF. I` O. ~ AT SOUTHOLD DATE: MAR. 29,1989
SCALE: 1°=30'
The sev'r.~~;o Linllosef and wxt~r sunal~~ ?ael,;tis fiol 'his TOWN OF SOUTHOLD
Iocatlon tr;;ve been Inspected ay.h+s~ii:,;,,itmoldaadlol. SUFFOLK COUNTY, NEW YORK NO. 89- 0305
{ other agenclap~y rlti te s 1 cr . If UNAUTHORIZED ALTenAnoN on ADDITION TO THIS
~ SURVEY M A VIOLATION OF SECTION 7309 OF THE
Ch+of of 4ureaK of PJas±ewater mana-ement NEW YORK STATE EDUCATION LAW
*COP I ES OF MIS Su11VEY NOT SEARING THE LAND
SURVEYORS INKED SEAL OR EMBOSSED SEAL SMALL ,,(P'{E OF N6k,
NOT BE CONSIDERED TO BE A VALID TRUE COPY q• h
_ *GUARANTEES INDICATED HEREON SHALL RUN ONLY TO a~ppp h, 0
THE PERSON FOR WHOM THE SURVEY IS PREPARED P""
HEALTH DEPARTMENT -DATA FOR APPROVAL TOSCONSTRUC T AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERN-
M NEAREST WATER MAIII-Ml, 2 NSOURCE OF WATER'. PRIWITELPUBLICL MENTAL AGENCY AND LENDING INSTITUTION LISTED Z+
R SUFF CO. TAXMA? DIST.MMSECTION 136 BLACK 03.. LOT 48 HEREON, AND TO THE ASSIONEES OF THE LENDING
NTHERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TWN9FERABLE
't TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT i
{ OTHER THAN TN09E'SHOWM HEREON. OWNERS ; L
M THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE *DISTANCES SHOWN HEREON FROM PROPERTY LINES ` a
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT TO EXISTING STRUCTURES ARE FOR A SPECIFIC
OF HEALTH SERVICES. PURPOSE AMC ARE NOT TO BE USED TO ESTABLISH 4589
APPLICANT, PROPERTY LINES OR FOR THE ERECTION OF FENCES. 44.x,
i , ._a4•l0 ,
ADDRESS
TEL.
YOUNG et YOUNG ~RHEAD,NEWAYORKE
'I SI = MONUMENT Q= STAKE c
I ALDEN W.YOUNG+ PROFESSIONAL ENGINEER
AREA = 1 1,826 S.F. .12845 -
K
AND LAND SURVEYOR N.Y.S. LICENSE NO
HOWARD W. YOUNG, LAND SURVEYOR _
NINE LOCATION Of WELL(W)+SEMIC TANK(ST)B CfSSPO013(C?) SHOWN HEREON N.Y.S. LICENSE N0.45893 f .,1 t
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ME FROM FIELD ONERWTIONS AND OR DATA OBTAINED FROM OTHERS
BRANOIS & SONS, INC. 1618 III
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OCCUPANCY OR FICATE
USE IS UNLAWFUL UNDERWRITEM CERTIFICATE ecuTHOLD N.Y
WITHOUT CERTIFICATE. REQUIRED
OF OCCUPANCY APPRO ED AS NOTED ;RA\VI h1Gl
D3amo3a DATE: B.P.# 1 I/WZ
31tl~1311N3~ SN311NMa30Nn FEE. BY: a:M
NOTIF RU LDING DEPARTMENT AT
765-1802 9 AM TO 4 PM F"W THE FOLLOWING INSPECTIONS:
C_OR A V C-Q-r R! DOE 1 FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
? ROUGH - FRAMING & PLUMBING
3. INSULATION if 1 l.t\V/1~maIG b
OPeRABL _ OPeRABLE 4. ENAL - CONSTRUCTION MUST . !'Z 1 Il-.1 ~I J
°JKYUC'JFYT - C COMPLETE FOR C.O. wLL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
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USE IS UNLAWFUL awM?ItSt+wwwoawn~atiru.ow NruuxwWlouvmr.nx..
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REVISIONS BV
PLUMBER C£RT/F/CAT/ON
ON LEAD CONTENT BEFOR
32' o° CERT/f/GATE OF E OCCUPANCY 32'- 0°
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21~- 3° IDS gn SOLDER USED IN !MATER 3 s° 7 0° o' %II 10~ %n
SUPPLY SYSTEM CANNOT r
EXCEED 2110 of 1 % LEAD,
PLUMBING ALL PLUMBING WASTE
I & WATER LINES NEED
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OCCUPANCY OR 12~¢
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