HomeMy WebLinkAbout18412-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19308 Date AUGUST 20, 1990
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 315 RACHAEL'S ROAD MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 108 Block 4 Lot 7.24
Subdivision Filed Map No. Lot No. 2
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 14, 1989 pursuant to which
Building Permit No. 18412-Z dated AUGUST 28, 1989
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is ONE FAMILY DWELLING WITH ATTACNED WOOD DECR
The certificate is issued to TOWN OF SOUTHOLD
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 89-SO-29- 8/7/1990
UNDERWRITERS CERTIFICATE NO. PENDING - AUGUST 20, 1990
PLUMBERS CERTIFICATION DATED 5/24/90-HARDY PLUMBING ~ HEATING NORTH
Geri
Buildi Inspector
Rev. 1/81
rant xa s
TOWN OF SOUTHOLD
lUILDING DEPARTMCNT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°- 18412 Z gate 19.~y
Permission is hereby pronted/t~o:
....././/..~~.GU...:t'1........:Q.. ~.O..I.d..//.~../~..~1.10~
...iA.l.!/. I~/~
to ..........~.......ll..:
2 ~/J~ j%
of premises located at ...............~.1..,,t.~.......l.~..r.'4 .....~~..(~....~..:al............/.
~.1. ~r. ~i..!~...
/
County Tax Mop No. 1000 Section naf...O~......... Bloc ...Q...y......pp lot No.././...c.~ /
pursuant to application doted 19p..~, and approved by the
Building Inspector.
Fee S..(+[/..tLG!/.~
. q~~
.......(Y ..ct>~Z~~~L
$uUdinp Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICA220N FOR CERTIFICATE OF OCCUPANCY " '
.1. This application must be filled in by typewriter DR 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 Erom Board of Fire Underwriters.
4. Sworn stateiaent from plumber certifying that the solder used in system contains
~ less than 2/10 of 1Z 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.
I£ 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
Updated Certificate oY Uccupancy - $50.00 •
5. Temporary Certificate of Occupancy - Residential[[~~$15.QQ00,ppCommercial $15.00
Date .....T~..,U...! ~
:icw Construction.........., OLd Or Pre-existing Building
Location of Property
House Nwo~. y~,, Street ^ Hamlet
onwer or Owners of Property.`}~~.`'k ~oJSln~,*t! „
.
County Tax Map No 1000, Section.~.Q~.~.~.....Block..~ .............Lot....................
Subdivision`..GG
...........................WWW.~~~.,,,,,,.....Fi~lped Map............Lot..~t{.`.........:,.I.......
Permit No..7 p ~ ~.....Date OqqE Permit»1_wy~{ ?~~~..Appllcant.~~1R!1.0.'~.. SO~~C~.I~.....
health DepC. Approval ~.5.~ 2:.I........... ~ .~U~nderwriters Approval
Planning Board Approval ~
Request for: Temporary Certificate........... Final Certicate.l5~........ ,
Fee Submitted: $...z:~;~ ~
~~~":~1:`:...~ .
APPLICANT
,,p `^i
C TEL. 7G.-1802
~ ~ - -
~ 3= ~ OFFICE OI' B,UILDi~~G IYSi'£LTOR
~ L:~ ~ ~
c~r+ ~ Ri• ~ 1?.Q. 130;'' ;
~ ~ - ~ TOIYN F:.:LI;
~~0 0!' SOUTH~~D,,~LY.I:IA71
2i
C E R T I F I C 8 T Z O. t7
Date MAY 24, 1990
Building Permit N~o. 18412
Oorner TWO BEARS
(please print)
Plumber HARDY PL. & HTG. NORTH, INC.
(plecisc print)
I certify that the solder used .n the water supply system
contains less than 2!10 of 1$ lead-
. ~~1%'r`c•,t^-sr~
(plumber's signature)
Sworn to before ~e this - -
~S day of
199
tlotar Public
Nota_: iwh_ic, ~~FOI~G-- County
MEUWIE V. dR04YM
Nary Pu61o, &Wr of Nora Yak
No.1900712
CanmYdon ~0a.19,10~~
i
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
100096$ BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038 i
Date AUGUST 29,1990 gpplicotionNo.onfile 65066689/A9 N 146420
THIS CERTIFIES THAT
only the electrical equipment as described 6elom and Introduced by the oppllcant named on the above opplicstfon number Jn the prorFSises of
TWO BEARS BUILDERS, 5/S RACRAEh'S LANE, LOT P/(1-7,2, MATTITIJCK, N.Y.
in the follouinR location; ®Basement O1JT 108 04 2
? IAt FI. ? Pnd FI. .Section Black Lot
urrs examined an Af1GUST 1.3 , 1990 and found to be in compliance with the requirements of this Board.
gxTURE RXTURES RANGES COOKING DECKS OVENS OISN WA RXISI?iKT ! NS
OUTLETS lPTACLES SWITCHES INCANDESCENT FllKx1ESCENT DTNER AMT. K. W. AMT. K. W. AML - K.W. AMT. K. W. ' 1A(1T. <N. P.
1? 36 11 1 1.2
DRYERS RIRNACR MOTORS tUTURE AMRIANC! RIDERS SRCIAL REC'ST TIME CLOCKS RILL UNIT HEATERS MULTI.OUTIET OMTMlRS
AMT. K. W. Oll N. P. GAS N. P. AMT. NO. A. W. G. AMT. Mfr. AMT. AMPS. TRANS. MAT. N. P. SYSTEMS AMT. WAITS
NO.O~ RET
3 F J O
SERVICE DISCONNlCT NO.OF S E R V 1 C E
AMT. AMP. rypE METER 11 ]V/ 113W ] d 3W 31 ~W NO.Oi CC. COND. A. W. a. NO. OF MI-LEG A' W' G' ND.OF NEUTMAlS A. W. G.
EQUIP. NR a OF CC. COND. Of NI~ItG OF NEUIML
1 100 CB 1 X 1 4 1 A .
OTNFR AMARATUS:
M070RSS1-3/4 H.P.
SMOKE DETECTORS-1.
s
.eeo~
WILLIAM T.STOC,K 1,IC.~B89E
1250 BMITHTOWN AVENUE
BOHEMIA, NY, 1171.6 OYrRAE MANAfiR
Psr 11 ~ i
This certificate must not be altered in any manner; return ro the office of the Board if incorrect. Inapscrors may 1]e fdeMifisd by t `r eu ntiab. _
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFIG7E MUST NOT BE ALTERED IN ANY M1INIIERs
~o~~EFOLk~~G`
PLANNING BOARD MEMBERS ~ ~ SCOTT L. HARRIS
Bennet[ Orlowski, Jr., Chairman N?~~ ~ Supervisor
George Ritchie Latham, Jr. `A
Richard G. Ward "''!/1 ~ Town Hall, 53095 Main Road
Mark S. McDonald P.O. Box 1179
Kenneth L. Edwards Southold, New York 11971
PLANNING BOARD OFFICE
Telephone (516) 765-1938 - TOWN OF SOUTHOLD Fax (5 I6) 765-1823
iiEMORANDUM
TO: Victor Lessard, Principal Building Inspector
FROM: Bennett Orlowski, Jr. -~p•~''~j
RE: Elijah's Lane Affordable xousing subdivision
Elijah's Lane, Mattituck
SCTM ~ 1000-108-04-7.2
DATE: August 17, 1990
Planning staff has been informed by Inspector Curt Horton
that a letter from the Planning Board attesting to the
completion of this subdivision is one of the requirements that
must be met before Certificates of Occupancy can be issued for
the building lots.
A performance bond for this subdivision was not required at
the time of final approval because the Town of Southold owned
the property then. Consequently, the Planning,Board has no
jurisdiction to determine whether this subdivision is complete
or not.
The extension of Rachael's Road, on which this subdivision
has frontage, is part of the adjoining private subdivision of
Elijah`s Lane Estates, Section 2. That performance bond is
still in effect and will remain so until the remainder of that
subdivision is completed.
I hope this clarifies the confusion on this issue.
Y.
cc: Supervisor Scott L. Harris
c'1c:LD I;:S:'~C:iUw ~~Unia I~ CONM€NT~ c,~\~
_ ~ - 'T^jN~
FOUt1DATI0N (1st)
FOUNDATIOid ( 2nd ) 9 99 _ - mO
2.
z
o~
P,OUGH FRAME &
3
PLUMBING
.g'a'r".
N
H
3. ~ - m
m
H
It1SULATI0t1 PER N. Y.
STATE ENERGY QI a
CODE
x
a
4 . .3
FIidAL
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ADDITIONAL COMMENTS:
HQ
a
~ `l
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H
T
C
_ _ _ _
/
BOARD O~E~\LTH .d...........
3 SETS 0 PLANS
FORM N0.1 SURVEY
TOWN OFSOUTHOLDv CHECK
BUILDING DEPARTMENT SEPTIC r•olzrl
' TOWN HALL
SOUTHOLD, N.Y. 11971 NOTIFY
. TEL.: 765-1802 CALL James. Cr. Ms=flahPn.....
Examined . l9 J!. ~ MAIL T0:
Q Town Hall, Main Road
Approved 19l/.~Pennit No. B..rf..i~ ~ Southold, NeRRw Yoryr~kRR11971
Disapproveda LS ~ IS Q U L5
D
.JUN 2 2 1989
(Building Inspector) BLDG. DEPT.
TOWN OF SOUTrfOLD
APPLICATION FOR BUILDING PERMIT
Date ,May, 8,,1989_... Iy,,,
INSTRUCTIONS
a. Tltis 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 [Iris application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shalt be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction oC buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
Town of Southold - Community Develop.
.
(Signature of applicant, or name, if a corporation)
Town Hall, Southold, NY 11971
• (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
OWNER
Name of owner of premises ,TOWN. .OF SOUTHOLD
(as on the tax roll or latest deed)
IC applicant is a corporation, signature of duly authorized officer.
James C• McMahon, Administrator, C.D•
(Name and title of corporate officer)
Builder's License No . .
Plumber's License No.
Electrician's License No. . rr .
Outer Trade's License No . .
1. location of land on which proposed work will be done . .
. 31.E . ..,~,9c}~IF~L S.R.4~ .......~T~!??'~~ .
. ....h
House Number Street Hamlet n ~,C
County Tax htap No. 1000 Section ~t!~.......... Block Lo[ . .
Subdivision Filed ~[ap No. Lot ~ .
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy VACANT
b. Intended use and occupancy Single-Family Residence
Odalon -
3. Nature oCwork (check which applicable): New IIuildinS • • •x••..... Addition Alteration
Repair Removal Demolition Other lyork .
per/ ~,~y~ (Description
4. Estimated Cost ....0.-!i.(h,~! Fee .Waived, ,-,Town Pro sect
(to be paid on filing this application)
5. If dwelling, number of dwelling units ..........1 Number of dwelling units on each door N./.A , , , , , , ,
ICgarage,numbctofcars .N/A
6. If business, commercial or mixed occupancy, specify nature and extent of each type oC use . N/,A .
7. Dimensions oC existing structures, if any: Front , NJ•A Rear . NlA.......... Depth . 1`1/,?. , , , , , ,
Height ..N/A....~......Number ofStorics..N%A...........
Dimensions oC same structure with alterations or additions: Front . N Rear . NlA........... ,
Depth ..NlA . . Ilcight . N~^. , , .Number of Stories . ~~9
Dimensions o~entire ~elw construction: Front Rear . , ~a?.....::::: Depth aZS!. , , , , , ,
' Hcigltt .0?l..9./.8., NumberoCStories...~,,,,,,,,,;,,,,,,,,,,,,,,,
9. Size of lot: Front .(p.~i , , Rcar , , a$,~ a .~J. ~ Depth ~ia/o~ ~."t~-7;7 i
10. Date of Purchase ..A~a...? .BH Name of Former Owner .S 4~~.~.CAG/:r!
1 I. Zone or use district in tvhtch premises are situated . ;/}f?(LIGULI,2l2~¢L, , , , , , , . , , , , , , , ,
12. Does proposed construction violate any zoning law, ordinance or regulation: , N 0, , , , , , , , , , , , , , , , , , , , , , , , , , ,
13. Will lot be regraded ............................Will excess fill be removed from premises: Yes t
14. Name of Owner ofpremisesT.own.af,,$p).{thq}d ,AddressMd~n';Rd, SautholdPhoneNo.74~`18`~~'.....
Name of Architect ..NiA Address N!9 Pggr~~p.N!?......... .
Name of Contractor.TWA..~gars,Buil,ders, ,address P.Q,9ox..'4117, Amagp o.329r.UR3P..:.
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 dimensions fro
property lines. Give street and block number or description according to deed, and show street names and indicate wheth
interior or comer lot.
SEE ATTACHED SURVEY
0 Gi~~
STATE OF NE1V YOR(C, S.S
COUNTY OF .
,James C . McMahon , , , , , , being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
Ilcistlte„Community Development Administrator
(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; th~'t all statements contained in this application arc true to the best of his knowledge and belie C; and that the
work will be performed in the manner set forth in the application filed therewith.
Swom to before me this ~ yy
~ ........day of.. 19~.`.
Notary Public, .,,,Suffolk-•~,Q?.nJ~,~~tl;,lV~_U~County
ICELEN K DE d~Nr+r `Pork • . , , .
~1q
S~
Term Expires March 30,18--~~ (Si^nature of applicant)
- ~ _ _
f
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
31.6' RACHAEL'S ROAD E.7/.~ FO APP OVAL OF CONSTR 710N ONLY
DATE ~ ~
R ` 175.00' N 51'?i'10" E
f5.?O' 22.17' APPROVED
a2z
3PJ
c? ~ - 385.00' - 1~
~e,,~~ ~ SURVEY OF n
~ ~ PROPER T Y
" J~ ~ A T MA T TI TUCK
s5 _ ,x a ~ ~ TOWN OF SOUTHOLD
TEST ~ - - ~ SUFFOLK COUNTY, N. Y.
~ ~ q ~ ~ = 1000 - 108 - 04 - P/07.2
~j
c,P~~ v L o r e Q Sca/e 1" = 4 0'
~ Oct. 13, 1988
U ~ " ~ ~"'a<Aa' ne.....
10.1` 4 ~~r~rl;. 1 ~I~JU Y~!i~?~~
ri4~ ~i~,,nt ~Eti~,~ rJ_".`I_~' '`F6
' s~ n
~ { r ~ ~~ln
.L•.
~ ~ 3° Vic.
~~~o ~ a
inm ~ DAnK BIIWN LOAM l~~E
yq~y ~
- - -JO.2' - - :
A 2~,e MOrN QTY LOW
• SLIB' - ~ Tt ~?"III r h c ~ s r•e,~ c fO~w1 Fd
Ory r.a• ~ 9 47'ON)10"' (yr rue °r~T" 9AIOY r ~ ~ 3: n~ 3 :yz ti-~9
° ~ y :III r.J1G~ _;l Lilo
~1 ~v ~ W f '
F ~ ~ t N/O/F WLL/AM 1 B/IXIEIP,F PA c ~ ~•.i ~ ~~.c? iSil~ cu tale Permit to
MzAw~ e ~ ~ kO~ERT A. GQELLE7gdJAAE P.BAXTER rALe elooeM cons.suct. , ,5= •
i
1'3P tiff / ~ , COAME tA/O ~~t ~ h t,.,-
~ I qeo (VACANT J w..
/ iY 85.8'' S 58'08'50" W za1 fNO nor /wM[Rt /Ee'I[Jt TO MAP OF Td-~ fM~~-
/ ~"io yb, ~ PROPERTY a?awAw PROroafro ~ y .
'ecrwW ~O W LOT>t FOR Tl~ NgRTN ~pd7j,49
N/O/F .pSEPH d AN1E NE12LE .o~ I IAOfRRM ALL/ANC[ lANO ~C9 5--1~~17i
(DWELL/NG J I RL9ulrf15` S y a,-°° 9 OFQy
AREA = 8?,S27sq.f . CD~,~r 1'~~I~ tank r
TAe eehr e / sod ee~e a oeel to ~'radG• - .M LIC. NO. 49668
NOTE ~ P RT Of PARK L RECREATION AREA ~ Prepared M accordance rIIA /Ae m/nhnern 1' D deP
,.1 a/en/erdi /or NIN swrere oe erfeAQeA7I ePs/eea hr NNe reslNnee ~>ll eon/orw
• MAP OF ftIJAH'S LANE ESTATFS,SEC / AT Me L./.A.L.S. end o~Proved cad eloped le Ale eleederde o/ TAe SIHoR Cover/r C S, P. C.
FILED FES. !4 /97~ F/LE NO. 6065 AT THE /a +aeA ase AT TAe New :
erA S/efe Land DenarNwrl o/ Nee/M Servke~ (/61 N~
OFF/CE OF ThIE SUFFOLK COUNTY CLERK. P. 0.
TNN Auoc?oNoa.
T. • leaeRoee e1 Pepe arI eeeq eoN sAo~n Aerer a ere hea RdI ,,~~/,/A/N ROAD
eMerreNow aeI er lroa Ida ae/eAMr1 bore o/Aerw SOUTHOLD, N. Y. l/97/
88 - 344 -f27
~6 RACHAEL'S ROAD (9.T
R: 176.00' N 61'?1'f0" E
t1.?O' ??.t7'
xz
az~ ~7 t~~ I
385.00' ~pR.P wp
' ~ ~ SURVEY OF
1~
40b' ° ; ~ W PROPER T Y
FOfN?0<T,ON ~ ~ ~ A T MA T TI TUCK
- ~ ~ ~ TOWN OF SOUTHC' D
/ ~ ~ SUFFOLK COUNTY, N. Y.
~ ~ • ~li,.~~ ~ 1000 - 108 - 04 - P/07.2
o ~ = Scale 1" = 4a'
~r,PLP ` L o r 2 ~ 1 Oc i. 13, 1988
~ Jum i!, 1!!! (rnria/on )
` Q ~ ~ ~ W S.pr x 1~Be r founal ray. ~
K
~O J
Q
~o.i.
~
,
B•I RN
k~ ~
!°.Y' ~J
2UC
9 at.ta'
uti I s a7•o1•eo~ ry
I W
~ N/O/F WLLGIM d BAXTER ~ PA
`waNO+ / ~ I $ k~0i619PT A. QO~EZLER6 JAAE P. XTER
Y3rs i ~ I
s I ~ 'p
S~+r . i ~e^i f VACANT 1
/ s~~ ~
/ ,~1~ da 6.t' 3 6t'o6'so z~ Fa° cor Nuw~Eies Rt?YR ro w~P of
/ reoPrflnr aaw~r PRar!!as
~•~'+w^' w Lots FoR tt+s MoRrN POAIK
IYIn/F Jq,~{ ! AAIrE IIEV[Lt' „~w; ~ 1paMN AuJAMCS lANps
~ ~~ay~~QY, ANC
GqL
.aVELLlNG J
AREA = 8?,927sq.ff. . ~
J 'o p20~0
N'~ e ~ N.Y.S. Llr'. NO. ^.9668
NOTE ~ R']!.~R~T Of PARK /RECREATION AREA ~ PryN~I b nesNlMp dIA IM wMirwr 8 Q
A/AP OF GL7JAH~S LAIC ..^STATES,SEC l +
~ L~
~,~M, wTa w~p I EYORS, P. C.
F1LE0 FEe. M /97t FILE NO. 8063 AT THE rn1 !j ~ •Sl~h Lr?I I Sl 20
OFF/CE OF T~E SUFFOLY COUNTY CL£RX. ~q~, ,~~f/p,, O. BOX 909
~A/N GOAD ~
: ~ , 1197/
OUTF? .O,
X88 - 344 -(21
.
~6 RACHAEL'S ROAD Q3-.~
R' 175.00' N 51'?1'10" E
azz azi V G 7 19gb
sr 365.00'
1
1 ~ ~ SURVEY ~ D~
0h~ [n
J A 9+ 4UF.-x
!STEPS ~
3P.3' W
o ///P STY. p
r 2 ~ PROPER T Y
a NOt/SE w
of~~E ~ A T MA T TITUCK
3y3' _ 2E0' v
rooo oE~x - - 4 ~ TOWN OF SOUTHG' D
a STEPS SUFFOLK COUNTY, N. Y.
,y ,~j' I
p~ dy q ~ _ 1000 - 108 - 04 - P/07.2
b LOT 2 ~ Q SC8/@ 1" = 40'
~ ~ ~ Oct. 13, 1988
QP tl ~ ~ Juns /9, 1888 (rsriiion )
j ~ p Sept 1, 1988 (f01M1d loc.
e° ~ Fab. 18, 1990 (final
~o.r 4 ,
SUtFOIK COUNTY UEPhH?PeEtdi OF HEALT!~I SERVIC'tS
SItJGLE FAMILY Db".cL!:P;G U1:1Y
~ env w ~ DA~UG r' ~9JU ~i S REF NO `3 ~ ~
1 WELL ~ I ~ ThP, $2W3ga '~K~O ~I ii ~ -Vdi° SJfnl ~IC~ ~ f ~(hlc
yaq ICl..9 f!OOh 't Lid fig '~ica i ~a~•21°iIE,III a.~~~Ui
AJ~ - _SO.P' _ _ J 29.6 Ofh2' a~`Q! x ~ OUF.iI ~~.~.i~'~E.
p 9'J7r01.1p,,, (N fh,_' ~~i;;~~r~,; os ~.Vd;:~~mat',,r !:"ar~zgemenl
SNep I w
t'O~"6 ~ ~ ~ h~'~ERyTVLL/AM~ER67EJgAEP
A/~~TfRrK~.L4~BAXTER
~'J2.S Q. ~ ~ w ~~.4cR Has. B-.QO-?g
,ti ' h
f~ I a
~ q (VACANT I
l ss0 oy. ^ tq
l ~ tea CERTIFIED TO:
/ ~ ea.as' 3 5K'05'S0 W la N ~0 R
~ Tp+wroeEC SOUTHOLD SAVINGS BANK
' RICHARD ODOEN
cr 0 W LOT! FOR T!~ NORTN FORK
IY/O/F JOB/ 6 AIV~ /1E?/X(E, rte; NO(Af/M/ ALL/AA1CL JANET ODOEN
I
WELLING l I yip IRNOS '
AREA = S?,S?7sq.ft. ~°N A~ LNG
G'9~
CZO O
NOTE ~ 1'!RT Of LARK t RECREATION AREA ~ Proporod M ~ceordanu r/M Ma minlmum ~ ~~"r LM. NO. !9P6@
AIAP OF E'LlJAN'S LANf :STATES,SEC l NoPdardr Jo? lllb torrga of asfaApshil _
FILED FE& l4 /3>•~ F/LE NO. 6061 AT THE Op M, L.LA.L.S. and o proud and olop/od P SUf~V ~ P, C.
Off2E OF TI~£ SUFfOL:' COUNTY CLERK. Iw rocA oio 0) rAo S'orA SJo/o Land
+s '
TIIh AraoNolion. P, O.
MA/N
- 88-344-(21