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HomeMy WebLinkAbout17814-z w • FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22228 Date MARCH 30, 1993 THIS CERTIFIES that the building ACCESSORY Location of Property 2600 DUCK POND RD. CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 83 Block 2 Lot 19.12 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 3, 1989 pursuant to which Building Permit No. 17814-Z dated FEBRUARY 9 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 ACCESSORY INGROUND SWIMMING POOL & FENCE AS APPLIED FOR. The certificate is issued to RICHARD & PATRICIA SPELLMAN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ' UNDERWRITERS CERTIFICATE NO. H-009595 - MAY 18 1989 PLUMBERS CERTIFICATION DATED N/A _ r Bui ding Inspector Rev. 1/81 r~osaR xo. s TOWN OF SOUTHOLD BUILDING DEPARTMENT ' TOWN HAIL SOUTHOLD, N. Y. BUILDING PERMIT CTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Nfl 017814 Z Date ...~i!"^':^~"~.......I t9.~~...1. Permission is hereby granted to: o . cY Premises located at ~.Y.S~:'}?......1-~.4.t.C~K.......~..G?~C.....!„!.a.......... ~-!~.~:~'~".`t~^~-........ ~ 2i.~......5...~ o~~ pp Counh/ Tox Map No. 1000 Section . ~:~Q's`.'......... Block ~.......~..ipLot No....ll...J.:..' pursuant to application dated ..~.r~'~'4i~^~'~....3 19.R.1..., and approved by the building Inspector. Q Fee ' ~:~e::~' Building Inspector Rev. 6/30/80 F i wcde e~Q~Be. [~a~C~~` ~j Q.o ~ q TOS1N OF SOUTDOLD GY ~ BUILDING DEPART:ICNT /~-,7/ TONN IIALL BLDG.OEPT. ' TOWN OFSUUTNt~LO L4v SOUTIIOLD, NEN YORK t t971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY ' DATE _ ~~;7 ~ ~~lJ . HEH COt;STRUCTION .?-„-OLD Oft PRE-E%ISTItiG BUILDING.... r~,~ --DACANT LAND.. Location of Propcrty...~DU_-~GLC- 6v>_ _~~~~LOI~/t; UOUSE NO_ STREET • ;1 IIAHLET Ovncr or Ovncrs of Property. ;/:~GfI~~YL/~_ /~~fj'~Z,jC/s~ ~~%-LL>yi/A^~ 1.._......~ Covnty Taa Map No. ]000 Section /~~Z•-. • Block ..~1.-. L o t' Subdivision.. Filed Map ........Lot... ••••-•...Date of Permit O1 ---.Applicant ~~~~S~UOGJ,.----- Ucalth Dept. Approval Undcrvriters Approval.._-,•,-•-•... PlanninC Board Approval Requc~t for Temporary CcrCificate Final CcrCificate Fec Subaittcd: $ ' cv. 10/14/88 Q.uz, ~ ~S6 c o aaaas~ i r'' ~~/7I~01 'e: ~S ~!j . f i Ie?a3awwo0 UU'OS$ j jr?7uap?saII 00'S~$ - .~auudnoa0 3o alva?;?73a0 63caodmay •9 ~ 00'05$ - 6aucdnaa0 3o a7e~?;?73a0 pa7epdII ~ -S 00'Ol$ -!s3eaS S 3a~o•OZ$ - 6ovcdnoa0 ;o area?;?73x0 pueZ 7vuar~ .y - 00'5$ - davrdnoa0 ;o a7ea?;t73a0 ;0 6do0 •E '00'00!$ - 3v?Ilanp 3v?7s?xa_a3d no 6orednaa0 ;o a7roz;i7.~a0 -Z Hai i. -00'05$ sassanisng _ 00"SZ$ `s3v?pI?nq 6aossaaoV o7 uoi7ippV OO~SZ$ Pi.ji ~°o]asnoi700'SZ$ `Iooa 3u?mming `00-SZ$ Sr?IIanO o7 uo?7e3a7TV 00'SZ$ IIa? a PPV 00'SZ$ Hu?ITanO naN - aONVdI1000 30 H.IVOI3Iy8g0 •l' =5333 -0 I PI?n a-7ua~?Tdde ay7 07 3n?]?3n at 3o;a3ay7 suosea3 ay7 a7c7s Ileys so7aadsr 3a? g 4]';`pa?vap s2 6ovudnoa0 ;o a]noi'3tlia0 a 31 -noT7uatldde ay7 6uedmoooe osle Ileys L56I `6 i?~dV o7 so?3d 7oI a3?7na ay] ;o d?ys3auno a7e.xedas pne alHa?sg8atn4yll~ysd6anedna~7 a 6q panss? ail?7 ;o lou.tlsgr pa?;zliaa r pae `Pa77?m ns a 0 3o a7e~i i73a ne 3• 0 P I ]ueoen so; ao?7eoildde ay -l :6ouednao0 ;o a7eai;i73a0 Parr 7ueoc4 303 -O •a7e~?3?73a~ r aiedaad o7 pa3?nbaa uoi7em3o;vt 7vaai73ad 3ay7o ao `sas?ma3d 3os3uIPT?~9 3o vo?7~adsu? dla;rs 3o apoa 3u?snot' hue ;o a7e0 a iI y ] '7nua?Idde aq7 07 ~a?7?3n v? so;a3ay7 suosca3 t'7 a7e7s cis so aadsvl 3vipI?n8 ay7 `pa?nap sr 6aaednao0 ;o a7eai;?13a~ a 3I 'LS61 `6 T.3dV o7',3o?3d 7oI a3?7va ay7 ;o d?ys3anno ale3edas pae aI$u?s nays Tiros y~?yn 6uedmo~ ail?7 r Sq pans? aI7?7 ;0 7ae37sge pat;?]3a~ a pun 7nea?Idde ayl 6q Pag3?s 7oadsv? 07 7aasaoa a 'aoi7eaiiddr pa7aidmoa ~I3ado3d V 'Z •sa3n7ea; ~iyde3yodo7 3o Ie3n7ev Iensnnn pas s3atpl?nq `s7aa.x''7s 'sau?I 67zado,xd iir $u?noys 6asadosd ;o Saaans a7eanooV •t s3a?pitnq so `sasn 3;a?m3o;voa_ao? ~L561 `6 I?3dV o7 3oi3d)ps3n?PITngs3u?7s?xa 303 's7vamai?~ba3 nerd a7?s Pa7aidmoo ;o IenoaddV paeog 8v?uveid 7tmgnS -9 •3u?pI?nq ay7 30; aiq?suodsa3 3aau?8aII ao 7aa7?go3V ay7 mo3; aauF?Idmoo apoa ;o aana?;?33aa a `sno?7ellnlsu? pae s5n?piinq 3eI?m?s pan saavap?sa3 aId?7lnm `s3v?pI?nq it?37snpu? `s3u?pi?nq Ir?~3ammo~ -S ssal sa?c7no~ ma7sSs ni pasn 3apios ]ey7 SatS;t73a~ 3a mn d•mo3i Y[ 3o Ol/Z nry7 •s3a7i><uapaN a3?d 3o p3eog mo.x; uot7e u q I 3 7vaina7e7s naong -y -(~a3 6-S)Icsods?p_a3e3anas pae 6lddns 3a7en ii ]sn? Irois7aaia 3o Ieno3ddV •E 30 -7da0 g7TraQ ;o Ienoadde Iev?3 'Z •sa3n7ea; ~iyde33odo7 30 Ir3nleu Iensnnn pae 's7aa.xls `san?I 673ado3d 's3uipl3nq iir 3o no?7eaol alr.anaae t'7?n 673ado3d ;o Sanlns Ira?3 -l :asn nav 3o s3n?plinq nav ao; :3u?nollo; ay7 47?e+ ao7aadsnl 3v?PI?nII ay7 07 pa77imgns puc xu? 210 za7?anad67 u? Paii3 aq lsnm vo?7eoiidde s?yy, .V ',SNOIyOfIIIySNI YlNV3I1000 30 iLLV0I3Iy21H0 1i03 NOIZV0I1ddV 2081 - 59L izvu Nrloy yNH1~LLHVd30 ~NIQIIR$ 040[LL[lOS 30 NMOy 9 'ON FRI03 ~ c'lELD I:,w.cR~~„lU:i ~~D,;TE ~OiKMENT° ~ ti ~o J m 1 . a op _ - - H ~C FOUNDATION (1st) ~ fu C 'J`J N FOUNDATION (2nd) _ m ~ ~ 2. z o ~ 6 ROUGH FRAME & .PLUMBING ti ~ H q ~ 7A I1ISULATIOPI PER N. Y. • • STATE ENERGY CODE _ l2 g G',0 l~ .p ~ r` 4 . Yi~Lw~r /v-e_ ~ ~ 9 y FZidAL `-P/) ` 3 I ~ ADDITIOPIAL COMMENT`S: x to x F-i .A 9 H ~ M ~ O z m A _ ~ d . [TJ b H ~ ~ ~ Z ~ 765-1802 BUILDING DEPT. INSPECTI®N [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ C~d- ~ REMARKS: DATE ~~~'~INSPECTOR 765.182 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ } ROUGN PLBG. ' [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS: 6 i' DATE ~e INSPECTOR r-!~ f ~ . TWE NEW YORK BOARD OF FIRE UNDERWRITERS NA<=~~ 8017.b3L BUREAU OF ELECTRICITY ~ 8E JOHN STREET, NEW YORK. NEW YORK.10038 r. ti, ~.,r~..?~.,..M3k~Y+ lfi 1.~9- 619?.ti?.89189 H 009595 ~atr ~ Applicatbn No. on file THIS CERTIFIES TXAT only the aMetrdcd equipment a deecrihed Mloto and introduced 6Y the appl4wnt nomad on the above application number in the pronsltse q( 1:CIlARD SPF,f,1,MAN, 'L600 Dt1CK I'UIiD RUAD, CIJTCHU(>IJJ;, N.Y. to the olbroin location; ®Basement OUT p3 f~1 1019.10 J R APRIL 78, J 969 ~ dt Fl. ? Pnd Fl. Sertiort' BlocK Lot Kvae exomined un andJound to he in complianre uith the reyuiremente of thte Board. RXTlMI MX URK RANWS COOKING DECKS OVENS DISH WAfiNRS UST fANS OUriRf ACIEf EWITCIIK INGNDESGlNT F1U011ltClNT OTNEn NAT. K. W. AMT. K. W, qMT. K.W. AMT. K. W. AMT, N. P. DRYlRS RlRNACE MOTORS tUTUM AKIIAHCE N~EIK frEOAI RlC~T TIME CLOCKS ENl UNIT IRFATERS Se ~TIT~ DIMIr1ER5 AMT. K, W. 011 N, P. GAS N. P. AMT. NO. A. W, G. AMt. AMP. NAT. AMPS. TRANS. AMT. N. P. ~ ~T AMT. WATTS SRRVK~ MSCONNECT NO.OF S E R V 1 C E AMT. AIN. ITPE ~ 11 TN I 1 ]W ] / T4 ] / AW ~~C,COND. Oi CC . ONa. NO. OP NIAEG a~X1 NO.Or NEUrRAIS OF ~E E IIGMI OTHER AMARATUS: IRade by a qualified Pl~rsan. ~e~'C R1C8AA11 SPEGI.HAN P.O.EtOR 11'.:7 DU(,K PONll R<iAD ONRa MANAORR t:UTCHUGIJF„ tiV, 11935 11 Per chit nrtfficob mast not be oMered in arty marmar; return b tiro offip of tM Roard if inwrrsN. Ins rs may 6e ideMifNd by 1Mir creTleatials. COPY FOR BUILDING DEPARTMENT. THIS COPY OP CERTIPIGTE MUST NOT 11E ALTlRED 1N ANY MAlMER. - J ~ ~ THE NSW YORK BOARD OF FIRE. UNDERWRITERS r~ACS i 801'1b.12 BUREAU OF ELECTRICITY. 83 JOHN STREET, NEW YORK, NEW YORK. 10038 Date HAY 18,1989 Application No. on file 61925289f89 R 009595 THIS CERTIFIES THAT only the alectrlcal equipment a dsecrihed 6ebLO and introduced hY the oppNcant named on the ohooe oppiicotion number in the premises of 1C,RARD SYELGNAN, 2640 UUCS. PdND RdA1), CU7'CR000F, N.Y. Lt in thefolloLCinp location; ®Besement ? Ist F1. ? Pnd FI.CiOT .Sertiarafl'1 BIceAUi IwAt 10'L9,1 C) teaa examined un AITR IL $8 , 1 989 end found to be in compliance with the reyuirementR of this &Aard. pXT11R! RXTURL3 RANOlS COOKING DECKS OVENS DISH WASNl~ lXMAUST FANS tXt1tETE ACLS SWITCHES INCANDESCENT PIUDIIESCENT OTHEfl AMT. K.W. AMT. K.W. AMT. K.W. NAT. K.W. AMT. H.P. 1 ) DRYERS FURNACE MOTORS WTURf MFl1ANp TEEDERS SNK:IAL RECM TIIAE CIOCKS EEtt WEIT HEATERS AW[11.OVi1lT OMAIAlRS AMT. K. W. Oll N. P. GAS N. P. AMT. N0. A. W. G. AMT. AMP. NAT. AMPS. TRANS: -AMT. N. P. ~ ~ ET AMT. WAT15 ) 'D 2 SNtVIQ DISCONNECT tW.Or S E R V 1 G E AMT. AAV. TTPE M~ 1 X tVA l X 3W S A 3W I X AW OPEMCOND. Of CC. COMD. OP N4lEG a'M ~IEG NO. OP NENRAVi Oi 'NWEViGRAL oTtRKI AFMRATUS•. FEk,Dk',RS:7. ~4 li 6 BASF,FC4:NT TO BASLrNEN'C f"EA;DER5:1.- 9 f) 6 BA5ENENT Td BASEMENT PANEGBOARUS:1 -3 C,7:R, tA0,1--5 C1R. L00 G. F,C.1:-3 "(SHIMMING P~')dl.) 'Plus crrt:if.icate covers compli.ancr at: the hate of iTlspectiL)n Holy. Aacauxe of uuuxuaA ~nvirunlaents it is advisable to e have f.raque~.tt tart:/and or. repairs -E'V ct< (:ont,inued tlTL )°ag,~ 2 OBrRAI MANAOlR Psr This arfificatamust not ba aherad in any manner; rNurn to the office of the Board if incorrscl. Inspector may be identified by their <rsdentialE. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE#LTEREO IN ANY MANNER. ~~mmaam,.~ ,.a•,~.,ax.+.-v.,,.-.,,m.....~~Am+mwwanaew~n?nom«»:arme+nf.% ~:~nW~x~. _ . _ 'k~5` ¢ "fSd , < s ~ ' w, r O Q ~ O Sti z ~ ~ 3 of 'd o0 rn - m ~ W ,O T~ y b m ~ O v m ~ a3 » ~ ~yt I c o`3' o od \ y r p yip X61 ~ OQ O o ' .e • ` - ~ ti a ti '.r. ~ ~ ~ ~ / ~ - e ~7 \i p5 JaSo ,o M1` ~ ~ 5 7~ PC~O' b. ~ , , _ PJ M1M1y, M1p0 x / A? c,/. O ?Pm oa ? i" 4SX0. S . " Y16Q ~(~O, / '~cJ _ Off, ~ x~.. ~ v g, ~ 0~ ` 1 o,~~ o^ ~ f ~ ~2, C p A Gp 0 ii / ~ (O~ `0000 ,~~,n^y d~-' P ir;:,.. j 5`•' . _.w ~..,,r._... , !.S 1 - ~..vv ~..r~..„~( ~ s `i ~~c pAe tl~~N-aD AwnlT m .~1 ~ ~ .o~~~o ~me~i~~mZt~lrO CO.amo.~,\!i~ - . yqD 2N(! mOOrD-C ~Q~c_'N~ N ~ JOr 9Q S20Cy~ E .~=A~~tpC ~ ~ ~ Z~-1 •p. _ . G ~ ~ ~ ~'~~~~~clz~ozv,3z ` ~ oc~ ~3m ZiOO~ ZZ~~i~nW W a O~~ TESTNOLE , A - ~ ai ~ t/J z 9 O C~ ~ D ~P .m„'~ ~ ~ ~ `i~ _ Y D P D.D, O/~~ QV1nG Qo ~m 2'O ,~~R O solL 20 Y O ~ O~ ro~O N~ ~ ~ m . SANDY O Z IM ~ f m m ,71 ~ Gl` 1 O ~ LOAM z A RI~ C pZ r CLAY ~ m m ~ Tj ~ ~ ~ 1 ^ MIXTURE eA, '9 SAN D OO 1. ~ c T="~ f1' s G RAVEL 18.0 SURVEY FOR KEVIN KNOBLOCH Dec. s,lse5 " MAR .25,1985 AT CUTCH06UE DATE JAN.16,1995 TOWN OF SOUTHOLD scALE t" _ 50' _ SUFFOLK COUNTY, NEW YORK No. e5-1300' R UNAV TN ORIZ ED ALTERATION OR AD OITION TD n1I! GUARANTEED T0~ - SURVEY R A VIOLATION OF 3E CTION 1209 OF iME NEW YORK STATE CDUCATION LAW SOUTHOLD SAVINGS ktd~ kCOPl E3 OF TNIS lVRVEY NOi SEARWG THE LAND ,`PtE OP NEB SUR VE YOM'S INKED SEAL OR ENR055E0 TEAL SNALL S h KGV ARAN~EES DINDICA TED NEREON SNALL ERVMPWIY iC/ >,A~D w' OP THE PERSON FOR wNOM THE SVMEY IS PREPARED O~ VO T ;ENi-DATA FDR APPROVAL TO CCNSTRUC T AND CN NIS AENALF TO THE TITLE CDMPANV~ GOVCJtN- `t' ~~"pY"'~ G AIM ~MLS NSOURCE Of WATERS P111M1TE ~PVlllt_ MENTAL AGEMGY AND LENDING INSTITUTION LISTED ' is `.<<~' 2 Intl 1000 SFG TION 83 pOfX OI LOT P/01910 HEREON, ANO TO THE ASSIGNEES OF iNEa ERO LNG rf l~~f4 BOARD OF HEALTH ?-3 SETS OF PLANS FORM NO. 1 ? SURVGY TOWN OF SOUTHOLD ,/CHECK dSG.<;~?• . BUILDING DEPARTMENT SEPTIC mart . TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY ~~~'--J%9~~ yy- Q TEL.: 765-1802 CALL . . Examined .t~' 7.., 199. ? • . • MAIL TO y Approved 1989. Pcnnit No.I,7'S! ~ L,,~ `.;1; , • ~ ~ 6.`.. ' Disapproved a/c E' i,~ l d ~ ~~9 ~ i;~13 TOW[V OF $OU 8 TfdO(.D (Building Inspector) APPLICATION FOR BUILDING PER~AIT Date 15 . INSTRUCTIONS a. Tlris application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 bets 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 Bui]ding 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 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. (Signature of applicant, or name, if a corporation) . ~ d. ate.. Q; ~l°b+':e:~-^vi:'. ~ t?'~~9. • (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. G 4~: ~<~o~o ~ . Name of owner of premises R~C~:...~~.~.`T!-~rY~.?+T~ . (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. ...9.585 .H . Plurnber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be done. ....2.~©O , , , ,,A~., ~,e~. • ~oJ~ ~ C~..... House Number ~ Streets ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ • Hamlet Ae~~ County Tax Map No. 1000 Section ~ Blpck ~ , , , , , , , hot •\a...~ !c V` Subdivision Filed tvlap No. Lot . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occu anc • •~S~ ~ ~o P Y ...,vs~.• b. Intended use and occupancy ...S~? • . 2ox36xy6 ~6row'~. ~..u.l .:~.c?~?~..•. • . • • . • • 3. Nature of work (check which Applicable): New Building , , , , , Addition , , . Alteration Repair Removal . ~ • • • • , Demolition ..............Other 1Vork .5yt~mr:.vro, Pool... j 4. Estimated Cost / ~ (Description) • lj Q .Q. Q...,........ Fee (to be paid on filing this application) g c g units . . . Number of dwelling units on each Cloor , . If era e, number of cars . 6. if businlnss, ommer oaldoremix, , • . . . . . . . . ed occupancy, specit'y nature and extent of each type of use . • ~ • ' 7 Hcinhtsions of existing strueNtUj~es, if any: Front . .Rear Depth , ' " tuber of Stories . Dimensions of same structure with alterations or additions: Front Rear . • Dapth.....,~ ,l .Ilcight. .NumbetofStories. ' 8. Dimensions oP'entire new construction: Front . Rear . .Depth • ~ • • • • Height . Nu{trber of Stories . r 9. Size of lot: Front ........~,~,g'•4'~0....... Rear ?!14•:47, .........Depth 15~~~yA.. , 10. Date of Purchase ' ' ' ' ' ' • . """"'•'••••••••••••.......NameofFormerOwner 11. Zone or use district in which P 12. Does ro ose~d construction vi Cemises are situated , , , , , , , , , , , . • • . . P P plate any zoning law, ordinance or regulation: . ,t)Q . . 13. Will lot be re"raded es , • ' • • • • , ' ' ' ' ' • • • • • Will excess fill be removed from premises: Yes 14. Name of Owner of premises .~-jc~, S.peu,Mw,~ • • • ' ~ o Name of Architect • • • • • • • • Address ~Q, , , , , , Pltone No..~8R : ~•3 ~ 1 , , ..Address . Phono No . Name of Contractor .:~o l~.'.~I-+ ,nc,oQ~ , • . , , , , , , ,Address 9QQ~~0~-0 '~~r'.~~~..~~c,,'~'~ q R~ • phone No. 2~~+$ : ~ ?;?2 15.Is this property located within 300 feet of~aTtinar~~and? *YES....NO.t~. *If yes, Southold Towzr Trustees Permit may be required. i PLOT DIAGRAM Locate clearly and distinctly alj buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blocl~ number or description according to deed, and show street names and indicate whether interior or corner lot. - I! STATE OF NE\V YOg~ COUNTY OF..~J.~-.lK,,,,,, 5•S ckEpY,C ' ' ' ' ' ' ' ' ' ' • • • • • • • • • • • • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual si niltg contract) above named. He is the ~ 1,~-~c~.Cr~'~~__. . j (Contractor, agent, corporate officer, etc.) • • • • • • ~ ~ ' ' ' ' ' of said owner or owners, and is duly autltorized to perform or have performed the said work and to make and Gle this application; that all statements contai,ncd 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 Gled therewith. Sworn to before me this i b'~ • 1.......... .day of ~i~ Ih~~1. / ~ n ' . 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Y_\\ s w~ 9' - - l ~ ~°,mp~pp, o n~~~~f .awn! ~A~~!m ~ pp °q~c ymrr~{~r5^~Vlo GQp>'<`~ m r~ ~ °9 Zooi/!p m00DC -d2~Ny~ f' ~ JO Q °9O 3fZ~GVZi~.f ~ G?'jGZ'~mC. ~ o o ~ ~ a (IZ~ ~ p , ~ ~ a, ~ O( TEST HOLE 00 A 9 -f ~ .y,, ~p :V V1 T O P 0 ~C pf~~2~0D ~ O ~O SOIL 2.O r ~i SANDY 2O ~ ~mmN S~~ rl O LOaM m ~Z4 r ^ MI%T URE 0.0 ~~qq Z151 G ~ 0 1251 ~ SAND 'AO~ 36<<ra ~ a O GRAVEL 180 SURVEY FOR KEVIN KNOBLOCH DEC. 3,1985 MAR 25,1985 AT CUTCHOGUE DnrE JAN 16,1985 TOWN OFSOUTHOLD scALE I" = 50' SUFFOLK COUNTY, NEW YORK NO. 85-1300 K UHAU TNORIZ EO ALTERATION OR ADDITION ro THIS GUARANTEED T0~ SURVEY R A VIOL A710N OF SECTION Tzov of rHE SOUTHOLD SAVINGSPj ~F NFI'Y ` NEW YORK STATE EDUCATION LAW K COPIES OF THIS lURVEY NOT fEARWG THE LAND lUR VEYO R'S INKED SEAL OR EMBOSSED SEAL SHILL M GUARANOTEES DIND GATED HEREOB SNAU. ERVNPONIY TO >~~D w' 60 o''P' HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS VREP AR EO ` ~ ~U, ~ +;a~ G ANO CN HIS DE HALF 10 THE ilTlE CON PANY, GOVFJIN- / 2 K NEAREST WATEl1 •AIN-NI. ~ NSOURCE OF WATER" PIIINITE _PUN.IC MENTAL AGENCY AND LENDING INSTITU iI ON LISTED "^`x<,S ;-h'~^ Cl R lUFf CO. TA%NAR qfi 1000 SECTION 83 fL.OCK LOT P/OIB IO HEREON, ANO TO THE ASS ION EES OF THE IE NDING I~ ' R 7N ERE ARE NO pW ELL11Nf WITHIN 100 FEET OF TN13 RRO PERTY INS TIiUT10N GUARANTEES ARE NOT TRAM SFE RA DIE ~-'Y"'.' n~ TO A001 TIONAL INSTIi UTION! OR SUB SE OVE NT °~~,=us~"-~ OTHER THAN 7NOSE SHOWN HEREON. OWNERS N 7HE WATER fU?PlY AMO SEWAGE DIfPOlAI SYfTEN FOIL THIf R[f IDE NCE N DISTANCES SHOWN HEREON FROM RFOP ERTY ONES og9 WILL CONFO RN TO TN[ 3TANDMDf Of TNC SUfFOIK COUNTY DCPARTNf N1 i0 EKISTING STRUC TURE3 ARE FOR A SPECIFIC OF HEALTH tfIIV ICL I. PURPOSE ANO ARE NOT TO RE USED TO ES TAl LISH ' YD S T E'104 ARPLICAMT~ PROPERTY LINES OR FOR THE ER EC 710N OF FENCES (A, ADORE fS _ TEL YOUNG & YOUNG R~RHEADNNEW YOP 'E NOTE •=MONUMENT ~~STAKE ALDEN W. YOUNG, PROFESSIONAL ENGINEER R E'.LOT N0.4, MINOR SUBDIVIS ION JOHN&OLI V{A 4N0 LAND SURVEYOR NY.S LICENSE NO 12845 FELLINGER-IHAR~~ I HOWARD W YOUNG, LAND SURVEYOR