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HomeMy WebLinkAbout17496-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 218050 Date MAY 23, 1989 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 2875 BEEBE DRIVE CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 103 Block 04 Lot 37.3 Subdivision SUNNY SHORES Filed Map No. 3231 Lot No. 12 conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 30, 1988 pursuant to which Building Permit No. 174962 dated OCT. 4, 1988 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 ATTACHED GARAGE AND REAR DECK. The certificate is issued to ANDREAS & FOTINI SANTAFIANOS (owner, } of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-94 MAY 19, 1989 UNDERWRITERS CERTIFICATE NO. N071024 MAY 9, 1989 PLUMBERS CERTIFICATION DATED LISO & DOOLEY PLUMBING MARCH 20, 1989 Building Inspector Rev. 1/81 soaas xo. s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N ~ 0 7 !t ~ 6 Z Date ...L~....'..~..........1 19..~ Permission is hereby granted t . .~.<c..~-.....~r`~...........~~. ~s..`~.~.9.. ` y..... .,w„~,I....... .1 ~ R....~zr~P.~.~-- ~ , r c premises located at ...R~.~..7~. ~A...~.~ :Q.........~KX.S..4~,~....~... ~?.:y Caunty Tax Map No. 1000 Section ......I.~..s~.r..-._.. Block .....Q..T........ Lot No.....~1.!.~...... ' pursuant to application dated ~P..".:~.!~.......~........, 19.8.., and approved by the Building Inspector. Fee $...`~?.85~.80.. Building Inspector Rev. 6/30/80 FORM NO. 8 ~ U lvJ TOWN OF SOUTHOLQ 1 ~ Building Department Town Hall MAY 2 3198,9 Southold, N.Y. 11971 765 - 1802 F1t.i%r. DSPT. APPLICATION FOR CERTIFICATE OF OCCUPAN Y -fOtNfU OE' S©~sYHptiO Instructions A. This application must be filled in typewriter OR ink, and submitted wi t~r~ to the Building Inspec- torwith the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property {fines, streets, and unusual natural or topographic features. 2. Final approval of Health Oept. of water supply and sewerage disposal-(S-9 form or equatl. 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and insta{la- tions, acertificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pxuperty showing alt property lines, streets, buildings and unusuai natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $25.00 BUSINESS $50.00 ACCESSORY $10.00 . 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. S 20.00 S.Uodated C.O. $ 50.00 Date~~./. NeWConstruction~,0ldorPre-existing Building Vacant Land Location of Property • ~R' • . • • ~ ~ • • • • • ~ House Na. Street Hamlet Owner or Owners of Property ~Y.~4'-!~~: r9: ~:4. J .1.1;4 l..~!? ~:1.?•.f'.r.~t~. g.-~ . County Tax Map No. 1000 Section , Block . A.:tY~.......... Lot . p1 »P d r= S u rt ~.tp G. ~ ~ ~ Subdivision ~ :......................Filed Map No.3 ; ..).....Lot No. "::'.1~...... . _ i _ PermitNo.~~7t'llq~.~DateofPermit~J•.~.~~.Applicant t?.,•1~0..~.rn.~.SJ,. Health Dept. Approval (9~ .~~~~........Labor Dept. Approval . Underwriters Approval .~E.S ..................Planning Board Approval . flequestforTemporary~yCertificate .....................Final Certificate .t/..:•.................. Fee Submitted $ r~S~~ ~ . Construction on above described building and p~er~mi~t meets al-l a~ppl`icable codes and regulations. Applicant .cf:~ .G~S!~:~s .I%~°l°~~:j' . Rev. 1070-78 ~.~5~ ~~e~:~ ° ~~7 C~ a i~a~o~ i~~/' 7a~- mod'.//"/ s ~y~~p TEL. 7G5-1802 o5~~~a~-co_ xowN o~ soux~o~.m ~Y` , , ~ OFFICE OF DUILDING INSPECTOR ~ P.O. I30X 728 c°n ~ ~ ~ TOWN HALL p~0~ ~ SOUTHULD, N.Y. 11971 C E R T I E I CRT I O N Date r,~-.~~ Buildin Permit No. d/~ /So G'o NrTa~oY/o <~~j/L P, Owner %ria~/^.r~ces Sage /a fi'a~o r (please print)/ Plumber ,~tfo /~~a~ ~~iynL~~~c~~i (pleaseTpra.nt~~ , I certify that the solder used in the water supply system contains less than 2/10 of l~ lead. ~ . ~ (plumber's si turel Sworn to before me this j~ day of /?Lw ' /i- ~?s` 19~. Notary Public Notary Public, ~~//-l County ' GOLOfaES l.. Lt50 Naar! Publio, Siate of New York £uffolk puwity • Nu. 48x10 Commission ExPises Oct. 3i, 1'dLD I': S:'=C;iC:l ~~DA,S ~ ~OMC(ENT° ,f ro m .,1 1. ~ ~ H S F6~SISDATION (1st) ~ (N ~ C /e a' ~ ?OUNDATZOW (2nd) p 2 • 0 1lf ~ / ~ ?OUGH FRAME Fd/ 4'` PLUMBIN G 1~- y 3. ~ m , H IIJSULATIOC7 PER N. Y. STATE ENERGY COD E x "~~~~ppp ,U o~, .-I m FIi1AL o z ADDITIOPJAL COMMENT5 m . . 3 _ ~ x ~ . 3• H 4 ~ H H O z ~o 0 W • M 06 ~ OU ' C" f ~-3 . - m a v ~ -moo ..O T65-1802 BUILDING DEPT. 1 NSPECTiON [ ]FOUNDATION 1ST f ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL rREMARKS : ~ - (,~u.r D,"-~r rrn Gi a-~-~~. -s t' n -y/ l "e I1 h . A.~n~ i~"Y1M Qf~ A2 DATE ~ ~ ~ INSPECTOR l 7 ass-isoa BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGN PLBG. [ ]FOUNDATION 2ND [ ] 1NS TION [ ]FRAMING FIN~QAL REMARKS: I " t~ / /~-C,~-.3;(' DATE INSPECTOR V 17~~~ r6s-sso2 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ } RO H PLBG. FOUNDATION 2ND [ INSULATION [)FRAMING ~ [ ]FINAL REMARKS: ~'~`~-i~t" ~ _ iP~nr2., DATE ~ ~ INSPECTOR ; '~L 765-1802 BUILDING DEPT. INSPECTIN [ ]FOUNDATION iST [ ROUGH PLBG. [ ] FO DATtON 2ND [ ]INSULATION FRAMING F~I/NAL REMA KS: ~ d"-~li G~~ DATE ~ INSPECTOR 765-1802 BUILDING DEPT. 1 NSPECI'I®IV [ ]FOUNDATION 1ST ( ] ROUGH PLBG. ' [ OUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~ g~ ' k DATE Q INSPECT ~ _ ~.._ti., 765.1802 BUILDING DEPT. SPECTION FOUNDATION 1ST [ S ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING FINAL REMARKS: G~r~ - ~ ' ~~~Gr~~ \ G,r_ DATE D ~ ~ INSPECTOR ~N"''v 3 Y,- i .fig ~ AGK 1 THE NEW YORK BOARD OF FIRE UNDERWRITERS r ~r7.1.35021 BUREAU OF ELECTRICITY 7,.a~ .k ~ ~ JOMN.RTf'MEET, NEWYORK, NEW YORK 10038 D.w MAY Oy, 7.989 AppNootion No. on ft4 58887 288/88 N 071024 THIS CERTIFIES THAT only the electrlca(equipment a dsecrihed 6doto and iwtroduced 6y the appllwrst nomad on the ahoee application numher ht the premiese eJ A, & 7tOTINI SANTA3?IANUS, 2875 BI:Bk~E ORIV3{, CUTCBUGUF:, N.Y. in thsfdbu:ing locotion; ®Baeement ® (At Fl. ? Ynd FI. GAk Sertion103 Bloek~ Lot 37 • 3 ~ war examined on APRIL 2K, 1989 ondJound to 6e in mmplienre with the rwyuirementA OJ th(e Board. NXTYIE RXTURES RANGES COOKING DECKf OVENS dSN WASHERS lXNAUST FAWS ~yf AgES SWITCHES IHGNDESClM FIUGIIESCEM OTHER AMT. K. W. AMT. K. W. AMT. K.W. AMT. K. W. AMT. N. r. 2'/ 3 9 31 2'] 1 l 0. S 7 1.2 3 P' DRYNIS RJRNACE MOTORS WTUM AMDANCE IYOERS SMCIAt REC'IT TIMEt:tOCKf ElIL UNIT MATERS STS DIMMERS AMC K. W. Oll N. r. GAS X. I. AMT. NO. A. W.O. AMT. AMP. AMT. AMrS. TRANS. AMT. N. P. ~ ~y AMT. WATTS 7. 30 1 7pVAf7. dfCONNlCT NO.OE S E R V 1 C E AMT. AMP. IVPE Ate 1 X PW 1 F TV 3 p TV 3 X ~W NO.OF C COND. A. W.O. NO. Oi NI-LEG A. W. G. NO. Of NEUTRMS A. W. G. EOIMr. rEf b a cc. c or NIaEC or NEUTRAL 1 200 CE 1 X 7 2/0 1 2/0 Oittp AAARATUS: tiLY,C.. HATZ;R N6ATRRS::i-4.5 R.H. G.]P.C.I:-3 SNOY.S D3STECTUR:-7. T8RS6 "C" ELk~CI'RCC L[C.S37277I RT. ~1, BOX 95M SOUND AVKNUf.' SAE _ RiVRRBSAD, NY, !1901 11 Per TMt nTtifkata moat not ba okered in any manner; return to the offiu of Hle Roard if incorrect. Inspectors may be identified AKeir 4. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. r: w., 1 - I_ t ~Y) ~ ~r d'~: C . - ~ f;. I ~ g ~ ~ ? I , ~ - I 1'~.~ - ' ~ ~ ~ j rt' ~ 6F{~ ESC urLl V E i '.lac / ^p 3010 j ~ I c} rJ E _ IG ~ r ---133 ~ ~ T; ---Er+7o2Y_¢R r"..WE~I ,d i _ ~K.. { U) 1 Z .~t~ E i E,_ Im ~ j , a I I ~ ~ ~ ~ ~+rdCE~R. CoNSYC~~ I n L',_ I _ y ~t \ I ~ m ~ ~ , ~ db j - ~h7~ I 7t! WELL . ~ A ~ j' ~ ' j l_ 1 N ~ i» . ~YJ~ ~C~ -ly 7lr ~;in ~~fT, I m~~r' v O r A:~•~ zN z;~ 'c ;3 CYO ~ jj Fr ~ , < ~o ~ n' ' T~ ~ 3 ~ t'. m z t„U lln~1: iL~t~ ~ ,~rn{-l' - i-~~;il ~ K n10 ~ 'Dii~y ' O ~ m h- FYI .3 Vi„ . m mp N TZ~7 l O C A~ ryq N A '+1 +f g y m C ~:^''_(«t~w..~,'vf; t= FBI t_EG: M~,._:~' ~ ~ ~n T[~ u' N O m C n h 7rc A w y O ;O r O nro D ~ m ~ O ~ O ~~n ~ O yrAy x iK~G ym~ ~ O Z I P ~ p O A y~ m O 1 IW rZ I~ 1/f W y D Z Q ,2,' ~ S y{ m ~ Z m ~ ° "~`~;3 - x ~A< mx>y ins ge Se,z: p a G +Oi Z O x - i~=a ~+o$G", ~ it ~a W 0 T H rZt Z p N~ 0 0 S O j aka. -a3~ ~ _ '1~ y o r m ~ < Y, T 2 }n m r r / ~ _ _ _ sonxD of xEAT zx V Sy^ ~f 3 SETS OF PL ANS SURVEY l LI~~I~ ~ FORM NO. 1 ~ TOWN OFSOUTHOLD CHECK - SEP 3 ~ I98B BUILDING DEPARTMENT SEPTIC FORM TOWN HALL NOTIFY BLDG. DEPT. vOUTHOLD,N.Y.11971 CALL ~'~"~-y'~-Jr-~'r~"!'=~''~'y TOWN OF SOUTHOLD TEL.: 765-1802 ~ Lt S O MAIL T0: Examined ,~-~~~.~?-~..~'.f..., 19~~. Approved 4~ 19$~. Permit No..~. 7. Disapproved a/c . ~.c~~.. . (Building Inspector) APPLICATION FOR BUILDING PERPAIT _ Date -`~?!='?~.•...a~~f.... , 19~~ 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 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. .....L-ls~ ~~,~c~i.GvR~f (Signari~re of applicant, or name, if a corporation) ~ B.P..0.+ cye S l lAe•+e~. _ Qc2 ti~c7~('-~'a { . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..........~o }~CCa d~44•..GO. e.~_`•t1..,w cG,u, A : . Name of owner of premises ~'.~4~~~=r+~:S:~: f: ~?~)N:1.,S.t?.;ty'YI?~,t'; 1,l~N,oS,,,,,,,,,,,,,,,,,,,,,, (as on the tax roll or latest deed) If applicant is a corporation~,`sig~nature of duly®authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No. ..8:9.3.®..NT'• • • . • • • • • • . Plumber's License No. . s~~° ~"+'a..P........... . Electrician's License No. S Other Trade's License No. . I 1. Location of land on w~Jhich proposed work will be done. • /3tblo~, . n,Qty~ . N/~o tM'(o,4Y QIJ .............~°4..~,~......3c+:,ta,s . D>?•>r.ti-........O:..n:C9T.. ~,,.i~t4,o.~~~.-.!°1:~:... House Number Street Hamlet County Tax Map No. 1000 Section ..l A Block . Lot . ,3 . Subdivision 1" l.b,.P. GF ..S!~.+rk~.`:!..Sbi u 2~..~..... Filed Map No. ;3.~..~.I,........ Lot .I. . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . b. Intended use and occupancy • ~w°•'•`•z'Y• •D wtit~th[ ~ 3. Nature of work (check which applicable): New Building Y Addition Alteration . Repair Removal , Demolition Other Work . Esc , ion) 4. Estimated Cost .....~.J.J~. ~ P.4! Fee z. ~ , / is application).-`..~ ~ ; (to be paid oh'filing th 5. If welling, number of dwelli~ units G.P......... Number of dwelling units on e c (s'T°1tl~ y:'.a....i If arage, number of cars • • • • . 6. If business, commercial or mixed Qccupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures,,if any: Front Rear Depth , . Height ...............Number of Stories . Dimensions of same structure with alterations or additions: Front . Rear . Depth Height Number of Stories . Hei ht /,Q, , , , , ction: Front 8j. Rear ..ftl Depth X04 . i 8. Di ~ensions of entire ~ 9c N~mber of Stories S.T. 4!? y . 9. Size of tot: Front 1.-3.3 'Rear . ~ ~ Depth S.'O............... , . 10. Date of Purchase ......:Y ..................Name of Former Owner . , . 1 1. Zone or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation: /.~l;Q . . . . 13. Will lot be regraded ..Y,~i.~}i h,dsS i,~-a"Ci N ~ ....Will ex~cse ~fiwl bye ~e~nf},ye~from premises: Yes 14. Name of Owner of remises . 5!~ ~o aoo ~?~y ~~4~NO.s... Address ..fd r,~a.~x..rrr~l..... Phone No:~!d: G:41:-.a?~'!.'~ Name of Architect .....H . µ5-.rar?.5....... Address •y,Y r, cs gPoaT, Y , . ,]Phone No.~~a -3aa'7 Name of Contractor a SQ P,H P P Y~ •s j. ~ t?.P.,, , , , , ,Address I'o>~v~rtf85. !an,BSP~pjP~hone No.~o;>• o?., ;~F.£{S. . 15. Is thls ro ert located within 300 feet of a tigidal wetlandl *Yes No , *If yes, Southold Town Trustees PermitPLOYTDIAGRAMed. Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ' - s 1k~~ O C~`~ Imo- STATE OF NEW YORK, S.S COliNTY OF . L.tiw~ n"a'"` r s ~ .S R, C~'~~" ~ being duly sworn, deposes and says that he is the applicant . (Name of individual signi ng contract) above named. He is the u i.w li c.'~i;d A-Gu na R~n~C~ Ol ~~C~R- , . (Contraactor, 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 al] statements 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 ~?9. s~~ ~ 19 Notary Public, . County a<7 f applicant) DPubYlo,SSat of New York ( greo,...••,:~ Suffolk Count' - No. 4841022 Commission Expres Oct. 31, ` ~ .~J' J W yj Ll.' , . ~ ~ . d d3tx- v a° ~ ~sF°°~c~ e. a a F C 1. G ~p s a E"~'i~ 41 ~ LL.Q ~ ib t~3mEwn~~ ~ C3 ~tig~ ~t{~ 'lRa+~ h L 3 4U k" '+i Uj `r . Q' ~ ~ ~.~.y+~'~. 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M tf( a ~ ~ 1i.. ~ YF ro''-xai m,°~°}}~~a .J ~ ~ t tiu'~ ~ z ~ w ~ O O ~ d o ~ m ~ ~ $ ~ ~ $ • Q E~~ ~ ,x E" p~ r a ss u t s 0 4 ? N ~ ~ s 0.Q n.o ~~~~are~a~ „ x O F w A d }CQ § ~ ~ t- Q y ~ O ~ ~ , '~yx,~s~a~ w~ ~~'~2~ ~ YOB X z ~µ1 ~ ~wO i~t-t ~ r-w Ana uC1~ - ~ ~ agf~ t, ~ ~ ~ 2 ~ ~ ~ ~ tt2 . ~ + ~ t ~ -~ft7~ nisi ~ ~ 3 ' ~ t ~}I , ~ if3 CY 1 ~ _ ~a ~ 3.E~~ G': S ~ ts~ ~ J h "~xs.... ~ ' ~ T" ~ x,3.9 } P s~ ; ~ ~ -I 49 ' ~~'"'-t.r_` 1}.5:.1 ~'-a~~ ~X+ . .._.~-ryTM _ q.,...~ti _ ~ ~N S.c+~. %ho% ~ 4i1 t Z t ~~~~;t £ r,~ I i ~3-~ v `.F ~t~ ~~~w.ri~1 . ~ ~ } 1 ~ ~ ~ tea„ i ~5~ ~~t ~ , ~ _ ~ v5 ti W I l~.w~.:rY Y4r.k '~.~Edw~rt ~Q~ ~ ~ Y ~.l ~ ~3 1 i ` ~j p~..~ t' t i ~ ~~3E ws ~ r. , ~ ~ ~ y_, ~~l ~ ~ -~-KlY1.~,71ihi~t~~~U.t3'Y~tt C7',~C~1~ _ 1~'a,f~t~''~j~i ~s~~~ ~ ~ yy~ ~~*4_~ t~ c !"`y~,t i ~ ~ ~ ~ ~ f a l u ~ }}F ~ ~j ~ ~F : a~ I ~ ~ p ~ ~ ~ Z sr i tt ~ 't ,f e~' _.___~__._..__.~z_J,..,,. f ` I SUFFOLK GO. i13AlTM OE/T.1i14rlli~iV H. 3. NO. 1~:'~.._ . 1 ..t ,w ~ y J~ ~a- A''~ L' ,.._~.C'. y~~ ~ i t T ° ~ 57~ tN.oF Lti~ SUFFOLK UNTY DEPARTMENT OF HEALTH SERVICES Tt1[ ~ ~11'Iri~Y Aflll~ ~ ,3~ ~ INGLE FAMfLY DSvELLING ONLY F~ ~ fj ~ DATE, t; ~~lil Tp T4iE 'bT~ f1F ~`FI!` (~yy~~y ~ t ~y ' ~S kEF NO n r ;i~. ~RF_Sl:rtt-.tCE) ! 611 ITS i ~ tft The sew duNO,~ a lW1tClIJC L41. D~ C!F ~R>w1L,Ttfi>ltB1llNt,. _ i eoye2. ~ ~ location ve been in<p~ cceu „y ~ . ~ other a i this ~ ~ ~ ~ 6kR. ~ ~ ~i s dTougS{ to tJa,~i, h ~ andlor f _ ' 5lJF'F61ft„K Y pEl?~'. df F~N4~# ' t Q 't ~~65 ~1 f of Boreeu of Wastewater Management _ f3RYiCt$ - iTkiR Afill'.OVA1~. ~f , weu.~ ~ ~ ~ I s8'' ',c".T i CE~f16~TRUCTIF~NCNiLY I ~ ~ i{. ~.1l~F. IQl,~.: ~r~dw~ G ~ t r ~ :n o~ ~ C1~MC~NUr~iv:?tit~' ~ . 1R.aac K4.. !;:_:~r~:~+c~'; ~'+9 S.'~q f3 SQ~4~ --4 :~12i~3tti~CE,} ~afa "t7,t.~F ,o _ . ' i ; ! 1 1 t,~3?. 4'"l~t'.¢•:~~~ 1D h9 F' C>~ ~atl~l+~lY . a t. He~? ! Cvllc.A,uT) . F`fi(.~C) FF.. CX7. 'S r"E ' ' _ n Z: ~l.i'ERN~:1ETZ "fG_t": ~16~t Sf1?A Lam: ; . -'-a , ~N! .r iv+7..t!1['.. ~~1~.~ 1.... ~ yv n2^ro!Gn.-r:=d ~ __y~ s o . urea seal a ~ IkY fir.,. ~.4.f 1' ~ st~.n~~ rnl ba aurMMraS C ~ { ,r. ; r vue atoy~ ~ ~ teex fnilicate~: heCeal atx1"1 R!A ~t ~ 'r - ss +:~e u on t+!a Oet~a!! W tira~ r L_~.--__.__. ~ o ;'rY 9oM'll!neMa1 H~MN.Ya~ _ ~p~~~p - , ~nsb 4Ri°fl fisted M1otaaa C:+t ~",..4xi1iTM'iP ~~j~'s~ srd ehe to itrta tpa- x~.. } ~`i.nj''< e V. i :1 . ~ z - ",'1 ~ . IiCFl1~0lAtit7 Y4/~S GREEMrORT IV3YY ~fORK r , 1 ~ SUFFOLK CO. HEALTH DEBT. APPROVAL o j o r' _+1 ,;13' ~ , ( t t~cu~ 4' - i r ~ ~ ~ oeclc ~ STATE OF INTENT ~ I N.l9f t3 ~"~~sr~zE iN.OFLt1.,E 150. 1, THE WATER SUrttMY~APID SEWAGE DISPOBA! LZ+~ 4~,__.- _ _ c 4 CdA~Aht;) i~ SYSTEMS FOR THIS RESIDENCE WILL O'~j ~ ~ ~ CONFpRM TO THE STANDARDS OF THE M, 26 ~ j i SUPfOIK CO. DEPT. OF HEALTH SERVICES. I:i t~?1tN) ml ~ ~ i _ i ~ 1s1 r 6e+it. yl APPLICANT ' (S WUtJCgq i ' ~ SUFFOLK COUNTY DEPT. OF HEALTH' i ~ SIYRViCES - FOR APPROVAL OF i wEL ~ 1 Cl ~ ° ~ Cf~STRl/ETION ONLY Sr ~ DATE: ~ ~v ! H. E: IEFF. NO.. i ~ j ~ ! _ r. APPROVED: O ; ~Kp? }„ice {1~ZZFJ~` (~`,51~JQ S.~ OLK CO. TAX MAP DESIGNATION: LA s t4!_-^- L~`h'~ftiJ1.}ME.N: PCL. i; ~ j ? , ~ DIST. St 3 . ~,ocK a ~.3 T~ ~ I ~ ^TA~!- JR of ` 1 iT 1~ ~ 5. f y ~ SC 1n/. 15p.f~ ~ Brix t*1 Y 1a 63•. E - a ' - Yt/ I hic.7rs . ! jr~ ~ i L~ rr tyi~,;. =:~~G'i~ TT7 ,Nt~,'r~' ~E~~ti~l`!/ ~k~(~~__J: D6E@: t. r~/ta v. ' vtcnu ~ ~ ~!i.o:,~1 Ih 1"f;E ~U€'F: ~?K``= ~~f=f A~ AMP MRP ht'JA,i. 2. EL~UAt!OhiS 42Efi%iG?t"i ME~d'd 6E/1i.EVEL v,r atw seas o ~•i!"`..t .i;:. ice. 1~~'~-~-`ice`; s:~-, consiAe _ 1 ~~a•. na, ce _ _ ~~S .c true cvcY ~t t r} x nwyy indir.et9~ har00n ~ ,i t.' ~ ~ _~l~ ~ iC L4 aon for Wham the w _ _ 1 :iy to Iha pnr heir p t: k r~ i r } 4 ' r rt ! F ~ i ~ - .q, ~,4 9 ~ ; 4 t ~1 ' c m+arad. srd on hip be 1 aWr / / . ` T f ! c i i ~ j, I ~ j.. ~ 1 }A-~ f ~ `j r'a c6mnenV. Oar ~ w v . ? i f t~ n _ , W Yhti Odpn(10 ~ 13M 1 -,i M~" F~/!(: !"ref i~, ii` artbn. Gaxanir~~ c. to atitli:iond 1 cw.:i~ri. ! }_":`e. r_ SAL ~ ~ ` • IICENSEO LAND SURVEYORS ~ GREENPORT NEW YORK ,.,rt. wsr - _ _ SUFFOLK CO. HEALTH DEPT. APPROVAL ~ H. S. NO. ~~~.cUGt~GE) ~ ' ~ S4NGLE A !LY DWELL6NG ONLY ~~U 1 ~ EXPIRES TVVO Y S F~'!J;~~ DP,TE OF fi,p~'si0~1r~: ~ +~I ~1~, l.f; , ~ `fir""fi 1 PECNt ~ ,y STATEMENT OF INTENT ~ i THE WATER SUPPLY ANd SEWAG3E DISPOSAL ~ N s~~E~. - ~,`IACAtJ7~ SYSTEMS FOR THIS REStDENGE WILL { ` ~ Q2~~ ~ ) GtlNFORM TO THE STAMQARDS Of FHE CR.>'"fU~r~E) i ~ ~ l / SUFFOLK CO. DEPT. OF HEALTH SERVICES. i ~ AP'PLtCANT p` ~ ~ SUFFOLK COUNTY DEPT. OF HEALTH So ~ J SERVICES -FOR APPROVAL OF ~k W CONSTRUCTION ONLY , , t,3 ktt1.~ M FRA+~w - ~ DATIE: _ _ , _ H. 5. REF. NO.: 1 ~ ~AL I~ APPROVED'. ~ ~ ~ F~. SUFFOLK CO. TAX MAP DESIGNATION: _ DIST. SECT. BLOCK PCL. !~3 A OWNERS ADDREl6 ~ t r E kt ~ .t_ ~-t ~ ~~e 5.7g i 5 w. i~;o ~ - Er~aa~x,_taY Itaq~3. \1 Ij i ~ I : t1T t~~3~ "~EF~~4 ~t7 Mp.!^" r ~{Se 'f1l'Y `.:.IiUFr'E~~, DEED: L i P. ('JACAMIT) FiLcL+ IW~#~{E ~~F- ~ rl,tf[K.'-.a FF t~F. Aa TEST HOL STAMP ELcVA~flt~tt5 P.E~~E~k. TC; MtEtO.Pa _°~El+ uE'VE:'L. 9 ~ 2~ tn~8 MAC? PR~P~(~TY . _ _ dt , _ _ _ _ A 11.E ~ t.... ~1T4.aN3~ V1, SEAL Gp~"~'~L-'~ ; 7?~}~,~1 Rt Cr~:;s~LJ t'i-~ ~E ~ , P~I.Y, , ~ti' - ~ u ° - 9~y 7ro y > > 4 i \ F ."U. ~ti*'E7 ljN~ $ ,tom: r: ~ ^ . 5. 1 't " L s k' O ~ 0 LMF,:EK~ LAMA WS~fOt48 Jr~rne~port, L. L, liT. Y. S~~ <S z5 ~w, 6itl!lTil'M?RT NE1M YORK 722- ~