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HomeMy WebLinkAbout17145-zFORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17726 Date JANUARY 31, 1989 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 3750 VANSTON ROAD CUTCHOGUE, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 111 Block I1 Lot 03 Subdivision SEC. D. NASSAU CLUBFi1ed Map No. 806 Lot No. 424 conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 16, 1988 pursuant to which Building Permit No. 17145-Z dated JUNE 21, 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 AS APPLIED FOR The certificate is issued to WILLIAM & MARTHA NEIIMANN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-80- Jan. 12, 1989 UNDERWRITERS CERTIFICATE NO. PENDING - Jan. 24 1989 PLUMBERS CERTIFICATION DATED San. 30, 1989- HARDY PLUMBING & HEATING 0..(. Bui ding Inspector Rev. 1/81 FOHai 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) No 017145 Z Date ........~~~:.......al ............... 19. a.0 Permission is hereby granted to: ................................................................................ ..~-~ ~~-...``..~pti?.:!~~~:....~ x..9..7../......... 1 -n -, (~ to ..~.~....4.......~`II.A...~.a~r~n,~.~ ..)...:~.1,t~-?'q..,.....~1%Q.....~+.~/~~~(~C~-[J ct premises located at .:~~. ~ d....l..~:~?~!...1~? .................~.~...~.~~-R......................... . ~~...!~~,.~..~..~:..I.~, ............................................................................. Caunty Tax Map No. 1000 Section .......I ~.~.......... Block .......~>!........`'.\'Lot No.....~.3............ pursuant to application dated ......~...t.1..Pf'.~,,.......~..~ .............. 19.k.a.., and approved by the Building Inspectar. Fee $...~.410.:.`5~ Building Inspector Rev. 6/30/80 ~ r~`~ ~ FORM NO. 6 I " TOWN OF SOUTHOLD ~ ~ ~~ 3 0 Building Department , y ! Town Hall ~"°"°"" 81.D~i. DEPT. Southold, N.Y. 11971 ~,,, TOWN qF SOUTh10 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriterOR ink, and submitted ~~~ 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 lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- 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 p;toperty showing all property lines, streets, buildings and unusual 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: Additions $25.00 1. Certificate of occupancy New Dwellino,$25.Q0, Accessory~$]0.00 Business $50.00 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. $ 20.00 5. Updated C.O. $ 50.00 Date .... l/~8~~............ NewConstruction, , , , , - Oyyld o//r~~Pre-~exQQisting Building ............ Vacant Land ............. Location of Property ... ~7 0.~ . Yait!"1~l~!~- .....................~,.... :~-~ ..... . House No. ~/` Street _ / Hamlet Owner or Owners of Property .`.t~~'~!": 4.~ '"'~^"~'y" .................................................. County Tax Map No. 1000ff Sect//i~~on ....~j......... Block .. /~.......... Lot..Q:~........... Subdivision . ~ 4r'E/).tl....~21~.w.~...Filed Map No. ro,`, , , .Lot No. Se'.~,l~..... . ~ L .~ //tt v . Permit No. ~~..~~5. Date of Permit ..~~~'~`~~Applicant (/"Gkr~..u!. ..~.tt„~d! ~, . . Health Dept. Approval ........................Labor Dept. Approval ~ / - ........................ Underwriters Approval ........................Planning Board Approval ..................... . Request for Temporary Certificate .....................Final Certificate ...................... . Fee Submitted $ ............................ . Construction on above described building and p I a icabl codes and re ations. APPlicant ............................ " /~2-.i................ Rev. 10-10-78 / , ~~~~ PLUMBING & HEATING NORTH, INC. JOBBING & ALTERATIONS LIC. NO. 1593P 7anuary 30,1989 Mr. Robert Wffndell Winds Way Construction Route 48 Southold, NY 11971 Dear Mr. W$ndell, Please be advised that the solder content breakdown is 95% tin and 5% lead on the Newman job located on Vanston Road, Cutchogue. Should you have any further inquiries, please call this office. Thank you. Regards, ~~~~~ Richard Durand Manager RD:mp P.O. Box 1460, 13500 Main Rd., Mattituck, N.Y. 11952 298-8181 Day 298-5691 Night ~_ c'lELR, I;:S;~~:1V;i ~ ~UniE ~ CUMM6NTS : A ;~ 3v ~~- ~ ~ C © ro ~ [T~ 1 . ~ ~ . ~ ,, H FOU[DATION 1st) p~~ W ~ ~ , T ~ D P ' FOUNDATION ( 2fSd ) - ~ _ ~ 0 /~ ' 2 . z o (JJ . ~ OUGH FRAME & P , f O PLUMBING ~ H y Y " 3. `- m y ItJSULATION PER N. Y. . STATE ENERGY CODE x ., '/ o . ~ ~ e ~ 3 . . . 4. ~, FI;JAL x ADDITIONAL COMMENTS: .~ f _ _ x ~ ro H j 7] S 'j f H '~ z od ~0 x ~ A °C • r }~ H x • t7 `1 fT7 • ro o4 .~ ~ r / ' ~/ ~~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG, (]FOUNDATION 2ND [INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~"'~j ~~/ ''-~-~ DATE ~y ~ INSPECTOR C~~~' T65-1802 BUILDING DEPT. fNSPECTIAN [ ]FOUNDATION 1ST [ ROUGH PLBG. DATE ~ ~~ INSPECTOR ~~ [ ] FOUNDATION 2ND [ ]INSULATION [~RAMING [ ] RINAL l2 ~~~~- ass-isoz BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: DATE l/ to ~~ INSPECTOR ~L/I~u~~~~~ D G 6 z ~ «s~ 7ss-iso2 BUILDING DEPT. INSPECTION [1~]~FOUNDATION i5T [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL DATE _~L~~ INSPECTOR ~ . THE NEW YORK BOARD OF FIRE UNDERWRITERS ''i"~" ' 7.000'1. ~ 1 BUREAU OF ELECTRICITY 83 JOHN STREET. NEW YORK, NEW YORK 10036 1. ;; A' =~'+~;..•~, 6"~iHR11kRY 'TJ'Y;"f'4A9 f,0?3;[4k4189 N G5'7?1~I N l G ate Application o. on fi e TNIS CERTIFIES THAT only the deetrled pulpmant v deECrihed 6ektto and Introduced 6y the appficent named on the o6oos appltoation numhsr In the promisee of iI1:61,7A14 NY..IiNANN, VAit3TON RUA11, ltll~TCHirx;lih;. N.Y, (:AR{A'PT;!(' S i Bl k L F (~ ~ ~ ect on or ot IRt FI. in thefollouinR krca a Pnd I. ~fRb `,'R~bAR~ 3Se , toas examined on andJound to tN! in complience ecith the reyoiremenu of thu Board. RXTUE! RXTURB RANWf COORMI{t DICKS OVENS DNNW EXNAUST FANS 1X171!71' ACTlf EYVITp1E5 NpNDESCENT FlUORFSCENT OTXER AMf. K. W. AMT. K. W. AMf. K.W. NAT. R. W. AMT. N.I. 3~ 4 37 32 i f `L J i 1 .2 4 >r ORYMS FURNAC! AgTORS tUTUM AeeUANq F9WIK SNX7Al REC'/T TIME CIOCKf pLL UNIT XRATERS MUti4WM OIAEMlRS AMT. K. W. Oll H.I. GAS N.I. AMT. NO. A. W.G. AMT. AML AML AMtS. TRANS. AMT. N.I. ~ ~t AMT. WATIE 3 F' 1 10 t. ~ 1 R00 fERV101 OKCONNfCT NO.q S E R V 1 G ! " AMT. AMI. TTPE ~ 1 X'PM t X 9W S X SW 3 X AW ~' ffM `COND. OF CC CG" D. NO. OI NIAEO a'IWd~"LM NO.OF NlU1RAl5 A• 1. 1 150 OA 1 X 1 1/0 7 7!0 O71MR ANMATUS: ~.F'.C.C~-5 KM(>X is 0}:T};<•T'OR : - 2 ~~ PAM, R. A(1RNti 275 'P()IIN RARAOR I.A13P: 301J'I'ROLU. NV, 71971 OE~AL RAANAON ]1 ~ r,t('r;Nfirt N0. 2tS~ P Per ~'~''~`- Thit urfifitoN mint rat be alNrod in ally Manner; rNum to fhe office of Me EoDtd if incorrM. InspacforE_moy be idanKRad by Moir eraderMiolE. ~ COPY FOR NJILDINC APARTMENT. TNIS COPY OF CERTIFIGTE IElSTl~S7 BE ALTERED IN ANY AYIMIER. • pw ~0~_.. _.._ . ° • ~d- ~ ~ ra~s~t~.ra~"ac~~. ~~ f~ .u V •'~ ~~ ~ , A ~ ~ S ~,. ~rf^ ~ _ F S `uv+R ^ «•~o ~ ~„ ~3J ~ T 4 `~ ~ r' u' ~ ~~~ ~ ~ ~.1., ~^ ~ . , ~~ f s* H: ~~-~,~ ,~~+. y~109- ,~ 4 S ~ ~~ ~~~ ~ ~~ ~' o ~ + °++1 1°atKs.f~, t ~~ . ~ ~' ~;' . ~: ~ e 4 {~ i r ' :. ~~ ~ b(µ~ J4 ~ }KF 1 ~ ~ _ 1 q iii ~g N 1~-ik~~3'.~,~ ~, r,. r, ~~ ~~~ ~u ,( J~} -~~ ~-''t ~,~~.~y ~ ~~ ~ ~" F ~* ~ln! N J '" , a Nt~ ~~ ~ 1%s '~1.~ p Ff~ x C` t ~ { ~~'a _ , zfJ i '.. a i ~ ~ ~ - ~ ~ F _ ~ .. ,.y., ~-~.,~ ..- ..J ~ < +/ ~ ~ > . ~ y - ~ l {~ pr r . ki i. ~ ~ ~ ~ ~ ~ ~ - ~,.e ~ ' ` ` ~ , ~ k . .,F t sk d _ I! ~ ~. ' R~ • •,~„ ~ ~~ . ~ / ~° ~ 'kI v'r~:, s~ :'6: ' iJt~ - - v - _ ~ :},. u ~ ll r fit, t , Y ~ ~ :1 c ~, O .r " q to ~ to C 'n ~ 7n 1n y ~ d ~ .. -i t -n ~ w yt "'~ rot ~ C ' ,~ ' . r „~ d p d n `t. Ckr}t.~]1c ~ u O~ ~' ~, W~zn a d ~, r ~ ~. co x n . x ~w ~ ~ d Ki,. l t m ' O ~ U L ~ ~i tl n'ip'; ~ . to ~ ~ m _ m ~ 2 I ~ f1 ~y -t ~~ O r -i L d 'i .2r' 2 ~ 3 ~ . ' .. Z"~ .~ A Y 1 1~ , . F h.. ~ ~ ~ i ~ y D r - 1 Il1(AH11 UI' II IC t\1,'1'11 ~~~~~ 3 sle•rs or~~,nNS r.;"'r„..:,E.:!......ap'+.}s;,~'.• ,s::.i FORMNO.I SURVEY TOWN OFSOUTHOLD cuecx -•-------- "~' 6~~8 BUILDING DEPARTMENT SEPTIC FORM ........ . .. . . ~ i TOWN HALL NoTlrv gLD6 peer. SOUTHOLD, N.Y. 11971 CALL -•?~~/`~ - /,~=~~ tOWN OF SOUTHOLD ~ TEL.: 765-1802 - - MAIL T0: ~ ~-{L Examined ... .~-~-':~.f-. ~^ ~ .., 19 g.~ d~ ~ -~/7a~~'_L%c~-"' C/ ~ APPLICATION FOR BUILDING PER~/IIT Approved ... ..i-t!~'!A-: 1.., 19 ~ g Permit No. 1..~ ~ ~ ~.~ Disapproved a/c ..................................... (Building Inspector) INSTRUCTIONS Date ...........(Ol.~.~., 19~/~ 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, buildin code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary insp t: ns. ' (Signature of applicant, or name, if a Corp ration) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises -!!\!! ~~i~^• ~ . ~ ~?~~.. ~-G". !?^!~/!~,J .................................... . (as on the tax roll or latest deed) i 1f applicant is or or 'on, s( t duly a~uth~orize~d officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No . ........................ . Plumber's License No . ....................... . /~,~ ~~r~,~~,~y. Electrician's License No. .~~ ............... ' Other Trade's License No . .................... . 1. Location of land on which proplo/s'ed work will be done. . ~;1~ . ru'":~. "":'Dx•"'. • ~' ~ • • • • House Number Street ~ Hamlet County Tax Map No.p1000 Section ......f~/.......... Block ..... ~~........... Lot .:"~ ............... . Subdivision . ~:~. !~~~.. I~ • -,/Ugdd,~s (~iT,Clat3.~i~+:.. 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 .....//.// ............................................................... .........~~7 ................................................... b. Intended use and occupancy ... v~ ~~'/ 3. Nature of work (check which applicable): New Building ..1/ .... Addition .t ........ Iteration ........,. . Repair .............. Removal .. , , . , ........ Demolition .......... ~ ...Other 1~ork .......... , ... . ~, (Description) 4. Estimated Cost ..... ~.~J ,,. P.°~.' :........ , .. .. Fee • • ' ' •(to be aid on filir~ this a he . g g . "...... , Number of dwelling untps on each fl g pp ation) 5. If dwellin ,number of dwellin units , . , .6„uL ` ~ Boor ............. . If garage, number of cars .. ?- ...................................... '~ ......... L ................. . 6. If business, commercial or mixed occupancy, specify nature and extent of each ty'~e of use . , L ........ . ..... . . . 7. Dimensions of existing structures, if any: Front ......... . . . ... Rear ...... ; ....... Deepth ........... , .i. . ....... u.I..... Rear G3 3' DLnensions'of same stivcture with] alterations or additions: Front ~3 ~'~ ... • ..'• , , .. , .. • y, • • • • ~ , • . p / ~ Stories ... I ....... . .......... . ~ r ...' ..... . ............. . 8. Dimensions~~ ntire new c Number of~Stories ... (,!L. , , .. ' ; ', •RearNumber of ~ / Height ~....... D~pth ............... 9. Stze of lot. Front ...,// •, t ............. Rear ...... 7.k........ . ........ ~ .................... Name of Former Owner Depth .... :? ............... . 110. one or use district in which premises are situated ........................o .. 12. Does proposed constructiop violate any zoning law, ordinance or regulation: ~.:, ...... . 13, Will lot be regraded ° ..Will excess fill be removed from prem~~ises: Yes No 14. Name of Owner of premisesWi/(n.., °~+?+?!r" ~q~,wti~/~l, Address~!fF. ~~rrery,v.. ~• P$o~}elNo.. 1.5. y-. ~ °.~°,~.. . Address ..... ~'''" °"`" "' • ....... Name of Architect . ~ ..... ~ • • , .. • 4• • • • • • • • • • /e a-~ 6!e„ ~ ',Juy~ ~ Yhone No ............... . Name of Contractor ..r./.~at~ +~"~aS..:7^.... , ...Address ....:......•... ,J11.`'.. Phone No..?`~ !~''~.. . 15. Is this property located within 300 feet of a tidal wetlands * s ..... No V.-... g Ye *If yes, Southold Town Trustees PermitPLO~ DIAGRAM ed ~I ~ Locate cleazly and distinctly all buildings, whether existing or proposed, and indicate all se~-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. ~~ i I iTATE OF NEW YORK, S S I~ II ~OliNTY OF ........ • • • • • • • • • • • . • • • .. • being duly sworn, depo Jy to +r W~ ~b~+• I/ ses and says hat he is the applicant (Name oI' individual si nin contract) ibove named. /~ ,~ i ii (Contractor, agent, corporate officer, etc.).I ~f said owner or owners, and is duly authorized to perform or have performed the said work ands to make and file this pplication; that all statements contained in this application are true to the best of his'~knowledge and belief; and that. the vork will be performed in the manner set forth in the application $led therewith. ~ i lworn to before me this _.., ~k ....~....:~:~': a : a.;t i' ....'flay of .. ................. 19'.~. ,~.,. _. dotary Public, .....~~~ ............... . ~~~~~ LINDAJ. COOPER Notary PuDllo, State of Naw No. 4822683, Suffolk County ~ Term Expires December 91, t8,_ County j ($ignature of applicant) ~_ i ,' t Ir (~ C.~ t>? c`~ ,. -z. 80 ~ "10 65 ~~ ~~~ 53~tlE. 230.0 -_ ---- -- t = i Z i 1 ~ app'. f r Tt~ ~, t ,, ~t ~ ',' x ~ ., Y Y /, f- ~ .~ c' ~;. -p --. S'~ , `,~~ ~, M/n/ i ~27,G ~' -~ -, .,f ;_ . ~„~ J.. ~ `' PLE E TE ~. `. '` penuirnn nwn~L.. \ , / / T'CiWN '.7~ °34L-T'Fif~ L t~, t~t~{ \~ __.. SUFFOLK CG SINGLE FANltLY.pW~~,~. ~ ~~ ~XPlRES TY1/p 1'~ARS FRC~I DA7 r~ v :~ ,APPROVA t ~ 'Y`~ #iava~L y 3Tl] 4i i'.i 4 ~~ l ~ ' . ~ ~ R~.M z c ` ' '. ,c , ; . WAT1FIaF ~UFPLY ktiD SdWAlif DISPOSAL »t~ , 1ri'~It TNNj RESiL't!~NCE WlLI ~L,1.~:L,T w~t ~~ ~ TM[ ~=. ?~- t m` R-FPK-eWRc~i S S u -a~ ;r ~ ~ll.P~t.L . __-~ , ~ -\ ,. 1, `60 ~~ i i><1 SUFFOLK COUNTY DEPT. OF 6{EAL' SBRVIC[S -FOR CONlTRUCTK?N ONLY A'P OV ~ r (/ DATE: ( H. S. Rtf.170.: ~ RPPROYfD: l ~~~g~ ~ n K CO. TAX MAP D~NATtON: c~esT. s~cT. sLOetc PeL. :1~ _ LI 1 _ .J t . 3 sJO W1NU°S Y~(AY Buf1..p1NG Co2P. ( taza Gtr~tJN tZaga ScuS't10L(j; H. Y,. rf 971 LSIb,)'~:.6483 7~- t33S +N+a+~4.r.~ri r. ~r 7 ~,.-# ~ e + P. N~~ µ n~a .~ _ r ~v'.~ reu,~... .C'c ~ . ~ - _ ~ ,ii y~ ,~~ y ~ i~ HF na~..c^^..~~ ~ 'e ~'S1CarBc :T' '~'.~4" M UU,a valiC iru3 cc>ay. UN8nt83Y ina~i.-3S?~ h9:BCln 4hY1f {tot y:9o thanwrxOn iqt whom the aUP/M ~~~.d +SI i5f6paraC. a?rd an fiis 3ahaM to iha .~ - . ~. - ,. oomDany: gCwPnmwn>n~ .~~a-.-. ny:. iqP may' .,. ., QAM~ AL to 9i .. pF NEyy ~Q AV~I. ~P ~P~GK ~~A~v yQP h pF', ~' f G s ¢ .% t < ' r O .. nF2sF. CS 26~'~~~~ 17~ ntn,,- :. vru +on •~ Ct ~v~ r i r~ ~• 4'` i_ ( ?~ ~`\ r,w t O. it _~ _. _ ~~ _ 8~+ _ ~S • ~ U ~ 'L9 ~ i ~ ~t~ , T ~ y \' _ ~ N76~~3~ ~. ! i t7 i ! ~~ i ~I ,~ Cv ifZ '4 c , `'~ ~ ' ~ ~. ~, ~ ~ ~ ~a ~` ti ..~ ~ ~ 1 ~~, ;4~ ~ ~ , w ~~.~ Y 19 _.. (S1 , .i._ ~ ~. ~ by~ W"ELt, y,~i 75 'TO o5 ~~~L.Ji ~ ~ `. 230.0 ~a _---- ~~ ~ O , ,~ lr 1 tC1 I ~, .. N - ~Q _. i ~1 ~ iv'1A~ ~p~ NttCt~~~.~`Y T frf as ~~ J 3 ~~jV • r....l~..) ~.,.. ~ . '.~' F17 is f ~~', ~~k~Jf N, >{v. l: ~t [7' TEIEDYM upST NB,?T9 _ ?~-1,i ~' 1 ~ ~, /•~ .V ~r--_ su t ~i~.ev wci.;. ~~t ~1 PDl1F'. WELL ~~ F30 L i-'{ZOV F:r~t. ~`.;, SUFFOLK CO. HEALTH DEPT. APPROVAL H. S. NO. V ~ ~ l ~~~ STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOW THIS RESIDENCE WILL CONFOlfM TO THE STANDARDS Of THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. ~~ APPL (CANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE H. S. REF. NO.. APPROVED: SUFFOLK CO. TAX MAP DESIGNATION: L DtST. SECT. BLOCK pCL. I~ III 11 3 - (J .. A r~ F l L t::i ;.~. F-. >^; a ~,~ : 1 :' Yi i~FJ)~4-Ci7~~ ,'p5"_ ~=fir DEED: L. is :- P, J .' 1- i', :;aQf j ~~~,i ~ ` i z. -~' Nt?~. ~~~~ ~U' •.~~c r. r~ • ~~u ~I N r j ' ' ~ :. O A M „ ' y v a c ,sine __ t C~.lj~ ~?~ U~ J tE~ l: a hl ~~ C~ a , SANG 8 ,.. g!,zs ~ ..... ~ . ~~ 3 CTF~t~ ~ MTMtP _.. 1 ~ .~ ) 44 mthem _ ,.~, ,.. , ~ otl ~ _ AM . - ~~~ ns , ~ 2.C0~1Tp~r~ ±7.~~'~ "rC7ME.M,t aE'!A~ L~ V~L. _ .. ~h : ,„ e ° . _ .. f,,. µ - ~ ( S_b89 n4 .,. Jt : _ .. ~ ,.. MAP [p~li -R3LY ilk ~~. ----- ~ cGEa>2.~ E _ _ _- ___.___ S p N QT - ' F~~~;\ ,~ ~,~,~q 'C%'' °~c --~ •y ` ~;; iL~tJME~f#"~ ~ RICK VAN TUYL, I~,C. ~ n~ ~ ' 4~_ia~ ~c ~ ~ LtGEN~DLAND~ ..~• \~La.~!osi GREENPORT NEW YORK ~I/C, '4`~l _ \ r ll t' r~ i !, ' ~b in- t ;;' --~- _ 1 ~ 'r/F ~L i i p O_ 'i ~ ~ ~~~• F'C~ t_ _ _ \., c -~ C ~~, `~, '~ ` } 1 ~~~ r ~~~ ~~ ~ `iZfi ~33~ E. ' 23GA ~F. `-_ ___ .~._..___ _ C E~. ~ - .. __ _ _ -_ ~ v~~ ~-. _ - ~ -----------.-_----- ~ ~q I=+T ~ i ~ mi __ „ µ~Z~ t~o ! } ! WFLL - ~ ~ U' k } i ' t., ~ ` -i ~, f 9UFPl)1K ~yu 1 h b .. ~ k - • ~ ,•t~JF, +;J 1 ~' :r"~ ' ~ `; ~~-, .-- ~,, W tc , ~-aee" . S~ __ l ,l- , ~ `' ,. 5.66'~33~ ~,( ~' 5a • $`L '- ' ~ ~'Li. tir.,lr Y wiEuNet,.::'9 _ - ~TG~ t~~ . ~ ~ a2. ~•J ~ Th Sftri z ~,~ :: f ~.. g :~ ~ kx r ° ~~ndarari/3r i ~ Ci!i~k~ €iareaa d YVaatewater Munagernerrt , v \ ! Y ., ~~~. ~~ ~ , ~r ~; PIZQi? P;.7JL ! P1~~5 ; ,~ L:CL}'Y ti~a~.~~=~rz, rr~~MAP+,'3F 1 •~ r v-_NA:i5AL1 ~lev r 4 ' ~ ~1,i8 F%(~Z2G~Gt:7'I ~~v~i< ~ 4_Ir~ ice- ~~1i=F". .k:'. ;~ 2.ce?I*ir.,~tf~, ~~~;~ `~i -~iC:~4~ ~ r,A L~u~L _ _.._ ~i«VE YL1- Gt~l..' ' .. ~ / rzl MttiP AM~fi11'3E~ -JLSL'/ E$~1988; laE C. ZO, 19 8 8 . `-~CA.1,E - ~ l Q-' YE' e C7'.IUE"'1L'.!`2~- rtfLE"h°.2I,Gc~S, F ~'~~i~ :~~~3 _ iYl !yl R R C YAM TUYL, LICEMSE~ I:Ai~ YBYdRS GREEMlORT NEW YORK SUFFOLK CO. HEALTH DEPT."APPROVAL H. S. NO. 8$- 50 - F STATEMENT OF INTENT THE WATEI! SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CyO~NFOR'MN TO THE STANDARDS OF THE .77,IFFOLK CO. DEPT. OF WEALTH SERVICES. Est AI'PLICAN7 SUFFOLK COUNTY DEPT. OF HEALTH SERVICES - FOR APPROVAL OF CONS7RUCTIOpi ONLY DATE: N. S. REF. NO.. 9 ~ "' ~ O -- O APPROVED: SUFFOLK CO. TAX MAp DESIGNATION: DIST. SECT. 9LOCK PCL ~ IOQ~ ili 11 3 'iu W;r~t :^ }': lh'!L3li! .i!it1G , ~.~ - :Oi.G G, titled 1L~:hll i S16)Zg4-6fJ$3 oS^ .. DEED: L. 3.l ~, P. L4AM g.' „ .., S AN L?y ' ~1 I. (7 .y tiZ - t.9 . '~ . O K J I ~~ i~, i :x~ .c, .,cstz ~. d13 iL:.. ~!~NU t -- ' t: ~t.,: ~. 1 I • ~ r,= ~