Loading...
HomeMy WebLinkAbout20182-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28263 Date: 03/08/02 THIS CERTIFIES that the building NEW DWELLING Location of Property: 1915 MANOR HILL LANE MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 108 Block 3 Lot 8.2 Subdivision Filed Map No_ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 19, 1991 pursuant to which Building Permit No. 20162-Z dated OCTOBER 2, 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 MOBIL HOME WITH ONE CAR GARAGE UNDER AS APPLIED FOR. The certificate is issued to JOHN A & PATRICIA C ZURAWS KI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91-SO-61 11 20/96 ELECTRICAL CERTIFICATE NO. H 026077 12/26/91 PLUMBERS GRATIFICATION DATED 03/05/02 JOHN A ZURAWS KI Au o z Signature Rev. 1/81 cosec xo. ¦ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 0 2 01 8 2 Z Dare ....14.~~ 19.~~.. Permission is hereby pro tad ~~..Qr..~....~~r~..u.~' ~.RCI.....:.:....... ~J ,....y..... i .y. ..~~y~s~L.....~c~....~.~......fr.Q1~ ..~....~L.........~.-..~...'~.~. . . . at premises located at ...~~~5.......~J .r.....~:.~~.....:- ~•`f•••••Gfl?3r.~.... . r ...............~2~..... ~'f..~?.~..-..................................................... . ...........................................................................pp.................................................................................... County Tox Map No. 1000 Section ~.J....,1Q..11........ Block ......:3.......... Lot No........fJ...!...2.. pursuant to application dated .....,I..~,l~ 19~~, and approved by the Building Inspector. Fee S.s~.l(x.'. ng ~t Bu I or Rev. 6/30/80 - - ~l~`-~ ~ ~ ~ Form No. 6 TOWN OF SOUTHOLD ~ I` ~ ~ 1'~n f~ BUILDING DEPARTMENT n'.~ ~ ~ ~ ~ ~ 4-i i ~ j TOWN HALL ~ 765-1802 ~ ~ ~ S ~I ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY,. J This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. 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 Ilealth Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Swom statement from plumber certifying that the solder used in system contains less than 2/10 of 1 % 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. Photocopy of Certificate of Occupancy - $ 0.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. ~~(r a~2 New Construction: Old,o/r Pre-existing Building: (check one) Location of Property: /9/SmW710ltgi//~1G ~V/PC~~~ ~f7~(,ie House No. Street L Hamlet Owner or Owners of Property: Sdrln l`22-~{'1Cl a. ~YQ c,JSkl Suffolk County Tax Map No 1000, Section ~0 g. Block 3 Lot p • oZ Subdivision T(,~~'S f3CyGS Filed Map. Lot: Pernut No. ~0(Q o2z Date of Permit. fo~Z ~4/ Applicant~Scs.~xL l Health Dept. Approval: 9~~~_ Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) ~RJ Fee Submitted: $ ~5 7 l J pplican ature I J S ~o~gpFFO[,~~, Town Hall, 53045 Main Road 0 ~ Fax (631) 765-1823 P.O. Box 1179 ,j. Telephone (631) 765-1802 Southold, New York ].971-0959 ~~l ~ BUILDING DEPARTMENT TOWN OF 3OUTHOLD CERTIFICATION Date: ~G-l~e~ .5 , ~ Oa Z-. Building Permit No. o~©~ ~ ~ z Owner: Sohn A k^d ~~'/Gray-C. Z(~YQWS}C/ (please print) Plumber: ~~EIYI , J1Y >~1 (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ~_s r~ lumbers Signature) Sworn to before me this 7 day of ~11 Q'2tl ,,~~201D~ Notary Public, ~ County ~ ELAINE M. GAR Notary Public, State of New YorN No.6G46163 Dualified in SWk/i Gygeq, Aston E4iec Mppt 7, 0700 ____.-w.__ . ~ ~ _ -.~~^^.T T.. _ o/PJ~ PAGE :t s ao,.v,tF~ Tli~ NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY JOHN STREET. NEW YORK. N~wy Y~RK 10038 DECEMBr'.R 26.191 07.437„9Y/91 N 1)26077 Uate Pti!~tlkrl~i°Nr~'.°• ~t><t.442 THIS CERTIFIES THAT only the ahctrical equipment v described helots and introdtscad by the applicant named on the chose application wumbsr in the premises of t ?4HN A, 7,URAASRT, PR I4 ATE R0. OFF ~;VE;RGkE:F.N, CIITfHGC.+iIE, N:Y. = Otl'k' 3 8.00) in the follotcinq 1ac~~EHB'F.it ~f,"~l ? /st FI. ? Ynd FI. Srrtitm Block Lut user examined an and found to 6e in coetplianee with the requirementr of ehu Board. RXTUN TAgB fW1TC/K!f RXTURES COOKING WCKf OVENS DIRt Mf AUST FANS OUTIETf INGNClfClNT FlUGI1E5CENT OTHER AMt. K. W. AMT. K. W. NAT. K.W. AMT. K. W. AMt. N. P. DRYERS RJRNACE MOTORS IUTURI AMUANp RfRIXiS fNOAtREC?T iIAAE CIOCKf ERl UNIT HEATERS AtUUFOUTtET DIMMERS AMT. N. W. Oll N. P. GA$ N. I. AMT. NO. A. W. G. AMT. AMP. AMT. AMPS. TRANS. NAT. N. P. ~ AMT. WATIr SERVICE DISCONNECT NO.OF f E R V 1 C E AMt. AMP. TYPE ~ 1 ew l / ew t / rw a x Aw nitdet»io. re c~ 2oiro. No. oP N4uc a ~ HI No. a NluTxus or i~Gmu I I;o cB t x 7 +rn i sin. s OTNER AF?ARATUS: z JOHN A. ~ P.C.7,CCRAWSK"[ P.O.BOX 79 NORTH Rll, - _ PFt"ONIC, NY, 7.1958 pENERAI MANA94 71 Q Q Per GV - This wrNficaro must not be oRarad in any maRnar; rNUrn ro tM offin of tM Raard S iatorrect. Inspectors may bs idantiRRd by Moir ctedeMals. _ Clihf fOR WILQWG 6E~ARTMBIT. TFBf C~1f OF' CERt~FFGTEIIKIST N0T' BE kLTERED fN AlIT MANiER. OTC a 765-1802 BUILDING DEPT. INSPECTION [ FOU ATION i5T ( )ROUGH PLBG. [ FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL . ~ REMA K5: DATE INSPECTOR l~L-~ 7sS-iso2 BUILDING DEPT. INSPECTION [ j FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ] FRAMING [ INAL [ ]FIREPLACE & CHIMNEY REMARKS: P I DATE 5~~ INSPECTOR 1' J i::S. ~ . iJ:i - I~ .:~Yi9LNT~ i. ~ ~ _ m ~ 'OUIJDATION I ~ (1st) 'OUNDATION (2nd) `o ~ ;OUCH FRAi•JE & ~ ' \ PLUMBING ' S~ y I. H :1JSULAT20;1 PER N. Y. I STATE E2IERGY CODE I , ' 7/[ ' ~ ~ • J H~ I • FI;IAL I - I o T ADDITIOPJAL COMMENTS: m x ' o~ ' ~ , x H . 'v 7] a \ p ~ . x _ } \ ~ z r1 o ~p H ~ ' _ a i BO,1RD OF HEALTfi f - ~ FORMN0.1 3 SETS OF PLAaS TOWN OF SOUTHOLD SURVEY _ _ _ _ _ „ ; " " " BUILDING DEPARTMENT CIIEClt . , , _ ~ ~ ~ ' ' ' • TOWN HALL SEPTIC FOR:1 ~ ~ ~ ~ ~ • SOUTHOLD, N. Y. 11971 TEL.: 765-1802 ttOTIF'f~ xamincd ~D ~ 19 CALL . htAIL TO: .pproved 199J. Permit No..o~.U/~ . Disapproved a/c _ . .......~D~ ~ - (Building Ins cto) , `S~ i{ ~~~~i ','APPLICATION FOR BUILDING PERMIT r~ _ TOwBCp,0 ~l 1 Date Se.P r. v~O~p ~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 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 areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- tion. 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 all 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 all Dave been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the gilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ~gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ie applicant agrees to comply with all applicable laws, ordinances, buil g code, housing code, and regulations, and to :mit aut}torized inspectors on premises and in building for necessary ris tions. - (Signature of applicant`"'e> t~Poration)... . (Mailing address of applicant) ~15~ fate wltet}ter applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. O•w t1 CQ.......... . amc of owner of premises . S(]!-l t\1 • A,• • r?• • 1'AT2~i~,,~ A G . Z1.~2 q~~ ~ as on the tax roll or latest deed) applicant is a corporation, signature of duly aut}torized officer. • 'ame and title of corporate officer) Builder's License No. ~ lA, .Plumber's License No. ~ t~ Electrician's License No. N~A 11 Otlicr Trade's License No. N I A Location of land on which proposed work will be done. . ~ I V (aTE ~Qq~ Ilouse Number E..~. N : / U . Street Hamlet County Tax Map No. 1000 Section Q~. Block ~ Lot a. . Subdivision 1 .l~T~.`.,~• • ~2:~~ • • . • • • • • • • , • -Filed Map No. .tP~Op (Name) Lot . State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....~l ~~•:~f~'r• • L,~;n~ • . b. Intended use and occupancy ...~~5~ ~~e`Ct~~t=}l.. 5~ , ~ ' ~ , Y.. . 3. Nature of work (check which applicable): New Building Repair Removal ' ' ' V • • • • Addition . " • • • ~ • • • • • • Demolition Alteration , , , , , 4. Other Work . , Estimated Cost ~U~oGY~, (~Q • ' • • • • • • • • • . . Fee.. (Description) 5• If dwelling, number of dwelling units ~ (to be paid on filing this application) If garage, number of cars • • • • • • • • • Number of dwelling units on each floor , . ! , , , , , • 6, If business, commercial or mixed occupancy, specify nature and extent of each t Dimensions of existing structures, if any: Front Na N t • • • • • • ' ' ' ' Height . , YPe of use , , , ,rJ • • • • "'•'••••••..NumberofStories..,,,,• •~•'••••Rear Dimensions of same structur,, with alterations or additions: Front • • ' ' Depth . Depth 8. Dimensions of a tire new construct on~ Front ...7.(~', , , , , , , , Rear , • • ' ' Rear . ..Number of Stories , I,i _ Height , ` , 9. Size um ber of Stories , l ~ ~ • • • • • • • ..Depth . • • ~ • ' of lot: Front ~u~a~ • • • `t.`. 10. Date of Purchase . ~t.L}.~ ~a Rear 4;,~• • . ~ . l.ci ~1, , ~ De th t ~ • • • • • • • Name of Form r Owner K~~:+(~`Ri. 11. Zone or use district in which premises are situated . R,~'SidEhr,AL p ~ ~p • • 12. Does proposed construction violate any zoning law, ordinance or rem f~42 • ~ ~?~N, G-a-• o ~ i C L ] 3. Will lot be regraded 1 • ~•ri..l2 C.. bulation: I) ~ . 14. • ' ' ' ' • • • ..Will excess fill be re oved~from • • • Name of Owner of premises~Nf1 ht •l, ' ' ' ' ' ~ R Name of Architect Address ~,~~x7 Premises: es . ills. ....~.keq~~ q.~.. N!~-. Phone No. 73~-.~r-(3 Name of Contractor . y ~ w • • ~ • • ' ' ' ' ' ' ' ' • • • Address • • • ~ , 15. Is this propert within •••••••••""'••••Address ••.•••••••••""•••PhoneNo......, Y 300 feet of a tidal wetland? Phone No. *If Yes, Southold Town Tr y *uired.~ ~ ustees Permit ma be req ~ PLOT DIAGRAM ' Locate clearly and distinctly ail buildings, whether existing or proposed ' interior or corner lot. ~ 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 whe ther (,c.~J i ~A iL C~c- ~'EiPTi Fi c ~=l T/O~ ~_~~39 ~ ~ , ~ • . - _ f ~ ~ - fat. CG~+c7~UC'~';. ~.>A; ~~ra ATE OF NEW y K ulv~rY O ' . 1,4- S.S (Name of individual signing cont~~~~ ' ' being duly sworn, deposes and says that he is the a ve named, pplicant sthc •~,(J »d owner or owners (Contractor, agent, corporate officer, etc.) ~ • • ' ' ' ' ' ' ' ' and is duly authorized to • • ~ ' ' ' perform or have performed the said work and to make and file this ication; that all statements contained in this application are true to the best of his knowledge and be ' will be performed in the manner set forth in the application filed therewith. n to before me t~hi{s ]ref; and that the ~C! ~...~day of .,19~~ • CLAIRE L GLEW • • ' • • County ~Y PuDUO, State of New York ~ ~ / ~ No 4679506 ~C//~~~~~~1C~ ^Ified in Suffdk County • ' ' ' ' ' ' • • • • • • • , Expires December 6,1 S 9a~ . (Signature of applicant) 1 _ J ~Q J = W F-'`~ f' Q ~ W W ~ J W J QI O ~~Sj k , ~ ~ ~ O ~ W W O S ~l ~ ~ ~ ~ f J J t) r L ,s r ~ W 4 ~ Y ~i~: d W „ O ~ ¢ ~ Vl ~ Q = W ~ m ~1 } y ~ J~ ~Ny~ o Q ~ ~ fJ°,a a ~a ''0Z x ~.V tiF- oJ. UN~ O U p Q~ W Y. J ~ N W ~ Q W V Z O ~ J ~ Q ` ~ O - ~ L ~ y` ~yi ; L I ti O Q~~ J J-~ W IL ~ ~nl J Z 7~ Q Q Ii ~ ; W WO WO in O > ~ W ~ ~ W h k W C3 `n ~I k r ~ ~ ! i V1 'Q : Id ' - ~ UI D V! U N N N U ~ I Q ~ i ~ Q Q ~I I J O cis i O , ~ ~ z ;LJ ! t r! i ~ y' _l ~ ~ O ~ ~ WQ ~ '~f 3 Y.iJ j ~ ; W d t ~ ~ 0. ~~M ! ~ ~ 1, ~ ~ < r x a Q (Ct i , ~ , ~ J O : ~i u ~ ~(bj / ~ - 1 ! j r 1.]~p 2 w' ~ ai L3 l f-~ ~ w R! ~ f j117 '3 ~ ~ w . ~ ~ r-fir i~. ~ ~ C~, , v,A ~ lp i ~ ~ ~ ~ _ - ~ . G ~ ~ - _ _ PPP L { ~!Q,~~1 ~ ~i i J ~ 2S'9Eb ~ _ - _ _ •M. Cat 6192 . _ u, o. ~'~~~yy ~ ~ ~ F 1 ~ V J ~ N ~ ~ ~ ~ ri ~ C O Q I ~ iy r ~ I `t v ' ~ - / ~ ? Q ~ ~ ~ O ~ 7 I s ~-I ~ ~ > ~ ~ ~ i ~t ^~i E Q, _..i ~ ~ ~ ~ ! N _ ~ tY ~ l ~ ~s•rb~ ~ :a•?~~,=1 ~o - n~. cz of ~zr~ ~ . F - - - ' , , - _ V ~ 4 _L I I - _ % ~ ~ ~ ~ ~ ~ ~ ~~r ~ ~ r Aa ~ s Z y v= g i > ~ o J J W vj = tt i ' J Q J ~ ~ f"'O ' s _ O _ ~ F ~j ' W O ~ 2 J Q d 4) s., Ci ~ ~ ~ ~ a al~~ VY L tc, N W Z ~ > < ~ c _ ti~ $ ~ ~ c .`c , 53 Q~W F t+' ~ r, < Z ~ W D Z Q O Z - ~ ~ E`xc~ raLC`;'ma ~4~~~^~r~` ~ W Z W W D W f. d D ~ l7; ~ ~ ~ °5 ~ W fr' c ~ m ?a ~ ~ dp ; ~ Q 0 ~ Yn ~ Z = d r J `f ~ °u-; cf ~ r ~ r:- ~,,(h,/c'Oa C Jvi f-Q O } ~ ~ D 7 ~ J N W lL F- O d u W U Z D Y QD .h; J ~ ' i li Q ~ ~ J J - Z W > ~ t!1 J Z t.~ t' Q .~t O~j Q _ !i 3 W O O of O > ~ O ~ ` ~ J. , . ~ C D ~ ii 4, - ~ rn W ~ D _h W D c ~ al +J i - a 4 , . ~ n , ' F-~nu~n in~nuD=< ~ p ~ - - - _ ~ ~ ~ V?~ ~ Y V } ` ~ 2 I ~ ~ O ~ :::1I~,~ W .iS ~ S ~ Y~ ' ~ LIL.~ L~ r ~ - } , ld ~ ~ Z~ ['1; ~ V y i_ ?61 1 ~i ~--'~t`~3--- y W ~ T n ~ i .t 7 i Z to V W d~ ~ r N ~ ~ 'i n 4-~ J d - Z ~ ~ t_:_ ~ > ~:3~~ 2, y~ ' - ' ti ' ~ '~i -1 ( - ~ Q ~ ~ W ~ -t Off' 1 _ 2 s s ~ ~ +n ~ w ' ~ ~ N _ . {i S] Y ~ ~ i ~ ~ 1. Y' L ~ J Z O L ;V Z m ~c--- ~ 7 J o G ~ of - - O pt ~ - ~ - u~ ~ n ~ - ~ ~ :661. l r- ; ~ ~ r: , N ~ S _ ~ n, . ~ '~i- ' ~ _ ~ m - .n . ~ +9r •r Snp `~4` ;G) ~ 1, z - ! - - _ _ _ f'N~'10, a t ~ J J~ ' ~ J r /~~I } v `S ~ 1iI ~ - W ; j ! j ~ ~ v C'~ ; fr' Y I (l ~ ~ .,,1 ~ ~ ,gyp _ i ti Z '__.4-. c ~ ~ ~ ~ r [[ill i ~ • f s ~ ,~.J ~ .y ~ i I hr ~ ~ i~ t Y- . i _y j; ~ i ! - ~ ~ _ _ ~ ~ ~8'16b ~ ,fir. - _ _ _ _ - - ~ ,l Gui ~ '4~ ~ ~ K ~ Q- Q O / ~ < / o x _ ~ ' Q J= N i t _ Y) > ~ n o u a~ ~ ~ .J ~ ~ Q W \ z- ~ d 3 IIJ ~1 < ~ W a' ,R ~ jV W C ` > ~ O ~ S o °a I^ ,I~ _ m f+ u S Q Jp J ' ~ ~ V ` V, O ~ ~ ~ 1 ~ ~1. I. ~ ~ ~ ~ O ~ U F, L ilgJ T S qi ~ S .Y iii ' ,4 ~ W > H. W F- F- } O Z ~ IX p•fC` I ~I VVIJ.v c;c W a u b na~"s~3 a < _ y F- ~ ~ O of G ~ L~' O < ~ O O J O ~ u ~ Or ay ~ ~ I (1 i - - -t.. V O i F- O a. to F. ~i` J f N W Q ~ W V Z. C~ ,J Q ~ s I, O r 2 , s ue G Fes- ; 0 F- Vl ~ Y I Y V ~ f~ W O N 1 ~ I C' ' ~ , I ; ~ y L _ f i ; ~ cn ti ' 4+. li ~ N W rx ~ I W O W i;'` . ~ v, ~ ~v}i~ Vhf tntnOVQS< p ~ - (r~:~.._. ` _ ^3 ~ ~ ~ . l ~ } V 'u ~ ~ f Wi ~ ice- ~ } ~ ~ ~ ~ i~ ~ ~ ~ a ~ yam. ;i 0. ~ ~ . x ~ . r _ jT="_- u t ~ ' - M - r; :.I y_ Yi . y ~r ~ v ' y i~,}y rr 'r ' a-~ ~ 5 }I ~S r~17{ ' r~ , n f ~ Syr} , ~ \ i J w ~ h' _ _ / `>.7r ~ i i e ! is < , ~ ~ ; A t7 j ! I t ~ ~ ~ n y~ G,3 ~ s. ` ~ l~J ! ,~tib I i Q~ ~r,._.._______... ~ _ _ _ /v~4Z I y 92'P-i ~ z ~ o ~ ~ _i z ~t'.~~ c>rt Via: o~ ~ ~ ' 4~~~ ~7t4ft'e3;.~J.,~G ~y~,. - ~ ~ 3 s ; ; / i SUFFULK CG HEAL `N UEPi APPRQVA?. t5 I~ H S NO '~I-',~~8{ , . , c / _ ,,a4. ~3 kA I STATEMENT OIF INTENT I'ii' f THE WATER SUPPLY AND SEWAGE DISPC~AL ~ ~ ~ S. O P CO ~Q~, ` - + c - _ r r0 ~i, ~ SYSTEMS FOR THIS RESIDENCE WILL y y '~t \ Qr3~~ r,y . I CONFORM TO THE STANDARDS OF THE i j I ~ REL,t~11~5 ~ ~ ~ ra 5UFFOLK CO OIPT. OF HEALTH SERVICtES. ' r .~~A ~ _ ,r.._•_-... - - ~ : ~ .'Nr9 -wE1.L ~ rr ~ Isl APPLICANT ~~~.~~~_~v~ i i I r t ~°~r~ ~ 9d ~ ; . ~ ~ SUFFOLK COi1NTY DEPT OF HEAL H ~ pp I «r ; - ~ ~ SERVICES -FOR 1PPROVAL dF i~ ~ I Q' ~~j , ~ 5.s~wk t~) ~ CONSTRUCTION ONLY ~~T~~~ I~~~_ ~ ~ ~ Il ~if . p ~ , ~ ~ I ~ C~ ~ DATE. ~ 0 ~ ` caoo~s 1 ,i ~u H. S. REF. q0. 91-x'4.81 a, 'R'3W~t,~~'`'~;~`f~~;~U,r~1Y. ~ ~ ,o' ~ APPROVED 3 ~ ~ t ~ r SUFFOLK CO. TAX MAP DESIf3NAT{ON. I ~ l~ ~ i ' ~ ! ~ r ~ -r~~; •r ~,G,,~ DIST SECT. BLOCK PCL . ~ . a ~ , . . _ ti . N f _ r00.~ ; N. OMINLRS AooRE'3S; ~ i n~401~Fl~~.~, - I~f~rtGA?'~ v ~ -r~• ` ~~.'_1 . , '~tnr iJ~N{:.~t~vt','Dj' . ~ hlUt~Tf, ~A~ ' _ _ _1 ~cT' I A{,63'~QdO E. -15.0 '.5.bg W. 25'. QAP~ ~ 4,4~.2~`' PECc~NIC:_N.~'.11 ' ~ B t r j ~ ~ ~ t ~ I • } DEED: L. P. ~ 11 I ~ ~ 2~ ~ TESt HOL STAMP ' aV ~ `n , i O~,j.~ ANuiJH~iATA t9 ~ i!'; l ~~,1.~~?~.~ IhuNlbdzedeheretfmaed~ ~ L.... ' , ~ t^~c to Nis survey Is a violation d I (r ~ VAS. ~ r 'ti ~ {C «+I ~ti ~'.{r f" f Section 720tt o1 Ne New Yah Stet. I ~ f ~ ~ ~aYR'~les~~o~Wfi.7r'i: ~,~a°M~?#nu. EduaelgnLea t Ly'.~p~/~ ~/~y'~ryy,~yi iJ~:+'~T~'::~TO •R I~~Y{~$ ~ ~f r f~~l;_ I~ ewe rrtr :ah~~.,~ot , i YM` ~~/1/~-~ { //11 cc/~~~w~~ t'IE lfif ti"~Jf~SC £'::i.1 Cf '?1V'~+ +•~~U'~1 emb~s_.r.oW 51'all no. be CU^akraal ~lA~ ~ , ~ ~ f'~~i~'Li`Y~ RFFC~k TU M~AI''~ :EA :~C.'dCL aoee,-::c(n.,a~K ~~r{S3}1~fQat31111C!!b ~y ati~ GwrantEesindicetedhrrea~she!Iron 1~~~`~IIAA11 ^ ~ / f Nsh_ only !orbs persor•for whom nre~ r ' t!tly~ ~j ~ ~ f O 6 Ajri(~ ~ ^ a pm;,ved. end on his belraNe su Ft ~.7~ ~)r~~i - ~U~f'Q{. k. .0. 'f'~IX-11{0. Ii~G`U'I ~J~l~.' d' Ne ~ I„~ _Y.~1~~.. j ~eferompany,gavemmentalapencyerq ~11` ~ - bndinb+in5lilclion listed hereon enA I ~ .'~WJ Y .I weI~~1~M li bNe daSl ~ ~ ~71lri~~f.o''`4!i ~ ~?laC~ ,+311 {f1Sp :.AND Guar~ar~teasf are bndY>B hdb s`~g t7§jIA4+',+19111 Ci 4t~8r IIQMIOIM mb". rotuuubn6l~ b add[igiel i,stBrAbns awGaegwlll . , ~ 3 sated (;W`d s;~ bQ.1eS~ffac~ory. 0M1"'a ~ SI~}~11Ar1 A: Caa~ F.~., Cold ~ ; ! L: +ai~l~tJ it G J 7'~3. _ OF . NEry i Ollbe a!'~l~i~r ~1d W8st9WS1W ~ ' S ~ IJi"~; r. ; tr; IJp'l,lE7 ~ir1,.., ~ ; # ; ~P ~Q~~;c vtiyl a \ u.~A~.~E ~~u ° _ r~gM~. ~~~_,~c~ raw r~,r~~_ t~s~:;~l~~ ~ ~ ~ ~ A.3E'gt _d~ tJ.Y_.,1rJ G. :rvk'JE'~!E:v - _a~'~.8 i~j * s ` ~ * ~ a N I 11 ~i~.I'~4~"N I~'i~.ati;T ~ - RO ffRICK YAN~ YI. P.C. ;i ~ i ~ ~•w - • ~ ~ i 0 i ' r~Q. ~=th1~ "yli~i J .:11N~ ~ D i 9y 1• LICENSED LAND SURVEYORS .aNV ~ ?Q ~ _.r s_..._` GREENPORT NEW YORK c,C. QEPt. r ' ~S ~ ' Jt11J~ ~'r.199!; OTC, ~ 1991 f,14V f~" NE~ITr', ~~Vli~ fEltOYNErOST Nh1~ _ A • • C7RRiLE/2) ~ • SoNN A E r~re~c~a G Z~,\,2.Awsk~ "Eno VrEw^ FUUNORTION PC..AN ~R\vATE /QoR~O OFF 6VER(,IPfFJJ, CurG1•{.~NY. SrEE~'="Li~w~s 'tfvc Map ~ 1 Oct - 108 - 3 - 8• a & F-r. t~ ovERNf~o £sr/Mareo U 991 Dao2E Ga.«.iNo l.tv6~ B. ~A.SO~{O~.O T/N " O ICI TR~I~~R l~-L`r x U~D~~~ g3 9 8°7' ~o;;RooF /U Fr ~/~EAK o~/?ceF ,orovrMZ' l ~ F. QE ?~Y2OOFI~[J]. pct T W~NDOW$ CFiL L~r'lU 0 `F- S ~ /Jb v~ E w. " ~AS~m~~T 8tr8~~cNdy 1' -__loor /N_7C__la" DEEP X__/6" W_/DE _2~rNCHtS w~ w~]o wS n _ . _ . T L__.r__~__.. i I FTI,bI~( ~N n u ovERNFAD ! 0 l~ V / ~ ~ ~~F (n~iCox'l~+~N OcAMS GARa~6 ~i g~~ DooR W Au.S i _...__.v-~_,__ . ___e.-,_-- _ _ -mot _ r~_r____. - -.e._~. _ 70 FT. (FN ~