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HomeMy WebLinkAbout26795-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28828 Date: 08/27/02 T~IS CERTIFIES that the building ALTERATION Location of Property: 8905 GREAT PECONIC BAY BLVD LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax ~4ap No. 473889 Section 126 Block 4 Lot 17.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 21, 2000 pursua_~t to which Building Permit No. 26795-Z dated SEPTEMBER 26, 2000 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 EXISTING GARAGE ALTERED TO A WORKSHOP/STOPJtGE BUILDING (NON-HABITABLE). The certificate is issued to JAMES & JANET D'ADDARIO (OWNER) of the aforesaid building. SIIFFOLK COIINT~ DEPART~4ENT OF ~RALTHAPPROVAL N/A ELR~-rKICAL CERTIFICATE NO. 1069423 08/09/02 PLU~4BEIAS Cl~RTIFIC~TION DA'~'~,~ N/A ~/u~ed Signature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28829 Date: 08/27/02 THIS Cl~TIFIES that the building ALTERATION Location of Property: 8905 GREAT PECONIC BAY BLVD LAUREL (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 126 Block 4 Lot 17.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 21, 2000 pursuant to which Building Permit No. 26795-Z dated SEPTEMBER 26, 2000 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 ALTERATION TO AN EXISTING GUEST COTTAGE AS APPLIED FOR. The certificate is issued to JAMES & JANET D'ADDARIO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELE~-r~ICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DAT~O N/A 1070207 08/12/02 05/21/02 STEPHEN T KARRASS ~u~or~~i nature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28830 Date: 08/27/02 T~IS c~TIFIES that the building ALTERATION Location of Property: 8905 GREAT PECONIC BAY BLVD LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax ~4ap No. 473889 Section 126 Block 4 Lot 17.1 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 21, 2000 pursuant to which Building Permit No. 26795-Z dated SEPTEMBER 26, 2000 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 ALTERATION TO AN EXISTING GUEST COTTAGE AS APPLIED FOR. T~e certificate is issued to JAMES & JANET D'ADDARIO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF ~KALT~ APPROV/kL ELEm-£KICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'£~D 05 / 21 / 02 N/A 1070207 08/12/02 STEPHEN T KARRASS A~~lgnature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUJF.~ING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 26795 Z Date SEPTEMBER 26, 2000 Permission is hereby granted to: JAMES & JANET D'ADDARIO OLD WESTBURYrNY 11568 for : ALTERATION OF TWO EXISTING GUEST COTTAGES AND DEMOLITION OF A POOL AS APPLIED FOR. at premises located at 8905 County Tax Map No. 473889 Section 126 pursuant to application dated JULY Building Inspector. GREAT PECONIC BAY BLVD LAUREL Block 0004 Lot No. 017.001 21r 2000 and approved by the Fee $ 158.00 ~ed~l'eu ~lgnatuI~e COPY Rev. 2/19/98 ~,~3\\ BUILDING DEPARTMENT "h ~ ~' '¢?,;~]t, ,'}~~'CATION FOR CERTIFICATE OF OCCUPANCY filled in by t~ewriter or ink and submitted to the Building Depa~ment with the following: ho 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 from Board of Fire Underwriters. 4. Sworn 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 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. Copy of Certificate of Occupancy - $25.00 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. ~--(~ ( ~ New Construction: Location of Property: Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Old or Pre-existing Building: ~ (check one) House No. Street ' ' Date of Permit. Permit No. ~:~q ~-' Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ 2~ , ~ Hamlet Block t4' Lot FiledMap. qT~>~ Lot: Applicant: O k~[.,~ q~ Underwriters Approval: Final Certificate: ~~(check one) Applicant Signature BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 1OO38 CERTIFIES THAT Upon the application of upon premises owned by BRITE STAR ELECTRIC 206 GREELEY AVE. SAYVILLE, NY 11782, ' DADARIO 8902 PECONIC BAY BLVD. MATTITUCK, NY 11952 Located at Application Numbe~, 1069423 Section: Block: Described as a Residential 8902 PECONIC BAY BLVD. MATTITUCK, NY 11952 Certificate Numbe~. Lot: 1069423 Building Permit: BDC: NS11 occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, Outside, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 9th Day of August, 2002. Alarm and Emergency Equipment Sensor 1 0 Appliances and Accessories Exhaust Fan 1 0 Wiring and Devices Receptacle 8 0 Switch 6 0 Fixture 4 0 Pole/Post Lighting Standard 5 0 Paddle Fan 1 0 Service 1 Phase 3W Service Rating 100 Amperes Service Disconnect: 1 Meters: 1 OTY Rate p. atim, Circuit Type 100 cb Smoke General Purpose General Purpose Incandescent OFCI seal I of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. i BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD Of FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ~ 40 FULTON STREET - NEW YORK, NY 1 0038 · CERTIFIES THAT ~ Upon the application of upon premises owned by BRITE STAR ELECTRIC * DeDARIO 206 GREELEY AVE. 8902 PECONIC BAY BLVD SAYVlLLE, NY 11782, MATTITUCK, NY 11952 Located at 8902 PECONIC BAY ~LV,r) MATTITUCK, NY 11952 Application Number: 1070207 Certificate Number: 1070207 r~ Section: Block: Lot: Building Permit: BDC: NS11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Outside, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 12th Day of August, 2002. I'~ Name QTY Rate Ratine Circuit Type Additional Charges 2 COTTAGES - NORTH & WEST Alarm and Emergency Equipment Sensor 6 Smoke Appliances and Accessories Exhaust Fan 2 F.H.P. Panels 1 100 10 1 100 23 Wiring and Devices Outlet 17 Fixture Receptacle 30 General Purpose Switch 20 General Purpose Fixture 17 Incandescent Receptacle 1 20 Special Receptacle 7 GFCI Paddle Fan 3 seal 1 of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. Town Hall~ 53095 Main Road P.O. Box 1179 Southold, New York 11971~0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Fax (631) 765-1823 Telephone (631) 765-1802 Date: Building Permit No. (please print) Plumber: Lie, mzTqg~ ' ¢le~e print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this day of ~r~ 0~.. , 20 0 ~- x'~,lotaryPublic,~ & -~fr191~. County JEANNE M, SANSEVIRO Notan/Public, State of New York No. 01SA5085633 Qualified in Suffotk County A Commission Expires September 29,'~'/0~),_~ B9/13/2808 12:16 6317278833 C THOMAS RA PAGE 01/01 Charles M. Thomas, Architect 1~.O. ]Box 877 Jamesport, New York 11947 (631) 727-7993 e mail: ,cdthomas63~aoLeom September 13, 2000 Town of Southold Building Department Main Road, NY, 11971 Re: Dear Bruno, D'Addario Residence (addition/renovation) Peconic Bay Blvd. Maffituck This letter shall serve to certify that the addition/renovation to the cottages at the D'Addario property will confom, to the New York State Building Coda In all aspects. All rooms have been provided with the required egress openinge, minimum light and ventilation are in conformance and each building will conform with part V! of the NYS Energy Conservation Code. In addition, we would like to include the demolition of the pool, shed and deck to this permit. Thank you for your attention to this matter. Ohoc es Thomcas PO E:,OX 83'7 JAivfESPORT, NY IIq43. (5i6) 727-7qq5 A DAP--.IO P--.ESI ENE, E --PECONI6 5AY 5LV[2. SUMMARY OF TOTAL THERMAL RATING IF THE TOTAL THERMAL RATIN~ IS ZERO (O) OR ®REATER, THE PROPOSEP DESI®N FOR THE BUILIDIN® ENVELOPE COMPLIES H/ THE ENER®¥ COPE. THERMAL TABLE AREA U-VALUE RATINg USED A. HALL ASSEPIBL¥ Al. NET INALLS 736' 0-/2 *4q 6-1 A2. ®LAZIN® 76.5' .32 +10 6-1 A3. POORS 36 ' .28 +3 6-i SUBTOTAL THERMAL RATIN® FOR SECTION A (AI+A2+A3) I~ ROOF/CEILING ASSEi',dDL¥ BI. ROOF/CEILIN® 52q' .043' 0 6-3 B2. SK:YLI®HTS .42 6-3 SUBTOTAL THERMAL RATIN® FOR SECTION B (BI+B2) ~ C. FLOOR ASSEFfSL¥ Cl. FLOOR 2,8i3.O ' C2. FOUNPATiON NALL ~LL PERIMETER 0 FT AEk2VE ®RA~E EXPOC;4JRE O PT INSULATION PEPTH 24" 48" ~] 84" ~ FOOTIN* SLAB EO®E INSULATION .046 PERIMETER R-VALUE 50-100 I.I SUBTOTAL THERMAL RATIN~ FOR SECTION C (C1+C, 2+C3) TOTAL THERPIAL RATING + 56 O.K. CONTRACTOR BUILDERS ,,.~ ~' JUL 18 ~'"~· * John A. Lee & Son, Inc. 136 OAKW©OD AVENUE-;- BAYPORT, N.Y. 11705 PHONE (516) 472..0017 FAX (516) 472-0454 July 17, 2002 Town of Southold Building Dept. Southold Town Hall P.O. Box 1179 Southold, NY 11971 To whom it may concern, I would like to request a six, (6) month extension for the D'Addario renovation located at 8905 Peconic Bay Blvd, Laurel, NY. Permit number, 26795. Sincerely, John A. Lee BUILDING PERMIT REVIEW CHECK LIST .APPLICANT NAME: SCTM#--- DISTRICT: 1,000 SECTION: BLOCK: DATE REVIEWED: $ //~/oo DATE SUBMITTED: / / LOT: I.~, / PROJECT LOCATION /30" STREET: ~ p,"~o.a,¢ /j~ Leo ~ CITY: L ARCHITECT / ENGINEER: < SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES ¢ NOTES: ZONING: PERMITES~T~MATE AMOUNT: $ .d~Off~-~ .00 ZONING DISTRICT(R~_.4~01)RS0~ AC, - CONFORMING: YES o~ NO REQUIRED LOT SIZE: SQFT. WHERE ACTUAL LOT SIZE FROM?TAX CARD ~,-~ ACTUAL LOT SIZE: SQFT. REQUIRED REQUIRED REQUIRED FRONT: .~' PROPOSE .D4~' ' SIDEYD: ,,'O '/,.~ ' PROPOSED: ,"~-~-'/~ ' REAR: LOT COVERAGE: ALLOWED: ~o % EXISTING: sf % NEW: sf % TOTAL: sf % CORNER? YES o~ WATERFRONT? YES o~ DESCRIPTION: LOTS 40,000SF --100-24. Lot recognition. (CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25. Merger. (A nonconforming at any time after July 1, 1983.) SUBDW. NAME: FAST TRACK: YES of~O~) DTE: / / PERMIT #:R10- PROJECT DESCRIPTION: ADD .~ACC OR N/D.' O1~' ~c AGENCY PERMITS REQUIRED FOR REVIEW NEEDE.]~ TOWN SPETIC PERMIT: YES or~ SUFFOLK COUNTY HEALTH DEPT: YES or ~ (BED #): NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or~"~ SOUTHOLD TOWN TRUSTEES: YES orlN__~ TOWN ZONING BOARD APPROVAL: YES or t~ TOWN PLAN. BOARD APPROVAL: YES orhLO FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18/80 PANEL #: 'b&/ FLOOD ZONE: NYS ENERGY:~R NO : EGRESS: VENT: LIGHT: NOTES: FEESTRUCTURE: FOUNDATION: SF ~R : ~",~ SF ~ : ~/~ SF TOTAL: L/~ SF TOT( SF)- ( SF)= ,2~¢.~' SF X FEE +$ '.5' OTHER TOTAL FEE FEE FEB 5 5 Woodland Road Old Westbury, New York 11568 Janua~ 31,2001 Attn: Bruno Town of Southold Building Department 53095 Main Road Southold, NY 11971 Dear Bruno: Our architect, Charles Thomas asked me to write to you to confirm that the garage structure that we are renovating on our property at 8905 Peconic Bay Blvd. in Laurel will not be used as a residence. If you need any additional information from our architect, our contractor, or me please feel free to give me a call. Thank you in advance for your cooperation. Yours truly, -'~~D'~ddario JD:nmc Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 Fax (631) 765-1823 Telephone (631) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD STOP WORK ORDER TO: James & Janet D'Addario 5 Woodland Road Old Westbury, New York 11568 YOU ARE HEREBY NOTIFIED TO SUSPEND ALL WORK AT: 8905 GREAT PECONIC BAY BLVD., LAUREL, N.Y. TAX MAP NUMBER - 1000-126-4-17.1 Pursuant to Section 45-8 of the Code of the Town of Southold, New York, you are notified to immediately suspend all work and building activities until this order has been rescinded BASIS OF STOP WORK ORDER: WORKING WITHOUT A BUILDING PERMIT CONDITIONS UNDER WHICH WORK MAY BE RESUMED: WHEN BUILDING PERMIT IS OBTAINED. Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by fine or imprisonment or both. DATED: DEC. 19, 2000 ~~//~;~ BUILDING INSPECTOR 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] INSULATION ] FINAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] RO~U~BG. [ ] FOUNDATION2ND [//]~INSULATION [ ] FRAMING [ ] FINAL []FIREPLACE&CHIMNEY jDATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [~/']'~NSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMA~5~ DATE 765-t802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [~>~j~ FINAL--/~ ~ [ ] FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: [ ] ROUGH PLBG. [ ~/*]' FINAL DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] I/~JLATION [ ~ FINAL DATE //- It FINAL ADDITIONAL COMMENTS: BLDG. DEPT. TQWN OF SOUTHOLD .... ........ 79J- Approved .... t/~. ......... ~.. Permit No ................. Disapproued a/c .................................. FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. ! 1971 TEL: 765-1802 BOARD OF HEALTH ............... 3 SETS OF PLANS ............... SURVEY ........................ CHECK ......................... SEPTIC FORM ................... NOTIFY: CALL I~IL TO: .................... INSTRUCTIONS Date ................ ,19 .... a. This application m~at be conpletely filled in by type~iter or ~n ink and sehnitted to the Building Inspector wi~ 3 sets of lllmm, accurate plot plan to scale. Fee according to schedule. b. Plot plan ~lx~ring location of lot and of buildings on promises, relationship to adjoining premises or pablic street, areas, and giving a detailed description of layuut of property u~st be dra~n on the diagr~n ~/aich is part of this ap,. 'ation. c. , ~rk covered by this application ~ty not be cu,,~enced before issuance of Building Permit. d. fl approval of this application, the Building Inspector xd11 issue a Building Pemit to the applicant. Such permit ~al t be l~pt on the premises available for inspection throughout the ~rk. e. No°building shall be occupied or used in ~hole or in part for any purpose v/aatever until a Certificate of Occupancy ~hall have been granted by the Building Inspector. APPLIOkTIUI~ IS ~ ~ to the Building Department for the issuance of a Building Permit pursuant to the Building Zo~ Ordinance of the To~ of Sonthold, Suffolk County, NO~ York, and other upplicable Lmvs, Ordinates or .l~gu .t~ons, for the construction of buildings, additians or alteratians, or for rt~,,Jval or demolitian, as herein describe~d~ The applic~t agrees to e~ly with all al~l. icable l~vs, ordin~a~es, building/cede, housing code, and regulat~ aad to ~it anthorized inspectors on ~ses and in/~ fo, r ~e~_~inspections. (Signature of applicant, or nane, if a corporation) (l~lailing address of applicant) (as on tim tax roll or latest deed) If ~limt is a ~ratim, si~e of ~ly mt~ri~ offi~r.i ..... ~ ................................................... (~ ~ title of ~rate officer) Builders License No .......................... Phsnbers License No .......................... ~lectricians License No ...................... O~r Trade's Liceose No ..................... .................................. ....... HOuse 1~ ~her Street "~, ~Jl~ ........................... (~) 2. State existing use and occupancy of pr~nlses and intended use and oc~ of proposed construction: 3. ~nture of ~ork (ct~k ~/fich applicable): ~ ~ildi~ .......... ~iti~ .......... Alterati~ ..~ ..... ~ir ..~ ........ ~al ............. ~liti~ ............ Otimr ~ ' - ~ripti~) ~. Esti~mt~ ~sL ..~.~. ............ ~ f~ .~to ~ ~id ~ fili~ this a~li~t~ 5. If ~lli~, ~r of ~11i~ ~mits .... ~ .... ~r of ~lling ~its ~ e~ ................ 6. If ~i~sa, ~rcial or ~ ~, ~i~ ~ture ~ ~tent of ead~ ~ of~..~ ............... ~. Di~nsi~s of ~isti~ s~res, if ~: ~t ................ ~ar ............... ~pth ................. ~i~t ......................... ~ o~ Sto~i~ ...................... '~0 ~ ~ ~ ~~ Di~i~ of ~ st~e ~th alterati~ or ~itions: ~t ............... ~ar ............... ~pth .................... ~i~t .................... ~r of Stories ............... 8. Di~nsi~ of entire ~ ~st~ti~: ~t ................ ~ar ............... ~p~ .............. ~i~t ......................... ~ o~ Sto~i~ ..................... ~0 ~ .~ ~ ~ ~ ~. si~ o~ ~ot: ~ ..~ ............ ~ ..... I.t~ ........... ~p~h .~ ............ I0. ~e of ~rd~a~ ..................... ~ of Four ~r II. ~ or ~ district in ~i~ pr~i~s a~ si~t~ .............................................................. 12. ~s ~o~ ~t~ti~ violate ~ ~i~ 1~, o~i~e or re,latin: .~ ................. 14. ~s of ~r of ~s ..~...~.~ .... ~ress ~.~.~.~~ ~.'~~ ~ of ~tr~tor ....................... ~ ........... ~ress ............................... ~ ~ .............. 15. Is tiffs p~r~flfin ~ f~t of a ti~l~tl~? * ~ ..~ ..... ~ .......... PLOT DIAG~ I~ate clearly ~ disti~tly all ~ildi~, ~r ~isti~ or pr~, ~ i~i~te all ~t-~ d~nsi~s ~ ~r~ li~s. Gi~ st~t ~ bl~ ~r or ~ripti~ ~co~ing to ~, ~ ~ strut ~s ~ i~icate ~flmr interior or ~r lo~. duly s~m, deposes and .says that he is tbe appllc~t (Contractor&(~-~ corporate officer, etc. ) ......................................... of said o~aer or o~ners, and is duly authorized to perfom or have per£on~d tl~ said ~ork ~J to make and ~ile this applicati~; that all statements contained in this application are tree to the best of his knowledge and beliefl and that the *turk ~aill be perfonmd in the marn~er set forth in the application filed there~rith. It~.VE'r' OF LOT..% # II 8 12 413> PART at= LOTS lO, ~P OF PROF~R'r'r' OF A. L. DOi, qNS" .ED At~. 14, Iq2q A.~ FILE It 21 1JATE: LAUREL kin OF 5OOTHOLP :FOLK ~T'K, NY NO/ES: · MONUMENT FOUND O PIPE F:OUNID OZC(5~ZL-~ HED®E AREA = D4~67 .~F OR 0.76 AC. RE.5 Ent:lr'e par'¢~l Is In FEHA Zone X as scaled Prom FIRH Panel 461 Pa~ I"do~ 4, Iqq6 ~.APHI C SCALE C Pond 147.96' JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET RIVERHEAD, N.Y. ll§O~ 369 8288 Fax 369-8287 543RVEYEE~ O2-OD-qq AI'-'IENt~E~ O-/-DO-qq .~UFF=OLK COUNI~' TAX ~ I000 - 126 - 4 - I-/.I C. ERTIFIEI2 TO: JAPIE5 D'AI:>I:2ARIO JANET D'ADI~ARIO N + W E S N. Y.S. LIC. NO. 50202 REFERENCE # 99-1~1 I