HomeMy WebLinkAbout27353-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29416 Date: 05/06/03
THIS CERTIFIES that the building ADDITION
Location of Property: 1695 HILLCREST DR ORIENT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 13 Block 2 Lot 8.13
Subdivision Filed Map No_ Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 7, 2001 pursuant to which
Building Permit No. 27353-Z dated JUNE 6, 2001
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 DECK ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to CARL DAGUILLARD
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
.—
!Y`AY44,1--7
Authorized ignature
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-29417 Date: 05/06/03
THIS CERTIFIES that the building ADDITION
Location of Property: 1695 HILLCREST DR ORIENT
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Nap No. 473889 Section 13 Block 2 Lot 8 .13
Subdivision Filed Map No. Lot No_
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 7, 2001 pursuant to which
Building Permit No_ 27353-Z dated JUNE 6, 2001
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 INGROUND SWIMMING POOL WITH DECK AROUND & FENCE TO CODE AS APPLIED
FOR.
The certificate is issued to CARL DAGUILLARD
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N-420210 05/16/97
PLUMBERS CERTIFICATION DATED N/A
AutGe/horized Sign ure
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT 3 Q 2
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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 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
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00
Date. x\\a���o3
New Construction: Old or Pre-existing Building: %1/ (check one) '`
Location of Property: �10� .% H�%- Q_#r`ST l) kk ,nE DQ\��J� 'c"oW� N� \\�tS-1
House NoStreet Hamlet
Owner or Owners of Property: (. A Q. \. f*6.1\\ l ATIL p
Suffolk County Tax Map No 1000, Section 3 Block c1 Lot \ 3
Subdivision �1x\tiCt.C%j E i4 S Sgt-%Iw L Filed Map. `> a\ % Lot: U
Permit No. ea�13S 3-Z Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval: /
Request for: Temporary Certificate Final Certificate: V (check one)
Fee Submitted: $ S O. O o
( 38-11 Applicant Aignature
co �2_ a9u14
BUILDING PERMIT REVIEW CHECK LIST °`�23,52
DATE REVIEWED:
APPLICANT NAME: °1u///Ar4 DATE SUBMITTED:-<
SCTM# --- DISTRICT: 1_,000 SECTION: L3 BLOCK: 2 LOT:-&/3
PROJECT LOCATION
STREET: /69S �� re5 CITY: �r.r r� SUBDN. NAME:
ARCHITECT/ ENGINEER: "��i¢ FAST TRACK: YES oA9
SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES o NOTES:
ZONING: PERMIT ESTI MOUNT:_$ ��K .00
ZONING DISTRICT: R4 R8 AC, CONFORMING: YES OR6 REQUIRED LOT SIZE: k6K SQ:
WHERE ACTUAL LOT SIZE FRO .j cARn ACTUAL LOT SIZE: ¢/S0? SQ
REQUIRED REQUIRED REQUIRED xz—_
FRONT ' PROPOSED: 4-0 ' SIDE YD: 96 '/ 46 ' PROPOSED: 2 t '/ e-7-' REAR: Go ' PROPOSEr"'
LOT COVERAGE: ALLOWED:26 % EXISTING: sf % NEW: sf % TOTAL:/S sf
CORNER? YES OR NO WAT ER FRONT? YES OR NO DESCRIPTION:
LOTS 40,000SF--100-24. Lot recognition. (CREATED before June 30, 1983), UNDERSIZED LOTS FROM
JAN.1997 100-25. Merger. (A nonconforming at anytime after July 1, 1983.)
rc pp
PROJECT DESCRIPTION(ADS LT.ACC oR N/D: �/ M a oL� / c ca 2 c o I5
AGENCY PERMITS REQUIRED FOR REVIEW
NEEDED
TOWN SPETIC PERMIT: YES or tv
SUFFOLK COUNTY HEALTH DEPT: YES or 0, (BED #): DTE:—/_/ PERMIT #:RIO-
NEW YORK STATE DEC: PRE-DEC 9iv75 YES o
SOUTHOLD TOWN TRUSTEES: YES o
TOWN ZONING BOARD APPROVAL: YES o
TOWN PLAN. BOARD APPROVAL: YES 09
FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18/80 PANEL #: FLOOD ZONE: ,
NYS ENERGY: YES O NO��
NOTES:
FEE STRUCTURE: FOUNDATION: f- SF
FIRST FLOOR //f6 SF-/Jec,r
SECOND FLR --*' SF INIT OTHER TOTAL
TOTAL: .,/9C SF FEE FEE FEE
TOT( &j4G SF)- Fs( SCS SF)= 3 qj-- SF X $ ,2o =$ 69.1a +$ 7S +$ L;D =$
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1.001290 BUREAU OF ELECTRICITY
F 85 JOHN STREET, NEW YORK, NY 10038
Date MAY 16,1997 Application No.on file 13902297/97 N 420210
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above Application number in the premises of
CARL DAQUILLARD, 1695 HILLCREST DRIVE, ORIENT, N.Y.
in the following location; ❑ Basement ❑ /st Fl. ❑ 2nd Fl. OUT Section Block Lot
was examined on MAY 13,1.997 and found to be in compliance with the National Electrical Code.
FIXTURE ECE►TACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. 1 K.W. AMT. K.W. AMT. K.W. AMT. H.P.
1 2 1
DRYERS FURNACE MOTORS FUTURE AF►UANCE FEEDERS SNC1AL REC'►T TIME CLOCKS UU UNIT HEATERS MULTI-OUTLET DIMMERS
AMT. K.W. OR M.P. OAS M.P. AMT. NO. A.W.0. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. SYSTEMS AMT. WATTS
NO.OF FEET
2 20
SERVICE DISCONNECT NO.OF S E R V 1 C E
AMT. AM►, ry� METER 1 X TW 1 JV 3W 8 AV 3W 3 AV aW NO.OF CC.COND. A.%! 0. NO.OF MI-LEO A.W 0• NO.OF NEUTRALS A.W.G.
EQLR►• ►tR I CC. OND. OF HI-LEO OF NEUTRAL
OTHER AMARATUS:
SWIMMING POOL-1
TIME CLOCK-AMP.40--1
G.F.C.I--1
*(SWIMMING POOL) This, certificate
covers compliance at the date of
inspection only. Because of unusual
-;�nvi.ronmentg it is advisable to
have frequent test/and or repairs
made by a qualified person. L L
<<< Continued oll Pane 2
' ` I vENERu MANAGER
Per
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN AN1l MANNER.
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE
1001290 BUREAU OF ELECTRICITY
7 85 JOHN STREET, NEW YORK, NY 10038
pate JMY 1,6,199-7 ,application No.on file 13902297/97/97 N 420210
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
CRL DAQUILLARD, 1695 HILLCREST DRIVE, ORIENT, N.Y.
in the following location; ❑ Basement ❑ /st Fl. ❑ 2nd Fl. 01JT Section Block Lot
was examined on MAY 13,1997 and found to be in compliance with the National Electrical Code.
FIXTURETACLK SWITCHES RXTURES RANGES COOKING DICKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS INCANDESCENT•FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT, K.W. AMT. K.W. AMT. H.P.
DRYERS FURNACE MOTORS FUTURE APPLIANCE!AIDERS SPECIAL RIC'►T TIME CLOCKS BILL UNIT NEATIRS MULTI-OUTLET DIMMERS
AMT. K.W. OIL H.P. OAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. SYSTEMS
NO.OF FEET AMT. WATTS
SERVICE DISCONNECT NO.OF S E R V I C E
AMT. AMP. TYPE MITER I X 2W 10 3W 2 A'3W 3,9 4W NO-OF CC.COND. A.W.G. NO.OF HIAEG A.W.G. NO. NEUTRALS A.W.G.
IOW►. PER d OF CC. OND. OF HIAEG OF NEUTRAL
OTHER APPARATUS:
TED CHESNTP.E JR. CO. LIC.#953,-E L L
P.O. BOX 255A
9280 SOUND AVE. ODIUM MANAGER
MATTITUC'K, NY, 11951-3138 11
Per
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by`their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
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REMARKS: /4evc;,
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76S-1802
BUILDING DEPT.
INSPECTION
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[ ] FIREPLAC & CHIMNEY
REMARKS: -�
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BOARD OF HEALTH . . . . . . . . .
FORM NO. 1 3 SETS OF PLANS . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . .
r� BUILDING DEPARTMENT CIIECK . . . . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC F0R:I . . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 NO;i F'f % r
9 c CALL
[xamincd .V,.:0HA I L TO . . . . . . . . . . . . . . . .
Ot . .. . . .c`. . .GL S ...
�pprovcd . . . 19*permit NO. . . . . . . .
)isapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I vvr- H,—A
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. Gil. .
(Building Inspec r)
LICATION FOR BUILDING PERMIT pp
Date , . . . `.1.�:�Ja. . . .. 19 `o
INSTRUCTIONS
a. This application must be completely tilled in by typewriter or in ink and submitted to the Building Inspector, with 3
:s 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 coverfd bY,� application may not be commenced before issuance of Building Permit.
d. Upb"pproval 01 t1I lication, the Building Inspector will issued a Building Permit to the applicant. Such permit
di be'kept on tkukWIses available for inspection throughout the work.
e. No building shall be occupied orused in whole or in part for any purpose whatever until a Certificate of Occupancy
II 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
lding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
;ulations. for the construction of buildings, additions or alteratio *t3
oval or demolition, as in described.
applicant agrees to comply with ad applicable laws, ordinances, e, housing c nd re ula ions, and to
nit authorized inspectors on premises and in building for necessary n . . . . . . . . . . . . . . . . . . . . . . .
(Si nature of applican , or name, if a corporation)
(Mailing address of applicant) NSI.
to whether applicant is owner, lessee, agent, architect � er, genets contractor, electrician, plumber or builder.
"tGk f, e
. . . . . . . . . . . . . . . . . . . . . . . . . . ..h.f.. ..�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ne of owner of premises . . .C.A.?--��- . . . . � �J�`t �.
(as on the tax roll or latest deed)
pplicant is a corporation, signature of duly authorized officer.
(Name and title of corporate Jo/fficer)
Builder's License No. . d�,. G y6r,47. . . . . .
Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . .
Electrician's License No. . . . . . . . . . . . . . . . . . . . . . .
Other Trade's License No. . . . . . . . . . . . . . . . . . . . . .
vocation of land on which proposed work will be done. . . . J. .' . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
louse Number Street Ilantlet
ounty Tax Map No. 1000 Section . . �.?. . . . . . . . . . . . . Block . . . . �. . . . . . . . . . . Lot . . . J C1:3. . . . . . . . .
ubdivision .I ILL. �c 57 S � r'z�. . . . . . . . Filed Map No. 7a Lot . . . . /�. . . . . . . .
(Name)
tate existing use and occupancy of premises and intended use and Occupancy of proposed construction:
Existing use and occupancy . . ...T. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Intended use and occupancy t/ �?�°?wt /oL fGc /Gc S (/� c �) �
—'7
. . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
'PCS( 11 'r,
3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteration
Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Othcr•Work r. . . . . . . . . .
(Descriptio.
4. Estimated Cost . . . . . . . . . . .V>. U1 . . . . . . . . . . . . . . . Fee . . . . . . . . , . . . . . . . . . . . . . . . .
(to be paid on filing this application)
5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . .
If garage, number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6. If business, commercial or mixed occupancy,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 . . . . . . . . . . . . . . . . . . . .
8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . ,. . . . . . . . . Depth . . . . . . . . . . . . .
Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . .
10. Date of Purchase . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . .
11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12. Does proposed construction violate any zoning law, ordinance or regu!ation: . . . . . . . . . . . . . . . . . . .
13. Will lot be regraded . . . . . . . . . Will excess fill be removed from premises: Yes ' N
. . . .
14. Name of Owner of premises I�� .P �.t�!�€v Address ��:r� yu:�^ S.T • • • Phone No. '?).3
Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No.
Name of Contractor . . . . . . . . Address !f'S:FS!r:c, /4'r k ru , Phone No.
15. Is this property within 300 feet of a tidal wetland? *Yes. . . . . . . . No. . )Va. . . .
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
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. UNDE"RITERS CERTIFICATE
REQUIRED
AP 7O` e AS NOTED
B.P.#
z) FEE: BY:
1u0TIF UILt)ING DEP T AT
71,5.180 9 AM TO 4 FOR THF
FOLLOWIN INSPE . NS:
APPROVED AS NOTED ° "' ^ : 1. rOUNDATI . tubo REQLIIRFf)
FOR POURS ,ONCRETE
DATE: G " B•P.# 2 ;y a= a. ROUGH NG p,, PLUMPING
FEE: � � —BY:�a7�{ :3 IPs tJl.
NOTIFY BUILDING DEPARTMENT AT 4„ i"It•, N MUST
786-1802 9 AM TO 4 PM FOR THE t . C PLETF
FOLLOWING INSPECTIONS: •• A _ N STRUCTION SH _L MEET
1 FOUNDATION - TWO REQUIRED IMMEDIATELY" HE REOUTAEMENTS OF E N.Y.
FOR POURED CONCRETE ENCLOSE POOL TO CODE STATE CONSTRUCTION & E ERGY
2. ROUGH - FRAMING & PLUMBING UPON COMPLETION CODES. NOT RESPONSIBLE OR
3. INSULATION BEFORE 'WATER" DESIGN OR CONSTRUCTION ERR S
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NST RESPONSIBLE FOR
DESIGN OR C;ONST.RUCTJON ERRORS
TATE OF NFWdOI &SJuOUNTY OF . . JLS. . . . . .
. . . . . . . . . . . . . . . being duly sworn, deposes and says that lie is the applicant
(Name of individual signing contract)
eve named.
isthe . . . . . . .1 1 .1 �. �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Contractor, agent,corporate officer, etc.)
said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
lica(ion; that all statements contained in this application are true to the best of his knowledge and belief; and that the
k will be performed in the manner set forth in the application filed therewith.
Irn to before me this
/.� . . . . . . . . .dUr V),t . .ifg . .
try Public, . . .-- Count
MARTIN CADEL
NOTARY PUBLIC. State Of Ntw Ycrh . . . . . . ' ' ' . ' . . • • • •
No..30-55s';a50 (Signature of applicant)
Qualilletl fn Nassau
Comff"4ion evNM -,i
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SURVEY FOR
ARTHUR V. JUNGE MAY 9 , 1990
LOT NO.II "HILL CREST ESTATES, SECTION I I JUNE 14,1989
NOV. 29,1988
AT ORIENT DATE: SEPT. 28,1988
TOWN OF SOUTHOLD SCALE I"= 50'
SUFFOLK COUNTY, NEW YORK NO. 88-1083
**,AUTHORIZED ALTERATION OR ADDITION TO THIS GUARANTEED TO:
SURVEY 4 A VIOLATION OF SECTION 7209 OF THE ARTHUR V.JUNGE
NEW YORK STATE EDUCATION LAM
*COPIES OF THIS SURVEY HOT SEARING THE LAND TICOR TITLE GUARANTE
SUR VEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL SOUTHOLD SAVIN QW MER
MOT BE CONSIDERED TO BE A VALID TRUE COPY
*GUARANTEES INDICATED MEREOM SHALL RUN ONLY TO A
THE PERSON FOR WHOM THE SURVEY IS PREPARED O
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT AMC OR HIS BEHALF To THE TITLE COMPANY,GOVERN-
* NEAREST WATER "IN-ML! *SOURCE Of WATERS PRMTE_PUBLIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED p
N SIFf CO. TAXMAP OISY 1000 SECTION 13 KOCK 2 LOT ALU HEREON,AMD TO THE ASSIGNEES OF THE LENDING M d
MTHERE ARE NO DWELLINGS WITHIN 100 FEET Of TMS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE
OTHER THAN THOSE SHOWN HEREON. TO ADDITIONAL 04STITVTMPS OR SUBSEQUENT
M TML WATER SUPPLY ANO SEWAGE DISMAL SYSTEM FOR THIS RESIDENCE OWN TAMCES SHOWN HEREON FROM PROPERTY LINES arm"CONFORM TO Til[ STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT TO EXISTING STRUCTURES M(FOR A SPECIFIC
OF HEALTH SERVICES. PURPOSE AMO ARE NOT TO BE USED TO ESTABLISH I'r
APPLICANT- PROPERTY LINES OR FOR THE ERECTION OF FENCES
ADDRESS INA
NORA&PI
"L YOUNG a YOUNG RRIIVERHEAD, NEW YORKE
NOTE-A 2 STAKE 0 MONUMENT ALDEN W.YOUNG,PROFESSIONAL ENGINEER
SUBDIVSION MAP FILED IN THE OFFICE OF THE AND LAND SURVEYOR N.Y.S.LICENSE NO.12845
CLERK OF SUFFOLK COUNTY ON AUG.15,1983 AS FILE
NO.7218
HOWARD W YOUNG, LANG SURVEYOR
•Tl[LOCATMOFWELL(W),SEPTICTAMKIST)GCESSPOOLS(CP)SHOWNNER[OM N.Y.S.LICENSE NO.45893
ARE PROM FIELD OBBERMTIONS AMO OR DATA OBTAINED FROM OTHER! R P
BRANDIS A SONS INC.