HomeMy WebLinkAbout17111-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-17684 Date JANUARY 18, 1989
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 665 SUTTON PLACE GREENPORT N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 033 Block O5 Lot 05
Subdivision EASTERN SHORES Filed Map No. 4021 Lot No. 36
conforms substantially to the Applicaticn for Building Permit heretofore
filed in this office dated JUNE 6, 1988 pursuant to which
Building Permit No. 17111-Z dated JUNE 16, 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 MARY JANE GROLL
(owner)
o£ the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-78-JAN. 9, 1989
UNDERWRITERS CERTIFICATE NO. N-046261^NOVEMBER 16, 1988
PLUMBERS CERTIFICATION DATED NOV. 19 1988-PECONIC PLUMBING & HEATING
Building Inspector
Rev. 1/81
FO&M 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 017111 Z oats ..........~..«.e~..l...~ 19.A.~'
Permission is hereby grouted to:
R ~ .
Ito ..,C~~~: ~~A.'...g,:....?~....... .
~^~`.As`:4:4~A.r....kY.~.... .
of premises located at ~O.S..........~~a.~-.,......~?1..I.!,?,s?:~a~.°.:~7'
County Tax Map No. 1000 Section .......a 33 Block Lot No..,.~.~~............
pursuant to application doted ......~.s!.....~ 19...4., and approved by the
Building innspector.
Fee $a~:~:
......./.L.~!.:...
.
wilding Inspector
Rev. 6/30/80
FORM N0. 6 , ~ - ~ ~ t
~ ~ c~r LL ~`~~~~~:;,i: ~I
I ;
TOWN OF SOUTHOLD ~ ' ~ `"~°~~-~°~'°~'~II
Building Department ' }
Town Hall Ji~ ~ 7 '
Southold, N.Y. 11971 ?
765 - 1802 ~.ee_, _ _
~mn
APPLICATION FOR CERTIFICATE OF OC UP ' '
Instructions ~.~_b_.,~._ ..a_
A. This application must be filled in typewriter OR ink, and submitted ss ®rw to the Building lnspec-
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 pept. 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 7957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of property 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 POOLS $25.00 ALTERATION $25.00
1. Certificate of occupancy New Dwelling $25.00, `Accessory $10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $100.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00
4.Vacant Land C.O. $ 20.00 eZ
5.Updated C.O. $ 50.00 Date 1J r
NewConstruction,,,,,, OldorPre-existing Building Vacant Land
r
Location of Property ....~.~.`~............Ss. ~:'.«U.N .Q~A~-~.... ~?~f1~'Lr F~fY V'.Q.~;T,
House No. Street Hamlet
Owner or Owners of Property ,
i
County Tax Map No, 1000 Section . ~ ~Q, , , , , Block .....:5 Lot S........... .
Subdivision .................................Filed Map No. ..........Lot No. .
Permit No~.~~.~,~ ~ , , , Date of Permit ~~~°.1,i5.~..Applicant . ~:t.~~,`~ ~`~CaG-G-~
Health Dept. Approval ........................Labor Dept. Approval .
Underwriters Approval ........................Planning Board Approval .`rt ~l3.L5........
Request for Temporary Cert`if/icate .....................Final Certificate ~ .
Fee Submitted $
Construction on above described building a~permit meets all applicable codes and regulations.
Applicant C'~~.~-:-:~...~~
Rev. 70-10-78
~,.3 ~ X81
FIELD INSPECTION DATE COMMENTS
`n
ti
c ~ H
V_._
FOUNDATION (1st) ~ T-
' C
~ ~
FOUNDATION (2nd) ,J ~ V
2. ~ z
8 it o
ROUGH FRAME / h
PLUMBING/
„z.~- o itJ~7- Ce v.~~2 T-N) u rr ~ .v7`I G
3. / y
K/ f /f?d'/°~cT.~O e ~ ~o
INSULATION PER N. / y P
G
STATE ENERGY
CSODE x
a
r~
4 .
FINAL G~
b
z
- ADDITIONAL COMMENTS:
- j~
" ~ T
~
x
'-a
~r
H 6.
H
O 'Y-
z ou
,..o
d
x
ra oG
a ao
r i
H
x ~
c
e7
r~ J
ro
H ~
7/// ass-isoz
BUILDING. DEPT.
INSPECTION
[ ] FF UNDATION i5T [ ] ROUGH PLBG.
FOUNDATION 2ND INS
[ ] ULATION
[ ]FRAMING [ ]FINAL
REMARKS:
DATE INSPECTOR YLN
fix.: -
~ ~l~~
765-1802
BUILDING DEPT.
INSPECTION
[ FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ ]FINAL
REMARKS: __~~~~.~-,+-J- -
~ P
DATE d INSPECTOR '
i ~i~~
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST C ] ROUGH PLBG.
[ ] OUNDATION 2ND [~SULATION
] FRAMING [ ]FINAL
REMARKS: ~ /UO ~ ~ y~
~i?'rK./y`'T/J mot/ /'~~Ti/L / T ~a6~
- cam/ J„` l
4
DATE ~ ~ INSPECTOR
~ ~ - 'F
_ ~ . a _
X65-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ["j
ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[t~FRAMING [ ]FINAL
REMARKS:
~c.Q/LO
DATE ~ ~ ~0 INSPECTOR ~
+
i TEL. 765-1802
~S~FF~~CpG TOWN OF SOUTHOLD
Z y~ OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
~ TOWN HALL
y0 ~ `c SOUTHOLD, N.Y. 11971 w
y~Ql ~ ,~~o ;
l ~ _ ,
I ~
JAN 1 7189 ~
C E R T I F I C A T I O N s~-~~'
~~f`4., Cad. e~~a~ i. l
Date ~17 ~
Building Pe~mit NNo. U 1 I
Owner~~~D~~
please print) / ,
Plumber
~ ///G ~G U/19/~//U4 ~A~/'U/
(please print /
I certify that the solder used in the water supply system
contains less than 2/10 of 1$ lead.
y (pl er's signature)
Sworn to before me this
day of V/l.~/f1.1~D b ~.~.~OG -
19~. Notary Pu3~lic
Notary Public,cJ(//r ~~~~i~ County ~gpsppgs~~ypWS~i
Notary Public, Salta of New York
No. 484+5752
Qualified in Suffolk County (y
CommiaaionExplr ig /y
~ _ T .
THE'-NEW YORK BOARD Of FLRE UNDERWRlTE1t5 t
)r35ozt -
99s FHUREAU OF ELECTRICITY -
NOVRMAF.k 1$,SygE§~OHN STREET, NEW YORK, FEEMf,~Y~RK 10038 N Oa6?.6~
lHte Application No. on file ,f4 FS 8ftl8kt
THIS CERTIFIES THAT _
only tha e4etrical puipment a desctihed Fle/otD and introduced by the applicaFat natnsd en the ahooe eppfiaotiow IKnntM1 in the premitee of
MARY ,7ANY, GROLZ., 665 S49'I'TON YI~A,CFt, lPO1,E1 $LT1. 4, GRF;TrNPOk`t'; N.Y.
in the olblcin 1 Q
J R °Ca~90~',N}Bf°fmf'~#$R ~ IAt Fl. ? Ynd Fl. Section Block Lot
u~oK etomined on and found to he in rnmpliance with ehe reyuiremeate of this Bwrd.
ta°
RxT{NE AC1K RX7URES RAHDES gOpKlRO oecES OVlNS UST FANS
aUT~TS NCANDESClNT FluotESClNT y AMT. K. W. MAT. K. W. AMI. K.W. NAT K W. MIT. N. F.
)a 5 3a 1a X0.3 t a r~
DRYERS FURlutx AN~TOB RtTWE At#ItUKE RMDYS sFEOAIIMC'?T TRlE GOCES Eu? wrT IIfATERf MM(t1M1Ytl~T Dlklhl[RS
AMT. K. W. fAl N. P. GAS N. P. AMT. NO. A. W. G. AMT. AAN. AMT. AAVt. TU1?K. AMT, n P, tltA~T AMT. WAIn
1 P 1.
SMVK7 DISCONlIEt:T tq.tl! S E R V 1 G E
AMT. AMr. TYPE E~ 1 / tW 1 X tW t X lW 3 x AW ffi
rK~' OF CC
COND. OF N4lEG Os N0. W NEGIRAlS ~ ~
~
Ml
1. .l)0 ('B X 7
Tus:
S1NOKt; PF."rlsCTt7R:-1
/
'PHkh;F: ^C" KL,MC.TRit;
kT, fit; BOX A5M
SOUND AV1'~NOti~~ ~ 1 IAOER
kYVFRHF;AD, NY, 719Di
_ CJ:CIRNSi~ NU, 3127 ` ~
Psr
Thit prNficoM mutt not Fx ahmed in any manner; return to 1M office of Mu Eaord if incorrect. impacton. ba'; 'rcrada
<~~C.ff7R pUlLpltw p~PARTMBIT, TFMf CQPT t1f ~CERT?P TIT NpT:M~ ~ l ~
TL'L. 7csa aoz
S~FFO~C'
~~0 t OG TOWN OIL SOUTIIOLD
•~~i ~ OPFICJ: OF BUILDING INSPECTOR
G
~ z P.O. BOX 723
,,0 ' ~ TOWN BALL
~~Ol ~ r~0~ SOUTIIOLD, N.Y. 1 1971
To whom This May Concern,
We are unable to complete your Certificate
of Occupancy because oL- the following reasons.
An application for Certificate of Occupancy
is not on file. ~ T'`~'~
/X/ NorUn,derwxit~erS~Gerti~icate;~on.Eile~.
The check is (outdated/no"t'~oi°"file: )
No flea~.th,~ Dept;Approval~ on,,=f,ilcj
No final inspection has been made.
_ Please contact our office on this matter.
Thank you for your cooperation.
building Permit it 1 ~ 1 ~ ( 2 ~~'~E
Building Dept.
***/j;/ Pdo,'Plumber_z;:So7,.acz~'Cexkificate"on~`file ~
( all permits involving plumbing being
issued after April 1,1984 )
/ wL
300
(J~W~~ ~ ~ . /l 9 ? /
' TEL. 7G5-1802
5~FF01kC
~~p ~ OG TOWN OIL SOUTIIOLD
~c OFF'ICI, OF BUILDING INSPECTOR
P.O. BOX 728
® TOWN BALL
~~Ol ~ r~0t' SOU1'IIOLD, N.Y. 1 1971
To whom This May Concern,
We are unable to complete your Certificate
of Occupancy because ,of the following reasons.
An application for Certificate of Occupancy
is not on file. ~
/X/ No Underwriters Certificate on file:.
/X/ The check is (outdated/not on file.)
/A'/ No F1ealth Dept. Approval on file.
P:o final inspecL•ion has been made.
. Pi.easo contact our office on this matter.
Thank you for your cooperation.
Building Permit it l I 1 f Z
Building Dept.
DIo Plumber Soldar Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
3 v a .~^.~s~-
/lf7/
~
U~~~( BOARD OF HEALTH
X14) g .
3 SETS OF PLANS .
li ~ @ FORMNO.t
Y 15 SURVEY .
TOWN OF SOUTHOLD CHECK #1 ,3,`2~...... .
s BUILDING DEPARTMENT SEPTIC PoRM .
~~pp
6117 TOWN HALL
SOUTHOLD, N.Y. 11971 NOTIFY
~}%a TEL.: 765-1802 CALL
D ~4
Examined 19 MAIL T0:
Approved ~,r(,(it?A_. 4 ,(v, 19~'~. Permit No. 1 7 ~ . ~ d' o ~I ~I ~ S
Disapproved a/c rc. `
.................................~'~n'.':
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date . ~ lj N~.... 19
INSTRUCTIONS
a. ^Tliis 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 gr~rited by the Building Inspector.
C
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Buildin; Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Re;ulations, 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 insp ctions.
. r-+-.~
(Signature dt"applicant, or me, if a corporation)
' (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises .............~!t'~!`4! ~N~ u"~ ~ L,L..
(as on the tax roll or latest deed)
!f applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No . .
Plumber's License No . .
Electrician's License No . .
Other Trade's License No . .
I. Location of land on which proposed work will be done. ~ i~~~;~,7n1 Q1~s~ ~ ,
G J
}{ouse Number Street .Hamlet
County Tax Map No. 1000 Section .......33....... Block , , , . , , , , , , , Lot
Subdivision Filed Map No. Lot...............
(Name)
State existing use and occupancy of premi/ses and intended use and occupancy of proposed construction:
a. Existing use and occupancy V.A:~v-.~a~.~
/n,,~.t .
b. Intended use and occupancy ~ ~Fr..'C}~cr.1.1~1:.~-.. Vv\jE
....~-:~r
3. Nature of work (check which Inapplicable): New Buildin '•..,..~,.,v
Re air g Addition . i t a , , , , •
P • • • • • • Removal Demolition Oth~ or
'r ~ ~..es n,..
4. Estimated Cost ..........~~,~.1. L7 ~?d ~ ~ Fee a
5. If dwelling number of dwelliri (to be paid (yp.Glb' • ication)
5> g units Number of dwelling units on etTO1,~~,
If garage, number of cars ' ' ' ' ' ' ' • '
6. Tf business, commercial or mixed occupancy, specify nature and extent of each t ~ ~ ~ •
7. Dimensions of existing structures, if any: Front . . : . Rear ype of use , , , , , , , , , , , •
Height Depth...............
. Number of Stories . .
Dimensions of same structure with alterations or additions: Front ~ • ~ ~ ~ ~ • ~ ' '
Depth....... Rear........
Ileight ......................Number of Stories .
$ Heinhtsions of entire new construction: Front , , ~ ~ • ~ ~ ' ' ' ' ' ' '
Rear . .Depth
g Number of Stories.
9. Sizeaflot:Front........ Rear .........:.............Depth.......................
10. Date of Purchase ~ • ~ • " " " " " " " " '
••••••••••••.......NameofFormerOwner
11. Zone or use district in which premises are situated , , , , , , , , • , , , , ~ • • • • ~ ~ ~ ~ ~ • ~ ~ ~ ~ ~ ' ' ' ' ' ' ' ' ' ' ' ' '
12. Does proposed construction violate any zoning law, ordinance or regulation: • •
13. Will lot be re raded
14. Name of Owner of premises ~ ' ' ' ' ' ' ' • Will excess fill be removed from premises: Yes No
•••••••••••.••...Address. .PhoneNo..
Name of Architect .................Address , ..................Phone No..... , .
Nance of Contractor . ,Address . .Phone No. .
15.Is this property located within 100 feet of a tidal wetland? *YL~S....NO.•X .
*If yes, Southold Town Trustees Permit may be required. ~
I PLOT DIAGRAM
Locate cleazly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property Gnes. Give street and bloc)4 number or description according to deed, and show street names and indicate whether
interior or corner lot.
P
.
-
II
i
STATE OF NEW YORK,
COUNTY OF , ...~C~~S.S
• ~ ' ' • ~ ' ' ' ' ' ' ' ' ' • • • • being duly sworn, deposes and says that he is the applicant
,(Name of indiv ual sign}ng otract)
above named. i
He is the . , I
,(Contractor, agent, corporate officer, etc.) • ~ •
of said owner or owners, and is duly autho'Irized to perform or have performed the said work and to make and file this
application; that all statements contained ink 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
~0. ...day of . 19d°.
Notary Public, , , , , .~~r:~!r!.. County
HELEN K. DE .
NOTARY PUBLIC, St of New York ~C:^-V~ .
No.4M78'/8,8u~folkCount~j S~ nature of applicant)
Term Expires March 30,19--
f.
- (VACANT) s.o.N. No. as - so - Ta
(DWELLINQ)
1 PUB</C
SCI T T ON Po.o4 WATER Ip STREET •
. PL q CF
420.00' N BBe 0y` yO..E
20 0
~UFP't}dd( a~ul~rv air ~ kO~At~41 rlii~ ~ yo22r
DATF.IAN g - 1q~ H.S. REF. t~{3. ~Sa°73~ ~ 1 sir
~ 1
The sewage disposal a d watr:r supply fuciliti~ dw t/115 1 eE ~ 2D.r ~
locatim~ have been inr,T cted by this Department and/sr i r. ~ p, 1
other rtei~ and ~ , d Pfl i~,saYt~Yay~towy. ' ~ sr.
W
"J Ck~+ef~ Bureau '~e~sstewater tQenagemefit t 1 ~3' 2\ ' ~M
r I o
1
pORC 23.2' 24.6'
Z ~ ~
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ra.s~ o y
U
V (DWELLINQ) N ~ ~ r .srv
ry e.e~ 9n~H0~$f N
aAnA OF M SS
2?..2'
or. s ` (VACANT)
f!j h'QOD
` 3rfP CH. -
= Y•
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4
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2
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a F~~v i
o`H
o _ r----_'"_
a ~ - _ _ s~ S 7B°3f'4D" W O O Cg7'w ~ F6r--'"-~~~ ~~W F EE.E 3STK
`r ~ ~ 58818'40
w FND 8'1.91
N/O/F SCMNE/DER ro oa~NElw ~~7
• 2 ~ (VACANT) Gj ~I \~J
( DWELL/NQ) ~
I ~ ' N/O/F TASKER
j ~ JAN 171989 ii
E•LCG. iyt_c'.T.
Prsporsd /n accordance xi/1hlhe mintmum To°~gtY'a„u",„¢
~'~r!r~'-0~~vi
slartdards for IINe surveys us ealaDllshed "
by the L.I.A.L.S. and opprared and adopted
SUR VE Y OF for suoh use by TM Nsw York S1als Land
Tl/!e Assoc/otlon.
The water supply 8 sewcye disposal sys-
teme for this residence will conform to the
LOT ~ V standards of the Suttolk County Dsparh
mant of Meal}h Servicec,
MAP OF
EASTERN SHORES
The locations of wells and cesspools shown hereon are from Ileid
F/LED APR/1 27, 1984.E/LENO. 402,1 observations and or from dnia obtained from olhars. \
TOWN OF SOUT>fIOLD CERTIFIED TO'
SUFFOLK COUNTY, N. Y GI~PANYERlGAN TITLE AVSURAN
- - 05 - 05 MARY JANE GROLL ~
N
A~ay 2 4, 1988 ~~ti~ ~ ~M
°5~,~ ~
D@C. 14 , 1988 (,FINAL) AREA = 13,843 , fie, 5d~ 2cm
i 9 C1
' ~ .Y L/C. NO. 4961.8
EC 't" P. C.
f5161 4 use
ELEVATIONS ARE REFERENCED p'
iD AN ASSUMED DATUM. MAIN R
SOUTMOLD, N. Y. 1197(
88 - 354
(VACANT)
(DWELLlNCi)
SCI T T ON t. '°~et/c w~h~R
20_09 /N STREET `
A CF
_ N Be ° 01' „ ryss
420.00' 30 E ~
EO.G
ro??2,
Ov sEi
zo. r
Z ~ ~ ~ _
' ~ ~ .
Q ~ ~ ~ 1~r°p W
/ q~~ -~Ysf~~, ~o .
G=.;2-J Q
Z Q . i h
Z ~ ~ ~ 2s~ 24'~
~.3 ~ y
o
U v ~ (DWELL~r~~ h
v
~1t2 N~ar-. y, ~ Q
~ ~ N 88
&a.S 23,t ~~op. 'yt ~
,
~g ~ 3 h ~ ~ L+.1 ~ (VACANT)
\1Y
_j ~ F" V 8
V ~rv• ~ O v~ J Y
~ ~ ~ bA
~ ~ ~
~ Q ~
Ltd 3'- 41 aL-,>
r.s C~ Gl. a o
~ G~ 3 a B ~ V
~ -
~
~
~ ~
~ o~~ I W H
o ~ 2
x > 81.6 h
~ ~ ~ - - _ E~•E TR~E~Ep~OeN~r FE
pdp, FCORRER I.0'N
ry ~ Q 3EK .~7 99' .
~ , „ : O 1~~• WIRE fE~ 9
S I6 37 4O W O O i/ PP.E STK
~ ~ 21 9 FND 82.91' 18
N/O/F SCHNEIDER ro ~ M0E"N
2 O/L E/W
I "2 bS- 3a °7 0
(DWELUNO) ~ (VACANT)
I N/O/F TASKER ,1~5r~~~~0~
' So~1~0~~ W.~
Prepared M accordance with dho minlmum ~~4Kt
standards (or /itle surveys us aslabl/shed
by the L.LA.L.S. eed approved and adopted
SUR VE Y OF (O/ saoA uas by The New Yark State Lond
TtJle Assoc/otlon.
The wafer supply 8 s~•Hage dlaposai sys-
T - terns Ior fdis resldsnce will conform to the
L O / ~ standards of the Suffolk County Depart-
V4 menl,ofp 4ealth Services.
MAP OF , t~~`"'9-"~-
E
it~wY~ 6
EA STERN S!
IO.RES
The locaflona of wells and cesspools shown hereon are !rom Oei i
F/LED APRIL Z7, 7984 FILE NO. 402.1 observations and or from data obtained from otders. ,s;`~;ti~ ,
r
.~E 4`
TOWN OF SOUTHOLD ` "
SUFFOLK COUNTY, N. Y cER7yFlEa ra
FJBS T AMERICAN F1 TL E 1NS ANCE ` r`
1000 - 33 - 05 - 05 ~ ~ coMPaNr ~~ay ~ ,.:r,
~ MARY, JANE GROLL t. METS09 Q~ OC
SC8/e 1 = 20 1/~~~'o~,~ ~~F9G~< ;,C ,~~5~-~v
May 2 4r 1988 AREA = 13, 803 - _ { ~ a.,
c .
~ .S. L/C. N0. 496/8
EC F ~ ~ CRS, F.C.
!5/6J 7 ~CZO
P. O. BOX 90.9
MAIN ROAD
SOUTHOLDr N. Y. l197/