The URL can be used to link to this page

Home My WebLink About30200-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPA/~TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30888 Date: 04/28/05 THIS CERTIFIES that the building NEW DWELLING Location of Property: 665 ARROWNEAD LA PECONIC (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 98 Block 3 Lot 4.1 Subdivision Filed Map No. -- Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated ~LARCH 29, 2004 pursuant to which Building Permit No. 30200-Z dated MARCH 29, 2004 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 SINGLE FAMILY DWELLING WITH COVERED PORCH & REAR WOOD DECK AS APPLIED FOR & AS PER CONDITIONS OF ZBA ~4886. The certificate is issued to GLENN & YVONNE MCNAB (OWNER) of the aforesaid building. SUFFOLK COlYArl~f DEPARTMENT OF H]L~LTH APPROVAL Ri0-00-0211 08/26/03 ELE~-£KICAL CERTIFICATE NO. 1093615 10/05/02 PLUMBERS CERTIFICATION DATED 03/28/05 CUTCHOGUE EAST PLUMB&HEAT 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-30889 Date: 04/28/05 THIS CERTIFIES that the building ACCESSORY Location of Property: 665 ARROWHEAD LA PECONIC (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 98 Block 3 Lot 4.1 Subdivision Filed Map No. -- Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 29, 2004 pursuant to which Building Permit NO. 30200-Z dated FL~RCH 29, 2004 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 ACCESSORY TWO CAR GARAGE WITH STORAGE ABOVE AS APPLIED FOR & AS PER CONDITIONS OF ZBA #4886. The certificate is issued to GLENN & YVONNE MCNAB (OWNER) of the aforesaid building. SUFFOLK COL~fY DEPARTI~ OF ~[F2%L~{APPRO~q%L E~ECI~I~ ~RTIFIC~qE NO. PLUM~ER~ CERTIFICATION D~l'~s3 03/28/05 N/A 1093615 10/05/04 CUTCHOGUE EAST pLUMB&HEAT Authorized Signature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY t .. 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..~x~,r~-~. -~2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). ~3 ,,~.~, rr~'o 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. .,~3~Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. .,~v~ubmit 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. Ifa 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 90, Swimming pool $25.00, Accessorg building $25.00, Additions to accessory buildin~ $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 $i5.00 New Construction: Location of Property: Jq~! O Old or Pre-existing Building: (check one) House No. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Subdivision Permit Nc~. ~ Date of Permit. Health Dept. Approval: 7~-~a~u.,:~ Planning Board Approval: Block ,3 Filed Map. -- - Lot: Applicant: .~gO~rAt ~ ~/vc,~O,.~ Underwriters Approval: t6t2Wgk.44.~F~..~ Request for: Temporary Certificate Fee Submitted: $ 6L~' '~'"'"- Final Certificate: (check one) Apphcant Signature Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 C,,~D L, DEFT 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. ,~.~.~,,~,n~-~. ~- 2. Final Approval fi.om 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. ,,~'~. 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, thc 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 90, Swimming pool $25.00, Accessory building $25.00, Additions to accessory buildine $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 $15.00 New Construction: t/ Old or Pre-existing Building: Location of Property: 6,$.5- ,,tbO,~_4~.~/~,4--~ ff.*mvl~ House No. Street Owner or Owners o f Property: (check one) Hamlet Suffolk County Tax Map No 1000, Section Subdivisiqn ~ Permit N& 4:~~-,~__ Date of Permit. Health Dept. Approval: .;::,~oa~a~,, $~tL~r-nf~ Underwriters Approval: .3 Block Lot___ Filed Map. Lot: Applicant: ,~g-,(:v~A~ Planning Board Approval: Request for: Temporary Certificate Final Certificate: Fee Submitted: (check one) OFFICE OF THE ~L~I[.DING I~PEC'I'OR TOWN OF SOtJT'HOLD Not'.a~I/' PU;3~L~c, ~(~ Cou~t'.y KATHLEEN RIVERS Nota~/Public, State of New Yol~k No. 4973963 Qualified in Suffolk Coun~ Commission Expires NovemberS, FORM NO. 3 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) PERMIT NO. 30200 Z Date MARCH 29, 2004 Permission is hereby granted to: GLENN & YVONNE MCNAB 16 GREENWAY TERRACE BABYLON,NY 11702 for : CONSTRUCT NEW ONE FAMILY DWELLING, ACCY I/G SWIMMING POOL & ACCY GAP~AGE AS APPLIED FOR PER ZBA. 3 C/O'S REQ. THIS PERMIT REPLACES BP~28257. at premises located at 665 ARROWHEAD LA PECONIC County Tax Map No. 473889 Section 098 Block 0003 Lot No. 004.001 pursuant to application dated MARCH 29, 2004 and approved by the Building Inspector to expire on SEPTEMBER 29, 2005. Fee $ 1,644.77 ORIGINAL APPEALS BOARD MEMBERS Gerard P. Goehringer, Chairman James Dinizio, Jr. Lydia A. Tor~ora Lora S. Collins George Homing BOARD OF APPEALS TOWN OF SOUTHOLD Southold Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 ZBA Fax (631) 765-9064 Telephone (631) 765-1809 FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF DECEMBER 7, 2000 Appl. No. 4886 - GLENN MCNAB STREET & LOCATION: 665 Arrowhead Lane, Peconic DATE OF PUBLIC HEARING: November 16, 2000 1000-98-3-4.1 (4 and 3 combined) FINDINGS OF FACT PROPERTY FACTS: Applicants are contract vendees of Lots 3 and 4 on the Map of Arrowhead Cove, Peconic, filed June 20, 1963, and will take the two lots as a single pamel measuring 365 feet on Arrowhead Lane, 136 feet deep on the southerly boundary and 118 feet deep on the northerly boundary, with an area of 45,201 sq. ft. The land is undeveloped. BASIS OF APPEAL: Suilding Inspector's Notice of Disapproval, dated October 2, 2000, denying a building permit because (1) the front and rear setbacks of the proposed house are both 36 feet whereas Code section 100-30A.3 requires 50 feet, and (2) the proposed garage and pool are located in the side yard, not in the rear yard as required by Code section 100-30A.4. AREA VARIANCE RELIEF REQUESTED: Applicants request a variance authorizing the location of the proposed construction of the house and accessory garage and pool as described above and shown on the Map prepared by Peconic Surveyors, L.S. dated September 25, 2000. REASONS FOR BOARD ACTION, DESCRIBED BELOW: On the basis of testimony presented, materials submitted and personal inspection, the Board makes the following findings: (1) The shape of the subject lot is such that observance of the 50-foot front and rear setback requirements would leave room only for an awkwardly shaped house, wide but shallow in depth. Applicants have developed a plan that takes account of the lot's shape; it includes placing the accessory structures next to the house, rather than in the rear yard, to take advantage of the lot's width. (2) Neighbors to the rear expressed concern over the proposal to build the garage only 30 feet from the property line. The Board understands the neighbors' concerns, but notes that under Code section 100- 33(B)(3), the garage could be built as close as 10 feet from the property line. (3) Because Arrowhead Lane is paved for less than its mapped width, the setback of the proposed house from the pavement will be about 50 feet. The sentiment of neighbors expressed at the headng leads the Board to believe that it is unlikely that Arrowhead Lane will ever be widened. (4) The action set forth below will enable applicants to build a home that is not inconsistent with the neighborhood, with reasonable setbacks, and will not produce an undesirable change in the cl~aracter of the neighborhood or detriment to nearby properties. (5) There is no evidence that grant of the requested vadance will have an adverse effect or impact on physical or environmental conditions. (6) The action set forth below is the minimum necessary and adequate to enable applicants to construct a home while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. By THiS CERTIFICATE Of COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 Upon the application of upon premises owned by Q.C. ELECTRIC INC. GLENN MCNAB P.O. BOX 518 665 ARROWHEAD LANE LAUREL, NY 11948-0518, PECONIC, NY 11958 665 ARROWHEAD LANE PECONIC, NY 11958 Located at 1093615 1O93615 Application Number: Certificate Number: Section: Block: Lot: Building Permit: BDC: NS11 Residential Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Second Floor, Detached Garage, Outside, Attic, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5th October, 2004 authority having jurisdiction, and found to be in compliance therewith on the Day of · Name QTY Rate Rating Circuit Type Alarm and Emergency Equipment Sensor 2 0 Carbon Monoxide Appliances and Accessories Oven I 0 40 Amps Exhaust Fan 3 0 F.H.P. Furnace 1 0 Gas Water Heater I 0 4.5 KW Air Conditioner I 0 36.000 BTU Air Conditioner I 0 42.000 BTU Electric Heater Baseboard 1 0 .5 KW Panels 1 100 10 Wiring and Devices Outlet 80 0 Fixture Fixture 80 0 Incandescent Outlet 128 0 General Purpose seal Receptacle 83 0 General Purpose Continued on Next Page I of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by Q.C. ELECTRIC INC. GLENN MCNAB P.O. BOX 518 665 ARROWHEAD LANE LAUREL, NY 11948-0518, PECONIC, NY 11958 665 ARROWHEAD LANE PECONIC, NY 11958 Located at Application Number: 1093615 1093615 Certificate Number: Section: Block: Lot: Building Permit: BDC: NS11 Residential Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Second Floor, Detached Garage, Outside, Attic, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Adr~ini~tra~o,0, or other ~ ~,4UatmheOrity having jurisdiction, and found to bi.iD lance therew~h on the >m Day of uct°oer,-uu~. vTy c~mP~ate Rating t. ircuit Iype Switch 45 0 General Purpose Receptacle 2 0 20 amp Laundry PaddleFan 1 0 Dimmers 12 0 Receptacle 13 0 GFCI Disconnect 2 0 60 amp Air Conditioner Service I Phase 3W Service Rating 300 Amperes Service Discoimect: 2 150 cb Meters: 1 seal This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [[]] :IRR~41LANcGE & CHIMNEY [~] :iRN~AFETY INSPECTION REf4AflKS: ~~ ~, ~ DATE ~'~--~"-~"- INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] ROUGH PLBG. - I~NSU~TION [ ] FRAMING [ ;] FINAL [ REMARKS: ] FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. [ ] FOUNDATION 1ST ~ ROUGH PLBG. [ ] FO/UNDATION2ND- [ ]INSULATION [~.~FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY....._~ ~ ~ DATE BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ~ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSULATION [ L~i~RAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY 7r,5-/.802 BUILDING DEPT. INSPECTION [ ] F~UNDATION 1ST [ [ ~ FOUNDATION 2ND [ FRAMING [ FIREPLACE & CHIMNEY REMARKS: ] ROUGH PLBG. ] INSULATION ] FINAL DATE BUILDING DEPT. INSPECTION ~.~~.~['/l FOUNDATION 1ST [ I ROUGH PLBG. [ ] FOUNDATION2ND [ ]INSULATION [ ]FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~~ DATE ~/~// INSPECTOR /~~ FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, NY. NOTICE OF DISAPPROVAL DATE~ October 2, 2000 TO Glenn McNab MC Abelson 16 Greenway Terrace Babylon N.Y. 11702 Please take notice that your application dated September 27,2000 For permit for one family dwelling, accessory_ garage and accessory pool at Location of property 665 Arrowhead Lane Peconic Suffolk County tax Map No. 1000 - Section 98 Block 3 Lot 4 Subdivision Filed Map # Lot # Is returned herewith and disapproved on the following grounds; · dwelling on comforming lot in R-40 zone not permitted pursuant to Article liIA Section 100-30A. 3 which states; No building or premises shall be used and no building or part thereof shall be erected or altered in the Low-Density Residential R-40 District unless the same conforms to the requirements of the Bulk Schedule and of the Parking Schedule, EN with the same force and effect as if such regulations were set forth herein in full. Bulk schedule requires front and rear yard setbacks of 50 feet each Proposed project shown with front and rear yards of 36 feet each. · Proposed accessory_ structures ( ~,araoe and pool ) not permitted pursuant to Article Ilia Section 100-30A.4 which requires all accessory structures to be located within the rear yard, The proposed accessory structures are shown within the side yard. 09:22 6317278833 CHUCKTHOMAS PAGE 01 Charles M. Thomas, R.A. P.O. Box 877 Jamesport, New York 11947 (631) 727-7993 Town of Southold Building Department Att~ntion: Michael Verity July 13 th, 2003 Re: Conditions~a_.~:~bb Residence, Arrowhead Lane, Peconic Permj~ft:~ll~zS~Z? tax mep number, f O00-9~.3-4.1(formerly lots 3&4) Dear Bugdin~Ent: This letter is to certify that I have inspected ~ae above referenced residence and have found that all of the following elements art; c.'~nstructed in full compliance with code. 1. Plumbing and Pressure 2. Structural Changes: Ridge, 2r~ Floor Ceiling Joists, Valley Rafters & 1*t Floor LVL's 3. Fire Separation for Southern Exterio~ Deck (Porch Area) 4. General Framing The plywood has been removed from bottom of the chimney. The plan has been amended to reflect a small 10'X15' deck addition onto the rear (North side) of the house. Drawing to reflect this as built condition ia associated with this fax. PLease note that the new North deck is c~nstructed within the outermost edge of the footprint of the house. Please feel frae to~tions =r concerns. 08/14/2002 09:22 G317278033 CHUCKTHOMAS PAGE 02 88/14/2883 09:22 6317278833 CHUCKTHONAS PAGE 03 FI~LI) INSPECTION REPORT J DATE J COMMENTS ROUGH F~M~G & -i / ~. PL~G STATE ENERGY COD~ F~ _~ ~D~ON~ CO~S TOV~N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 Examined '~/to .20 .g Appro,~ed q/tt~ _, 20 ~. Disapprox ed ac Expiration ,20 BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying~? Board of Beahh 3 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ~'/ ,20 o2.~ a. Th/s 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 waterways. 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 issue a Building Permit to the applicant. Such a permit shall be kept on the prenfises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Exes' building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. .M?PLICATION IS HEREBY MADE to the Building Department for the issuance ora Building Permit pursuam 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building tbr necessary inspections. ~'?/ttx~'b/~ (Signature of applicant or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises ~,v',v/ ~ y~,~ (As on the tax roll or latest deed) If applicant is a corp_ogation, signature of duly authorized officer - (Name and'title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section ~ Block ,.~ Lot ,~' ~ Subdivision ~ff,~wq.,4/-Oa~ (--~6/~ Fil~ Map No, ~/O Lot ~ ~ ~ 2. State existing use and occup~cy of praises ~d int~ded use ~d occupancy of proposed construction: a. Existing use ~d occup~cy ~ ~ 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost ~'a/?oTff' ~ ~ Intended use and occupancy,.~/A/~/t5 ,W',,6Ct,7 ~,~erf~--~ ~anw~ ~7'~tr-~ y,~--~' ,~ Alteration 5. If dwelling, number of dwelling units If garage, number of cars Addition Other Work Fee (Description) (To be paid on filing this application) Number of dwelling units on each floor /~s:,"~'&,~ ,~ / 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. --/V,~4~ -- 7. Dimensions of existing s~any: Front ./~ear ~5~ . Height ~ Number of Stories~________~ ~ Dim~ame structure wit~or additions: Fro~''~ R~ D~th. .l:~Fght_ .,,Number of Stories 8. Dimensions of entire new construction: Front 6-;g~.5 Height ..~/ Number of Stories ,~(0.5', qtY ' Rear ,.~{,-g' Depth Name of Former Owner ~-~n,,~//g/,~.~6~r_ ,,q~::~o~// 9. Size of lot: Front l 0. Date of Purchase 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ~ 13. Will lot be re-graded? YES NO v/~Will excess fill be removed from premises? YES NO I~ Address ~ - 14. Names of Owner of premises Name of Architect ~ Name of Contractor ~ ~////q -- 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet ora tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. Address ,.~o.~, .t/~eor_~' &7" Phone No Address .......... z Phone No. NO 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. if elevation at any point on property is at 10 feet or beloxv, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ~.t~-oc~() ~::~/,~/ tt~c ~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contra, go above named, (S)"e is the CC/.O~ /14C_/~t~ )* 0U0~/F2:~- 0¢' tg~eoe~ ,~- (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are tree 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 7 rd, day of ~t°~'/~. 20 0~_ - Notary Public :, 'T/mY PU3LIC, St~,e of Signature of Applicant I em fnmtller wilh Ihe STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES and will abide J~y lhe condlllon$ sel forlh lherelo end on )he permll Ia conslrucl. LOT ~ N. $4'09'50' E. II 7.$0' SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES PERMIT FOR APPROVAL OF CONSTRUCTION FOR A SINGLE FAMILY RESiDEhCE ONLY FOR MAXIMUM OF 1~ BEDROOMS EXPIRES THREE YEARS FROM DATE OF APPROVAL S. 84'09'50' W, TEST HOLE D~4TA SURVEY OF PROPERTY A T PECONIC TOWN OF SOUTHOLD SUFFOLK COUNTY, N Y. 1000- 98- 03- 03& 04 SCALE.. 1" = 40' AUG 16. 2OO0 The Iocelions of wells ~nd cesspools shown hereon ere from field ohservolions Md or from dote obtained from others. e~LL NO TE' L 0 T NUMBERS REFER TO ' MAP OF ARROWHEAD COVE ' FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON ~ PO, 1965 AS MAP PlO. 3@10 ELEVATION$ ARE REFERENCF-~ TO AN A~SUME~ DA TUM. VACANT : ~ ~ 1.5 ® CERTIFIED TO' GLENN Mc NAS EVON Mc NA~ CON6RES$1ONAL AJ~$TRACT CO., INC. FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK ............... r . LIC. NO. ~9618 _,~., ....... ~ y~ ~ .C. ~=~,201~ ~. ~ l~ ~ee ~ . ~,r ..... ~0~.9~3 00- I em fcamlller ~lt~ Ils ST.4N~$ FOR APPROVAL AND CONSTRUCTION OF SU~URF'.aCE SEWA6E DI~PO,.~4L SYSTEM~ FOR ,.~IN~I.E FAMILY RE..~DENCE$ RVEY A T PEC~ TOWN OF SOUT~LD SUFFOLK .C~NTY, N ~ ~A~, Y' = 40' -" ~.r ,~'~ NOV. 8, ~000 ( rev/s/on ) MARCH ZI~ ZOO2 (revlOn / , I · ...... JUNE I4~ ~00~ (co~c. founds "~ ' ~O COVE ' ~ ~ ~ ~c NAB (~ ~~.S]~. NO 49618 I ~ ~0 TRAqnET O0- 223 I om f~lllor w/Ih Ihe STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SIN6LE FAMILY RESIDENCES end wi# obide by Ihe cendllions se/ forlh Ihereln end on I~ permll Io ¢onslrucl. l ~.' VACAHT , LOT SURVEY OF PROPERTY A T PECONIC 135.8~' TEST HOLE DATA S. 84'09'50' W. VACANT _ O~ 41.5 LOT (~ ia~ m~ SY/ I;~' 4NY 4L TE~4 T/ON OR ADD/T/ON TO SURVEY IS A VIOLATION OF' SECTION 7'809 OF' THE iVEY/ YORK STATE EDUCATION LAm EXCEPT AS PET~ S~CT/ON ?EOR - SUBJ~/I$10N E. ALL CERTIF~CA TION~ I'IE~ON AI~ VALID FOR ~ MAP AND COPIES TIvtER~O~ ONLY IF' SAID MAP OR COPIES ~EAR THE ~=RE$SE~ $EAL OF THE SURVEyoR tl~4OSE SIENA TURE APPE,4R$ HEREON. ~arno~u_~r TO cou~t r ~m s~ ~ n~ ~ '~.re~= ar" · u~r~ um~ ar ~rr,e~ ~u. suRv~msunuz~a co~v TOWN OF SOUTHOLD SUFFOLK COUNTY, N Y. 1000- 98 - 03 - 03 &04 SCALE.. I" = 40' AUG. 16, 2OO0 SEPT, 25, 2000 (prop.hse. NOV. 8, 2000 ( rev/sion SEPT. 7, 2001 (revision garag N The locations o/ wells and cesspools shown hereon ore [rom fiekl observelions end or from dole o~leined [rom ollmrs. NO TE, L 0 T ~ERS REFER TO ' MAP OF ARROWHEAD COVE ' FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON JUNE EO, 1963 AS MAP NO. 3~10 ELE'VA T/ONS ARE ~ TO AN ASSUMED DATUM. CERTIFIED TO" GLENN MC NAB YVONNE Mc NAB CONC,~RES$1ONAL A~TRACT CO.~ INC. F'IR$T AMERICAN TITLE INSURANCE COMPANY O~ NEW YORK PECON/~ ~ (631) 76 '~ ~~) 765 - 1797 P, O. BO~ g ~ LA~ ~ lEtO TRA ~ ~EET SOUTHOL[ N, Y. 11971 O0- 223 FOR ,.q~t.,E O0 - 223