HomeMy WebLinkAbout21833-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEP~RTNENT
office of the Building Inspector
Town Hall
Southold, N.Y.
C~RTIFICATE OF OCCUPANCY
No Z-23307
Date OCTOBER 25, 1994
THIS CERTIFIES that the building
Location of Property. 435 HU~4EL AVENUE
House No.
County Tax Map NO. 1000 Section 63
Subdivision
ONE FAMILY DWELLING
SOUTHOLD, NY
Street
Block 2 Lot
Filed Map No. Lot No.
Hamlet
16.4
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 14, 1993 pursuant to which
Building Permit No. 21833-Z dated DECEMBER 14, 1993
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 A ON~ FAMILY DWELLING WITH ATTACHED REAR 6 X 6 DECK; FOR
FIRST FLOOR ONLy *
The certificate is issued to
of the aforesaid building.
PINE GROVE CONSTRUCTION COMPANY, INC.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 93-SO-87 SEPTEI4BER 23, 1994
UNDERWRITERS CERTIFICATE NO. N327835
PLUMBERS CERTIFICATION DATED TANDY PL~ & HEAT
SEP~ER 22, 1994
SEPTEMBER 30, 1994
* - CO FOR FIRST FLOOR ONLy.
Rev. 1/81
S~/~ UNFINISHED.
FORM
TOWN OF $OUTHOLD
BUILDIN~ DEPAJ~TMENT
TOWN HALL
$OUTHOLD, FLY.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNllL FULL
COMPLE11ON OF THE WORK AUTHORIZED)
NO
Permission Is hereby granted to: . ~
~ ~ .~.~,,~.~:..~,...~.,.. ~,,~
.................................................... ~...~J.~ ...............................................................................
CountyTax Map No. 1000 Sectlon.....~....~... .............. Block... ,~... ................. LotNo./..~.(..,~,..,,L,L(~.,,'-~,.
pursuant to application dated .~.../.~gd" ................................................... 19...~ ........ and approved by the
Building Inspector.
Rev. 6/30/80
Form No. 6
TOWN OF SOUTtIOLD
BUILDING DEPARTMENT
TO~ th\LL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: 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 Approw~l 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.
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 applicaot.
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-existinK Buildinm - $I00.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupa~cy - $50.00
5t Temporary Certificate of Occupancy - Residential $15.00, Commercial ~15.00
Date~ /
/' ...............
New Construction ........... Old Or.re-existing Building..
Location of Property.. ~.~. ?....4/~- ·~- ~-[ ~,- .t~..~-.- .J.~.~.~. i i i i i i i 5.~.' ~//1~?.0}.../.~..~.~. o/~.~ ~..~-
House No. Street Haml/et ~
O~wer or Owners of Property..~.~.,.-....~-~.J./.~?------~.~.~-.~,-.~- ........... ' ..........
County Tax Map No 1000, Section .......... Block................Lot ................ . ... ..
Subdivision Filed Map Lot
~ermit No ......... Date Of Permit ................ cant .......... ' ...................
iealth Dept. Approva] .......................... Underwriters Approval .........................
'lanning Board Approval ........................ /
lequest for: Temporary Certificate ........... Final Certicate..-~. .......
'ee~,<~g~tl~Submitted: $....-~. ................... ,...~...//~. ~.~·
THE NEW YORK BOARD OF FIRE UNDERWRITERS
1015~26 BUREAU OF ELECTRICITY
~-- ES JOHN STREET, NEW YORK, NEW YORK 10038
THIS CE~IFIES T~T
~, examln~ on 8B~ 19,1994 ~ ~und ~ ~ tn co~ce ~h the N~ Elec~c~ C~.
12 4 12 i / 12.4
FuRNAcE MOTORS FUTURE AFf'UAKI Fr4OIRS SPL~AL RIC'PT
K.W. ~LI H.P. G~ H.P. ~T. NO. A.W.O. ~T. AMP.
1 F I 20
I 4
S~RVICE mS~OHNE'=T INO. OF I
i1~ C~ MEiIRT"~
HOTORS ~ 2-F H.P.
G.F.C.II-4
EXHAUST FANS
PEAK ~CTRIC S~RVICS
54 STRATLBR DRIVE
SHIRLEY, NY, 11967
LIC.#712-E
rhis certificate must not be aJtered in any manner; return to the office of the Board if incorrect, inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT, '[ }{~$ COPY OF CERTIFECATE MUST NOT BE ALTERED IN ANY MANNER,
Town Hall 53095 Ma~n Road
P. O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765 1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
CERTIFICATION
Building Permit No.
Owner:
· (please print)
.f
(please
print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
(Plumbers Signature)
Sworn to before me this
~ day of~Dc--~o''~~-~ 19~~
Notary Public, J'-~/-~-~'/ county
RICHARD C. SMIll'I
NOTARY PUBLIC, ST&T~ O~ ~ YORK
QuaLified In Suffolk Co.. I~- ~,~451 ~._.
¢1. ~ ~,
FOUNDATION
(1st)
FOUNDATION ( 2nd )
ROUGH FRAME &
FLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FI;JAL
ADDITIONAL COMHEIITS:
765-~,8~2
BUILDING DEPT.
INSPECTION
FOUNDATION IST [ ] ROUGH PLBG.
FOUNDATION 2ND [ .] INFLATION/
FRAMING [/-~ FINAL
REMARKS:
DAT~ INSPECT~
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ I ,~)UGH PLBG.
FOUNDATION 2ND [//]' INSULATION
FRAMING [ ]FINAL
INSPECTO -
765-1N2
BUILDING DEPT.
INSPECTION
REMARKS:~
DATE ~__~INSPECT~
765-1802
BUILDING DEPT.
]FOUNDATION 1ST [~ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
[ ] FRAMING [ ] FINAL
DATE INSPECTO
765-1802
BUILDING DEPT.
INSPECTION
[ ] ~DATION 1ST | ] ROUGH PLBG.
~/FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS
765-1802
BUILDING DEPT.
INSPECTION
[~FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
[ ] FRAMING
FINAL
DATE
TO~VN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~_ 17875 Z~
Date
~e,~ni~si0n~i~he~jeby grantec~to: . ~' .~2
,~/~:~'~- - .(.¥,~..~.......~_~....~ ................ ~ ............. _
... ,~..../~..~....~.....~,.....".~..~.~..:....~,../.../~..~. Y
....... ........
at premises located at ......... .~-...~ .......... ~.~....~...~~....~ .~..~. .............................................
Courlty Tox Map No. 1000 Section ......... ~.....~... .... Block. ......... ~ ....... Lot No ...... ./--'..~...&--r,~, ..
pursuant to application dated ..... .~.?..'~../../..,.~.... ................................ , ]9....~,~., and approved by the
Building Inspector.
~e, $...~.~4."....~X
Rev. 6/30/80
0j~¢¢;'$
236 THIRD STREET · P.O. BOX AH
GREENPORT. NEW YORK 11944
UTILITY OFFICE
POWER PLANT
SUPT OF UTILITIES
October 30, 1990
Mr. Robert Fisher
1252 William Floyd Parkway
Shirley, N.Y. 11967
Re: Lot ~16.1 - ~435 Hummel Avenue, Southold
( Old Ostroski property )
Dear Mr. Fisher,
Please be advised that the above referenced property is within
our franchise area and therefore has direct access to the Public Water
Supply System. The water main on Hummel Avenue is 6" in diameter, and
runs the entire length along the North side of the road.
If you should have any further questions, please feel free to
contact me at (516) 477-1748.
Very truly yours,
Gerald W. Hickson
By direction of
the Superintendent of Utilities
GWH:cr
'tOO ¥oars of Gommunit¥ $orvico
FO~,M NO. lB
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)
N°Jq? 2103g Z Dote ...../.g.../.~...~ ................................. , ~9~....~.
Permission is hereby granted to: , , , , ,~.
.......
. .....~7-~...4~..,..~.:m....,.x.A~....z.-....,'~ ~
..... 77 ...... ? ........ 2r'"."~;~.~ "~.__ ___,,/, ................................................... ~ ..................................................
at premises located at ....... /,~.~.~.< ....................................................
pursuant to application dated .~...~... ,~.../ ........................... 19 .........and approved by the
Virginia Watson Fisher
1252 Wm. Floyd Pkwy.
Shirley, N.Y. I196-I
Town of Southold
Building Dept.
Route 25
Southold, N.Y. 11971
Attn: Tom Fisher Bldg.
Insp.
October 21, 1992
Dear ~.~r. Fisher,
As per our conversation of this morning, please accept this
letter as our intention to merge titles re, our lots on Hummel Ave.
in Southold NY to one single deed as soon as my attorney can draw
up t~e necessary paperwork. Please be advised we plan to merge
these parcels, regardless whether or not, their is an actual change
in ownership by me. This will accomplish the lot now to ]De known
as lot # 16.4, as we discussed.
If this letter is acceptable, please process my permit
renewal, at your earliest convenience, and mail to me at the ~bove
address. If you need to reach us by phone, please call us at (516)
395-6086,
Sworn to before me this
day of October, 199.2
Notary Public
21st
Sincerely,
Vir9%inia Watson Fisher
MAY I 5 1991
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
~OUTHOLD, N.Y. 11971
TEL.: 765-1802
BOARD OF HEALTH ............
3 SETS OF PLANS ............
SURVEY .....................
CIIECK ......................
SEPTIC FORH ................
~ ~ ~ '" APPLICATION FOR B[JILDING PERMIT
NOTIFY[
CALL .....................
MAIL
Date ................... 19 . . .
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 2
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 tkis application may not be commenced be£ore 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 throu2~.out the work.
,% No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall 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
Buiolding Zone Ordina,~ce 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/,r~moval or ~14~ion, as herein described.
Th~ applicant agrees to comply with all applicable laws, ordinances, build~f:pde, housja~.4od~, anW]regulations, and to
admit au .horized inspectors on premises and in building for necessary, in,p~/Ri~.9~.~ ~ /,~,,,~ ~
. . : z . ...........
/f~nSt'ure oi appl}~' t,~ff, name, ,t :i corporat,on)
(Mailin= address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
, ame ofo','ner of premises ..................................................
(as on the tax roll or latest deed)
Ir'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 T~ade's License No ......................
tlouse Number Street. Hamlet
County Ts:: Map No. 1000 Section .. .d ...... Block .................. Lot .... ~ ........
Subd vision d.~~....~.. .................... Eiled Map No ............... Lot ...............
(NameI
2. State existing use and occupancy of premises and/intended us~ and occupanc~ of proposed construction:
k. Im,nd,a u~ .... . .~...~. ~. g.~.. ~ ~g~/!..-.. ~~,-. ?:.,~..~ ....
3. Nature of work (check which applicable): New Building .~.. · ·
... Addition .......... Alteration .......
ReFair .............. Rbmoval .............. Demohtion .............. £w£mr~i ng pool ...........
Tenn£s Court: ......... kccessory Bu£Iding .......... Fence ....... Other Work ............
~. Est~matedCost ,7~-~. ......................... Fee ..~_~.~..~¢ ....................... "
· ' /' (to be paid on filing this application)
! ·
5. If dwelling, number o£ 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 rise ......................
7. Dimensions of existing structures, if any: Front... tv'~ Rear Depth
Height ............... Number of Stet/es .........................................................
D~ensictris'o£ s:mtct st~.-tcture with alterations or additions: Front ................. Rear ...................
l$~tIt~,.,:~. ~ ,, .................. Height ...................... Number of Stones .................
8. Dimensions of entire new construction: Front,., .~...fid ........ Rear.. '.~.~ ....... 'l~e'p't~' .
.c~t ............... ~t, berol' Sto~e~ ..;:~..,,~:. - - ~ ................... ~. · .,~ ....................
9. si~ octet: Front .... /.¢<.g. ............. /.¢ .2<. ....... Oep h .~.. .................
lO. Date of Purc~,,a.se .. ,/~.~y'..(.$'.?. ................ ['~innc of Fenner Owner ..............................
11. Zone or use district in wl~ich premises are situated... Z'.(..-: ~. ~. ...........................................
12. Does proposed construction violate an5' zonin~z law, ordinance or regulation: /~.~ ....................... ~-/- ....
13. Will lot be regraded ...,~...D ............. .~ ........ ~Vill excess fill be remove, gl from premises: Yes , cL. No..
Name of Owner ofprem;.sesf0~¢~[~-~.~(-d.,~~<- Address /"q .5-¢Z .f~,~.~f'~ltff~'~'.~-. P tone No .....
14. Name of Architect ....... . .... ]. :::. :. ]. :::]]Address ] :2~/r;/¢'{~.~.zz//,'~//.~'?!. mhd;;
Name of Contractor . .~.~. .................. Address ......... ~/,/.'~'~: .... Pho ~- · ......... ~. :-- ..
15.Is this property lo~cated within I O0 feet of a tidal wetland? ~¥gS .... NO-A.-
mIf yes, $outhold Town Trustees Permit may be required.
PLOT D;AGI~kM
Locate clearly' ;md distinctly all buildings, whether existing or proposed, and. indicate all set-back ciimensions from
property lines. Give street and block number or description accordin°~ to deed, and show street names and indicate ,vhethcr
interior or comer lot.
~ 0 REMOVE EXCE,~S FILL
::-RO,~ ABOVE PREMISES ~
~V~AY ~~ ~
c~ ~N~ ~ -
STATE OF NEWrsYOI~I~, ,. g ~ o
COUNTY_.-_ --OF' d.¢ ~/~ ...... ~'~,
..... ~/~D~e~.~.. &'. ~/J~ ............. being duty sworn, dcposes~dsayst~atheistheappticant
(Name of individual signing contract)
above named.
(Contractor, agent, corporate of[icer, etc.)
of said owner or owners. ~d is duly authorized to perform or have per[o~ed the said work and to m~x and ~le this
application: that all statements contained in this application are true to the best of bix know{edge and 5clic~; and that the
work wB] be pcrl'o~ed in [he m~er set [orth in thc applicatiou ~Icd therewith.
Sworn to before mc this
,, ~~ ~ .........
N 70° 45' 10" E 142.00
HUMMEL
JT.Z ..,,4 X,,o -
,4~.oo, 's I~' 4,-' ,~" w
A VENUE
( LUMBER YARD )
USES PUBLIC IFA
~UFFOCK COUNTY DEPARTMENT OF HEALTH SERVICES
FOR APPROVAL OF CONSTRUCTION ONLY
DA~ ~, REF._I~K
The ~oeationa of wellu~nd
obaervaffona and or from data ob
Scale 1" = 30
~a ahown boreo. ~e from field
Dec.
2,
1987
from o~re. AprE 12, 1991(revise lot)
SURVEY OF Lo,,,.
PROPER T Y [ .--,,,
A T SOUTHOLD
TOWN OF SOUTHOLD '"
SUFFOLK COUNTY, N. Y.
· AREA= 28,400 sq. ft.
SINGLE-FAMILY DWELLIN~ ONLY
CER=IFIED TO, EXPIRES TWO YEARS FROM DATE OF APPROVAl..
TICOR TITLE GUARANTEE TITLE No. T 1290-0554 ~
ROBERT L. FISHER
NORTH FORK BANK & TRUST CO.
Prep_ared in a~ord~tee wiff~ the minimum
atan'.darda for title eurvej, a ,m eatabgahed
by tl~e L.I.A.L.$. and ap~oved and adepted
for euoh uae b)' The I~w York State Land
Title A,eooiation,
ELEVATIONS ARE REFERENCED TO
'~N A.~,SUMED DATUM.
The water aul~oly and aew~ge diapoeal
eyatema for thio reaidence wi~ conform
EAST END REAL ESTATE
775 Montauk Highway
Shirley, N.Y. 11967
87 - 886 B
FNO
52 0.7'
HUMMEL
(VACANT)
N/O/F JAMES ' M. ¢~RA TTAN
4§' 10" E 142.00'
,
142. O0 '
A VENUE
37.0 36.7
(LUMBER YARD )
SUFFOU( COUNTY DEPARTMENT OF HEALTH SERVICES
FOR AI~=ROVAL OF CONSTRUCTION ONLY
DATE H.S. REF. NO
S 70' 45' 10" W
35.9
SURVEY OF
PR OPER T Y
A T SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y.
1000 - 63- 02- 16.1
Scale 1" = 30'
1987
Apr# 12, 1991(revise lot)
April 19, 7994 (foundab'on)
TEST
BORer6
DA TA
AI~OVED __
The Iooationa of welle and ceaepoole ahown hereon are from field
obeervatione and or from data obtained from others.
LOAM
17'
AREA: 28,400 sq. ft.
CER T/FlED TO'
T!COR TITLE GUARANTEE TITLE No. T 1290-0834
,ROBERT L. FISHER
NORTH FORK BANK t TRUST CO.
Prepared in accordance with the minimum
atandarde for title aurveye ae eetabliahed
by the LI.A.LS. and approved and adopted
for ouch uae b,v The New York State Land
Title Aeaoeiation.
ELEVATIONS ARE REFERENCED TO
AN ASSUMED DATUM.
The water eupply and eewage diapoeai ~
ayatem# for thio reeidence will conform /'f/.~A~'~
t_o the et~d~de of The ~ffo~ C~ty /~~~
. LIC. NO.
' ' PECO~ ~RVEYOR$, ~
(~) 7~.- ~o~o
P.O. BOX ~0~
MAIN ROAD
S~THOLD, N.Y. I~71
49~ 8
87- 886 B
PIPE
(VACANT)
N/O/F JAMES ' M. GRA TTAN
._ N~ 70° 45' .I0" E.~ 142.00'
~?.~. j ~' 37~ 37~
.
142. O0 '
HUMMEL- A VENUE
37,0 36.7
( LUMBER YARD )
SURVEY OF
TEST
DA TA
,O.A,,'.OVALO~C~'"UO~""~Y I TOWN OF SOUTHOLD
DA~0V lS ~9~ .s~.~q/7 SUFFOLK COUNTY, N Y.
~~ 1000 - 63- 02- 16.1
*~ ~ ~_. Scale 1" = 30'
Dec. 2, 1987
The Iocatione of welle ~d =eaepoole ehown hereon are from field
obearvatione ~d or from dsts obt~ned from othere. ~~'~,?. '; '*' AprE 12, 1991(re vise ]o t)
.
28, 400 sq.
ZT REA =
C~R TIFIED TO'
TfCOR TITLE GUARANTEE TITLE No. T IZ
ROBERT L. FISHER
NORTH FORK BANK z TRUST CO.
The water supply and sewage disposal
systems for thia residence will conform
Prepared in accordance with the minimum
pt~n.darde for title eurveye aa eet~h,qehed
l~y the L.I.A.£.S. ~ ~proved ~d a~ted
for euch uee bY T~ New York Sta~ L~d
Title Aeaoeiati~.
ELEVATIONS ARE REFERENCED TO
AN ASSUMED DATUM.
to the standards of The Suffolk County
Department of Health Servicee.
EAST END REAL ESTATE
775 Mofltauk Highway
Shirley, N.Y. 11967
OCT ~,
SmC. DEPT. OF
HEALTH SERVICES
"'
(~) ~ ~ 502o ~ ~,
17"
87 - 886 B
( VACANT )
N/O/F JAMES M. GRA TTAN
N 70° 45' 10" E 142.00'
PIPE PIPE
~.o'E ~.~r. 3~.
320.7"
14200'
A VENUE
37.0 36.7
(LUMBER YARD )
HUMMEL
SUFFOCK COUNTY DEPARTMENT OF HEALTH SERVICES
FOR A~'ROVA' OF CONST,UCT,~
DATE H. S. REF. NO. 93-SO-8
APPROVED
70*
45' ~
10" W
SURVEY OF
PROPER T Y
A T SOUTHOLD
TOWN OF SOUTHOI~D
SUFFOI,K COUNTY, N. Y.
The locations of wells and oeaapools shown hereon are from field
observations and or from date obtained from others.
· 4REA= 28,400 sq. ft.
1000- 63- 02- 16.1
Scale I' = 30'
Dec. 2, 1987
AprY 12, 1991(revise lot)
April 19, 1994 (foundation)
Sept. 20, 1994 (final)
0.7
/7'
CER T/FlED TO,
T!COR TITLE GUARANTEE TITLE No T 1290-0854
ROBERT L. FISHER
NORTH FORK BANK ~ TRUST CO.
Prepared in accordance with the m/n/mum
standards for title surveys as established
by the L.I.A.L.S. and approved and sdopted
for such use by The New York State Land
Title Aseooiation.
ELEVATIONS ARE REFERENCED TO
AN ASSUMED DATUM.
The water supply and sewage disposal
systems for this residence will conform
to the standards of The Suffolk County '""
Department of Health Services.
'~ N.Y.S. LIC. NO. 498/8
" " PECO~C ~¢¢R~YORS. P.C.
MAIN
SOUTHOLD, N.Y. 11971
87 - 886 B
OWNER ~'~-REET 4,,.~,~ ' VILLAGE DIST. SUB. LOT
RE~AR~S ' .
~c,. .~ ,~ ~17~ .~:~,.~ ~,- L~ /~ ~1,h44~/~?::1.:,~ ~ ~r~--
TYPE OF ELD. / I ---
,, _ PROP. CLA88 /
LAND IMP. TOTAL DATE
~1 ~4 /urE-BP~-2.1 ~ ~ ~- Conse o~-Cc, ,, ,IF c.~ll,~
~1,14- ~ ,., - -,. <x,. :.~ '-~
"'. :.~" ..
'"' ~'~ - l] TILLABLE
~ ', %~' .[~out~o[ ON ~O~9 ~ ~ ~¢~ - ~ WOOOL~UO
'~r ~:~' _ ___
' ;~ "'~ '"' ' ~ DEPTH MEADOWLAND
[ ,'.:." ' .~.'~' '.,,~'~,.., 2o0
.... ,' : ..;~?;~,... ... ,,,, ,,,' .. ~ .:.:~ ; ~ BULKHEAD : HOUSE/LOT
,'~..,~' -,~,-,.~.. .... ,~ ~:' · ~ ~.~,--,?~: ...-. ,....,. ~ .....
COLOR
TRIM
M. Bldg
Foundahon
Extension
Extension
Extension
Paho
Porch
Deck
Breezewa
Garage
Basement
Ext Wails
Fire P~ace
Dormer
Driveway
PC
CB
Bath
Floors
Interior Finish
Heat
Dinette
Kit.
' I
Rooms 2nd Floor
Fin B
Attic
Rooms 1st Floor
Woodstove BR.
*' ' /~'~TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET ~ VILLAGE DIST~ SUB. LOT
·
FOR~ OWNER, ~ / ' ' '
~m~ ~~ ,t,' - '~ '~ ' ""
/, W ~PE OF BUILDING "
.~' s~s. w. ~ I I .~.M CO~M. C.. M~CS. M~.
~ND IMP. TOTAL DATE RE~RKS
J
AGE ~UILDING ~ONDITION
N~ NO~AL BELO~ ABOVE
Acre
Tillable ,- FRONTAGE ON WATER
W~land ~' ';' FRONTAGE ON ROAD
M~adowlond r :~ '"~'' ':.* ~;.~ DEPTH
:,. ~,.. ...... . , .~Z ~: .. ,
H~ Pl~ , ~.
Total ~ ~ , : : ,'~' '-
~ldg.
~r~s[ort
.1sion
;nsion
rch
~ch
,ezeway
'age
rio
B.
COLOR ~ *Z~'~ ,
:oundotion
IExt. Walls
IFire Place
Roof
'Recreation Room
TRIM
Rooms 1st Floor
Rooms 2nd Floor
Drlveway
JDinette
LR.
SR.
FIN.
O~WI~ER ~T-REET VILLAGE DiST~ SUB. LOT
TYP~ OF BLD.
LAND IMP. TOTAL DATE
FRONTAGE ON WATER T~LLABL~
FRONTAGE ON ROAD ~9 ~ g ¢~ - Off ~ WOODLAND
I'
DEPTH ~O~, MEADOWLAND
BULKHEAD HOUSE/LOT
TOTAL
OWNER
-/~-~"~'/,~ _~_~/~TOWN/~ OF SOX'I~LD PROPERTY RECORD CARD
- ~ I VILLAGE SUB.
LOT
/~lr, r~1 bsfro s~,'
v,. ~ I I FARM
cOMM. CB.
TYPE OF BUILDING
MICS. Mkt..Value
LAND IMP. TOTAL DATE
REMARKS
O0
AGE
NEW
FARM
Tillable
Woodland
Meadowland
House Plot
Total
NORMAL
Ac re
BUILDING CONDITION
BELOW ABOVE
Value Per Value
Acre
FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
DOCK