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Home My WebLink About32166-Z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31724 Date: 08/03/06 THIS CERTIFIES that the building ALTERATIONS Location of Property: 3480 ORCHARD (HOUSE NO.) County Tax Map No. 473889 Section 27 ST (STREET) Block 1-- ORIENT (HAMLET) Lot 3 . 3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 28, 2006 pursuant to which Building Permit No. 32166-Z dated JUNE 28, 2006 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 ALTERATIONS TO AN EXISTING ATTACHED GARAGE FOR AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR "AS BUILT". The certificate is issued to CHARLES DEVOE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. H067806 05/03/00 PLUMBERS CERTIFICATION DATED 06/28/06 RICHARD DEVOE Rev. 1/81 ., Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 , (' ,">'i''i,c ,'''jv~u.'' J IJ ()'"-<.c""'-6'~ " II 0-1.o...:.~t .-" -r: -.- JUL 24 " 'J'i ._~. __....J :~~':_',Ql.~~_ APPLICATION FOR CERTIFICATE OF OCCUPANCY !. 1\" 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: I. 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 2/1 0 of I % 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: I. 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 I. 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. 7?1' I(J~ New Construction: Location of Property: 318'0 Old or Pre-existing Building: (check one) House No. &!Ct{If~t:> S, Street O/!../E NT Hamlet Owner or Owners ofproperty: Cf{IIR.t..E5 bE VOE- Suffolk County Tax Map No 1000, Section 0;;17 Block OOD.3 Lot OD3. Ou ~ Subdivision Filed Map. Date of Permit. .:r""'e: 01~ :100" Applicant: Lot: Permit No. 3.:21(;,' Health Dept. Approval: Planning Board Approval: Underwriters Approval: Request for: Temporary Certificate Final Certificate: X . (check one) Fee Submitted: $ ,) 5. DO ~ '1lJ/ ~ Applicant Signature ~.70~ ),; C-a f:/3 n)1 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. 32166 Z Date JUNE 28, 2006 Permission is hereby granted to: CHARLES SAYER DEVOE 3480 ORCHARD ST ORIENT,NY 11957 for : ALTERATIONS TO EXISTING ATTACHED GARAGE FOR AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR AS BUILT. THIS PERMIT REPLACES 26113. at premises located at 3480 ORCHARD ST ORIENT County Tax Map No. 473889 Section 027 Block 0003 Lot No. 003.003 pursuant to application dated JUNE 28, 2006 and approved by the Building Inspector to expire on DECEMBER 28 2007. Fee $ 150.00 "'- ORIGINAL Rev. 5/8/02 --.--"---,------._-~ ~...~~_._~..._~..-"."......... ~,.7Cj(l/:,. I' .." ~ .' THE NEW YORK BOARD OF FIRE UNDERWRITERS 'AGB 1 IURUU OF ILICTRICITY 40 FULTON STRUT, NEW YORK, NY 10038 Dat~ P}\Y 03,20'30 Application No. on/Il. 1:,h'E,1:-~'9: :1';:, H /,:)6780,:, THIS CERTIFIES THAT PE..IUIIT NO, 2C 113 2 only th, .I.clrical 'qulpm,nt tu dllcrlb,d b~low and introduc,d by th, applicant named on th, above application numb" is in th. prlmiSl' of RICHARD & CIlARLE DevOE. 3480 In th. followln, location; 0 BaSlm,nt WQI .ram/".d." .".PRIL 27,2000 ORCHARD STREET ORIENT, II',' o 1.. Ft. ~ 2"d FI, GAR Sectl."27 BIock3 Lot 3. " and found to b, In compliance with the National EI,ctrical Cod,. ' f1Xl1JRE OunEII FIXTURES .wanlelNT RAN ES AMT. K.W. COOKINQ O'CK' OVENS AMT. K,W. AMY. IC.W. IICI"ACLlI SWITCHII INCAN.,Ie. aTH._ 5 4 5 5 DISH WASHERS EXHAUST FANS AMT. IC.W, AMT, H.'. DRYERs AMY. I.W, FURNACE MOTORS FUTUII APPLIANCI FEEDIRS IPECIAL IEC,", TIME CLOCKS BELL TRANI. UNIT HEATERS MULTI.OUTLET SYSTEMS AM'f. H,'. NO. OF FEET AM'f. WAm H.'. NO. A. W. Q. AMT. AMP. AMT, AM'.. AMT. OIL H,P. eAt SERVICE DISCONNECT NO. OF S E MITER EQUIP. l' 2W l' 3W 3' 3W 3. loW NO.OF,fRC,COND. R A.W.G. OF CC. CONO. NO, OF HI.LEG v A.... TYPE AMP. OTHER APPARATUS: PAllELBOARDS: 1.-3 CrR. 60 3.F.C.I:-1 SHaKE DETECTOR :-1 RICH-O.RD DEVOE 3480 ORCHARD STREET ORIENT, NY, 11957 ~. .' -=r ,.... -.,+. ... '...:.' I"~ --' .l.... \ ,~), '1 i ~""." . ", ", J,. . .- I .J.'.. ',', ., ,~~ ',,- . . ,L) "< ",-' ,,' .~ ,>.l\~} )J'~., , ''',.-' i:' '. J . J ,-;. ,. : ~-I.-~:-,,-;.: : -~.- --.:- "--- ..-~ . ..... L~ DIMMERS C A.W./i. OF HI-lEG E NO. OF NEUTRALS A.W.G. OF NEUTRAL Ll2~ GENERAL MANAGER 11 Per Thll certtflcate mUll not be ollered In any manner; relurn 10 Ihe olllce of Ihe Board II Incorrect. In.peclora moy be Identified by Ihlir credentloll. COPY FOR BUILDING DEPARTMENT. THIS copy OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 Fax (631) 765-9502 Telephone (631) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: (;,/;)8/ ore f , Building Permit No. ;2" If 33~llclt (~~ Owner: CHIt(t.E<; bE VO"L (Please print) Plumber: R'CHAR.D bE. VOE. (Please print) I certify that the solder used in the water supply system contains less than 2/1 0 of 1% lead. t~ fP<-J- . (Plum ers Signature) ~v~\l County Notary Public, BONNIE 1. DOROSKI Notary Public, State Of Newlbrt No.OID06095328,Suffol~nty Term Expires July 7, 20 ~ d-&I/}t; 3 d- \ ""'Y> 765-1802 BUILDING DEPT. INSPECTIO ] FOUNDATION 1 ST [ ] F~DATION 2ND [vrFRAMING [ ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIREPLACE & CHIMNEY 3 II L: ). DATE /PJln INSPECTOR ~~ d0// 3 -p d-t\t,1o 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ;:e [~GH PLBG. [ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: Jfl.MJ~ ~--6~ ~ ~~ -- W iotzftM/~J-e- ~~ /4- I5xlsh/tA-j ~~ ~ - {fl~ JM.~ g~~~51/.h-~.~ ~;]~ -; t-vl~- ~ /V,.vf- ~- $v ~~.~.~/ '~d~ - s1iJ~ fhJ.~~, "DATE /;/-;1/' f' INSPECTOR. (") ;lJ;r~'~ ~41r8~~ (db- /170 ~aLt/ ,2/ud-- - ;??// 3~ 3d- \\:,\.0 765-1802 BUilDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMI [ ] FIRE ACE & HIMNEY [ ] .,dUGH PlBG. ~NSULATION [ ] FINAL @/c' tb ~- DATE! .1 3 2-t ~ C, --t:;- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] I LATION [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: CL? DATE INSPECTOR ;2~ / 13~ 3';f-\\.,\., 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] ~LATION [v( FINAL - ~-r-~--~~;; ~ - DATE ~,.. -., COHHENT~ , ~~=========~=================================I , , ----------1 '. 'NDATION ( 1ST) IGR FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE 'II 7(/o(ocd I ' II II II ~___--1' FINAL II ~ 11-- II II ~ - ---==-=-===============A_==== _~====================_================- ADDITIONAL COHHENTS: ---=============================--=====================---=============================== .... ----------- -------------------------~----- -- --- ---- - - --- - --------------- ~t rlt t "" d ll~ gJ{i'" 6- ~.< z\,,).) O~ <::P () -D " tt 7t ~C3 t>j ;:. rlL t7 <::' I J::~ f- ~L !il"'- lil~ "d o-i ~ ft1-2/ TOWN OF SOUTH OLD PROPERTY RECORD CARD -..,.. RES. 2.( (;1 'S' ~.\J~ tt Or-;, , e. ' SEAS. VL. S '6() VI LLAGE DIST. SUB. Ii __d .ff, ()I-;e (1 of .2- E ACR. . ;itJi! W TYPE OF BUILDING FARM COMM. CB. MICS. Mkt. Value c ;- eJ' J't Weedfond ()~ D FRONTAGE ON WATER ',S6 FRONTAGE ON ROAD I <3 Go, ~ ~~- / tL J.( r: DEPTH Tillable Meadowland House Plol 06 BULKHEAD Tolol 1---- j r , \-.-. -. f""'\ I ,...,\ r- -, COLOR lJI4.+ TRIM iU t I 'c - - - - -- t--. - t-- L_ - , . I,f, " 'l- I~ . 1- 1---_. I ~ l -- - f- _. rI fJ -, i 'I'" 1 r " i . 0; 87 I I . L-- -t--. .. -- i -, , M, Bldg, /0 X.j ..... - ='f:-<" 1. ~. IL/'12.4 2(;( x 3'2- =- 1596 I~ Extension --_. r '- f--. Extension I Extension Foundation I?I~ J Bath 2-. Dinette Porch Basement r~.04wJ Floors WIU K, I Porch Ext, Walls 0, I~, Interior Finish S/L LR, / ~reezeway Fire Place - Heat t ,~, -:!r, ; DR, / ..,r; ~~ 'r" /t"U)~()e 11.1"-2'-1::' / SO t6L1 Type Roof '/ Rooms 1st Floor SR, 2 Garage b/b C~ !/y' . Patio Recreation Room Rooms 2nd Floor FIN. B '0, B. Dormer Driveway Total Sc>8S 1,1 . ~'1' )' . .FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL: 765-1802 BOARD OF HEALTH ............... 3 SETS OF PLANS ............... SURVEy........................ CHECK ......................... SEPTIC FORM ................... E:xanined................., 19.... Approved.... ./J?:: .~1...., 19. :rr Permi t Ii>. ?.:.& \ '" \0 ~... NOTIFY: CALL .. ...... .......... MAIL TO:........ ..... ....... ~~ ~~. ~~ ~.. ~~ ~......... ..~... ......... Disapproved a/c .................................. ..........................:.............. ... ......iP~ -~_.(('-IT.r It l.~ \' ..... ............ Irk' ._, " ", ~ UUL ,<10001 ;~' BLDG. DEPT. T WN F S UTHOLD a. This application DlISt be ccaq>letely filled in by typewriter or in ink am sul:mitted to the Building Inspector wi 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot am of buildings on prEmises, relationship to adjoining premises or J1lblic streets or areas, am giving a detailed description of layout of property DlISt be drawn on the diagr... .tlich is part of this application. c. The wort< covered by this application I'B'j not be C<J1IlEnced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector ,rill issue a Building Permit to the applicant. Such permit shall be kept on the prEmises available for inspection throughout the wort<. e. Ii> building shall be occupied or used in """Ie or in part for any prrpose whatever ootil a Certificate of Occupancy shall have been granted by the Building Inspector. .. . .. . . . ~ . . . .. . . . . . . .. . . . . . . . . . . . . . . ~ . . PPLICATION FOR BUILDING PERMIT Date............. ..., 19.... INSTRUCTIONS APPLICATUJl IS JEIlEBY !WE to tbe Building IlepartDEnt for the issuance of a Building Permit prrsuant to the Building Zone Ordinance of the Town of Soutbold, SUffolk Camty, New Yort<, am other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for I'E!IDI1al or demlition, as herein described. The applicant agrees to ccaq>ly with all applicable laws, ordinances, building code, housing code, and regulations, am to adnit aLIthorized inspectors on prEmises am in building for necessary inspections. ....l.Ud..&t.c)=-........................ (Signature of applicant, or nane, if a corporation) .:fI'!P. 9.~!W:~. ~t ..~(~r. Mf. .m.'??.... (Mailing address of applicant) State -,;b,ther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumer or builder .. Q.<;~~.1:'!~. A~. .6';1!f.~.f:~......................................................................................... Ctl.M.'-E'J DE: V!)E. NatE of owner of prEmises ............................................................................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly aLIthorized officer. " .................................................................... (NatE am title of corporate officer) Builders License Ii>. ..... ~o.~.f:............... Plumers License No. .... .1<)p'~.~............. El .., . 'o,J& ec.trlclBllS LlcetlSe li:>.. ..LV...................... Other Trade' s License Ii>. . N!J!Jl.. .. . . . . . .. .. I. Ulcation of lam on wich proposed wort< will be done.............................................................. .... .:Y.t~.......................... t>~tf~~~ ..~T.............................. .Ol!-. ~~....................... IbJse liUIber Street Hanlet .;;1.7 3 .3."3 Camty Tax Map Ii>. 1000 Section................ Block................ Lot ................ SUbdivision ...6~('\<1~~~.t[..1:.~............ Filed Map Ii>. ..~.n )...... Tnt ...;1... ....... (NatE) 2. State existing use am occupancy of prEmises am intended use am occupancy of proposed construction: a. Existing use am occupancy . 51.~ht. f.1s~W..'I..D. .L..l&.l..f:(N(J....................................... b. Intended use am occupancy ...Q'l-l&,t.f?t/:\(~y..J?IJJ?f:(~6...,.4~~.~~.m~1.As6.v.(~T"...... 4. (Deseri pt ion) fee ..................... ...... .............. ..... (to be paid on filing this application) If d..lling, number of d.elling IHlits ............ Number of d.elling units on each floor ................ If garage, IUlDer of cars...................................... f'J.'tllre of...,rk (d.eck ",id, applicable): New Building .......... Mdition .......... Alteration .X......' . Repair ............ Rawval ............. llenDlition ............ Other Work .................................. * Estin..ted Cost . ?p~~:~~......... ... 3. 5. 5. 7. If business, cmmercial or mixed occupancy, specify nature and extent of each type of use...................... Dirrensions of existing structures, if any: Front..................... Rear .......................... Depth............................ lleight ......................... Number of Stories ...................... DinEnsions of sare structure with alterations or additions: Front.................... Rear............................ Depth .................... lJeight .................... Number of Stories ............... B. Dimensions of entire new construction: Front ................ Rear ............... Depth lleight ......................... Number of Stories ..................... Size of lot: Front .................... Rear .................... Depth 9. 10. II. 12. 13. 14. !late of furdlase ..................... Nare of Former o.mer ........................................ Zone d... .L.ch. . ed l or use lstrlct In ""'II pranlses are s:tbJat .... ".................................................................. .................................................... Does proposed construction ;jolate any zoning 1...., ordinance or regulation: ..t!c................... Will lot be regraded ........q........... W!Jll excess fill be renvved iran premises:. YES R> Nares of o.mer of premises .c.~~s..b~..~~....... Mdress J.r~..~./:W1.!>..>.r..~(J;t;JI H10ne lb. 3.,tJ.~?P. Nare of Architect .................................... Mdress .............................. H10ne lb. Nare of Contractor ................. ...... ............ Mdress ................. ... ..... ... ...H1one lb. 15. Is Ulis property within 300 feet of a tidal "",tland? "YES.......... 1Il...'f.,..... "IF YES, &uJ1IID 'IlHl TRIlS1EIlS PEIMIT MAY IlIl ~RED. PLOT DIAGRAM locate clearly and distinctly all buildings. Wether existing or proposed, and indicate all set-back dm..nsions iran property lines. Give street and block IUJber or description according to deed, and shai street names and indicate WeUler interior or corner lot. SEE sul?.Vey 5rtlY/~ IN ~(.NT srAIE OF l'I'NI YOlll<. CUlNIY OF ..~~!".q4;........... S5 .. .,<~~f(~~ .t>.~~................................... .being duly ....,m. deposes and says that he is tile applicant (Nare of individual signing contract) above oared, lie is the .. .o.~~Yt.tl~.A~,-,. ~!I,.;~~~..... .......... ...... ...... .... ......... ..................... ....... (COntractor, agent. corporate officer, etc.) of said owner or owners, and is duly authorized to perfonn or have perfomEd tile said ...,rk and to make and file this application; tllat all staterents contained in this application are true to the best of his lu:ooledge and belief; and tI.at tile work will be performed in the mamler set forth in the application filed therewith. ~m to before III? this A A ....;)..;Q.~...da of ~i:.....19..9.7.. lbtaryPublic ..... ..Ar-.J~~ ..~.t2c.-.y~........ (Signal~ of Applicant) JOYCE M. WILKINS Notary Public. State of N_ YOI1l: No. 4952246, Suffolk County Term Expires June 12, ~ C) 0 I PLUMBING ALL PWMBING WASTE & WATER UNES NEED TESTING BEFORE COVERING +",.m .....,..r i<! "',' i f"r',"r";'''1fcoppertubingISUsed 7 . , _:____. _j,_.-c-__~or water distributing , I 7; I ' b,/I ! I: em; piping shall be .' '-f'_'_' _.,.:f_" :, - ' ,:;';~ . ,_' ........ Fe; of_....L~. .', -. -..-. ['-', . '/ ' ",""f !~,. I': :.""'-crj( . . :, Pl.IuMBERCERTIFICATION . . . . " .. .~. ONLEAD CONTENT BEFORE 1;-.1>) ;J.n?,V7 .., ' , i... I I. t... -'i.:..j..~: ...CERTIFICATEOFOCCUPANCY "~;,, "~~/r.>.)I ,oj j~__ __I _ I ! t-. : ; ! ': I: I ,~ . SOLDER USED IN WATER OIO<"l.S:<1fflJo:W-:--'~!- ----OJ -~ I ; i'~ SUPPLY SYSTEM CANNOT . i [ ...' J.!..t..,.... - O..:..,I-..-_~"..~, EXCEED 2/10 OF 1% LEAD. 1" -.-- i---- '..jL_:'__I___ _. _ __. i -j t I' I ! .t- _~_-JI --~ -' 1-- ~-_:")--~---I------I------~-~'- ;'1' ""!.~,.. :' 1~..'WT~c~~Tp~~~~IF'CA~ : I:' ~ . I Ii '..; .., I,.....fe....r'...' "r'! 1\f':-"a\!EDASNOTED0')'~ -,--'-----1- 1---:- - I--r--I--'--+--'~-I'- ---;--- . ~--~~~-t't-'l7 B.P.# UtlJe ':l:~- : --;~.~ -~--J-':_+ .. .; i: . I - .... : ~L ....- ::~, Y ~U~NG ~~~;~~t':;~ ~;.--l~T'I..L. :.. "f. :, 'j" :.. .; .)..1.:./ ,.;...... '+~i ... .~. r ~~~~~I"z~N~ 1~~P;gTI~:S~ FOR THE ~-- --i-i I L :. '4~~-E I~ ; ; : : fr. -T-1;-:o ~g~~'~DNC(>N:~EQUIRED r++, _ JT i L to T_: 1/--:I-J ~~"~OO~-NO "W..NO , .......... ..~...! .. , ... ...... .... j ..:. j... It :'1''':''' .,.. .p. ..j- .... : ...f~~~~1~~~~~~g~~~:L: :~:: :, ~--+---, I I i --, -1--"1 : i IU THE ~EQUIREMENTS OF THE N.Y. ! : "'r...~TAT CONSTRUCTION & ENERGY. : - L_...L__L .__L__l I I I I: qOD ~'O~~~N~~~~,~~IE~R~~~ SBf , .. UNDERWRITERS CERTIFICATE REQUIRED rIGL-D I~~L , , __o__,__u ____..,._.. ...--j.--- . -. ~ .. 1.'l"~lIb Co"" __n..__......,.... "~T' .....; , , , , , , , , n.."__ _..._c... ... , , , , __o.l.I:~Co.' ,o..i.n __.;... 'n h. , , -- -........ 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";'" ...... Z:N,'l"-':";,;/; @-~ . .~. .:~"~-";::: ':'-' '.~v~) ,; - - - . - - ..--... ----., "" "-' , .. - ~ ?7:'.'><,,".<\:~-:.,\, ;.,",,;'~. -':_-':".~E',:fV:,:;~:j.' ' :: I. ,':',.'c'<< '~~.'~~:C~~;~ ...'.... , . '." "O/~_ ..~ '-<:'. .:~, ~€<'. . <;;('9~b... '.' . ~';:;:;; -..'41, .~. . 0 0': '.' ......<~ ' . l!.z"--,. '.. ~~~ . ..._ ~.,.:,..~.~......, ....~ t'.. , ........~., '.... '. " .); ~" " : ~'~-, ,~ , .' " '.1. 't> Iq. , -v~~ . ....... .f. / /' .#.- \ .,. SUFFOLK COUNlY DEP OF HEAL. 1M .~.. , , . SINGLE FAMilY DWElUN(; ONlY DA~ H.S. REF. NO. 85-So-.,o'~3 The sewage disposal and water supply fac~ities for thil location have been Inspected by this Department Illd/or -."~~,~~ti~. . ..,', CltiIf Bureeu of Wasfewatllr .......,..,11 \. '.- . ~~laeNCE) . .' -.... """ , . / .'(~/ . ~/ A '. "~I " . .~e:.~"I' ":"-~~~j ,<';<~.~1:-~s " ~ " ~.~>, .."..I.. f .......... ,.'. "'\.;~ .:. ''"\.. " .... ""', _v '. "... ,\ .......\-. ..- :~; ,."'1',"t!, i .. .~.<,\! .' 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'; .~: ~...-;- ,~-.."';'" ~ -," ~-~:. ~-.-~:-:~- -:-J~?:_~'.-~---~~;'~~~.~'-~:~~!jt,~': ':. . . .~iJFf()LK t6,Ht'Ai.:i'HOi;~:r'. APPROVAL ........."...,.... '.....,~."'^.""=.. . ~:i:~:-. .'j:'-'- ~:.-. :'.:'~~::,.'., (~ t-L s~- -~NO~'~t~~v"~""~ ' -,: . ,"-<-;;',-': ~:f",'" ~,~ . ',..:' ::':'-"'if<~~,:j_;-,'-::'" ,. '...\- ~.' . ~/,:~,.,.. "",",,,': ~ ','>,-'-'. . .,'-,- ,_ ~ f-; "~" ~; ;" , ~ '.- . '. _o~, -~.'.' " --,~,;. . t. ~ :' '. .'., .... ..T nMEN'1 f' NT . THE WATQ SUPI"LY AND sfiJlAGE DISPOSAL' SYSTEM$: '.FOR THIS RESIDENCE WILL CONF'ORM "TO THE ST AHOARDS OF THE $UFFol,:k~~, DEPT. OF HEAL 1H SERVICES. i '(S)' I AflfrLlCANT I ':..;. SUFFOLK COUNTY SERVICES - F'OR CONSTRUCTION ONL Y DATE: H. S. REF. NO.; .1!ESQc,Z33.::.:.... APPROVED: DEPT. OF HEALTH APPROVAL OF J SUFFOLl!: CO, TAX MAP DESIGNATIO~ OIST. _.. SECT. _B~OCK ;CW' 10C9...- .02,1_ '3 ......3 OWNER$ ~.ES$: ! . . . ., ,;..c __.863,0 OI2CHAI2D Sf.' J .:.~012IENT. 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