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Home My WebLink About37043-Z Town of Southold Annex 10/30/2013 P.O. Box 1179 54375 Main Road 7~ f Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 36590 Date: 10/30/2013 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 4330 WESTPHALIA ROAD MATTITUCK, SCTM 473889 See/Block/Lot: 111-9-15.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this otficed dated 7/25/2008 pursuant to which Building Permit No. 37043 dated 3/6/2012 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: inUound swimming pool with fence to code as applied Wool with fence to code as applied for. The certificate is issued to WALTER & COLLEEN PETERSON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 4013267 10/14/08 PLUMBERS CERTIFICATION DATED AA thed ignatu eignatu e TOWN OF SOUTHOLD y BUILDING DEPARTMENT TOWN CLERK'S OFFICE (It"Al SOUTHOLD, NY 1~! ~44R BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit 37043 Date: 3/6/2012 Permission is hereby granted to: WALTER & COLLEEN PETERSON 4330 WESTPHALIA ROAD MATTITUCK, NY 11952 To: CONSTRUCTION OF AN IN-GROUND SWIMMING POOL IN THE REQUIRED REAR YARD AS APPLIED FOR. REPLACES EXPIRED B.P. # 34110 At premises located at: 4330 WESTPHALIA ROAD MATTITUCK SCTM # 473889 Sec/Block/Lot # 111-9-15.11 Pursuant to application dated 7/25/2008 and approved by the Building Inspector. To expire on 9/6/2013. Fees: PERMIT RENEWAL $125.00 Total: $125.00 r Building Inspector 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. 34110 Z Date AUGUST 14, 2008 Permission is hereby granted to: WALTER & COLLEEN PETERSON 4330 WESTPHALIA RD MATTITUCK,NY 11952 for CONSTRUCTION OF AN IN-GROUND SWIMMING POOL IN THE REQUIRED REAR YARD AS APPLIED FOR at premises located at 4330 WESTPHALIA RD MATTITUCK County Tax Map No. 473889 Section 113 Block 0009 Lot No. 015.001 pursuant to application dated JULY 25, 2008 and approved by the Building Inspector to expire on FEBRUARY 14, 2010. Fee $ 250.00 Aut i d nature COPY Rev. 5/8/02 i Form No. 6 TOWN OFSOUTHOLD BUILDING DEPARTMENT 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: 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'eleettical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 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 (priorio April 9, 1957)`non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, stroets, 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 $50-00, Additions to dwelling $50.00, Alterations to dwelling $50.00, Swimming pool $50.00. Accessory building $50.00, Additions to accessory building $50.00; 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. t4ze125:)1 New Construction: Old or Pre-existing Building:` _ (check one) Location of Property: U, ~ 99 FKAU (Z rn l j(AJC,~ House No. Street Hamlet Owner or Owners of Property~!`~~ Suffolk County Tax Map No 1000, Section BIac: Lot' ~S. Vol Subdivision ' , , ailed M t~13Z ap. Lot: Permit No. 3 f~: Date of Permit Applicant{z~kyk~ azr 1 Health Dept Approval: Underwriters Approval: Planning Board-Approval: Request far: Temporary Certificate Final Certificate:- (check one) Fee Submitted: $7 Applicant Signature NNNNNNN NN NNN NNNNNNNN NNNNN~G3nNNNNNNNN c0 CSC BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY c5 5 40 FULTON STREET - NEW YORK, NY 10038 5 C~S 5 5 CERTIFIES THAT 5 L5~ Upon the application of upon premises owned by 5 5 5 JOHNLUDEMANN WALTER PETERSON 5 PO BOX 621 4330 W. PHALIA RD cS NEW SUFFOLK NY 11956 MATTITUCK, NY 11952 c~ Located at 4330 W. PHALIA RD MATTITUCK, NY 11952 55 C~ Application Number: 4013267 Certificate Number: 4013267 e5 Section: Block: Lot: Building Permit:. BDC: ns11 5 S 34I~d 5 5 Described as a Swimming pool occupancy, wherein the premises electrical system consisting of 5 5 electrical devices and wiring, described below, located in/on the premises at: S Outside, Pool/Spa, 5 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard 5 5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 5 authority having jurisdiction, and found to be in compliance therewith on the 14th Day of October, 2008. 5 Name 2 Rate Rating Circuits TV- 5 AdditionalCharges S includes pool sub panel S S Appliances and Accessories L+ 5 Pool / Spa Bonding 1 0 7C S Pool Healer 1 0 Gas 5 5 Wiring And Devices 5 S Fixture 2 0 pool Incandescent 5 S Receptacle 1 0 GFCI 5 Receptacle 1 0 20a-pool Special / twist lock 5 S Switch 4 0 Gen, Purpose S 5 5' 5 (swimming Pool): This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have 5 S frequent test and/or repairs made by a qualified person. CAS 5 seal 1 of 1 5 5 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 S S 17N N N NN NN N NNNO Of SOOlyp6 TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/ STRAPPING [FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE INSPECTORS 3) TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ) FOUNDATION 2ND [ ] IN T [ ) FRAMING/ STRAPPING [ FIN 1 [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ l FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE r l 3 INSPECTOR ho..~,OF SOUry06 ~ ~-_777 TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1ST ( ] ROU LEIG. [ ] FOUNDATION 2ND [ ] I ULATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE Q INSPECTOR FIELD INS ECTION REPORT DATE COMMENTS ~a FOUNDATION (1ST) i 1)ATION (2ND) - I m y ROUGH FRAIVIDVG & ~ PLL MBING ' LNSLILATION PLR 1. - - - - - STATE ENERGY CODE !I - - - v. i 1 1 FLNAL A4 m `d X r AD ONAL CONIMEl O Z - m r x 0 r~ - b TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following, before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans TEL: (631) 765-1502 Planning Board approval FAX: (631) 765-9502 Survey South0ldTown.NorthFork.net PERMIT NO. 1 l (V Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined 20\ _1 Storm-Water Assessment Form ~(/JI/ Contact: Approved 20_ Mail to' Disapproved a/c i-ask ro3y~l Phone O Expiration , 20 uil nsp c r APPLICATION FOR BUILDING PERMIT 2 8 Date 2S 20 VU INSTRUCTIONS a. This application-MUD ST be dompletely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets ofplans, accurate plot plartors le. 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 premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pan for any purpose what so ever until the Building Inspector issues a Certificate of occupancy. f. Every 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. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant 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 for necessary inspections. - (Signature of applicant or name, if a corporation) 4~n tI'nrolY ?O~ ?^A a rucK IJ~ 119 2 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trades License No. 1. (,p nof ezgt~ lanki OL whr~ - Q~r"ill~beeddone: M P~ _ , J House Number Street Y(,~ Hamlet Y~ County Tax Map No. 1000 Section l~ 3M Block 6 I C0 Lot ) J Subdivision _ Filed Map No. Lot . • 2. State existing use and occupancy of premises d intended se an occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy ham`. )oeai-~ 3. Nature of work (check which applicable): New Building Addition , Alteration, Repair Removal Demolition Other Work 11-A 1yis-m 4moo ~C^ (Description) 4. Estimated Cost Fee r~e.7~-~ (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 Reaz 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 regulation? YES NOel~ 13. Will lot be re-graded? YES_ NO Will excess fill be removed from premises? YES_ NO 14. Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YESNO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE 1?WUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 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 below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES NO-ef * IF YES, PROVIDE A COPY. CONNIE 0. BUNCH STATE OF NEW YORK) Notary Public State Of New York ss. No. 01116185050 Qualfired in Suffolk Coun COUNTY OF ) ^nmmiasinn Fxnirer Anril 14 0 L ! AY, VF;F t I lit C-~( ~X.~-~ being duly swom, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the (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 true to the best of his knowledge and belief, and that the work will be performed in the manner set forth in the application tiled therewith. Swo to before me this G ~~1 day of n cam! _ 20& o _ C'k Notary Public Signature of Applicant ooK Town of Southold Erosion Sedimentation & Storm-Water Run-off ASSESSMENT FORM col PROPERTY LOCATION: s.C.T.Ill THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER, GRADING, DRAINAGE AND EROSION CONTROL PLAN District section Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. Item Number: (NOTE: A Check Mark ) for each Question is Required for a Complete Application) Yes No Will this Project Retain All Storm-Water Run-Off Generated by a Two (2") Inch Rainfall on Site? (This item will include all run-off created by site clearing and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) 2 Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? X This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFlow! 3 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural X Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? 4 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of ? Five Thousand (5,000) Square Feet of Ground Surface? J Is there a Natural Water Course Running through the Site? ? ? Is this Project within the Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Beach? 6 Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vertical Rise to ? X, One Hundred (100') of Horizontal Distance? 7 Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Off ? into and/or in the direction of a Town right-of-way? 8 Will this Project Require the Placement of Material, Removal of Vegetation and/or the Construction of ? any Item Within the Town Right-of-Way or Road Shoulder Area? (This Item will NOT include the Installation of Driveway Aprons.) 9 Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse? M NOTE: If Any Answer to Questions One through Nine Is Answered with a Check Mark in the Box, a Storm-Water, Grading, Drainage 8 Erosion Control Plan is Required and Must be Submitted for Review Prior to Issuance of Any Building Permit! EXEMPTION: Yes No Does this project meet the minimum standards for classification as an Agricultural Project? Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan is NOT Requiredl STA-FE OF NEN' YORK, CONNIE D. BUNOh COUNTY OF SS Notary Public State of New Yo, K No.Olb-U6185050 Fhat I, z being duly Strom, deposes ands lMi nn _ ~ l for Penult, (Name of individual signing ~Document) 0.I And that he/she is die ...S.`.-.- (Owner, Contractor, Agent, Corporate Officer, etc I Owner and/or represenuttive of die Oamer of Owner's, and is duly authorized to perform of have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be perfor ned in the manner set forth in the application filed herewith. Sworn to before me this; ~ o d:n~ of ,10:~ Nota ry Public ....."r ~ (Signature of Applicant) FORM - 06107 arty ~y~FOt4f, Southold Town Building Department 54375 Main Road Permit 34110 Southold, New York 11971 Permit Date: 8/14/2008 V i. (631) 765-1802 Expiration Date: 2/14/2010 Parcel ED: 113:9-15.1 BUILDING PERMIT RENEWAL LETTER Dated: 8/1/2011 Applicant: WALTER & COLLEEN PETERSON Location: 4330 WESTPHALIA RD MATTITUCK Work Description: IN GROUND POOL CONSTRUCTION OF AN IN-GROUND SWIMMING POOL IN THE REQUIRED REAR YARD AS APPLIED FOR A FEE OF $125.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT. Owner: WALTER & COLLEEN PETERSON Address: 4330 WESTPHALIA RD MATTITUCK, NY 11952 MATTI The permit listed above has expired. Please contact our office as soon as possible to begin the renewal process. All work on the project must stop on the expiration date. No work is permitted or authorized beyond the expiration date. THANK YOU, SOUTHOLD TOWN BUILDING DEPT. U.S. Postal Service,~. CERTIFIED MAIL,, RECEIPT (Domestic Maii Only; No Insurance Coverage Provided) -0 M a M1 j// p Postage Certified F fU / Postmark C3 Return Recelp ~ O (E~eturn nt Re I Here C3 Restricted Delive RB C3 (Endorsement Regw ) rl Total Postage & Feea O `O nr _ L~L~ Co--2e-( C~eita~lc 3ulid o M or PO Box NO. 4~jQ 5r - City, Stare, ZIP.4 ^ " Certified Mail Provides: ¦ A mailing receipt ¦ A unique identifier for your mailpiece ¦ A record of delivery kept by the Postal Service for two years Important Reminders: ¦ Certified Mail may ONLY be combined with First-Class Mail, or Priority Mail,. ¦ Certified Mail Is not available for any class of international mail. ¦ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. ¦ For an additional fee, a Return Receipt maybe requested to provide proof of delivery. To obtain Return Receipt service, please complete and attach a Return Receipt (PS Form 3811) to the article and add applicable postage to cover the fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for a duplicate return receipt, a USPS, postmark on your Certified Mail receipt is required. ¦ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agant. Advise the clerk or mark the mailpiece with the endorsement "Restricted Delivery". ¦ If a postmark on the Certified Mail receipt Is desired, please present the arll- cle at the post office for postmarking. If a postmark on the Certified Mail receipt Is not needed, detach and affix label with postage and mail. IMPORTANT: Save this receipt and present It when making an Inquiry. PS Form 3600, August 2006 (Reverse) PSN 7530-02-000.9007 Y3JIHt7 _ - auenmraawsnvrr!a~ . ¦ Complete Kenna 1, 2, and 3. Also complete A. Signature Item 4 If Restilcted Delivery is desired. ;Z Agent ¦ Prim your name and address on the reverse x ? _Addresses so that we can return the card to you. B. Race] ( rated Name) C. Date of Delivery ¦ Attach this card to the back of the mailpiece, or on the from N space permits. D. Is delivery address different from item 1? ? Yes 1. Article Addressed to: 3 y~~0 If YES, enter delivery address below: ? No 3. Service 1Ype C3 Certified Mall E3 Express Mail ? Registered ? Return Receipt for Merchandise ?Insured Mail ?C.O.D. 4. Restricted Delivep fFx" Feel ? Yes 2. Article Number Mans*f mservk*1abO 0/56 r>r~6a ~3rr„_ 3i~ Ps Form 3811. Februarv 2004 Domestic Return Recelat rnosasm.u.rxen UNITED STATES POSTAL SERVICE I I I II I First-Cfass Mail ostat No. G-1 0 Paid • Sender. Please print your name, address, and ZIP+4 in this box TOWN OF SOUTHOLD BUILDING DEPARTMENT P.O. Box 1179 Southold, N.Y. 11971 Southold Town Building Department ? Permit 34110 54375 Main Road Southold, New York 11971 Permit Date: 8/14/2008 µi64' (631) 765-1802 14Expiration Date: 2/14/2010 TM" Parcel ID: 113:9-15.1 BUILDING PERMIT RENEWAL LETTER FINAL NOTICE Dated: 1/31/2012 Applicant: WALTER & COLLEEN PETERSON Location: 4330 WESTPHALIA ROAD MATTITUCK Work Description: IN GROUND POOL CONSTRUCTION OF AN IN-GROUND SWIMMING POOL IN THE REQUIRED REAR YARD AS APPLIED FOR A FEE OF $125.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT. Owner: WALTER & COLLEEN PETERSON Address: 4330 WESTPHALIA ROAD MATTITUCK, NY 11952 The permit listed above has expired. Please contact our office as soon as possible to begin the renewal process. All work on the project must stop on the expiration date. ?5138 py5u OD~~ ?3y6 6316 THANK YOU, SOUTHOLD TOWN BUILDING DEPT. pF SO(/THOIo Town Hall Annex Telephone (631) 765-1802 54375 Main Road Fax (631) 765-9502 P.O. Box 1179 G Sr. Southold, NY 11971-0959 i ~~~~OUNTV BUILDING DEPARTMENT TOWN OF SOUTHOLD October 25, 2013 Walter & Colleen Peterson 4330 Westphalia Rd Mattituck, NY 11952 TO WHOM IT MAY CONCERN: The Following Items (if Checked) Are Needed To Complete Your Certificate of Occupancy: Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. (Contact your electrician) A fee of $50.00. Final Health Department Approval. Plumbers Solder Certificate. (All permits involving plumbing after 4!1/84) Trustees Certificate of Compliance. (Town Trustees # 765-1892) Final Planning Board Approval. (planning # 765-1938) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. Final inspection by Building Dept BUILDING PERMIT: 37043-In-Ground Swimming Pool JUL-30-2006 08:57 From:HP MATTIUCK 6312983525 To:7659502 Paee:4/4 S331S(la1 NM0i YUH! 105 08vos "ti NNVld NM01 u C --SOS r VEZ NM01410OOS '3000 NM013H130 d0 SNOIlICNOC CNt/ C3aif 031i 9£Z 1131MO 011M nSdnd S3000 NMOl 8 G I_t/1S ~i X01 M ANN a31dM WHOlS NIt/13a JO S3000 llV H11M Ald!NOC o ~v R VOIJU8301nMiM 03HI1103!! iwVlNn SI 3sn Q uw, ue3~sa3ua~~3aNn ~ 80 AONVdnooo rr~ ~y u H O + e v • 6 1+ a d 4 a O r ~ v 1i31aM. 3lib~38 0 v 3 00 01100d SOION3 ~ „J1131d1a3WWl„ a 'SHOM3 N0110f1d1SNOO HO NOISM v HOd 3181SNOdS3H ION '3IV1S AHOA M3N JO S3000 3HI JO SIN3W3un038 3H1 133W 7VHS NOI.LOAdISN0O 7V D 00 10 3 L3ldAOO 38 Ism NOIlOrldl~NOO - 1VNIJ FR NOI1Vlf1SNI y N Wgnnld V ONIWV8J - Honou 'Z i~'~5I a 31KrNO0 03unod uOd 0381n03H OMl - NOIlVONf10d 'l SNO1103dSNI 0NIMOIIOJ 3H1 80d Ad 4 Ol WV 9 Z081-99L ltl 1N3W1FfVd3O ONIOII(18 AdIlON 8 33J I- 4 #'d 8 31V0 0310N SV O a dV .o \c ~NL1;Nd~,S\ ..Z0/S0 39Vd 1D311H.7UV C[dVN031 6599LBLCES GENE M8164r40 07-30-2008 06:59 SOUTHOLD BUILDING DEPT 16317659502 PAGE3 _ -,0-,?008 AS:5' Fi ,iii:HF' MHTTT_li_F_ Pa +r.; i ,ri' lr~ `d;.,f' ~ ..~i{ ~d•iP/~4~~"'"''~' .~`^~~v~~ TA~s~1"~y'str"' , '7•:r~y,'~°'r r ,i' 5" F r ai X y Y Yx e d~ n~J?' ik~? 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