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HomeMy WebLinkAbout21855-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23657 Date MAY 17, 1995 THIS CERTIFIES that the building NEW DWELLING Location of Property 905 WILLIS CREEK DRIVE MATTITUCK, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 123 Block 10 Lot 3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 13, 1993 pursuant to which Building Permit No. 21855-Z dated DECEMBER 29, 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 ONE FAMILY DWELLING WITH ATTACHED OPEN PORCHES & GARAGE IN CELLAR AS APPLIED FOR. The certificate is issued to PATRICK J. SCOLLARD (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 93-SO-70-MARCH 31, 1995 UNDERWRITERS CERTIFICATE NO. N-344266 - MARCH 2, 1995 PLUMBERS CERTIFICATION DATED SEPT. 26, 1994-CUTCHOGUE EAST PLUMB.&HEAT. Building inspector Rev. 1/81 FORM NO.3 t 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) Date ...�r ...... 197 .. N2 21855 Z Permission Is hereby granted o; lti�..1 lk��f . ... ...... ' .5.....✓ �GY. ................................. to .................. /°l ...,........... .!4�.... ...... r..• ................. o ee, ell .,.1..... ,...... ..4f `i�y .......�. G. �. ................... ` y .. at premises located at.... �..........� .. ;G� .,.. .. . r.,... ............................................... ........................................ � ........................................ ....... County Tax Map No. 1000 Section .....�. 3 Block.......,f.a,..,..... Lot No. ..... 3 I .. ....................... pursuant to application dated .......r. y1���. 19...l��.... and approved by the li Building Inspector. Fee W� ........................ Buildr Rev. 6130/80 r - Form No. 6 TOWN OF SOUTEIOLD �' "1� � � � r,�Y •d BUILDING DEPARTMENT ---- TOWN HALL TOV; -�;C:. 765-1802 ,`{� S0t.3'i NCB! APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 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 2/10 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. G. 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 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 applicant. 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-existing Buildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $1g5.00•, Commercial $15.00 Date , T✓.q.�J,IC;c New Construction. . .. . . . Old Or Pre-existing Building. . • • • • • • • Location of Property. . .`.° . . .. . . . pi.+ 12Gi K 1727V .A - - i1)7�7j1TijG1L . .. ... . . . . . House No. Street Hamlet Onwer or Owners of Property. . County Tax Map No 1000, Section. . /z3 . . . . . . .Block. . . . . .Q . . . . . . . . .Lot. . a Subdivision. . . . . . . .Filed Map.( -4Z7. . . . .Lot. . . . .� . . . . . . . . Permit Nolv��1S5 „Date Of Permit. . . , . . 7 c [7 . . . . . . . . . .Applicsnt.L :�: . S, otCvj,2�. . . . . . . . . . . Health Dept, Approval. . ,/„J �—.7.Q, , , , , , , , , , ,Underwriters Approval�� E Zo JS'1gS . , . Planning Board Approval.. . . . 1:'.. . . . . . . . . . . . . . . • • I Request for: Temporary Certificate. . . . . . . . . . . Final Certicate.. . . . . . Fee Submitted: $„ .4 as .25. 4 r57 nnnr rn...m 0NWFOIAr TEL. 765-1802 TOWN Or OFFICE OF BUILDING INSPECTOR P.O. BOX 1179 TOWN HALL SOUTHOLD, N.Y. 11971 C E R T I F I C A, T I O N i Date el Building Permit No. Z, Owner' SCo(lard (please print) Plumber . 6lL�Yhnnt� rC Z{ 6)��(please print) V C PLO n( (� ItA)G Arob f} CAl11U(� i I certify that the solder used in the water supply system contains less than 2/10 of la lead. f , I (plumber 's signature) Sworn to befor- mo this a= _day Of 19 ubli Gotar r otar�l Public—'`"—"` f 1 c,,L-_- e—County NIARYELLIN WHALEY - Nbtuy Pubic,State of New York r No 4795158 Qua!tfvd in SulI019 county ,_ Id 3,- THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1001071 ' BUREAU OF ELECTRICITY F— 85 JOHN STREET. NEW YORK. NEW YORK 10038 Date MARCH 02,1995 Application No.onfile 06942095/95 N 344266 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in thepremises of J. SCOLLARD'S, 905 WILLIS CREEK DRIVE, MATTITUCK, N.Y- in thefollowinR location; ® Basement ® Lst Fl. ® 2nd Ft. GAR/ATTIC/OUT .Section Block Lot was examined on FEBRUARY 27,1995 and found to he in compliance with the National Electrical Code. FIXTURE FIXTURES I RANGES COOKING DECKS I OVENS JOISHWASHERS EXHAUST FANS OUTLETS EGEPTACLES SWITCHES JINCANDESCENTI FLUORESCENT I OTHER I AMT. I K.W. I AMT I K.W. I AMT I KW I AMT. I K W. AMT. H P. 83 64 65 83 1 1 7.9 1 1.2 5 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ISPECIAL REC'PT TIME CLOCKS I BELL I UNI7 HEATERS I MULTI.OUTLET DIMMERS I AMT. K.W. OIL H.P. GAS H.P. AMT NO. A W.G. AMT. AMP. I AMT I AMPS TRANS.I AMT. I H,P I SiSTEMS AMT. WATTS NO.OF FEET 4 - 1 7 600 [ SERVICE DISCONNECT NO.OF S E R V I C E AMT. I AMP. TYPE METER 1 q RW I,e'tW 3,e 0W 3,B'4W NO.t�lc' COND. A.W.G. NO,OF NI-LEG A'W''G' NO.OF NEUTRALS A W.G. EQUIP. OF NEUTRAL CB 1 X 2/0 1 2/0 OTHER APPARATUS: { JACUZZI-1 30 AMP GEN/TRAN-1 't TRANSFER SWITCH-1 MOTORSr1-3 H.P. ,1-2 H.P. ,2-F H.P. ,10-F H.P. C PANELBOARDSI2-1 CIR. 60 G.F.C.Ts-15 ` G & S CONTRACTOR LTC.#578-F BOIL 215 GENERAL MANAGER III SOUTHOLD, NY, 11971 Per 1,1 ! This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT.THIS COPY OF CERTIFICATE MOST NOT BE,ALT.ERED,IN ANY,MANNER. S A M U E L S & S T E E L M A N May 11, 1995 1 21995 Gary Fish, Building Inspector Southold Town Building Departmentr. `u `„ Town Hall Southold, NY 11971 Re: SCOLLARD RESIDENCE Willis Creek Road Mattituck, NY Dear Gary, I have inspected the double door which separates the Garage from the storage area in the above referenced project. It is a one-hour labeled door, manufacturered by WARNOCK-HERSEY. It fulfills the requirements of the fire code. Thank you very much, Tom Samuels cc: Peconic Development Corp. ARCHITECTS 25235 MAIN ROAD CUTCHOGUE, NEW YORK 11935 (516)734-6405 FAX(516)734-6407 JUDITH T. TERRY a t Town Hall, 53095 Main Road TOWN CLERK r`° P.O. Box 1179 » (�s � r7, c Southold, New York 11971 REGISTRAR OF VITAL STATISTICS vY� :, �' - Fax (516) 765-1823 MARRIAGE OFFICER d �0 Telephone (516) 765-1801 RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD jam 'L-em -W THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24, 1993: RESOLVED that the Town Board of the Town of Southold hereby adopts two (2) new forms to be used under the Flood Damage Prevent regulations of the Code of the Town of Southold: "Floodplain Development Permit Application" [FDP(93)] , and "Certificate of Compliance for Development in Special Flood Hazard Area [C/C(93)] . } p � J . 1.' BLDG. E)E r. TOWN OF SO:Pi11OLD � erry � Southold Town Clerk August 25, 1993 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION . [ ] FRAMING [✓] FINAL REMARKS: y f i i DATE -sl� _INSPECTOR i � l r r M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS LATION [ ] FRAMING [ FINAL REMARKS: i i i f i f DATE S �L �� INSPECTOR M-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL REMARKS: i f t 4 4 DATE J C9 INSPECTOR M-1"2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ) ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING [ FINAL REMARKS. 3 - DATE S INSPECTOR M-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ I ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSJXATION [ ] FRAMING / [ FINAL REM KS: 6 ` >� DATE 31 3/9�INSPECTO rp , ... pp M-lW2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL t REMARKS. E k i 4 t tf E ii t I 1 V/ DATE d7 INSPECTOR "` M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ FINAL REMARKS: S y i . f DATE /[ INSPECTOR M-1302 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ J FINAL REMARKS: DATE INSPECTOR /�L� M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [prFRAMING ( ] FINAL REMARKS: / .� . DATE _INSPECTOR M-1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ROUGH PLBG. [ ) FOUNDATION 2ND [ ] INSULATION [ J FRAMING [ ] FINAL REMARKS: t t i C E i, DATE INSPECTO ` a M-1802 BUILDING DEPT. NSPECTI [ ] FOUNDATION 1ST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARK$-.o fzx�� "eln cya Az DATE 7 INSPECTOR M-1302 BUILDING DEPT. 1 PECTIQN [ ] F NDATION 1ST [ J ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ( ] FINAL REMARKS: _ DATE INSPECTOR 6 M-18a BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ I INSULATION [ ] FRAMING ( I FINAL REMARKS: - t DATE �� INSPECTOR M-1302 BUILDING DEPT. NSPECTION [ FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ( ] FINAL ol REMARKS: /,� C . T DATE I INSPECTO rl JAPES H. RAMBO, INC. March 2, 1994 Samuels & Steelman, A. I .A. Main Road Cutchogue, New York 11935 Re: Scollard Residence Gentlepeople, Enclosed please find pile log on the above referenced property. The piles were 20" in length, 10" average butt size. They were driven with a Delmag #5 diesel pile hammer developing 9100 ft. lbs. of energy with fixed leads. The minimum capacity is 27 tons per pile. If you have any questions, please do not hesitate to call . Sincerely, Thomas E. Samuels „ . cc: Peconic Development Corp. • TRUSTEES gOFF0j f SUPERVISOR John M. Bredemeyer, III, President ��0 CpG SCOTT L. HARRIS Albert J. Krupski, Jr., Vice President Henry P. Smith w Town Hall John B. Tuthill .r T, 53095 Main Road William G. Albertson �y O�� P.O. Box It79 Telephone (516) 765-1892 # �a Southold, New York 11971 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD December 14, 1993 Tom Samuels Samuels & Steelman 25235 Main Road Cutchogue, NY 11935 RE: Permit #3925 SCTM #1000-123-10-3 Dear Mr. Samuels: The following action was taken by the Southold Town Board of Trustees on October 28, 1993 : RESOLVED that the Southold Town Board of Trustees amend permit #3925 to reflect Samuels and Steelman survey dated September 4, 1993 to construct a one-family dwelling for Patrick Scollard. If you have any questions, please do not hesitate to contact this office. V truly yours, John M. Bredemeyer, III President, Board of Trustees JMB:jmd cc: Bldg. Dept. t.; ' VeAk ofF04 TRUSTEES John M.Bredemayer,ITT,President SUPERVISOR Henry P.Sr"Vice President SC OTT L.HARRIS AlLett J.Kmpski,Jr. John L.Bednoeki,Jr. slTown Hell John fJ.Tuthill $3095 Main Road P.O.BOX 1119 Telephone(516)765-I M BOARD OF TOWN TRUSTUS Southold,Nov York 11971 Fax(516)765-1823 TOWN OF SOUTHOLD June 13, 1991 En-Consultants 1329 North Sea Road Southampton, NY 11968 Re: Ira Gordan SCTM #1000-123-10-3 near Mr. Haie: The following action was taken by the Board of Town Trustees during its regular meeting held on June 6, 1991 regarding the above matter: WHEREAS, ROY HAJE ON BEHALF OF IRA GORDAN applied to the Southold Town Trusteen for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated January28, 1991 and, WHEREAS said application was referred to the Southold Town Conoorvation Advisory Council for their findings and recommendations, and, WB73V-%Z, a public hearing wan held by the Town Trustees with respect to said application on June 6, 1991 at which time all interested persona wcro given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premiaee in question and thw :surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation subluiLLed concerning this application, and, WHEREAS, the Board has determined that the project as proposed will not affect the health, oafety and general watfare of the people of the town, NOW, THEREFORE BE IT RESOLVED THAT ROY HAJE ON BEHALF OF IRA GORDON BE AND HEREBY IS GRANTED PERMISSION UNDER TILE WETLAND ORDINANCE TO: Cnnstruct one-family dwelling, deck, pool, sanitary system, bluestone or similar pervious driveway. Approximately 750 c.y. of fill will be trucked in from upland source. Construct a fixed "L" dock consisting of 4' x 1001 . 1ong. Wave baffles will be constructed on thw outer sections as well as the southerly 40' of main dock section. Two pilings will be placed within the "L" acetion. To construct steps within the inter-tidal area to provide access along the beach as per revised plan dated March 5, 1991. Located Willis Crook Drive, Mattituck. This permit will expire two years from the ual-e it is signed. Fees must be paid, it applicable, and permit issued within six months of the date of—this notification. Two inspections are required and the Trustees are to be notlfled upon complction of maid project.. Please return to the building Department for a dotermination on tha need for any other permits which may be required for this project. Permit will be issued upon payment of the following fees for work to be done below Mean High Water Mark: 7/ e very truly yours, John M. Bredmmeyer, III President, Board of Trustees JMB:jt oc: Bldg. Dept. Conservation Advisory Council file i Board Of Southold Town Trustees fs SOUTHOLD, NEW YORK i PERMIT NO. .. 39Z5... ... .. ... DATE: ...J..tu+e.?.1.9.9.1 iF 4'. ` ISSUED TO ......._...I.ra...G.ordon................ . ... ......-... Pursuant to the provisions of Chapter 616 of the Laws of ± fhe State of New York, 1893, and Chapter 404 of the Laws of the ' State of New York 1952: and the Southold Town Ordinance en- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS end the i REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS:" and in accordance with the Resolution of The Board adopted at a meeting held on .,Lune..G,.. . 19 91., and in consideration of the sum of $ 150..00.. . . paid by Y Es;-ConeuJtants on behalf of Ira Gordon ± i r N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authoriws and permits the followings R v Construct 1-family dwelling,deck,pool,sanitary system, bluestone R or similar pervious driveway. Approx. 750 e.y. of fillwlll be true It ' in from upland source. construct a fixed "L" sect, Construct ste wlin the inter-tidal area, all as per plan dated March 5, 1991. Fall in accordance with the detailed specifications as presented in the originating application. IN WITNESS WHEREOF, The said Board of Trustees here- by causes its Corporate Seal to be affixed, and these presents to S : be subscribed by a majority of the said Board as of this data. y k .. ...........�.... ....... ...... 1 •��iiv:w'r.:..9'.sY��T.i�•r_Y�f; �".��dr��"e7s�i".�"3Ts"'�' '...-• 1 �. _, a New York State Department of Environmental Conservation Building 40—SUNY, Stony Brook, New York 11790-2356 (516) 751-1389. Am 1 AMENDMENT TO PERMIT Ica :�OV �o In _ a 3� � -1 M be_ l wne Thomas C. Jorling I Commissioner :SO,, -k� 11971 Date: /Uovcx ker 17/ 1113 Re: Permit No. & Location: -4 1-14-732 - ooa66-6001 -0 Willis CreeK 'bcix tlUEA,),-K SCT/n -# /yoo - - 3 -/0 - 3 Dear 'I1C, (�,orUoA : _ y eclugst to extend reviewed puraiian�, ar E �x7 x4`at oit—��. O LO Your recent request to modify the above permit has been reviewed pursuant to 6NYCRR, Part 621. It has been determined that the proposed modifications will not substantially change the scope of the permitted actions or the existing permit conditions. Therfore, the permit is amended to authorize: Alt worK s �a�� bee done in o,cCcr 80,AGe '0 PkaV\s P 're.tl b,/ ThoN,gs C . JQMVe`S d Aee 9 /Lf- I93 . This letter is an amendment to the original permit and as such, shall be posted at the job site. All other terms and conditions remain as written in the original permit. Very truly yours, CC'� Deputy Regional Permit Administrator CC: T �14MVQ`S New York State Departn,_.it of Environmental Conservation, Building dQ—SUNY, 51nny Rrook, New Ynrk 1179(1-235R (516) 75 :- 1389 9b Thomas C. Jorling June 10, 1991 Commissioner Ira Gordon 230 Kimberly Lane Southold, NY 11971 Rg; 1-4738-00266/00001-C Dear Mr. Gordon: In conformance with the requirements of the State Uniform Procedures Act (Article 70,CCL) and its implemeuLIng regulations (6NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are unable to ccmply with any conditions, pleasa Uu..tdct un at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Very truly yours, Mark C. Carrara 4-Pt Environmental Analyst enclosure MCC-.SIC 9530-6 VNII j-25C i NEW :SYIATF DEPARTMENT OF ENVIRONMENTAL CONSERV, i DEC PERMIT NUMBER EFFECTIVE unit ln4738-00266/00001-0 Jura: 10, 1991 FACILITY/PROGRAM NUMBER(,) PERMIT EXPIRATION DATE Under the Environmental Conservation Law IECQ June 10, 1994 TYPE OF PERMIT IChed: All APPliclolt Bmj't rr--II Kcw Opt.., OM"U.1k.., Orc"It to ConRfu[t `YCrmlt to Uperatt Article 15, Title 5: Article 17, Titles 7, 8: Article 27. Title 9: 6NYCRR 373: Protection of Water SPOES Hazardous Waste Management Article 15, Title 15: Article 19: Article 34, Water Supply Air Pollution Control Coastal Erosion Management Article 15, Title 15: Article 23, Title 27: a Article 36: Water Transport Mined Land Reclamation Floodplain Management Article 15,Long Island Itle S: Article 24: Articles 1 a Freshwater Wetlands 6NYCRR Wells 380: Radiation Control Articl Wild, 4 eScen 15, Title 27: l Other: ic and Recreational T14Wetlands Rivers Article 27. Title 7; 6NYCRR 360' 6NYCRR 608: Solid Waste Management Water Ouality Caniticatioo PERMIT ISSUED TO TELEPHONE NUMBER Ire Gordon 016 1765.5008 ADDRFSS or PFRMITTEF 230 Kimberly Ldrle, Southold, NY 11971 CONTACT PERSON FOR rERMtTreo WORK Tr.I EPIIONE NUMBER En Consultants - 13Z9 No. Sea Road Southampton, NY 11968 (516) 283-6360 NAME AND ADDRESS OF PROIECTIFACILITY Willis Greek Drive, Hattittiek LOCATION OF PROIECTIFACIUTY Peconic 8a COUNTY TOWN,CIIYIVILLACE WATERCOURSEIWETLAND NO. NYTM COORDINATES Suffolk Southold E:_ _ NA— DESCRIPTION OF AUTHORIZED ACTIV:TY Construct a single family dwelling. driveway. atid clock Truck 150 cubic yords of 9113 to apilipelliad areiis--n sits All wark +. k. one in accordance to plans prepared by John T. Metzger dated February 16, 1990. 1ast revised 2122/91 . By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL,all applicable regulations,the General Conditions speolf led(See Reverse Side)and any Special Conditions Included as part of this permit - A R ADDRESS C _ ;hristine J. Costopouloss: A 0 ILED SIC,tATUR( /t DATE !`�+ Page 1 of GENFRAL CONDITIONS Inspections 1. 1 ne permitted site or facility,including relevant records,is subject to Inspection at reasonable hours and Intervals by an authorized representative of the Department of Environmental Conservation(the Department) to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to Ff:l 71-0301 and SAPA 401(3). A copy of this permit, Including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the Project Alta Failure to produce at copy of the permit upon request by 8 Department representative Is a violation of this permit. Permit Changes and Renewals 2. The repartment reserves the right to modify, suspend or revokes lhls permit when: a) the scope of the permitted activity Is exceeded or a violation of any condition of the permit or provisions of the ECL and pertinent regulations is found; b) the permit was obtained by misrepresentation or failure to disclose relevant facts; c) new material information 's discovered; or d) environmental conditions,relevant technology, or applicable law nr regulation have materially changed since the permit was issued. 3. The permittee must submit a separate written application to the Uepartment for renewal, modifica- tion or transfer of this permit.Such application must include any forms, fees or supplemental infor• mation the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. a. The permittee must submit a renewal application at least; a) 180 days hofnra expiration of permits for State Pollutant Diocharge Climination System(SPDES), Hazardous Waste Management Facilities(HWMF), major Air Pollution Control(APC) and Solid Wact? Management Facilities (SWMF); and b) 30 days before expiration of all other permit types. 5. Unless expressly provided for by the Department, Issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms,con- ditions or requirements contained in such order or determination. Other Legal Obligations of Permittee 6. The permittee has accepted expressly. by 1hA erarrrtion of the application,the full legal rosponclbili- ty for all damages, direct or Indirect, of whatever nature and by whomever suffered, arising out of the project described in this permit and heA agreed to indemnify and save harmless the testate from suits, actions, damages and costs of every name and description resulting from this project. 7. This permil dues riot convey to the permittee any right to trespass upon the lands or Interfere with the riparian rights of others in order to perform the permitted work nor does It authorize the impair- ment of any rights,title,or interest In real or personal property held or vested in a person not a party to the permit. 8. The permittee is responsible for obtaining any other permits,approvals, lands,easements and rights• of-way that may he required for this project. Page 2 of ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 Mile S), 24,29,3a, 36 and 6 NYCRR Part 608 I ) 9. Thar if fuh,r. rip rationt by the Star* of New York require an al ether envlruuurerrtolly deleterious materials associated with the terstion in the position of the structure or work herein authorized,or project. If, in the opinion of the Department of Environmental Conservation 13. Any make,W dredged in the prosecution of the work herein permitted -it shall cause unreasonable obstruction to the free navigation of said shall be removed evenly,without leaving large refuse piles,ridge,across waters or flood flows or endanger the health, safety or welfare of one bad of a waterway or floodplain or deep holes that may have a tar people of the State, or cause loss or destruction at the natural tendency to cause damage to navigable channels or to the banks cf resources of the State,the owner may be ordered by the Department to a waterway. rarnnve n,alter the.tructuml work,obstructions,or hazards caused 14 Ihere shall be no unreasonable interference with navigation by the work thereby without expense to the State, and if, upon the expiration or herein authorized. revocation of this permit, the structure, fill, excavation. of other LS If upon the ehpiratlui tar rerusation of rid,peradL the project hereby modification of the watercourse hereby authorized shall not be com- authorized has not been completed,the applicant shall,without expense pleted, the ownrn, shall, without expense to the State. and to such extent and In Such time and manner as the Department of Environmental Ca parthe State, and to sure ntalsixtriC end in orrh Limn zed merman e.rho Department of Environmental Conservation may require.remove all or Conservation may require,remove all or any portion of the uncompleted any portion of the uncompleted structure or fill and restore the site rtn,ehire or 101 end ,.,tore to its forme, condition the navigable to its former condition. No claim shall be made against the State of and flood capacity of the watercourse.No claim shall be made against New York on account of any such removal or alteration. the State of New York on account of any such removal or alteration' 16 It granurd under Article 36. this permit does not signify in any way 10. That the State of New York shall in no cam be liable for any damage that the project will be free from flooding. or Injury to the structure or work herein authorized which may on'caused 17 If granted under 6 NYCRR Purt 606,the NYS Doportment of EnvLron by or result front future operations undertaken by the State for the mental Corservaton hereby certifies that the subject project will not conservation or improvement of navigation,or for other purposes,and contravene effluent limitations or other limitations or standards under no cialu,Or right to uun{rensatlon,hall accrue from any such damage. Sections 301, 302, 303,3%and 307 of the Clean Water Act of 197, 11 Granting of this permit does not relieve the applicant of the resp01151- (K 95.217)provided that all of the conditions listed herein are met hillty of obtaining any ether permission, consent or appiuvel Lunn Is. All activities authorized by this permit must be In strict conformance the U.S. Army Corps of Engineers,U.S.Coast Guard. New York State with the approved plans submitted by the applicant or his agent as part Office of Cerrural Services or local covernmentwhich may he renuirod of the permit .pplicatlen. 12. All necessary precautions shall be taken to preclude contamination NYSDEC approved of any wetland or waterway by suspended so:Ids, sediments. fuels. Such approved plans wan prepared by 5/23/9pp solvents.lubricants, epoxy coatings,paints,concrete,leachate or any on SPECIAL CONDITIONS 1. To protect the values of the tidal wetland. a permanent buffer zone shall be established. There shall be no disturbance to the natural vegetation or topography within an area extending 60 linear feet landward of the tidal wetland boundary: 2. A row of staked hay bales or approvable erosion control devices shall be placed 50 feet landward of tidal wetland boundary on approved plans at commencement of regulated activities and remain in place until project is completed and all disturbed areas stabiliaed.with vegetation. 3. During construction, no wet or fresh concrete or leachate shall be allowed to escape or be discharged, nor shall washings from transit mix trucks, mixers, or other devices be allowed to enter tidal wetlands. 4. Any debris or excess material from construction of this project. shall be completely removed from the adiacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands. 5. The storage of construction equipment and materials shall be confined to within the project work site and/or upland arras greater than 60 linear feet distant fro18 the tidal wetland boundary, 6. All areas of soil disturbance resulting from this project shall be seeded with an apprnpriata Irvronpial grass seed and mulched with hay or straw within one weak of final grading. Mulch shall be .maintained until a suitable vegetative cover is established. 01C.1`5111417 NUMBER 1-4738-00266/00001-0 ,ROCRAM;FACILITY NUMeiit Page �'— 95-366t lTM71—]Sc "I ?RKSTITg rfrIOTtdLNT OF tSFr. (1-1.4 SPECIAL CONDITIONS For Article ( 1 j7. If seeding or soil stabilization is impracticable due to the time of year, a I temporary mulch shall be applied and final seeding shall be performed at the earliest opportunity when weather conditions favor germination and growth, but not more than six months after project completion. 8. Driveway and parking araas shall be constructed of pervious material . 9. Roof runoff shall be directed to drywelle a minimum of 100 fect landward of the tidal wetlands boundary for immediate on-site recharge. 10. Dry wells for pool filter backwash shall be located a minimum of 100' landward of the tidal wetland boundary. 11. There will be no draining of swimming pool water directly or indirectly into tidal wetlands. 12. The septic system must be a minimum of 2' above groundwater. 13. Floats and .ramps must not be stored or rest on vegetated tidal wetlands_ 14. No dredging is authorized. SUPPLEMENTARY SPECIAL CONDITIONS A THRU J ATTACHED DEC PERMIT NUMBER _47 _ i_ FACILITY la NUMBER PROGRAM NUMBER Pa e of �_. SUPPL.iZggfiRY SPECIAL:.2MITIQYS Tha• followine conditions apply to n11 parmitss A. If any of the parmit conditions are unclear, the permi.ttea shall contact the Division of Regulatory Affairs- at the address and telaphone. noted balov. B. A copy of this permit, or aPFrova�l.and ap�rpved project plans and s lement- a eon bons shall be available- at tie prejeet its whenever author work is --progress. C. The permit sign enclosed with the permit or a copy of approval letter shall be protected from the veacher and posted in a conspieious location at the work site until completion of authorized vork. D. At least 40 hours prior to commencement of the project. the permittee shall complete and return the top portion of the enclosed receipt form certifying that be is fully avers of and understands all provisions and conditions of this permit. Within one weak of completion of the permitted work the bottom portion of that form shall also be completed and returned. E. For projects involvinx activities to be accomplished over a period or more than one year, the permittee shall notify the Regional Permit Administrator in writing at least 48 hours to the commencement of resumption of work each year. F. If project design modifications take piece after permit issuance, the permittee shall submit the appropriate plan changes for approval by the Regional permit Adalmlitrator prior .to undertaking any such modifications. The pormittoo is advised that substantial meaifieation may require submiss- ion of a new application for permit. G. All necessary precautions shall be to preclude contamination of any w.atlaads or waLerwey by suspended aolida, sediment, fuels, solvents, lubricants, epoxy coating, paints, concrete, leachata or any other environmentally deleterious materials assoCiaued wlt11 the project work. H. Any fal.lure. to comply precisely with all of the terms and condition of this permit, unleas authorized in writing, shall be treated as a violation of the Environmental' Conservation Law. I. The permittee is advised to obtain any permits or approvals that may be required from the U.S. Department of Army Corps of Engineers, New York District.' 26 Federal Plaza, New York BY 10007, (Attention Regulatory Functions Branch), prior to commencing dcrk authorized herein. J. The granting of this permit does not relieve the permittee of the responsib- ility of obtaining a grant, easement, ar other necessary approval from the Division of land Utilisation, Office of Genaral Services, Tover Building. Empira- Stata Plaza, Albany, IlY 12242. which may be -required for' any encroachment upon State-owned lan8s under water. Regional. Permit Administrator NYS Department of Environmental Cons. Bids. 40, SIMY--Ronm 219 stony Brook;, NY 1'1790-2356 (516) 751-1389- DEc JAMES H. RAMBO, INC. BISHOPS LANE SOUTHAMPTON, N.Y. 11968 PHONE:(516)283-1254 WUNNEWETA ROAD CUTCHOGUE, N.Y. 11935 PHONE: (516) 734-5858 March 2, 1994 Samuels & Steelman, A. I.A. Main Road Cutchogue, New York 11935 Re: Scollard Residence Gentlepeople, Enclosed please find pile log on the above referenced property. The piles were 20AA n length, 10" average butt size. They were driven with a Delmag #5 diesel pile hammer developing 9100 ft. lbs. of energy with fixed leads. The minimum capacity is 27 tons per pile. If you have any questions, please do not hesitate to call. sincerely, Thomas E. Samuels cc: Peconic Development Corp. AMES H. RAMBO, INC. PILE DRIVING LUG ob Name: 15I=4DL4L-A%TT> Site Location: U'�"% 1��1 h. C-f-e V- M,'ATTI T.JC.K.. ASy Piling No. Blows Per Estimated Piling No. Blows Per Estimated Foot Capacity in Foot Capacity in Tons Tons I-A a• _S9. 7 o C51, Y ID .2 . � v (a xv 4r, a f =5- 4- v27 3-0 9 � o. -•�. ; 9� yam, s �� � �� ,� � • � BOARD OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLA. TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . DECBUILDING DEPARTMENT CHECK DEC 410 TOWN HALL SEPTIC FORK . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NOT I FY TOWA CALL ! GU4jt Examined . . . :; 19V rtn I L To Approved . 7 . . . . . . .. 199.�Permit No. G�� SS f . . . . . . _ . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . /�Build•fn Inspector) APPLICATION FOR BUILDING PERMIT DateA 66r 1,2.). . . ., 19`l3 INSTRUCTIONS a. This 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 sheets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 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.QQpp . . . . . . . . . . . . . . . . . . . . (Signature of applicant, or name, if a corporation) (Mailing address of applt ant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. r¢YcG�.'tect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .p. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . . . . . . . . . . . . . .t2 . . . . . . . . . . . . ffr!rk. ...LT . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) n y Builder's License No. . . � . . . .. .. .. .. . . .�I . . . . . . . PLeeluC �ev��� Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . I. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . VC Ile !G. . .. . . . . . . . . . ./�a ;.. . ... . ... . . . . . . . . . . . . . .. House Number Street Hamlet ry County Tax Map No. 1000 Section . . . :�" !'n3.... .1. . .(.,. Block . . . . . . .��. . . . . . .. . Lot . . . . t?. . . .+. . . . . . . . . Subdivision . . . !7.4Lf.�6Y, .y/eW. �t `!! .'�j•tuG►I . Filed Map No. . . pJ 3 �/ �/Lot . . . . . . . . . . . . . (Name) 1 State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . . . . . . . . . . . . . . . . Vol Co2!t .vty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . . . . . . . . . . . . !nzy!��. . 4?'!! !1 . . . .�!� Ce. . . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . . . . . Addition . . . . . . . . . . ;V teration . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . ���7 ao (Description) 4. Estimated Cost . . . . . . . . .1, .T! d/e • _ • . • . . . . . . . . . . . Fee . . . . . . . . (to be paid on filing this application) 5. If dwelling, number of dwelling units . . . .m . . . . . . . Number of dwelling units on each floor . . . . . Kd. . . . If garage, number of cars . . . . . , 4*n1a f4 , - •> uo e3 s^s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures, if any: Front . . . . .'`a. . . . . . . . Rear . . . . ... . . . . . . Depth . . . #?A. . . . . . . . Height . . . .!t3 . . . . . . . . Number ofStories . . . . . . . . . . . . . . . . . . "` . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . ?. . . . . . . . Rear . . . . . a. . . Depth . . . . . . .n?. . . . . . . . . . . . . Height . . . . . . . . ."?. . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . .la's f.r. . . . . Rear . . . . .Cv3.fT . . . . DeP,th . . ,3.,3.<7, . . . . . Height . . .?9 fT. . . . . . Number of Stories . . . . ..?,e; 4y47- "6. A�f. Ht%EL? 9. Size of lot: Front . . . . . ./3 y f7. Rear . . . . . . ./`/ti?% f7 . . . . Depth . . . . 1 . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . /!^.d.<j0.'v44ri . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . . . . . . ..'10. . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . . �1-1.. . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes 14. Name of Owner of pre ises Address a04A*P? ./ . Phone No. 7 .� 9� . • _ . Name of Architect F-L. . . . . . Address . . Phone No. . .%3�'(oYQE� Name of Contractor . . . . Address 1�� �9�*� Phone No. . . ??' . . .15. Is this property within 300 feet of a tidal wetlan � *Yes. .✓ . . No. . . . . . . . . *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAbf Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. �EE E�CL�J'ED J'L�iv,S 6� ..far-r.�ux.Ld � �te�Lt-dt apt �srltii "-e 6td STATE OF NEW YO,K, , S.S COUNTY OF . . . .��(t,�. 7. . . . . .i. . . . . H Ut Z.r, . , , ..• , . , _ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4/-eCFNT. .EUJ" . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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 filed therewith. Sworn to before me this . . . . . . . . . . . . ./ . 7��). . .day of,l✓.'t'.t. Y. 1n14.1. . . 1 —, 19'. Note Public, . . - 1 L . h! . . . County (Signature of applicant) The water supply and sewage disposal systems for this residence wil'conform to the standards of The Suffok County 1. Department of Health Services. r SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY l POO DATE K S.REF.NO. APPROVED /R= 40.0o' L = 59.78, \ LLJ AAA ORpINACiE \ t>'" N SFK ET , aD WAYI N R 'I Ici u (WALK ..,v 1F l/ 9.4E p t 5 2?. a4 ( TdONJ 11 I m\ '�� ✓�f I" 7 `L .A'Dgo , R 60.00.' 1 1 .. 1 r -t= 25 '� i z S L M W E ill 8 c tip' a. S. Lf lea sr( sEr t � O L01 °9 scr N306, 45 $ a N �j O \ T I0 SUR VE Y OF \` �' T LOT 17 MA P OF N "HARBOR . VIEW AT MA T TI TUCK" 9 FILED AUGUST 21, 1987 FILE NO. 8377 4� A T MA T TI TUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. " P 1000 - 123 - 10 - 03 Scale 1" = 40' Feb. 16, 1990 ���uq° ox, July 9, 1990(topo & set stks.) Dec. 20, 1990(revise) P CERTIFIED TO : CHICAGO TITLE INSURANCE Mar. 3, 1994 (foundation) �� COMPANY RIVERHEAD SAVINGS BANK o� srn IRA J. GORDON no tE �.A JUDITH A. GORDON -- Pi�P oSCoC Cor/ fo�.r V' �i000seal i"/7o .-2 of 4// /reeclel!;:6 = 750 c yods D j aEsr�9h. AREA = W472acres Pre aced in accordant° with the minimum / * Y.S. LIC. NO. 49618 standards for title surveys as estmWithed P / RS, P.C. by the L.LA.L.S. and roved and adopted ELEVATIONS ARE REFERENCED (5 /or such use 6y The New York State Land TO N. G. V. D. . Title Aasociallon. A O. /ZZj9/ /�V/5/o1 ;/ ��4 Srt MAIN SOUTHOLD, N.Y. 11971 90 - 133 i M.a.u.arb of m S~ cots* N of G 6EP SUFPOLK COUNTY DEPARTI@R OF HEALTH SERVKM FOR APPROVAL OF CONSTRUCTION ONLY A o o DATE K S.REF.NO. 93-SO-70 0 24 I95 M �` APPROVED R= .00- SOW N O STN •�(1_I� / L SET J P-60.00i t 11 p� Ln27�5' LC vw4 NON N, -� ��y, �p��E 'PC 0 O1 fo � 4 g o v SE W E s 'FFO-K COkJN7Y t;;.PARTME-Nff OF FIEALTH 8 RVICEfi ��i ' ° ° ;s•`� r�`�� �/ \ A �o {y ..r . . ,,. mpft, aiMhe - �I' k c. '' r a. Per IX-0fa. trc•� :' _. r �{�, \ � off V�� �� gg4 v$£T 9' SURVEY OF � 81;,- LOT 17 FNP MAP OF +E "HARBOR . VIEW AT MATT/TUCK" f , t FILED AUGUST 21, 1087 FILE NO. 8977 A T MA T TI TUCK TOWN OF SOUTH_OLD9f, ;� � �" ►�'�� o i SUFFOLK COUNTY, N. Y. 1. 1000 - 123 - 10 - 03 — L OV Scale 1" = 40' G Feb. 16, 1990 �j/0�` a��•9° July 9, 1990(topo & set stks.) µVito `iG Dec. 20, 1880(reriae) P /CERTIFIED TO : Mar. 8, IM4(foundation) .( CHICAGO TITLE ASURANCE COMPANY Jan 24, 1995 (final RIVERHEAD SA VINGS BANK IRA J. GORDON JUDITH A. GORDON ❑& = ��Po3e�c. can�o yr �oio�,osece' arlourJ� oW 4// ireecla = 750 ou,yoGs . A AREA = 1.0472acrea f. v Pr�•pprrrd n accordant• with Me o*dmtwn N.� S. 1, NO. 49618 �•y4adrdt /or Nth•wr r•as MaMphod r'�CONI fir���S .�pr����"t t*Wd ELEVATIONS ARE REFERENCED V - C' arw►A�T1w IWw Yak 8rr.Land (516) 783 - TIa1a r0 N. G. V. D. . f/ZZ/91 I-cV/s/a^ /7/94 rc� ,- P. O. BOX MAIN ROAD �2 3/�90 e�i5io� SOUTHOLD, MY. 11971 �/1 inn The water supply and sewage disposal f systems for this residence w11 conform P�` to the standards of The Suffolk County 1, Department of Health Services. QCkA (��1 V SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY 0 o DATE I -; R S.REF.NO. CEP • APPROVED R= 40.00' LLI AREA OpAISAGE N J \ m SET :. O �¢ k U W t 'SWAY) 196.87r Z a o_\ vi vo ® =27.25> L 01 ioP bye Z v� e ,r Z kO0. NN GO• 07 Q' O ` ador 'F 2 4L\ �4 Sao {Da `,led A 9 _ srK ;%rod ?D ` -`off920P \ $ i .� O s � --0F . ai W E o + 1•�l p' 4 . ' e tl + ifs _ f 11: •♦ ♦ S. ♦ i it ' �. :(` �t'r 1 .-f + SrK ,,JJ SET 1.01 tb t,y ` ' l� e t,o l se 0 g b a I ♦r- S, j0 SUR VE Y OF ( � SET LOT y7 RID— � MA P OF G.00 ,E . "HARBOR . VIEW AT MA TTITUC6c°� FILED AUGUST 21, 1987 FILE NO. 8377 A T MA T TI TUCK ` TOWN OF SOUTHOLD - 9;64 0 ,"' ' SUFFOLK COUNTY, N. Y. �.N — —� • P pP ew 1000 - 123 - 10 - 03 r; O Scale 1" = 40' Feb. 16, 1990a�u;9° July 9, 1990(topo & set stks.) � �CJ/ Dec. 20, 1990(rovise) P CERTIFIED TO : CHICAGO TITLE INSURANCE // areo� shaoke dL A \ COM A&K Y`Q tEi EAD SA BANK= po. of srnee ��j RA J. GORDON lTH A. GORDON ®=Pr�Posto! confo�r �+ O � D Pio�oosed amour�� o>< I-/LlreeaCe�v_ = 75-4-e�.r�s _.. . —1 -- i A •- r AREA = 1.0472acres s Pr7ged in accordance with the minimum N.Y.S LIC. NO. 496I8 standards for title surveys as estabUshed P VEYORS, P.C. gthe L.I.A.L.S. and app roved and adop ELEVATIONS ARE REFERENCED ted r such use by The New York State Land (516) 765 - 5020 Title Association. TO N. G. VD. . P. O. BOX 909 2/22/9/ rev/51011 MAIN AD SOUTHOLD, N.Y. 11971 /2 3/�90 rFv,.S,ar� 90 — 133 i TYPICAL LEACHING FCOL A� Ai r c op"p a° ` AkeC FINISHED GRADE 1' . 15 S. ' 25 "rNEpp O r MIN. 2' MAX. , • # o /-� CONCRETE COVER ;® �ft6°oka0ql_ 7r > CONCRETE CHIMNEY-• 2'MAX. 0/ ^ V m Q 9 INLET ---•- arfi y� o o NORT „11 F " " , „1 ��`Y, I 1 l f 1 ^ n �1w1,�Pr rtn a 0 ` CO MIN. 4 OIA. APPROVED PIPES I MATtI�U/C/K o d n y PITCHED MIN. 1/8 /1 �yl _J J 9 F ' e �=j ? i o G 1r Ilt� o n - -• 8 AIRPORT `��, ,. Q 2��, OfJ C]O , h, " ODOR _ - t1/MAX. 25' / 7 F NiFq$F / 7. m/ �.MPM P.qt 410 4 23 5��� \�o , R OOI�OC� e I L I Cam- K rai ooka Pr or /i • ♦ Y � s ITE iq+ j x 1 13�•57' �.. p �I` 3FMIN. LEACH3ING �1111 a ��QL:II�.�C� rc"F_ ( J '4 ,, SECTIONS ,I► W �'^y • ` G 4? E A T P L~ C O N I C > , COLLAR a I�FN'. £UtC 1\(I 53�r•.I . N, m / i I3 A Y � cc 2'MIN. GRiOUNOWATER 6' MIN. PENETRATION ` q�K ' • \ • / ' I -"`%l " ' u�1 ' � � �/ /71, �,�Le T-C INTO A VIRGIN STRATA ^ /"' BACK FILL MATERIALL TO BE CLEAN r-,t, �/�C. �pp�p�� ,, \ q¢%•� W OF SAND AND GRAVEL + / O � ,. // SAND AND GRAVEL cC,dNO Pro ••rt�wC , ' , n 10 rT. P IALKI,4AY . I � RECTANGULAR SEPTIC TANK Wi�-1`E is. N, ( / ��' . a S'1'STE h'I - O /' /� �\ DO NOT PROCEED q)i7__ 1-1" l .I 7 CFI" ,. 1!°jt...1 4 \♦ ` \ 1 �� .4 A. .. / I�/� a fl` t� / UI,STIL IIL,�.� SURVEY OF Tc/�� DAY . M 1 .Ir 1% FT _ / �� FOUNDATION LOCATION 41.,D F_X�t)9 rr� /1_2-y - iZOF'DSEt7 H� BE I'�l��4I.. l:,P)°€_."s.':<� [�!� �'�:�e,14�. ri4� /aT S BEEN APPROVED SY 6T F_M ' , '4 "IX) y p ry P \�.�/ // I C E "•_4 ial.�3 C; ��.�.'F m 1.) ��"`r ;?e�`•d4 FOR THE 3. 8 FT Dl.A � DEE.P • �. ,:�rc, .4 FT „ :, �: 1 I 1. F01.tINDATt0f�1 j�;°,t £�gac��n L.E�•c.�-•jlhlq F�L.5 `-� 1 �-O '' POURED C€��I PETE O - I- 8FT PIS 9- 4 FT PEEP (_E1JT'IJrZE) ` �,P/ \ 2. ROUGH - ��:�.E��+1' G t& PLR.,AASING f w 1=xr9d, 4£�11>t4 LEAc.44iNG-r �c='L- fC0N ,_'RmJCTtON tA.!JST 1 LP `2�0��': f71I7E 1 LF' t(/ - 2{5 �I�E C B�. Cf31�J�P"'I_��.TE I~OPi C.>°3, 1 A D � ° l-'�LL COnN S I RL)C I•ION4. SHALL MEET C T �. I?of REMAREMENTS OF THE- N.Y. L- 2W to -4w rll�we: , Tr Ct}I�° TL3C�'II`sZ ENERGY P1.UM3R/�:�3 = CODES. NOT RESPONSIBLE FOR �� tt �'o / a DESIGN 0R CONSTRUCTION ERRORS ALL i{��•tll4 LING Y:�� LOCKING CASTING j' tr"!!TER UNMS NEED TO GRADE / 8 I-+ AT - / FINISHED GRADE TESTING CEFO E COVERIKG 9 � OlJ'9E --I"1,s�1�l - � '� ��� G� � �� u;.uh'a'ti;„ IIY+1,N3i: CHIMNEY-+ 1' MIN. 2'IMAX. 1 , - � 1 •`•, 12 ` r � � �- •,....� i.- REQUIRED : 4'M A X. ICE-T;&,I IJ� "A.L L- j 1 • ' � I /J�l f�� c�,/� i �" -!✓ &xre GGA 'T1t.Ar3ER•S - �' 1' t1z•5 'Lfa / /_ U 20' MIN TOP Tl-� F✓l.. t Il.res' \ ^ ` .SIf7E .`its I�,5 - E R i 8 �•�C�'-Cc' UP."? :'�:"REPSWIFI9CATE R IRM INLET - 12" "' -+OUTLET If coppertub:ng.lsuscd L-�T- _« Ing IN. 4" OIA. AP- 6• MIN. 4" DIA. AP- fDr water dlStr all be I,�,� � / ROVED PIPE _ ITCHED 1/4"/1' " PROVED PIPE ,I system,pipinti IS PITCHED t/S"/1' typgg K or L only G' �• t:,o, o2S Z SITE LJ VA 4t'6 4 .. +� bs .EM, E.Lr 8.I25 rn ,. �•IATE iZ L�G.1--II?I�I C�6F P. - �\ w _ ._ .... _ . ._>.,.._. ..... . . . PovL. 1.J� pEl2�'o1ZATrA t�t'ii"L.. ' ' I - �' r1 1-•1 a L..E \ '- / f - �..3 J � o o -f-g,a' y _ �L Esc / 10 SCTM # 1000-123-10-3 PFzA,i J v=tZ. 'T/F EL..,t rJ,6 r +lo, - •I- +� m w .� - - - - -1 - - , - -- - ZM > !. 8 F`i' D I.e. , A-FT DEEP 0 5 - PROPERTY: = Q W g _ 905 Willis Creek Drive LL, . ' FI 'ATIO Tk 14.0 %r \ F ; ` l' 1 I � ADDRESS Mattituck N.Y. 11952 Q M u ER CERTI E ORE 9 , �;;'' Gc r .�. 'r;.:. I I L o PLUr'�B NTENT B :FORE t✓T•�.1►.�ItJ ,A�L_Q ! - ,✓ram ; ? 1;<:y;' �- , W • N = OWNER: Patrick Scollard ON EAICATE OF OE CATER �►� ro cc�.a TI►..tR�t✓a.� �, I U _-_ _ - Ic��\ I 129 Stafford Avenue ¢ �- • u USE NOT / I 4. Garden City, N.Y. 11530 CE p IrJ _ ca 12,�,t>E.:�>:3•S' SOLPLY SYSTEM CANNOT LEAD' ��-- l0 N -. i •.r,, SUS2� OF Ep o � _ _ �� EXISTING : Agricultural-Conservation (A-C) PAR o31►•I EX FINS � ZONING 3T©R I�•!Fe.TG 12-- t�1 t►�J E 14 / \ GOAR�C r gc ,••Ip 5YSTEt�i G FT C71�,n 4 PT DC,L• P � � � ��_J N SITE: 1.0472 acres LEA-c-i- -A CT FOOL-5 I PCiz AREA j4c>L_j S E GO ta.t4 EIZ ,4 ToT.Q L. c1 F_Cly c�n+•�t�1 C�T!✓r� To Do t.J�181� / �� �� p I SURVEYOR: Peconic Surveyors P.C. °' - r _ _ Southold, N.Y. 11971 �, G UTrr"�=tz� 1 / - f 'z I GZ-25'I o"W License # LS 49618 ��' Pf t4 30r 00' Dated: February 16, 19910 `" '` ,'•� `� t INbiGENaUS, fs.N:� ti-W LPL IzGD 11 r NOTES: -Elevations shown are based on National to Geodetic Vertical Datum of 1929. E . y t- 7r6 -Public water is available) to the site IJ6TE 2 � Project No: 931'.y IN P- -t_E \\ \ \\ " 3The locations of wells and cesspools FINE TO...- 8� �N, _ �� �, shownhereon are from field observations Drawn By: U-r/G b ? �--`_ _ �' 75 Fr t and or from data obtained from others. 14 - -- - 11. �F_A K `(AK7- , Checked B T� HEALTH I am familiar with the standards Date: tQ1 Ili!� 1-A O L..E rr \ _ _ - __-__ _-a DEPT. for approval and construction of _�LV,A_r I�E+aU_t•�1�*t�1 � \\ ` -"�,-�___.- ' �. � �-� ��/Y\/Vl 1.1-1�-J. I rl � Ir ItJ F©12t�'T 10't�.l - _ 4 STATEMENT subsurface sewage disposal systems Scale: { : Zo -o 7/1z/Q3 +3p P1� .6_g=0" o.G. 6EA6H _ T.�Li-`f �\\ ��� �� ' ���/ 11- ICo-`I° for single family residences and will abide by the conditions set *_I - \\ �� forth therein and on the permit to Sheet Title: construct. SITE t.�. iz-A�E EL*11,5' ` �r -sT•Q e. >�� __- _ F - �P : %4" FT � � X I � I�L/�� FT �} J _-�I _ �.z�J4 9 Fi r,S t,�����-- -- Q i t � b� ( SIGNED: , y Er�T IC. 03= �•►�LL - - ? pPatrick co and & SITE Ln.l It- TAN � •- i �� DETAILS •. .------ • I �. •7 5' lJ L � �' �5'F_�.G,_ITOrZ12o+.tT.�L _ _; v . /� ^ _, ,,~v,a. �•y RDIJ!-Ip I�TEFz � � ' I� ' I _ _�..•{ t7" I� �`C/ t 1 l p •, yt5 xe 2 IN 8 FT' ti,AIW, to FT N/I •� I Sheet No: _.='_f'SaIB"r1� tto,� :.G,2�•3�E �,�/ NoTE (�Rot�ERT�( t-I.o.p PRIOr�. /�pP�,ovAL. FRor✓!: z 1 C, I'CQ I - O = 7I4s sc o 1-4 S `�/4/11 Ps � q 1 - 50-Dj � NYsD� PEIzM3T # I- 4736-Cc 2Ccfo/000al-o --- - P F-P-S.11 2_ TYPICAL LEACHING FOOL l-- I f V^1 P. FINISHED GRACE b�'`� 25 a✓ �� \) It MIN. 2' MAX CONCRETE COVER -- \ ' CONCRETE CHIMNEY 2'MAx. { bbb ��... , f 20"—_.'1 r t, a--i v!-'\, a i .' � � Ri( - /.'; // N(x fiT W.•.•a +x' INLET 1 i / ,,tr_. + r MIN. 4"01A. APPROVED PIPS r r 3 / �Nq"; of r r PITCHED MIN. I/S"/I' r �l '� 11ATTITUCK jCIO X!rl c >�I V, MAX. 2S' ISS " 74 f� /' J PJ ?Of �\ SITE. '� � ► -- / // t 'ham ... � ,.•., I p S' MIN. LEACHING � / \ G R 1; A �' P T C O N I C COLLAR SECTIONS a. a / g BI A Y , 2'MIN. 60 GROUNIOWATER S' MIN- PENETRATION BACK FILL MATERIAL TO BE CLEAN INTO A VIRGIN STRATA Lj I"'i 64i x . .l L."Y d-I r ( [! ,�) OF SAND AND ,RAVEL _ Uj SANG AND GRAVEL F. - _ L [ �. , /, 1!. ✓ / \ I / � / , u� E s c � wry..r ° I 1� RECTANGULAR SEPTIC TANK ` 1 Y L � -- —-- --'---- — P RC`racy o ED .I-.J 1'r^P_ �\�� \ \ I I r rJ u I 900 C4 �E!'TICG T/\tJ IL \ ( 1 a 3- P? c T p x .q. FT DEEP ! r \ W I - AFT rJl.a r FT D EF' ( FLlT JrLc) I \ 't. \� ' 13 I r� Ex�N s1 ot�.r L ESN I tJ� ��. � f ' � \ � ` �� � �,, i_- 2 W t o 4 W - E3 T$•. I I P` EE C) t° I i LOCKING CASTING � � ` � �\* 4Xr� ' TO GnADF rims LED GRADE i CHIMNEY 1' MIN 2'MAX. 4'MAX. �E�i411J " L. IL i 20 MIN TOP TI.."� F-L , 4- 11.4ax \\ \ �`\ It- :' ` ~ `F F'-` �. • ,,. INLET IN 4" CIA AP ROVED rt E MIN 4" DIA. AP I I I / ITCHED 1/4"/1' 18 r'ROVEO r'Ir'F_ (� PITCHED 1/8"/1' * STC^(R'F.rI -`t�T�1' L)!.�G!•-IIT1 � r - ' ' t� , 1 _ . -- ` SCTM 1000-12.3 10 3 l - D L-*, " A- Fr PEi=-r PROPERTY: 905 Willi Creek Drive . ADDRESS Mattituck� NY. 11952 N - L \ \ I \ � I OWNER: Patrick Scollard �' e�.�. ��''> '��� \ �n `\ \ �1 ;� `' I 129 Stafford Avenue ` Garden City, N.Y. 11530 1 EXISTING Agricultural-Conservation (/A-C) ZONING F I N I- ec'- STc'�f�1 y.•I�.T L=R- D f I► .lAa l:: \ 1.??F 1 cn,A R ,r YSTI_M (c, ('T D -4 FT DEL-LP SITE: t� 1 ,0472 acres L C►-+IiJ CT fxX>L c-%> I P`(z .\ — AREA S, ca F.t.< cvrJii-J Cc.T Gp To Do vJ rJ ST�,LIt3 � � -- `�� �� p SURVEYOR: Peconic Surveyors, 'P C. �' "F�. c• T ��'�. Southold, NY. 11971 e� 4. License # LS 49518 � �,� 30,cc Dated: Fehrl.iary 16, 1990 7. 1 I. ,a.—GR \ / C'7 .CJ t l+ ✓ �✓ti" - NOTES: - PROPOSED PLANT LIST " � : _- ,�" �.4. �- �.,e_-, deed __ ___. _ __. 1O. .. _ . ` -Elevations shown are based on National e __ \ �� n� Geodetic Vertical Datum of 1929 t�s '�o' 7.5' BOTANICAL NAME COMMON NAME �` \\ \ — II �` ! t _ �� _ j f'l�blic wE�ter is available to) the site Project No 1���; SEA SHORE PLANTINGS \� �' `�� _ fn I �, ,y __ _ _ The locat^ins of wells and cesspools C-O.- To I shownhemon are from field observations Drawn By. lJ T/G �', ` \\ and or from data obtained from others�'�''��'� ILEX glabra "Compacta" Compact Inkberry — � Chf�cked By T;�. ILEX opaca American Holly \ _ —— �� \� `=-{ i4 JUNIPERUS conferta "Blue Pacific" Shore Juniper 7F_67— JUNIPERUS virginiana Eastern Red Cedar `� __- = _ 1 HEALTH "I am familiar with the standards ;�,jtF, - -- -- - deed - - -- / - MYRA pensylvanica Bayberry _ — _ — DEPT. for appro_v_a! and cons tructieon of i�1 FC?Imo.t T lO't`-.I PRUNUS maritima Beach Plum —— — — _ G i�,ti� ; ` - - -age d p - jr � � __ _ __ __< I STATEP�{ENT subsurface_sewa e dis osal s stems Sc.a 1� /I z/a 3 �, ,3c P�, ROSA rugosa hybrids Rugosa Rose \ -- tV _ - J. icv _Qo for single-family residences and _LnN+.Jt;a �.IAL.L ? ,� ��� — -- will abide by the conditions; set �, ORNAMENTAL PLANTINGS / a� ShE rat 1,tie, � � forth therein and on the pelrmit to construct. SITE C1R.�t��. EL+ 11,5' BERBERIS thungergil "Crimson Pygmy"Crimson Pygmy Barberry BETULA ni ra "Heritage" Heritage River Birch ,.�� r-T Y�+1r-T DAMMERI 'Coral Beauty" Cotoneaster Coral Beauty 1 �1 : SIGNED: ` EUONYMUS alanus / Com acia Dwarf Winged Euon mus P arick �ca��-- '-- ----- -- SITE y `�� _ EUONYMUS kiatschovica "Manhattan" Spreading Euonymus \\ \ . __ + FORSYTHIA intermedia Lynwood Gold & Spring Glory 1 �� CLEven,. t2.1, HYDRANGEA macrophylia Blue Lace Cap ILEX crenata (spreading) Japanese Holly Compacta + I �' IE, +" 3' ILEX meseNeae Blue Princess I I� Oregon Grape Holly 2, 1 MAHONIA aquifolium Far ti-/IIPJ. Io Irr PICEA pungens "Glauca" Colorado Blue Spruce .I T r Sheet No PIERIS ' Japanese Andromeda-- japonica PINUS strobus Eastern White Pine QUERCUS rubra Northern Red Oak ` RHODODENDRON Lavender/Pink ��� 'J�''E- - ('cz.cr�ER-T� 1-�,QD F='RIG�r..., sI`pPRovo.L FR�+✓I� 1 � F I �r " �,.v - 7i--aE 5C.D I_4 S 9/•4/qI NS f SOPHORA JAPONICA "Regent" Re ent Scholartree 2✓A, o- G I j o" o ' �t--E- SPIRAEA x vanhouttei g Vaghoutte Spirea �' " NYs �`='c. �� ,� TAXUS baccata "Rependans" Spreading English Yew `� - - =^TES VIBURNUM Tomentosum Viburnum �-�`I'o'-o h'�'4 �f'''z-p aP i R►�q>TEs.E:3 P F_12>,� 1`T 4:t 39 25 4/2q /9 3 4 ( LU 0 VA 1 I V I V I 1 i OII cc LL7- __ - r Uu w - ,-~U v wo as hI L I N CA — � -� 1-- _ - _-- _-- _- - -- _J we -- - - i - - j - 6 ( 1 5F�- � Z .. ----2 x 8 CCA SILL LL L VI 1/2wDIA. ANCI IOR BOLTS8'-0" O.C. 8" DEPTt1CX _ < _ c,)Gn ADEn cn c3" CLR. TYP �t4 BARS --- - ---- - - - � ; Q2 ^ x4 BARS*3 REM_STIRRUPS na1 77 - Id 2wCLR. 2" CLR. 2 -o �T I n c.�t,) ! I Project No. �3 11--31/2" EXPANSION 20' � I � - -{ � - - - JOINT (TYP.) - Drawn By 7 *3 REBAR STIRRUPS C� 12" - � 4" CONC. SLAB Checked By: N------ Date: 1© / t /93-3" CLR. _rr : , ' Scale: ri '2 - P6 SARSM7 Sheet Title• _. -2 - �r4 BARs cJ ZgI�2F� f F�TIt*3 BARS- N CI I IL �� 1 PILEYt i6l, �4+,tiJoFZ- eoL-TS 2� j Gam _ gji0 �EMBED. �t4 REBARCOr'iTiNUOUS � 10 DtA TIMBERPILESheet No:ol COL. , F,7^I1....... ,- '2 SCALE 1" = 1' -0" „, _ r r R. • � �I�_OII ( ' s . b'-o” FDI..1fJra�.TlOr.! I.JAL L �,TYi'� PoUIZED PI,.AcZ lam" T1�K 'iZE11J FoRGEf� cc��c.R.ETE FoU►Jr.�.ToN 8, PJAY ABc�/� I�IAI..L ©N C1T�AnE ��F.1��li p�JP 1�ILrt�1G - - . - � Fc�crT'II.I�. PROvtI� r�.I�iPPRa�FIrJ� �9T I l>j�'I .�' , VJ ,1'� I � \ - I w+� L t-J NA tr•l U M C,u'T`>-CFZs FILL L L� �r�l� �.1, 4 �' f. — — --- - ---- 8. .A 5 s h-�C�I�.11J � �9Fj�G I - y. ets112. I • ..: I I 1 LL 9 j Q Ll , CO, 00 - - --- -- - - g ---- -- —---_- - �-- + -- -- ------------ - --- ._.- ----- � � -� - :yam . - _ _ - - - - --4 3 _ 4. r 1-IOU5E i I ` I , t 1 ! ► I i __ ^----- I 1 { _ 5EwE; ! ;_ SrJMP J.L I ' ( I I I►'�!'I �• ! � I a I I ! I R , �••, __--- --- I � I � I I o I to I .• f • ! T I I I E , I 1 N-�'I L F � I I � s i ---- i I I ; �`� PIPE col-l.,1 M Q A I ��- r ' ' { I -__- _- .�._.,. '�� � l � I I I � I i - _-`---_-.--_.""' I r I ` I � � r`..7 � V�1 t� K"J o �• I � I a. C1 _ 101— �'e , \ ! Q- 0 �,�. -�/ ,..a M Rcr NJ Fopr,N 0 _ G , j � r�E _ �.7C,a ir•J-_ i ( ( `� � x � 4 �I I -- -- - - ---- - - --- L CEIL. tJC- I �r , I I ! - ----------------- i PAS I I N FIL EI7 cca cp A , Co" Ap:CSvE. I 66 Z I , I � � • AG - - - (!)-,4 , TiTri Ln rz I I T N l I _. I1Ti /'t V. iII Ii {- - jI i w J zLL 4 SX4 STOP WALL rh v(L . w < ^_ R PAD I q �I I N I Rj I i ► i 1 r l -- ---- I I I I I ; ! = I -f I x \ �•��/�C. ,� yk. I i }.� C �.•J 1�1 I'T' BOIL •,,' . f- u I ! ! 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'S0 s* palr�cr P^PEFL d i N 4 i�IRE -I, / 'rRE�cI-1 �,.k��1 9 r Drawn By: : �UT SLIAR� To eUt� p 0 Checked By tJ 5 t - -� N i G I i I - --- ' r I a cam► I I"1AS7 t= L tJ C -'�_._ �tG? I It2 �; � I III ------- I � � ' �� � O + �' � / '►JC•rl`�� �=_ I I w �. QLT1�)r�TE. # I. I '� N ► Date: I�/ * L4�fJ GEr��r2- St•att.IC�LES _ I; dl ct1 '(J I 1 "'+ I t + ( I ! I ! ! i I i +� 1 ! r I l,•l/ 5%: " l �pn�� '1t'J Ir► TNt✓EZ. Il __ _ — __ __ --- -- _ -- -_- ' �� �-( IV, _ i ��', Scale: F Fr-I_.T 0-T't�r2Go l,J W-sGoa r I I I I I I I I I 1 1 1 ► 1 1 U� I ' 13 ��� _ +oi�3?�` - _ - I t',eY' - •� I er.l I ,� z. 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