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HomeMy WebLinkAbout32872-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-33416 Date: 12/02/08 THIS CERTIFIES that the building ADDITION Location of Property: 90 DEER DR MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 114 Block 10 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 30, 2007 pursuant to which Building Permit No. 32872-Z dated APRIL 2, 2007 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 ATTACHED ONE CAR GARAGE ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to CLIFFORD D POLACEK (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 4011001 09/10/08 PLUMBERS CERTIFICATION DATED N/A Authorized Signature Rev. 1/81 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT Qw 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: 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. Corrin-iercial 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) nou-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property sliovving all property lines, streets, building and unusual natural or topographic features. 2. A properly completed aplfliUU1011 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 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, SwitTu-ning 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, Corrinaercial $15.00 Date. o New Construction: X Old or Pre-existing Building: (check one) Location of Property: House,No. Street 'I-lan-let Owner or Owners of Property: --c-if V-r) a f- e- Suffolk County Tax Map No 1000, Section 1 Block. Lot Subdivision Filed Map. Lot.- Permit No. 2 (?7 Date of Permit. to C ell-_ 0 Health Dept. Approval: Underwriters Approval: p,j F-[(,P-- pzd Planning Board Approval: Request for: Temporary Certificate Final Certificate: X (check one) _ Fee Submitted: $ 33 L I I L Qle-C. Ap icant Signature James F.King,President X�QF S�U�y Town Hall Jill M.Doherty,Vice-President �0� Ol0 53095 Route 25 P.O.Box 1179 Peggy A. Dickerson Southold,New York 11971-0959 Dave Bergen G Bob Ghosio,Jr. �Ol �� Telephone(631) 765-1892 Fax(631) 765-6641 couffm BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0385C Date: November 25, 2008 THIS CERTIFIES that the construction of a one-car garage addition to the existing dwelling At 2905 Westphalia Road, Mattituck,New York Suffolk County Tax Map# 114-10-1 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 10/26/06 pursuant to which Trustees Permit#6482A Dated 11/15/06 and was issued, and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the construction of a one-car garage addition to the existing dwelling The certificate is issued to CLIFFORD D. POLACEK owner of the aforesaid property. Authorized Signature a. 0 r�[JPJ�[1�[.n[.n[.nCl[1�[1[1L1�[J�[Ji1[1�[J�[J�[J�[1[1[lGf[JE1@J�[J�[J0�[JUJ i.li.0J�[1[J221[1�[J�C1[n[J�rJ�r3 L- E-1rLM:n[J�[. :[.I�rJ�[J�[J��L3rL3rJ@.r2[JPL[P 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 5 BUREAU OF ELECTRICITY 5 5 40 FULTON STREET - NEW YORK, NY 10038 c� 5 CERTIFIES THAT 5 5 5 5 Upon the application of upon premises owned by 5 5 5 5 5 SABAT ELECTRIC CLIFFORD POLACEK 5 5 50 PAT LANE 2905 WESTPHALIA RD 5 MATTITUCK, NY 11952, MATTITUCK, NY 11952 5 Located at 2905 WESTPHALIA RD MATTITUCK, NY 11952 r55 5 j Application Number: 4011001 Certificate Number: 4011001 5 5 5 5 Section: Block: Lot: Building Permit: * BDC: 5 5 ns11 CCJ 5 Described as a Residential occupancy, wherein the premises electrical system consisting of 5 5 electrical devices and wiring, described below, located in/on the premises at: 5 5 5 Attached Garage,Outside, 5 5 5 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 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 loth Day of September, 2008. 5 5 Name OTY Rate Rating Circuits Type 5 5 Wiring And Devices 5 Fixture 2 0 Incandescent 5 GFCI Circuit Breaker 1 0 20a 5 Outlet 2 0 Fixture 5 Outlet 6 0 Gen,Purpose 5 Receptacle 1 0 20a Special/twist lock 5 5 Receptacle 7 0 Gen,Purpose 5 Switch 1 0 Gen,Purpose 5 5 5 5 S S 5 5 5 5 5 5 5 5 sea/ 5 5 t of t 5 5 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 5 o ����������������������� o 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. 32872 Z Date APRIL 2 , 2007 Permission is hereby granted to: CLIFFORD D POLACEK 2905 WESTPHALIA ROAD MATTITUCK,NY 11952 for ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 90 DEER DR MATTITUCK County Tax Map No. 473889 Section 114 Block 0010 Lot No. 001 pursuant to application dated MARCH 30, 2007 and approved by the Building Inspector to expire on OCTOBER �2 , 2008 . t Fee $ 200 . 00 horized nature ORIGINAL Rev. 5/8/02 f Now York State Department of Environmental Conesivallon ; Building 40—SUNY, Plony 0rouk, MqK- York 1144 ' DATE i i"ii.��. ,�,...-�....- '✓vyu,IC •�J�+++'1 ThomasC. Jorlln4 �cta� Cammisslon�r Dear 1 � A review has buen made of your proposal tot �u����� � � ca.,� "J w+ ,U . c. B"sud on the information you have submitted, the New York State Department of Environmental Conservation has determined that the parcel project iar Greater than 300 ' from inventoried tidal wetlands. Landward of a substantial man-made struct-ure greater than 100 ' in length which was constructed prior to 9 20 77. Landward of the 10 ' ' dbove mean Mea level elevation contour on a gradual , natural slope. Landward of the topographic Crrst of a bluff , cliff or dune which is greater than' 10 ' in •levatlun at,.jve mean sea level. Therefore, no permit is required under the Tidal Wetlands Act (Article 25 Of the Environmental Consd.rvatlon Law) . Please be advised, however, that ; no construction, aedimentation or dlsturbance of any kind may take place seaward of thu lU ' contour or topoyrd hic crust without a. permit. It is your responsibility to ensure that al� nacouaary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surdca or vegetation In this area as a rasult of your project , Such precautions may include providing adequate work area between the 10 ' contour or topographic crest and the project ( i.e. a 15 ' to 20 ' wide construction area.) or erection. of a temporary Once, barriar, or hay bale berm. Please note that any additional work, or modtficaklon Ga 00a peolpot as described, may require authorization by thlN Department. P1e440, pont:40t this office it such are contemplated. Please be further advised that this letter doses not relieve you of the responsibility of obtaining any neceavary permits or approvals from other ayencias . . (� Vary truly yours, ' Deputy Hdglona Permit Administrator SOUryolo TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION . [ ] FRAMING / STRAPPING P�INAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE ����� INSPECTOR Of SO(/lyo�o 3 7 � �— TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] INSULATION RAMING STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: r 0 Z4 Zoo DATE INSPECTOR ho�a0f SO�lyo�o 3�$ 7o — 7— eourm,��' TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION XFOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: c � K✓ 1 � IV-oa / 1 r c DATE 7, INSPECTOR FWL-D INSPECTION REPORT DATE COMMENTS FOUNDATION(IST) y ------------------------------------- FOUNDATION (ZND) on 0 y � ROUGH FRAMING& PLUMBING + y Oaqtioot INSULATION PER N.Y. � 3 STATE ENERGY CODE _ a FINAL ADDITIONAL COMMENTS C� g L o l° s� ' - o z b G. � z Z � x d b y James F. King,President O��QF so�ryo Town Hall Jill M.Doherty,Vice-President ,` l0 53095 Route 25 P.O.Box 1179 Peggy A.Dickerson Southold,New York 11971-0959 Dave Bergen G Q Bob Ghosio,Jr. �� .� �O Telephone(631)765-1892 �yCDU Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD January 24, 2007 Clifford Polacek 2905 Westphalia Road Mattituck, N.Y. 11952 RE: CLIFFORD POLACEK 2905 WESTPHALIA RD., MATTITUCK SCTM# 114-10-1 Dear Mr. Polacek: The following action.was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, January 24, 2007: RESOLVED, that the Southold Town Board of Trustees APPROVE the amendment to Permit#6482A to an additional 18" to the width of the garage to accommodate a 10' door, and all as depicted on the plan surveyed by Young and Young approved January 24, 2007 by the Board of Trustees. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, f James F: King President, Board of Trustees JFK/hkc r James F.King,President ��0� so yo Town Hall Jill M. Doherty,Vice-President ,`O l0 53095 Route 25 P.O.Box 1179 Peggy A.Dickerson Southold,New York 11971-0959 Dave Bergen �� Telephone(631) 765-1892 Bob Ghosio,Jr. OlCOUIVTY Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 6482A Date of Receipt of Application: October 26, 2006 Applicant: Clifford D. Polacek SCTM#: 114-10-1 Project Location: 2905 Westphalia Rd., Mattituck Date of Resolution/Issuance: November 15, 2006 Date of Expiration: November 15, 2008 Reviewed by: Board of Trustees Project Description: To construct a one-car garage addition on the northwest side of the existing dwelling. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the plan received on October 27, 2006 and survey prepared by Howard W. Young received on October 27, 2006. Special Conditions: The installation of gutters and drywells to contain the roof run-off. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Jam F. King, Presid t Board of Trustees 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) 765-1802 . Planning Board approval FAX: (631) 765-9502 Survey www.northfork.net/Southold/ PERMIT NO. 3 2 Check Septic Form N.Y.S.D.E.C. Trustees Examined ,20 Contact: Approved 120 Mail to: Disapproved a/c j Phone: Expiration ,20 _,s__ Building Inspector ® 20N APPLICATION FOR BUILDING PERMIT -- -- f Date INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to.scale. Fee according to schedule. b.Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d.Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. 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 regulatl5pf, and to mit authorized inspectors on premises and in building for necessary inspections. (Signa •r of applicant or name,if a corporation) CLIFF POLACEK 2905 Westphalia Rd. (MailWW ,oW)(pJ4 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder CcjiveV- Name of owner of premises C f 1 of--a rJ . �� CL C l (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. 600 Plumbers License No. Electricians License No. me Other Trade's License No. 1. Location of land on which p opo ed wo ill be done: House Number Street Hamlet County Tax Map No. 1000 Section_JJ�. Block Lot ' Subdivision Filed Map No. Lot- (Name) - 2. State existing use and occupancy of premises and inten d u e and occupancy of proposed construction: a. Existing use and occupancy r'�e al p �/ ( C o .. b. Intended use and occupancy r yLA e — !�G,✓c 9 e 3. Nature of work(check which applicable): New Building Addition X7 Alteration Repair Removal Demolition Other Work 0 (Description) 4. Estimated Cost �,��� �� Fee (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. rq 7. Dimensions of existing structures, if any: Front . / Rear Depth • S Height ,S Number of Stories Dimensions of s me structure with alterations or additions: Front l0 lD Rear Depth Height 2 5' Number of Stories 5- 8. Dimensions of entire new construction: Front Rear 2 _ J Dep th Height 12 Number of Stories 1 1 � ) 9. Size of lot: Front 71 Rear I ��Y Depth l C—7 P 10. Date of Purchase Name of Former Owner W / Fog d rV9 6'!2 11. Zone or use district in which premises are situated Readef,/TtG,1 T 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO X 13. Will lot be re-graded? YES NOXWill excess fill be removed from premises? YES NO X l n ld�e(C [ 1�, lM,c.I � fvyz14.Names of Owner of premises d��t IJ d Address 6r q Al t 'hone No. ��c[ -3vi Name of Architect Address Phone No Name of Contractor fJ S 11 2 t� , Address 1� r'6d act Lgove Phone No. a.�g� 8 O&Ct ttTL d<< rY11072- 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES K NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES X NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide suivey;',to'scale,Nyith accurate foundation plan and distances to property lines. 17. If elevati'6h-At;a4y point on property is at 10 feet or below,must provide topographical data on survey. STATE OF NEW YORK) r SS: COUNTY OFS(/, �([ � Macd� ,/ � being duly sworn, 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 filed therewith. Sworn to before me this Z2 day of /L1dW01hl 20 07 Notary Pul5lic Si ure of Applicant KAKEEN DREXLER Notary No blic 01 OR6039770state of W York Qualified in suffolk County o Commission Expires April 10,201..-. Young & Young N" _ a�F� NN>O 400 Ostrander Avenue, Riverhead, New York 11901 �m� 631-727-2303 �.2. �N4= Howard W. Young, Land Surveyor oW=A V�O Thomas C. Wolpert, Professional Engineer F�W� Robert C. Tast, Architect oN�� �pl _ Ronald E. Pfuhl, Landscape Architect Douglas E. Adams, Professional Engineer z, yob I ovl ' Cvo NOTES . mS g l I NJ s., I' ♦' o � AREA = 22,047 SQ. FT. 7 ti • SUBDIVISION MAP 'DEER PARK" FILED IN THE OFFICE 1Q N � Ti� I OF THE CLERK OF SUFFOLK COUNTY ON JULY 25, 1160 AS S L I FILE NO. 3204. F 78'/61/0,/E � NU • FLOOD INSURANCE RATE MAP - SEE PANEL NUMBER W S FIRM ZONE BOUNDARY LINES AS SCALED FROM FLOOD 36103G0481 G LAST DATED MAY 4, Icicle?. 124 7 INSURANCE RATE MAP = g 3 �FOO S(O oL��� SURVEYORS CERTIFICATION =w=� W 01 Jt / ,y� p� �' Lot 11 • WE HEREBY CERTIFY TO CLIFF P O LAC E K THAT THIS a=�= 3 �� `gam ��'�,�v'r , '�Nc SURVEY AS PREPARED IN ACCORDANCE WITH THE CODE OFF O W PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK <wFF STATE ASSOCIATION OF PROFESSIONAL LAND SU S.Gn (( ' U _,,,,�p,� .�I 1i _ / �` 6� - Icy i�:';^}"'.. ';'�:: -% ¢' t =g_o .j. / c-0 4j'i R91yic h D-"vD 'D O `.t;- �V wQ Q 0 A. m4j� �0 � rye! /6 3' `+� `• _. :... ` y o �c'��v/ l <q,� Sa- >�" HOWARD W. YOUNG, N.Y. . L.S. NO. 45893 fjs y t;:4.�:' a � 0 �' 000� �o`er Nw K !n� LAB JCS o Y / vow oti � per ❑4 GaSrDT4 N cli SURREY FOR w ¢ ' I CLIFF POLACEK LOT Iq "DEER P�RIG�� R., z � ion }oo At Mattituck, Town of Southold o 0 Suffolk County, New York � m _ County Tax Map District 1000 Section I14 Block 10 Lot 01 E�20 FOUNDATION LOCATION SURVEY U z 0 �► wN D ELu��. DEP7. TOWN F S�L'TNO:J J FOUNDATION LOCATION AUG. 2, 200-7 oats ADDED FIRM ZONE LINE MAR. 26, 2001 ao MAP PREPARED DEC. 14, 200(o O of y I-4N I]=MONUMENT SET =MONUMENT FOUND =STAKE SET ®=STAKE FOU SCALE: I"=40'ND - 3.NO. 2001-0320L '<F F C=CHIMNEY RO=ROOF OVER 5 STOOP CE-CELLAR ENTRANCE DWG. 2006_0450—fI �ao'�=, S A:' 1 , N. • p . P � ko r 0 i �O`��9 46. y ocasC 2c�3 �PQ O�3 �S/ ��Sr Sr'Rr Qsr LL\ h o .V• O �O�` O Sp ;'cOUyO � . `� Fp�1 N. griaN Qar O COO oaA o,, o V` OV NOrE: =MONUMENT. SUBDIVISION MAP FILED /N THE OFFICE NOTE. OF THE CLERK OF SUFFOLIC COUNTY ON 1. SUFFOLK COUNTY TAX MAP .. ✓ULY 25,1960 AS FILE NO.3204. DIST. 1000 SECT. 114 BLK 10 LOT I REVISIONS YOUNG & YOUNG OCT. 22, 1990 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK AUG. 6, 1991 ALDEN W. YOUNG HOWARD W.YOUNG PROFESSIONAL-ENGINEER AND LAND SURVEYOR LAND SURVEYOR. N.Y.S. LIC. NO. 12845 N.Y.S. LIC. NO.45893 } UNAUTHORIZED ALTERATION OR ADDITION TO SURVEY FOR: CLIFF POLACEK THIS SURVEY IS A VIOLATION OF SECTION NE ��7209 OF THE NEW YORK STATE EDUCATION L O r "O N _ COPIES OF THIS SURVEY MAP NOT BEARING I 7 "DEER PARK „t"�.. � THE LAND SURVEYORS INKED SEAL OR co EMBOSSED SEAL SHALL NOT BE CONSIDERED fl ra TO BE A VALID TRUE COPY. r' AT GUARANT $D TiO: MA r rI TUCK GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE TOWN OF SOU -HOLD ',,• 6 f R SURVEY IS PREPARED,AND ON HIS BEHALF �� � `f� ?C THE TITLE COMPANY, GOVERNMENTAL �n f`� AGENCY AND LFNDiNG INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE SUFFOLK CO., N.Y. Br LENDING INSTITUTION: GUARANTEES ARE I NU? TRANSFERABLE TO ADDITICNAL [19�-E /: a �•, � I DATE: p� p NO. �pp NST�TUTIONS OR SUBSEQUENT OWNERS. - 40 MAR. 27, 1990 90—01 pp w COMPLY WITH ALL CODES OF OCCUPANCY OR NEW YORK STATE & TOWN CODES � � AS REQUIRED AND CONDITIONS OF USE IS UNLAWFUL APP V D AS NOTED j � '� WITHOUT CERTIFICATE POHlaTotivNzEA P.# � �� LD TOWN PLATNING BOARDDATE: OF OCCUPANCY FEE: BY: LDTOWNTRUSTEES NOTI Y BUILDING DEPARTMENT AT - - �l f d�� N.Y.S.DEC 765-1802 8 AM TO 4 PM FOR THE J0w'� FOLLOWING INSPECTIONS: - -- � 1. FOUNDATION - TWO REQUIRED , 0 t( 5 �®f FOR POURED CONCRETE 6 y e CERTIFICATION OF 2. ROUGH - FRAMING & PLUMBING u Gcr� NAILING & CONNECTIONS 3. INSULATION 4. FINAL - CONSTRUCTION MUST `6 Lov c►' r REQUIRED. BE COMPLETE FOR C.O. � [ ALL CONSTRUCTION ,SHALL MEET THE f Ci jots REOUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR • n�tt I ' DESIGN OR CONSTRUCTION ERRORS. 1 v LOwcr�f 6e P fi cc,Vf rtsitfic"� fg�F L✓�f4 ` K vy� chi*'" J/ I OD ZONE / a G n 1 s OMPLY WITH CHAPTER 46• r"`rL- Y Y`r S UTHO D OWN CODE.TION _ - T ,1zc v •� 1; f c �y 1 rf•P ALL CONSTRUCTION SHALL tjv MEET THE REQUIREMENTS OF THE • >6`•©�` CODES OF NEW YORK STATE. '1 t M` � i k a. II I i yb�t E 4, ��gEo rV o , Z F F P O L A C F 1� r t APPROVED BY: SCAIE'� „ � DRAWN BY Q' DATE: REVISED M 63 �T9TF 0 NEON �0�� DRAWING NUMBER