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FORM NO. 4 TOWN OF 50UTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z- 1626 l Date October 6, 1987 THIS CERTIFIES that the building CONSTRUCT ADDITION TO BOAT STORAGE BUILDING Location of Property 5770 Mill Road Mattituck, New York House No. Street Hamlet County Tax Map No. 1000 Section 106 .Block 06 .Lot 13.3 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated September 29, 1984 pnrsuant to wtfich Building Permit No. 13532 z dated.....................N°vember 14, 1984 ....... 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 ......... ADDITION TO EXISTING BOAT STORAGE BUILDING MATTITUCK HOLDING CO. The certificate is issued to ..................... ~o.~n~;,x~x~XX ................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N656957 N/A PLUMBERS CERTIFICATION DATED: ..... Jilting Inspect;; ............. SUBJECT TO Oleg YFdkR REVIEW BY PLANNING BOAP~ Rev. 1/81 YOW~ OF SOUTHOLD BUILDING DEPARTMENT TO~VH HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 13532 Z Permission is hereby granted ,o: . ~ ................. M...~..~~ ...... ...~....~ .......................................... .... ~~=.~.~. ........ ~. ,~ ...... ~~ ~ ~... ~. ~..~ ....... ~...~~... ~.~. ,,,,,~,,, ,=,ed,,...~ ......... ~...~.~..~..:~~=.~.~.~ County Tax Mop No. 1000 Section ..~.~..~., .......... Block ....(~.....~,., ......... Lot No....O...~.....~...t..~... ..... pursuant to application dated ............................ ~ .............. , .... approved by the Building Inspector. Fee $ ........................ Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y, 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m~ to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5, Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date 5/1.1/87 NewC°nStruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Propert¥ Hill Road & Mattituck Creek-W/5 of Mattituck Creek House No, Street Hamlet Owner or Owners of Property Mat.tit. uck Holding Co. County Tax Map No. 1000 Section ..... 1, .0.6 .......Block . . . .0.6 .......... Lot....0.1?.r ? ....... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.. ] ~5.~.~.. Date of Permit . l ]/.1/%./..8.Z~pplicant .M..a.t.t.i.t.u..c.k..H.g .1.d.i.n.g..C.o.: ........ Health Dept. Approval ........................ Labor Dept. Approval .................. ; ..... Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate . Yes Fee Submitted $,. ~,5...0.0. ..................... Construction on above described builO,ng~,a~ p~ ~ ~s ;~y:able codes Rev, 10-10-78 ' ' Southold, N.Y. 11971 (516) 765q938 September 30, 1987 Mr. victor Lessard, EXecutive Administrator Building Department Town Hall Southold, NY 11971 Re: Site Plan for Mattituck Holding Co. Dear Mr. Lessard: The following action was taken by the Southold Town Planning Board at the regular meeting of Monday, September 28, 1987. RESOLVED that the Southold Town Planning Board, following a field inspection, recommend to the Building Department that a certificate of occupancy be issued for the site plan of Mattituck Holding Co., located at Mattituck, SCTM~ 1000- 106-6-p/o 13.3 subject to a one-year review. If you have any questions, please don't hesitate to contact our office. Very truly yours, ¢. BENNETT ORLOWSKI, JR. CHAIRMAN SOUTHOLD TOWN PLANNING BOARD TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This is Co advise you that the job under building permit no. 13532Z issued to Mattituck Inlet Marina on __!0/17/84 for Addition is completed and a final inspection bas ( ) has not ( x ) been done. An-Underwriters Certificate is needed fn order to complete this file, i~ is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, retnrn same to the above office with a check for $25.00payable to the Town of Sonthold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an i,spection date Occupancy or nsc is nn]awful without a Certificate of Occupancy. Ptease help ns to clear up this matter so that legal action docs aot have to be taken. :- Thank you for your prompt attention. Very truly y~, Victor Lessard Executive Administrator VL:gar THE NEW YORK BOARD OF FIRE UNDERWRITERS ~LOO~L07]. BUREAU OF ELECTRICITY 8E JOHN STREET, NEW YORK, NEW YORK 10038 ~Date a...--~; ~7~ ~ppllcat~o~ No. on f~le only the alee trical equipment ~ described below and introduced by t~ applicant named on the able application number in the premises of ~ttit~l¢ In2et M~in% Ft. of b¢ill ~ W/S of 5~tt. Inle2, ~atti2~, N'.Y, wasexaminedon ~t 27~ 1~t8 andfoundtobeit~compliancewiththerdquirementsofthisBoard. FIXTURE FIXTURES RANGES OVENS FANS OUTLETS SWITCHES FLUORESCENT MERCURY DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS UNIT HEATERS DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: S .E R NO OF CC COND, A,W,G PER ,O' OF CC CONO, I 3/o V I C NO, OF HI-LEG OF HI-LEG NO OF N TRALS OF NEUTRAL ' 3/0 S Electric 215 Soutl~ld, N~Y, 11971 Lic. 578 This certificate must not be altered in any manner; return to the office of the Board if incor~*ect Inspectors may be identified IILDING ENT. THIS COPY I ANY MANNER. FIELD IN~FEC~%ON DATE COMMENTS FOUNDATION ~__~t> ~i/ FOUNDATION (2nd) 2. ROUGH FRAME & .... PLUMBING INSULATION PER N. Y. STATE ENERGY FINAL , ADDITIONAL COMMENTS: NEW YORK STATE DEPART~ENT OF ENVIRONMENTAL CONSERVATION PERMIT PERMIT NO. [ ARTICLE li, (Protection of Water) [] ARllCLE 25, (Tidal Wetlands) ARTICLE 24, (Freshwater Wetlands) [] ARTICLE 36, (Construction in £1ood Hazard Areas) PE~IT ISSUED TO Mattituck Holding Co., ADDRESSOPPERMITTE~kN~I Road-~ Matittuck, NY 11952 LO~ATION OF PROJECT (Section of streal,, tidal wetland, dam, building) Mlll Road, Mattituck Inlet, 7M~ttituck DESCRIPTION OF PRO)ECT Construct a 40' x 180' prefabricated steel building a minimum of 45' landward ~gh ma~-sh as--per-supptied-pt-an-received Septemb~ ~/6, 1~$4. All roof runoff will be discharged to the designated area west of the proposed b~lldln9 . Mattituck Southold Suffolk GENERAL CONDITIONS JPERMIT XPIRATION 12~31/86 gATE 8, That lhe State of New York shall in no case be liabJe for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or bnprovement of navigation, or for other purposes, and no claim or right to 9. That if the display of lights and signals on any work hereby authorized is nol otherwise provided for by law, such lights and signals as may be pre- scribed by the Uniled States Coast Guard shall be installed and maintained by and at the expense of the owner. 10. All work carried out under lhis permit shah be performed in accor- dance will1 established engineering practice and in a workmanlike manner. il. If granted under Articles 24 or 25, the Department reserves the right to reconsider this approval at any time and after due notice and hearing to continue, rescind or modify this permit in such a manner as may be found to be iust and equitable. If upon the expiration or revocation of this permlt~ the modificatmn of the wetland hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such remove all or any portion of the uncompleted structure or fill and reslore the she to its former condition. NO claim shall be made against the State of New York on account oi any such removal or alteration. 12. This permit shall not be construed as conveying to the applicant any right to trespass upon the lands or interfere with the riparian rights of others Io perform the permitted work or as authorizing the impairment of any rights~ (SEE REVERSE SiDE Ae De Ee DEC # S.UPPL~..~I~T.A!I¥ SPECIAL CO~UOITIONS The following conditions apply to all permits: If any of the permit conditions are unclear, the permittee shall contact the Division of Regulatory Affairs at the address and telephone noted below. A copy of this permit or approval and approved project plans and pupplement- ary .couditipns shall be a~ailable at the project site whenever authorized work is in progress. The permit sign e~closed with the permit or a copy of approval letter shall be protected from the weather and posted in a conspicious location at the work site until completion of authorized work. 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 he is fully aware of and understands all provisions and conditions of this permit. Within one week of completion of the permitted work the bottom portion of that form shall also be completed and returned. For projects involving 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. If project design modifications take place after permit issuance, the ps,mitres shell submit the appropriate plan changes for approval by the Regional Permit Administrator prior to undertaking any such modifications. The permittee is advised that aubstantial modification may require submiss- ion of a new application for permit. Ail necessary precautions shall be taken to preclude contamination of any wetlands or waterway by suspended solids, ~ediment, fuels, solvents, lubricants, epoxy coating, paints, concrete, leachate or any other environmentally deleterious materials associated with the project work. Any failure to comply precisely with all of the terms and conditions of this permit, unless authorized in writing, shall be treated as a violation of the Environmental Conservation Law. 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 1~ 10007, (Attention Regulatory Functions Branch), prior to commencing work authorized herein. The granting of this permit does not relieve the permittee of the responsib- ility of obtaining a grant, easement, or other necessary approval from the Division of Land Utilization, Office of General Services, Tower Building, Empire. State Plaza, Albaay, NY 12242, which may be required for any encroachment upon State-owned lands under wa~er. Regional Permit Administrator NYS Department of Environmental Cons. Bldg. 40, SUNY--Room 219 Stony Brook, NY 11794 (516) 7~1-7900 ~EW YOP~ STATE DEPARTMENT OF ENVIRONMENTAL Building 40, State Uaiversity of New York Stony Brook, New York 11794 516-751-7900 October 17, 1984 Mattituck Holding Co., Rill Road Mattituck, NY 11952 Inc. RE: 10.-83-1201 Dear Sir: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing Regulations (6NYCRRPart 621) we are enclosing your permit. Please read all conditions carefully. If you are unable to comply with any condi- tions, please contact the Regional Regulatory Affairs Office, Department of Environmental Conservation, State University of New York at Stony Brook, Building 40, Stony Brook, New York 11794. Also enclosed is a permit sign which you are to conspicuously post at the project site, protected from the weather. Very truly Daniel J./~arkin Regional&Permit Ad~mtnistrator DJL:ll I~ISDEC, Regional Permit Administrator Bldg. 40, SIR"I--P~on 219 Stony Brook. t~ 11794 ~ermit No. Issued to (A~ent) ,, , Dear Sir: Pursuant to General Condition Eumber 1 of the above referenced permit you are hereby notified that the authorized activity shall co~nence on This notice is to be sent at least two days in advance of co~en'c~ment of the project. The permit sign will be posted at the site and copy of permit will be available at site for inspection. Submitted by , Failure to notify or post sign will leave ~mer and/or contractor subject to applicable penalties for non-compliance with permit conditions. }~SDEC, ~ezionel Permit Administrator Bldg. 40, Slll~--9~om 219 ~tony Brook, NY 11794 RE: Permit Issued to (Agent) _ Dear Sir: Pur~u4~'Ito Ceneral Condition Number 1 of the above referenced permit you are hereby notified that the authorized activity ~as completed on Submitted by, (This notice is to be sent to above address promptly upon completion of pr6~ct). Failure to notify will leave e~ner and/or contractor subject to applicable penalties for non-compliance with permit conditions. New York State Department of Environmental Conservation NOTICE Permit No. The Department of Environmental Conservation (DEC) has issued permit(s) pursuant to the Environmental Conservation Law for work being conducted on this site. For further informa- tion regarding the nature and extent of work approved and any Departmental conditions on it, contact the Regional Permit Administrator listed below. Please refer to the permit number shown when contacting the DEC. Expiration Date 12/31/86 Regional Permit Administrator 95-20-1 (11,82) NOTE: This notice is not a permit Southold, N.Y. 11971 (516) 765-1938 October 23, 1984 Mr. William Boscola Mattituck Inlet Marina Mattituck Holding Company Mill Road Mattituck, NY 11952 Re: Mattituck Holding Company Site plan Dear Mr. Boscola: The Planning Board took the following acLion on the regular meeting of the Board, Monday, October 22, 1984. RESOLVED that the Southold Town Planning Board refer the site plan of Mattituck Holding Company locaLed at Mattituck for the construction of a boat storage building to the Building Department for certification. If you have any questions, please don't hesitate to conLact our office. CC : Very truly yours, BENNETT ORLOWSKI, JR.,CHAIRMAN SOUTHOLD TOWN PLANNING BOARD ~y Diane M~ ~cnultze,, ~ecre~ary Building Department(with three copies of plan) T D LD Y Southold. N.Y. 11971 (~1~) 765-1938 November 9, 1984 Mr. William Boscola Mattituck Inlet Marina Mattituck Holding Company Mill Road Mattituck, NY 11952 Re: Mattituck Holding Company site plan for storage building Dear Mr. Bo$cola: The following action was taken by the Southold Planning Board, Monday, November 5, 1984. RESOLVED that the Southold Town Planning Board approve the site plan of Mattituck Holding Company for a storage building for boats located at Mattituck, plans dated as last amended October 15, 1984 and as certified by the Building Department. If you have any questions, please don't hesitate to contact our office. Very truly yours, Building Department BENNETT ORLOWSKI, JR., CHAIRMAN SOUTHOLD TOWN PLANNING BOARD By Diane M. Schultze, Secretary FORM NO, 3 TOIJ~N OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ To -/~*~'~. ~ff/Z-.U~....~.~/.oz. Z ~C/.. ~,. ~... ~/z..4~ / PLEASE TAKE NOTICE that your application dated..~~~.. ~., 19~ for pemit to construct. ~ ~T~ .~.. ~ .~/--~2~ ,/~7,~: .~ ........ at Location of Pmperty ~O~ ~<&~ ~.~ ........ ~/~.~.~ -' ~o~s~ ~o~ ................ ~troot ..... Hamlot County Tax Map No. 1000 Section ... [.~.~. ..... Block ....O. ~ ...... Lot . ~.ff.-~ ..... Subdivision ................. Filed Map No. " Lot No. - -~ , ....... is returned herewith and disapproved on the following grounds .~. ~'~(5~.07..ff.. ~. =. ~.~z,x:. .~.,,r.,:/.c,~c .~'x,~. . . ~. z nc.. ~",~ ~.~. . . x~f~./.~. . .,~. ,.-. F.~;. ,~.~ ..~.. .'-. .o . . -. . . .?.,-'<. c//~x,r/x. .,~n~. : T.,' ~ .x,,. . ~.5~. . ,.:'x ~. ~ . >'/~.:,,-x .~ . . ?. . '.---..o." Building Inspector RV 1/80 FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined .tt.~.....O. ....... 19~.~ Approved ................. 1~ . . · Permit No .......... Disapproved a/c .............................. /~. · · ...... ~ '5:"~/~'~-f eC'~(~,~ APPLICATION FO" BUILDING PERMIT INSTRUCTIONS l~ece±ved...J(~.[.¢.. ,19..~. 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 streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation· c. The work covered by this application may not be commenced before issuance of Building Permifi 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 necessaryJ~.a~--~-~ ~"'. ~4-~x~insllecti°ns' ~ ~, ff~ (Signature of applicant, or name, if a corporation) ././. ...... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· ...... ,~. /,2.~' J ~ ~ . ./.qo.,z . . (Z).. .m?.,v~/Z ...................................................... Name of owner of premises .. J?J.~.-ff]./. ~C/~_~/~x../--/O/~./>//~..~.. ~ .................................. (as an the tax roll or latest deed) If appl~.o~rpo_ratio~,_signature of duly authorized officer. (Nam~l&6f corporate officer)~J Builder's License No .......................... Plumber's License N~...~e'. O.A~. ~~. . ..-TT ......... Electrician's License No..~-~.~457... ~.../".~... Other Trade's License No ...................... -'~/ Location of land on which proposed work will be done.. [~ 3 b.k-. t~O.&-. ~..44..~..~.'IT~.I.T.O.F~.~ .~'~..~.,. ........ · ©..~..~. ~TT.,F.O~.K ~L.¢.~( .................. W...~. I ! ~ :e.c~ ~.,..~.. .............. House Number Street Hamlet County Tax Map No. 1000 Section ..... /. q~..~ ......... Block ....... o..d'. ........ Lot....(?! .5..: ~ ........ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: · Existing use and occupancy .~...~t... IO.l~6~ J~Pv[[ [T'.O.c4<' I~:~:~ ~ffl ~,.~ b. Intended use and occupancy ~T .~TO.~% J¢.~[ t-nXP~ [ 0,'~}~ M'~.~ eV&.g~r~.C I 3. Nature of work (check which applicable): New Building .......... Addition . .~ ..... Alteration ..,~ ...... Repair .............. Removal .............. Demolition .............. Other Work ............... . .~)1~2~(_.~ (Description) 4, Estimated Cost ........................... Fee ...................... .! (to be paid on filing this application) 5, If dwe rog, number of dwelhng !Pints ...... ~. · ·: ..... 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 .l~h~.fi~}a~.~; ........... 7. Dimensions of existing structures, if any: Front .... F~.~ ./ ...... Rear .... ~,O./. ..... Depth..~.&~'O .t ........ Height .... ~"J. ~. ...... Number of Stories ....... .c~..~-~.t~_ ..................................... Dimensions of same structure with alterations or additions' Front .... ~.~../ ........ Rear ...~.~..t ..... 8. r)imensions of entire new construction Front ... :5 ~,.~., ..... Rear .... ~ ~;~.~. ' . Depth . .~P ......... Height ....~..~:rt-. ~ .......Nu~nber of Stories ......... c~.ho.[-.. ......................................... 9. Sizeoflot: Front .~,.,.,.,.,.,.,.,.,.,t~..-~...~J..,~.~., Rear ~..~../~&~ , Depth ;~.~t~!.~.P , . 10. [,)ate of Purchase .... 'A'~/P.~.~.../..~.~'./. ....... Name of Former Owner .~., g,.l~f~Tf__~t~.'.~ ............. 11. Zone or use district in which premises are situated ..................................................... 12. D6es proposed construction vioiate any zoning law, ordinance or regulation: .... ' ....... . ......... 13. Will lot be regraded ........ I'¢..c2 ................ Will excess fill be removed from premises: Yes (~ 14. Name of ~,,w,,n~r._o,f~premises~¥T?,aol.~.~[~. ¢-,o ..... Address~4~14.,P-~.. i~.&-rl'~T~Jr,-q'~ .... Phone No. ~.q~.-~ .~. .... PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blockinumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, S S .......... (.~1""--( l~. *.~.. '~.qq .~ (~....~..~.,. .......... being duly sworn, deposes and says that he is the applicant (Name of individual signling contract) above named. He is the (Contractor, agent, corporate officer, etc.) of said own, er or owners, and is du!y 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 ork will be performed ~n the manner set forth in the application filed therewith. Swbrn to before me this 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ................ , 19... Approved ................ ,19... Permit No ............ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... Date ................... 19... 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 streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by tlds 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 °f 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. (Signature of applicant, or hame, if a corporation) :-(... ! ( ...... (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 apda cj~poratign, sigr~ure..of duly au~ed of~cer. k,,~,r (Na~ne and title of corporate offi ),/" Builder's License No. ]./~...~. (l! ? ~:-...(.~.: .Nfo./~N' .~,.~.) Plumber's License No ....... !J ?. b[.lf. ........... Electrician's License No ....... ~.[. ~..[.~.[~.-:-. ....... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ...................... .~ ............................ House Number Street Hamlet County Tax Map No. 1000 Section .................. Block .................. Lot ................... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and oc.cu, pan~y of proposed construction: a. Existing use and occupancy ............................. " · ........... b. Intended use and occupancy .................................................................... 10. 11. 12. 13. 14. t/~ature of work, (ch~ck whic,h applicable): New Building .......... Addition .......... Alteration .......... ~epmr ........ ~..... ,,. ~moval ............ Demoht~on ......... Other Work ............. ~'~ '~| '"~ ~ !!;~!:.].L "'. (Description) ~ '~ i ........................... Fee ~ i ~' (to be paid on filing this application) [~d~V~liing, number o f dwelling~units ............... Number of dwelling units on each floor ................ If garage, number of cars .... ~ .................................................................. If business, commercial or mikeld occupancy, specify nature and extent of each type of use .................... Dimefisions 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 ..................... Dimensions of entire new construction: Front ............... Rear ............... Depth .............. lteight ............... Number of Stories ....................................................... Size of lot: Front .......... i ........... Rear ...................... Depth ..................... Date of Purchase .......... ~ .................. Name of Former Owner ............................ Zone Or use district in which pr~mises are situated ..................................................... Does proposed construction viqlate any zoning law, ordinance or regulation: ................................ Will lot be regraded ........ i ................... Will excess fill be removed from premises: Yes No Name of Owner of premises Address Phone No Name of Architect ......... ! ................. Address ................... Phone No ................ Name of Contractor . .~ ....................... Address ................... Phone No ................ PLOT DIAGRAM Locate 'clearly and distinctly aJ property lines. Give street and bloc} interior or corner lot. buildings, whether existing or proposed, and, indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether STATE OF NEW YORK, COUNTY OF ................. ............................ 5 ..................... being duly sworn, deposes and says that he is the applicant (Name of individual sigg, lng contract) above named. He is the ' ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dully 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 ........ ; ............... day of ..................... , 19... Notre3, Public , County : ,' (Signature of applicant) c~EEK / NOTE: J INSET "A"-L.I L.CO POLE LINE -SCALE' ~"= 50' _/ Mil L I I= MONUMENT 2.' TOTAL AREA = 55.2 ~ ACRES $. ZONING USE DISTRICT- "A"RESIDENTIAL'AGRICULTURAL ~ "C"LI6HT INDUSTRY 4. CONTOUR LINES SHOWN THUS= ........ ARE APPROXIMATED FROM 5 SUFF. CO. TAX MAP- DIST. I000 SECT. lO6 BLK. O06 LOT I:~,$ / ~ / / ' D APPR©V'E BY INSET "B"-L IL.CO. POLE LINE -SCALE: 1"=50' ALDEN W. YOUNG,PROFESGIONAL F~'GINEER AND LAND SURVEYOR N ~S. LIC[~:!~. v~u. 18845 ~f'o.~. ' ~ 2;~~ SURVEY FOR: ~'o ¢o.,, xb,,,t. MATTITUCK HOLDING CO, '%'~'"'.- ~'~ AT MATTITUCK ~" ,~ TOWN OF SOUTHOLD sr~ ',' " SUFFOLK CO~INTY, NEW YORK YOUNG a YOUNG REcEiVED EY OCT. 15,1984 OCT. 12, 1984 MARCH 9,1984 FEB. 7, 1984 NOV. 24 1981 400 OSTRANDER AVENUE RIVERHEAO ~ NEW YORK NOTE MI~_ L / INSET "A" - L.I.L CO. POLE LINE - SCALE~ I"= 50' I..'- MONUMENT 2.r TOTAL AREA = 33,2 ± ACRES :~, ZONING USE DISTRICT - "A"RESIDENTIAL-AGRICULTURAL /~ "C" LIGHT INDUSTRY 4. CONTOUR LINES SHOWN THUS: ........ ARE APPROXIMATED FROM U.S.G.S. CHART~ "MATTITUCK NILLS~ N.Y.*' 5 SUFF. CO. TAX MAP- DIS[ I000 SECT. lO6 BLK. O08 LOT ~ -- INSET "B"-LJ.L.CO. POLE LI~E-SCALE=1"=50' / / OCT, 15,1984 SURVEY FOR OCT. 12, 1984 MARCH 9~ 1984 MATTITUCK HOLDING CO. FES. 7 i984 NOV. 2¢. 98 AT MATTITUCK DATE ~ ~UNE S0,1981 TOWN OF SOUTHOLD SCALE; I"=100' SUFFOLK COUNTY, NEW YORK NO. ; 81-547 YOUNG 8 YOUNG RIVERHEAD, NEW YORK ALDEN W YOUNG~PROFESSIONAL ENSIREER AND LAND SURVEYOR N3CS. LICENSE NO 12845 HOWARD W. YOUNG, LAND SURVEYOR N.YS. LICENSE NO. 45895 ~ N 28°00. / I I I / I / / / / / / / / / ///k \ \ / \ / ~ / / / / / I / I Wflham ~OScoIo, dr "50 0 N B7° 36' §O"W- 0 s o 35 Lot YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK PLAN OF PROPEP'IY PRLPARED MA, T iT UCK AT MATT. I-UCK OF SOUTHOLD SUFFOLK CO., N.Y. FOR 82 66' 42 60' (N. 87°48'00"~A NOTE 530' Lot 0 ,/ LOTS REFER TO MAP OF "SHORE ACRES", FILED IN THE OFFICE OF THE CLERK OF SUFF, CO, ON JAN 3~ IDl{- AS FILE NO, 41 (S 89°48'40"E, = BEARINGS REFERENCED TO MAGNETIC NORTH IN DEED OESCRIPTIQN. '1 Go/bUr~ 28o00'20,,i 32 7 / / / 1 / / / / / / / / / / / / / / ~oso / / f 1 Wdhorn ~OSco/o dr Lot 35 N 87° 36'50"W. YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORE, PLAN Of PROp,IF'I F PRLPAR~-'D ,:OR k~, -FiTUCK HOLDING MATT 'I-UC K tow~'~ OF SO U-FHOLD SUFFOLK CO., N.Y. (S89 4260' {N 87°4D'OO"W) N 87° 19'. NOTE' 09¸ {ND 530 _ / Lot 0 LOTS REFER TO MAP OF "SHORE ACRE$"~ FILED IN THE OFFICE OF THE CLERK Of SUFF CO. ON ,JAN.$, 1914 AS FILE NO. 41, (S. 89°46'4-0"E.) = BEARINGS REFERENCED TO MAGNETIC NORTH IN DEED DESCRIPTIQN. I-- $c~ u~_: -~% ILd' / \ OCCU? i C¥ OR J iLo" API~ROVED AS 'N,OTED ~2' DATE'/f//~ B.P. :~ /~ 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: ~1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CON'STRUCTION MUST BE COMPLETE FOR C, O, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N, Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. "~ller~l~l of INa Dec, mere elept by ~ Llcens~t Profil* danal Engineer, Is Illegal", Section 7209, Subdlvldo~ ~,, l~. T, Stele ~uo~,flo~ Lew, Office Of Gordon K. Ahler.~, P. E Ofiioe Of Gordon K. Ahlers,-P.