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24130-z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25477 Date: 01/12/98 THIS CERTIFIES that the building ALTERATION Location of Property: 150 NEW SUFFOLK AVE MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 114 Block 12 Lot 3.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 12, 1996 pursuant to which Building Permit No. 24130-Z dated MAY 15, 1997 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 ALTER AN EXISTING COMMERCIAL BUILDING INTO A LAUNDROMAT AS APPLIED FOR & AS TO CONDITIONS OF SOUTHOLD TOWN PLANNING BOARD & D.E.C. The certificate is issued to HANDY PANTRY STORES, INC. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N441618 12/30/97 PLUMBERS CERTIFICATION DATED 12/23/97 HENRY PETERS .J B ildin Inspector F Rev. 1/81 FORM NO. a 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) N° 24130 Z Date ....... . . . .... .....f ................. Permission is hereby granted t . Glf�. ............ 11.. .. r........... .......... ......erl:......./.U .gf'�..6................... t0 y�A,.Cf ...a'::?1-.. .. . .. ...f.... �.r� ....... . . ..... ............. FiT GfrlZ c�.... ..?t63 ¢6—. cc .. .......... ...h�' ;;.. ............ter'.... ............................................................. ............................................... ................................................................................ ...... ..................... at premises located at........ a County Tax Map No. 1000 Section .......11 ..... Block ...—6. ......../Lot No. .14.1........... ... . pursuant to application dated ...... . ... .. ... ......./,I................, 19.1.1...., and approved by the Building Inspector. ly� 2� Fee $.,x.5 f.••• ••• g........... ..................... ?-.6-uiidin I for Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 unusua� 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 1T, lead. 5. Commercial building,'I industrial building, multiple residences and similar buildings and installations, alcertificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. ' I B. For existing buildings ( rior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses' 1 . Accurate survey of pIFoperty 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 dwell ng $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 Buildinz - $100.00 3 . Copy of Certificate �f Occupancy - . .251;. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . .°. .. . .. . . 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . Old Or Pre-existing uildin . . . . ` Location of Property. . . . . . . . . . . G Y V. ✓✓. .. . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property.. .I. . . . . . . . . .. . . . S .t°re . . .:�.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Sec ion. ... . . . . . . .Block. . . . .,: . . . . . . .Lot. . . . . . /. . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . .`. . .. .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. ., .3-0. . . . . .Date lOf Permit. . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . I . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . <" Fee Submitted: $. . . J. , SJR'. . . . . . . . . . . . . . . . O!V �G r' /� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICANT Co 't as LP �� 0Gy Town Hall, 53095 Main RoadY ti z Fax (516) 765-1823 P. O. Box 1179 y�0 r Telephone (516) 765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I. F I C A T I 0 N DATE: V1� Building P rmit No. CII 3 r Owner: (please print) \ Plumber: �\ " y y (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. \ (Plumbe s Signature) Sworn to before me thi �✓ day ofd 19 /No ryvu ic, IIA, County mM � roL salon 8ComExpie Dec. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1135129 BUREAU OF ELECTRICITY F 40 FULTON STREET, NEW YORK, NY 10038 Date APRIL 06,1998 Application No. on file 14780597/97 N 441618 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of JOE STOCKEN, 12250-2 ROUTE 2IR 5-p,, MATTITUCK, NY E in the following location; ❑ Basement 1st Fl. ❑ 2nd Fl. Section Block Lot was examined on DECEMBER 24,1997 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES I RANGES IcoOKING DECKS OVEN$ DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. . AMT H.P. 29 11 52 1 29 1 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ISPECIAL REC'PT.I TIME CLOCKS I SELL UNIT HEATERS M SYSTOEMS ET DIMMERS AMT. K.W. OIL H.P. GAS H.P. AMI. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS 3 F 1 40 SERVICE DISCONNECT NO.OF S E R V I C E METER NO.OF CC COND. A.W.G. A.W.G. A.W.G. AMT. AMP. TYPE EQUIP. 1 0 2W 1 0 SW S 0 3W 3 0 4W PER 0 OF CC. G. NO OF HI-LEG OF HI-LEG NO,OF NEUTRAUS OF NEUTRAL 1 225 CB 1 X 1 3/0 1 3/0 OTHER APPARATUS: LANDELL FILTRATION SYSTEM-1 AIR COMPRESSOR-1 WASHERS-31 DRYERS WITH ON/OFF SW.-40 PADDLE FANS-6 MOTORS: 1-5 H.P. ,2-F H.P. ,1--2 H.P. -PANELBOARDS:31-1 CIR. 10,1-3 CIR. 100 G.F.C.I:-2 <<< Continued on Page 2 >>> GENERAL MANAGER Per 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 MUST NOT BE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 2 1135129 BUREAU OF ELECTRICITY F 40 FULTON STREET, NEW YORK, NY 10038 Date APRIL 06,1998 Application No. on file 14780597/9'7 N 441618 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of JOE STOCKEN, 12250-2 ROUTE 25, MATTITUCK, NY in the following location; ❑ Basement ® Zst Fl. ❑ 2nd Fl. Section Block Lot was examined on DECEMBER 24,1997 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ISPECIAL REC'PT. TIME CLOCKSBELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS SERVICE DISCONNECT NO.OF S E R V I C E METER NO.Of CC GOND. A.W.G. A.W.G. AMT. AMP. TYPE EQUIP. 1 0 2WJI 9 9W 3 0 3W 3 D 4W pER 9 OF CC.COND NO.OF HI-LEG OF HILEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: FRANCIS J.MC LOUGHLIN LIC.#4046- Ldp L L25 MONELL AVE. ISLIP, NY, 11751 GENERAL MANAGER S11 Per 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 MUST NOT BE ALTERED IN ANY MANNER. a - TIDE NEW' 'YORK BOARD OF' FIRE UNDERWRITERS FACE 1 1135129 BUREAU OF ELECTRICITY 85 JOHN STREET, NEV YORK, NY 10638 Date DECEMBER 50,1997 Application No,on file 14-18050/97 N 444161.13 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of JOE STOCKEN, 12250--2 ROUTE 25, MATTITUCK", NY in thefollowing location, ❑ Basement ® 1st Fl. ❑ 2nd F1. Section Block Lot was examined on DECEMBER 24,1997 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS . DISH WASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMt. K W. AMT. K W AMT. K.W AMT K.W AMI. HP 29 11 52 1129 1 1 1 1 1 1 F DRYERS FURNACE MOTORS FUTURE APPLIANCE tEEDERS SPECIAL RECTT TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS T. K.W. OIL H.P. GAS H.P AMT NO. A.W G AMT. AMP AMT. AMPS TRANS. AMT H P. SYSTEMS AMAMT. wAirS HOST FEET 3 F 1 40 SERVICE DISCONNECT No.OF S E R V I C E AMT. AMP yr METER 1 p,1W 1�.3W J O 8W SA AW NO.OF CC,GOND, A.W G. NO.OF HbIFG A,w.G. NO Of NEVTRAlS A.W.G. EQUIP. PER B OF CG COND OF HW,,& Of NEUTRAL 1 1 225 j CB 1 X 1 3/0 1 3/0 OTHER APPARATUS: LANDELL FILTRATION SYSTEM-1 AIR COMPRESSOR-1- WASHERS WITH .IOA DISC,-31- DRYERS WITH ON/OFF SW. -40 PADD10 FANS-6 MOTORS 11-5 H.P. ,2-F H.P. ,1-2 H.P. -PANELBOARDS01-1 CIR. 10,1-3 CIR. 100 G.F.C.I1-2 L L <<< Continued on Page 2 >>> GENERAL MANAGER imitln� Per 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 .MUST NOT. BE ALTERED IN ANY MANNER. , THE NEW' YORK BOARD OF . FIRE UNDERW;.I RS PAGF. 2 F BUREAU OF ELECTRICITY I 1 85 JOHN STREET, NEW YORK, NY 10038 Date I`1$IC'MlBr'`R 30,199 7 Application No.on file 14780597/97 1441618 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above appmber in the premises of JOE STOCKEN, 12250--2 ROUTE 25,. MATTITUCK, NY in the following location; ❑ Boaement ® Ist Fl. ❑ 2nd Fl. Sectiock Lot woa examined on DECEAfffiER 24,1997 and found to be in compliance with the National Code. FIXTURE ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENWASHERS EXHAUST FANS OUTLETS INCANDESCENT RUORESCENi OTHER AMT, K W. AMT K W. MIT, K.W AMT. M.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL NEC-PT TIME CLOCKS BELL UNIT LTI.OUTLET DIMMERS SYSTEMSAMi. K.W. OIL H.P. GAS M.P. AMT. NO. AWG AMT. AMP. AMT. AMpS. TRANS. AMT .OF FEET AMT. WATTS SERVICE DISCONNECT No.Of S E R V I C E METER NO. CC COND AWG A W.G A�W G. AMT, AMp. TYPE EQUIP. 1 N tW 1,B'aW 3.P aW 3X AW PER a OF CC.COND NO OF HI OF HIAEG NO.OF NEUTRALS OF NEUTRAL OTHER APPARATUS: FRANCIS J,MC LOUGHSRIN LIC.#4046—I , L L AVE. ISLIP, NY, 11751. GENERAL MANAGER 11 • s5 Per 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 BUI LD ING, DEPARTMENT. 'THI S COPY.,OF 'CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 1 11:1.11 tllfil'bG111111 II I;t'I111 IIl 6'1'1< 'u 111111IIIA'1'1 ml ( III.I., - - (i • ;uuuunriln( ctrgl� r 11111111 IrlIAIII'. A Q Il:i 11 l.n'I'Illll 1'ISN 11, y , '•�-••-••._ I�I '� :rrn 11� r.nr.ltur ,. (-.0011, ________ .. _ __.._._m_ m___T.:______--_ ....__.,......_.. _____ ...,_.. .m.........,.,_,._.,,,.____�...,....----.".....,.... ._ AIIIItYIIIIIAI• 0 9" ,:t-ate Pollutant Discharge E irnination System (SPI)FS) DLSCH"GE PEWMIT KU W�, f ,� Special Conditions (Part 1) 13}(,W Industrial Code: 7235 SPDES Number: NY- 0226793 Discharge Class (CL): 01 DEC Number: 1-4'738-01467�00U� UU1 U TOxie Class CM: N Effective Date(EDP): 06 Mijot Dtafusge Basin: 17 Explfauon Date(EaDP): 0 Sub Dryimage Basin: 02 Mo4i*,%tion Date(s): %latex Index Number: Oroundwator Attachment(s): Geral Conditions (Part ❑ 130. 11 9 Compact Area: TLix SPDES permit is iasuo in eompliame with Title S of Article 17 of the Environmental Cowervadon Law of New York State and in compliance with the Clean Water Act as amended, (33 U.S.C. Section 1251 et. kq.)(hereafter referred to as 'the Act'). PM''vlftTEElyp;IE AND ADDRESS Atteadon: Mr. Steven J. stocken Name, Mr. Steven J. Stocken Sheer: 183 Smithtown Bglrlevard _ City: Nesconset State: NY Zip Code: 11767 is authorized to discharge from W$ facility described below: FAC=Y N01k AND ADDRESS Name: MAttittiek Laundromat Lutiatioa(C,T,'v7: SOutbiiolcl (T) Coumiy: Suftol"K Facility Address: li+n§t) MaIn Road City: Mattituck State: NY Zip Code: 11$52 h'YTM -E: NA TIVI -N: 4 From Outfall No.: 001 at Latftnde: 400 59' 21" &Lonb mde: 72 3203" iuw rcxeivimg water$known a$: Groundwater Class: GA and; (list other Outf-AS, Receiving Waters&Wattr Classifications) Suffolk County Tax Man Nutrbers -------- ---------------------- Districtt 1000 Section: 114 Block: 12 Lot : 3-1 in accordance with the effluent limitations, monitoring requirements and other conditions set forth in Special Condidoai (Part 1)and Central Conditions(Part 11)of this permit. DISCHARGE N10NITOUNG REPORT (DISK)AkMING ADDRESS Matting Name: Mr, Ste llerl J. Stoukerr Street: 183 9mithtown Boulevard City: Nesconset State: NY Zip Code: 11767 Responsible Official or Agent: Phone: ( 516)3 61-94 4 0 - 'ibis permit and the authorization to discharge shall expire on midnight of the expiration date shown and the permittee shall not disdarge after the expiration date unless this permit los been renewed. or extended pursuant to law. Tp be authorized to digr h+ ge beyond the expiration ditto, the permirtw shall apply for a pertuit renewal no less than ISO days prior to the expiration date shown abort. --�.-- - Dr,—mb7loN: J. Maloney F�l[at Aduiu+istiaiGr; R. Hannaford ---- R. Schrock A4,11-w Buildia9T40 - SLrlv's W. Spitz R. Thompson t=tiwrz: ear: 4-11a /�7 yE d :R0 : T 2 NOW L r L, - cr95 New'York State Department of Environmental Conservation Ank Bulldtng 40 - SUNY, Btvny Brook, Now York 11790.2366 Imbolldl Telephone (618) 444-0366 qqW Peceimile (61614"-0360 loAn r.Cdiill Actint Cmnmis*nr CERTIFIED MAIL RETURN RECEIPT RE4IIESTED May 7, 1997 Mr. Stephen J. Stocken 183 Smithtown Boulevard Nesconaet, NY 11767 RE: NYSDEC Permit # 1-4738-01467/00001 SPDES Facility # NY -0226793 Dear Permittee: In conformance with the requirements of the State Uniform' Procedure& Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your SPDE.S Permit above. Please carefully read all general and other condition0 in the permit and any schedule if included to insure compliance during the term of the Permit . This Permit should be kept available on the premises of the discharging facility at all times- Very truly yours, /, r Diana L. Sanford Environmental Analyst I DLS!cg enclosure cc: R. Hannaford File SPDES * 0226793 Part 1, Page.2,of__4_ FINAL EEFLUENT(,IMITATIONS AND MQNITQRING REQUIREMENTS During the period beginning June 1, 1997 and lasting until June 1, 2002 the discharges from the permitted facility shaft be limited and monitored by the permittee as specified below: Minimum Monitoring Reouiremenb Outfall Number& Discharge Limitation$ Measurement Sample Effluent Parameter Daily Avg. Daily Max. Unita Frequency Type outfall 001• Laundromat Process Waste Water Discharging to Groundwater-Class GA 'low NA 12500 GPD Continuous Recorder )H (Range) NA 6.6-8.5 SU Monthly Grab Total Suspended Solids NA 30 mgA Monthly Grab Total Dissolved Solids NA 1000 m9A Monthly Grab Oil 8 Grease NA 15 m9A Monthly Grab Surfactants NA 1.0 mgA Monthly Grab Samptes for monthly Discharge Monitoring Report(DMR) analysis MUST be collected from the carbon effluent port _ADD(TIONAL O R REPORTING REQUIREMENTS FOR OWNER$ QF A COASTAL DYNAMIC WASTEWATER TMIMENT SYSTEM Vlth each monthly DMR submittal, the permittee MUST submit the following: }A copy of the original receipt for granular activated carbon replacement, if done during the reporting period. J A copy of the original receipt from a N,Y.S, licensed waste hauler for the removal and disposal of any wastewater or sludge. ;)A copy of the Suffolk County Water Authority water bill for the facility. r)A copy of the relevant pages of the Daily Log Book that is required to be maintained on site(see the manufacturer's Operation and Maintenance Manual). The log book must record the volume of incoming supply water to the facility, the volume of water processed by the treatment system, the volume of water discharged to the leaching pools, and any pertinent information conceming the operation of the treatment system. Ill of the original documentation referred to above, must be maintained on site and be available .o NYSDEC or SCDHS Inspectors. £ 0 d 60 T Z N0 W ,Z6 - Z 'IIs PLANNING BOARD MEMBERS ��SUffU(� co RICHARD G.WARD Q� Gy Town Hall, 53096 Main Road Chairman o 1 P.O. Box 1179 GEORGE RITCHIE LATHAM,JR. w Z Southold, New York 11971 BENNETT ORLOWSKI,JR. p Fax (516) 765-3136 WILLIAM J. CREMERS y ��� Telephone(516) 765-1938 KENNETH L.EDWARDS PLANNING BOARD OFFICE TOWN OF SOUTHOLD January 14, 1997 Steven Stocken Handy Pantry 183 Smithtown Blvd. Nesconset, NY 11767 Re: Site plan for Handy Pantry, Main Rd., Mattituck SCTM# 1000-114-12-3.1 Dear Mr. Stocken: The following resolution was adopted by the Southold Town Planning Board at a meeting held on Monday, January 13, 1997: BE IT RESOLVED that the Southold Town Planning Board authorize the Chairman to endorse the final plans dated May 19, 1992. Conditional final approval was granted on February 24, 1992. All conditions have been fulfilled. Enclosed please find a copy of the plan which was endorsed by the Chairman. Please contact this office if you have any questions regarding the above. Sincerely, Be6neOrlowski, Jr. Chairman enc. cc: Thomas Fisher, Sr. Building Inspector o _o t_,uaJ NYSOLC P6imil No, 1-4736414$2r0P01Q ' SPDES 0 0226793 Part t, Page ,o/4 )EFINITIONS OF DA14x AVERAGE AND AILY M XIMUM the daily average discharge Is the total discharge by weight or in other appropriate units as specified herein, during a slender month divided by the number of days in the month that the production or commercial facility was operating.Where less ,An darty sampling Is required by this permit,the dally average discharge shall be detemtined by Uhrs summation of all the measured oily discharges In appropriated units as specified herein divided by the number of days during the calendar month when reasurements were made. The daily maximum discharge means the total discharge by weight or In other appropriate units as specified herein, during ny calendar day. IONITORING LOCATI 1NS The permittee shall take samples and measurements, to Comply with the monitoring requirements specified in this permit, : :he locatiop,(s) indicated below: (Show sampling locations and outfalls with sketch or flow diagram as appropriate) ``_—, � • _ ^ `..°�__ � i r'' ` / 1, / `r0 0=='r—}gyp r►- - V � ss..uc- , -trao• 1\� 4 0 d CIO : T71- NOW -A 6 — z - d n 9 SIDES 9: -0228793 Fari i, ray® ,pf RFCOR INS+. RFP R7lNANn AnDITIONAI f-AONITORINC RcnUloc..cr-Gra a) The earmittae shall also refer to the General Cond!t!gns rP-art A)1^r thi.PC—;*A . :.;_^_I • j• w , v - .. \ VI y V,UV 1101 II IIVI IIIONVII Concerning monitoring and reporting requirwmentAc",4 mn.ialpnc. b) The monitoring information required by this permit shalt be summarized, signed and retained for a period of three years frurn the date or the sampling for subsequent Inspection by the Department or Its designated agent Also; l A owto IK- Jj nuvyuisWrl required by'thi5 permit shall be summarized and reponea lytwlomt reuu DisclUraAi hni' in Report (DMR)forms for each _g3Umiil � rdstq_ month Min^ 1^J. U... .I,. 'C_J (,-1ow F,._ r$pvlwq y^Cnvv .0 til\.Ips auvnu apopiuw VGIVYI. Mann forni5 are a'vdiiabiw ai the Departments Albany \. .,\.,..••• Tht: 111...I,.Nrwrttrlg pvriw vvyala Orl um BAIvwv3 ueAc u('u`iiS yeAA mil and Il le tepUlFe will be due no later!Mari 1"1.x-. -1,006.A..,.of fr.a ,.«vliNl Iviivi' � 1�. J • vrr v y Ylv linlV dl GalLli IGpIJ(1111a�JttrH/U, Send the orioinai (too sheet)of each DMR none to, Sant the nnnnnri ,•.,ov(ll,)rli ehceAr of each DMR one;,, to N.Y S. Department of Environmental Conservation 1 V Division of Water Suffolk County Department of Health Servicas Bureau of Wastewater Facilitlea Operations 15 Horsablock Place 50 Wolf Road Farmingville, New York 11738 P.@any, New York 12233.3506 Attn, Jim Matoncy,P.E. Phone (518)457-3790 Include a copy of the laboratory analysis with the NYSDEC-Region 1 and SCDHS copies Send the first copy (second sheet) of each UMH page t0' N.Y.Q. Regiora!:^!tet-r engineer-Regign 1 Rnarlinn An. RI INV&h Rfnnv Mrnnk �_......e .- - .. � -.-..j w.-... Cluny Brook New York 11746-11eA :) A monthly"Wastewater Facilities Operation Report..."(for,92-15-7)shall be submitted(if box is checked)to the{ j Regional Water Engineer and/or[ j County Health Department or Environmental Control Agency listed above. )) NunuumpMumv with the pruvisiuns of this permit shall be reported to the Department as prescribed in the a4aoled Genera!Coiltiiiiurle(pari)i). t) Monitoring must be conducted according to test procedures approved under 40 CFR Part 136, unless other test procedures have been specified in this permit if the permittee monitors any pollutant more frequently than required by the permit, using test procedures approved under 40 CFR r=are 136 or as speuinned in this permit, the results of this rnoniioring shaii be iriciudeu ill till's ceicuieuvili anti revvAuiily OF ule until lir,the DibOlwije fvlvlhiuring Repvli5. )j Caicuiauon for aii limitations which require averaging of measurements shaii utilize an aritirrnetir; nie,An ulilvsm o(nerwise spt:65ud in tris penniL 1) Vniess otherwise specified, aii information recorded on the Discharge ivionnoring Report shah be based upon mea5afe(rlenly and salnplilig Cariiad Out duiiilg uii Inusi rvCe-illy Loliip;6td"rePoiurlg pnri0u'. Any laboratory test or sample analysis required by this permit for which the State Commissioner Of Healtn Issues certificates of approval pursuant to section five hundred two of the Public Health Law shall W conducied by a laboratory which has been issued a certificate of approval inquiries regarding laboratory certification should be sent to the Environmental Laboratory Accreditation Frogram, New York State Health Dep8iuireli Cerlief I& Laboratories and Research, Division of Environmental Sciences. The Nelson A. Rpckefe0af @I IpLo &zita laza, Albany, New York 12201. S 0 1 d 0 T : T L N O W A- 6 — Z — d S PARACO GAS CORP . 14 KROEMPR AVENUE RIVERHEAD, NY 11901 (516 ) 727-11390 TOWN OF SOUTHOLD FIRE MARSHALL/BUILDING DEPT. MAIN RD , SOUTHOLD,NY SEPTEMBER 5 , 1997 DEAR SIRS , PLEASE BE ADVISED THAT OUR COMPANY HAS BEEN RETAINED BY THE OWNER OF THE PROPERTY AT 12250 MAIN RD. ,MATTITUCK KNOWN AS THE HANDY PANTRY LAUNDROMAT TO INSTALL. PROPANE GAS TANKS AND GAS LINE , THE INSTALLATION WILL. CONSIST OF 2-1000 GALLON ABOVE- GROUND L. P . TANKS , POLYETHEL.ENE GAS LINE FOR UNDERGROUND SERVICE , AND GAL.VINIZED PIPE WHERE STRAPED TO THE WALL TO THE POINT OF THE GAS METER . ALL. PIPING INSIDE BUILDING IS BY OTHERS , ATTACHED FIND THREE COPIES OF TANK AND PIPING LAYOUT. ALL WORK TO CONFORM TO NFPA PHAMPLET 54 AND 5£3 , THE. WORK IS SCHEDULED TO BEGIN TUESDAY, SEPTEMBER 16TH. PLEASE CALL, IF YOU HAVE ANY FURTHER OUESTIONS .THANK YOU. 5INCFRL. ROBERT A. FFINDT, .JF: SALES MANAGER, LONG ISLAND (516 ) 727-1590 New k State Department of Environmental Conservation Build SUNY, Stony Brook, New York 11790-2356 v Telephone (516Y 444-0365 _ Facsimile (516) 444-0360 John P.Cahill Acting Commissioner CERTIFIED MAIL RETURN RECEIPT REQUESTED May 7, 1997 Mr. Stephen J. Stocken 183 Smithtown Boulevard Nesconset, NY 11767 RE: NYSDEC Permit # 1-4738-01467/00001 SPDES Facility # NY -0226793 Dear Permittee : In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your SPDES Permit above . Please carefully read all general and other conditions in the permit and any schedule if included to insure compliance during the term of the Permit . This Permit should be kept available on the premises of the discharging facility at all times . Very truly yours, �7 Diana L. Sanford " Environmental Analyst I DLS :cg enclosure cc : R. Hannaford File I State Pollutant Discharge Elimination System (SPDES) _ DISCHARGE PERMIT 126M911 " Special Conditions (Part 1) Industrial Code: 7215 SPDES Number: NY- 0226793 Discharge Class (CL): 01 DEC Number: 1-4738-01467/00001--0 Toxic Class (TX): N Effective Date (EDP): 90 '/91/97 6/O1/97 Major Drainage Basin: 17 Expiration Date(ExDP): 0 6/01/0 2 Sub Drainage Basin: 02 Modification Date(s): Water Index Number: Groundwater Attachment(s): General Conditions(Part 11)Date: 11/9 0 Compact Area: This SPDES permit is issued in compliance with Title 8 of Article 17 of the Environmental Conservation Law of New York State and in compliance with the Clean Water Act as amended, (33 U.S.C. Section 1251 et. seq.)(hereafter referred to as "the Act"). PERMITTEE NAME AND ADDRESS Attention: Mr. Steven J. Stocken Name: Mr. Steven J. Stocken Street: 183 Smithtown Boulevard City: Nesconset State: NY Zip Code: 11767 is authorized to discharge from the facility described below: FACILITY NAME AND ADDRESS Name: Mattituck Laundromat Locadon(C,T,V): Southold (T) County: Suffolk Facility Address: 12250 Main Road City: Mattituck State: NY Zip Code: 11952 NYTM -E: NYTM -N: 4 From Outfall No.: 001 at Latitude: — 400 5 9' 21" &Longitude: 720 3 2' 0 3tt into receiving waters known as: Groundwater Class: GA and; (list other Outfalls, Receiving Waters&Water Classifications) Suffolk County Tax Map Numbers ------------------------------ District : 1000 Section: 114 Block: 12 Lot : 3-1 in accordance with the effluent limitations, monitoring requirements and other conditions set forth in Special Conditions (Part 1) and General Conditions(Part 11) of this permit. DISCHARGE MONITORING REPORT (DMR) MAELING ADDRESS Mailing Name: Mr. Stephen J. Stocken Street: 183 Smithtown Boulevard City: Nesconset State: NY Zip Cade: 11767 Responsible Official or Agent: Phone: ( 516) 361-9440 This permit and the authorization to discharge shall expire on midnight of the expiration date shown and the permittee shall not discharge after the expiration date unless this permit has been renewed, or extended pursuant to law. To be authorized to discharge beyond the expiration date, the permittee shall apply for a permit renewal no less than 180 days prior to the expiration date shown above. DISTRIBUTION: J. Maloney Permit Administrator: R. Hannaford R. SchneckAddress: Building 40 - SUNY W. Spitz23790-2356 R. ThompsonSignature: Dater//Z //7 • �� -.. .a iw i - uu-u rU11000U 1-V SPDES#: 0226793 Part 1, Page 2 of 4 FINAL EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS During the period beginning June 1, 1997 and lasting until June 1, 2002 the discharges from the permitted facility shall be limited and monitored by the permittee as specified below: Minimum Monitoring Reauirements Outfall Number& Discharge Limitations Measurement Sample Effluent Parameter Daily Avg. Daily Max. Units Frequency Type Outfall 001: Laundromat Process Waste Water Discharging to Groundwater-Class GA =low NA 12500 GPD Continuous Recorder )H (Range) NA 6.5 -8.5 SU Monthly Grab r otal Suspended Solids NA 30 mg/I Monthly Grab I otal Dissolved Solids NA 1000 mg/l Monthly Grab Dil & Grease NA 15 mg/I Monthly Grab Surfactants NA 1.0 mg/I Monthly Grab Samples for monthly Discharge Monitoring Report(DMR) analysis MUST be collected from the carbon effluent port. ADDITIONAL DMR REPORTING REQUIREMENTS FOR OWNERS OF A COASTAL DYNAMIC WASTEWATER TREATMENT SYSTEM Vith each monthly DMR submittal, the permittee MUST submit the following: A copy of the original receipt for granular activated carbon replacement, if done during the reporting period. ?)A copy of the original receipt from a N.Y.S. licensed waste hauler for the removal and disposal of any wastewater or sludge. 3)A copy of the Suffolk County Water Authority water bill for the facility. 1)A copy of the relevant pages of the Daily Log Book that is required to be maintained on site (see the manufacturer's Operation and Maintenance Manual). The log book must record the volume of incoming supply water to the facility, the volume of water processed by the treatment system, the volume of water discharged to the leaching pools, and any pertinent information concerning the operation of the treatment system. Ml of the original documentation referred to above, must be maintained on site and be available o NYSDEC or SCDHS inspectors. NYSDEC Permit No: 1-4738-01467/00001-0 SPOES#: 0226793 Part 1, Page 3 of 4 DEFINITIONS OF DAILY AVERAGE AND DAILY MAXIMUM The daily average discharge is the total discharge by weight or in other appropriate units as specified herein, during a calendar month divided by the number of days in the month that the production or commercial facility was operating. Where less than daily sampling is required by this permit,the daily average discharge shall be determined by the summation of all the measured daily discharges in appropriated units as specified herein divided by the number of days during the calendar month when measurements were made. The daily maximum discharge means the total discharge by weight or in other appropriate units as specified herein, during any calendar day. MONITORING LOCATIONS The permittee shall take samples and measurements, to comply with the monitoring requirements specified in this permit, at the location(s) indicated below: (Show sampling locations and outfalls with sketch or flow diagram as appropriate) I — u O ,opo SPDES*: 0226793 Part 1, Page 4 of 4 RECORDING, REPORTING AND ADDITIONAL MONITORING REQUIREMENTS a) The permittee shall also refer to the General Conditions (Part II) of this permit for additional information concerning monitoring and reporting requirements and conditions. b) The monitoring information required by this permit shall be summarized, signed and retained for a period of three years from the date of the sampling for subsequent inspection by the Department or its designated agent. Also; [X] (if box is checked) monitoring information required by this permit shall be summarized and reported by submitting completed and signed Discharge Monitoring Report(DMR)forms for each one month reporting period to the locations specified below. Blank forms are available at the Departments Albany office listed below. The first reporting period begins on the effective date of this permit and the reports will be due no later than the 28th day of the month following the end of each reporting period. Send the original (top sheet) of each DMR page to: Send the second copy (third sheet) of each DMR page to: N.Y.S. Department of Environmental Conservation Division of Water Suffolk County Department of Health Services Bureau of Wastewater Facilities Operations 15 Horseblock Place 50 Wolf Road Farmingville, New York 11738 Albany, New York 12233-3506 Attn: Jim Maloney, P.E. Phone: (5 18) 457-3790 Include a copy of the laboratory analysis with the NYSDEC-Region 1 and SCDHS copies. Send the first copy (second sheet) of each DMR page to: N.Y.S. Department of Environmental Conservation Regional Water Engineer- Region 1 Building 40-SUNY @ Stony Brook Stony Brook, New York 11790-2356 ;) A monthly "Wastewater Facilities Operation Report..." (form 92-15-7) shall be submitted (if box is checked) to the [ ] Regional Water Engineer and/or[ ] County Health Department or Environmental Control Agency listed above. J) Noncompliance with the provisions of this permit shall be reported to the Department as prescribed in the attached General Conditions (Part II). e) Monitoring must be conducted according to test procedures approved under 40 CFR Part 136, unless other test procedures have been specified in this permit. If the permittee monitors any pollutant more frequently than required by the permit, using test procedures approved under 40 CFR Part 136 or as specified in this permit, the results of this monitoring shall be included in the calculations and recording of the data on the Discharge Monitoring Reports. g) Calculation for all limitations which require averaging of measurements shall utilize an arithmetic mean unless otherwise specified in this permit. h) Unless otherwise specified, all information recorded on the Discharge Monitoring Report shall be based upon measurements and sampling carried out during the most recently completed reporting period. i) Any laboratory test or sample analysis required by this permit for which the State Commissioner of Health issues certificates of approval pursuant to section five hundred two of the Public Health Law shall be conducted by a laboratory which has been issued a certificate of approval. Inquiries regarding laboratory certification should be sent to the Environmental Laboratory Accreditation Program, New York State Health Department Center for Laboratories and Research, Division of Environmental Sciences, The Nelson A. Rockefeller Empire State Plaza, Albany, New York 12201. PLANNING BOARD MEMBERS �0$UFFO(,t-c0 RICHARD G.WARD h�0 Gy Town Hall, 53095 Main Road A Chairman P.O. Box 1179 GEORGE RITCHIE LATHAM,JR. y x Southold, New York 11971 �+- T BENNETT ORLOWSKI,JR. O Fax(516) 765-3136 WILLIAM J.CREMERS �'� Q� Telephone(516) 765-1938 KENNETH L.EDWARDS Oj JL �a PLANNING BOARD OFFICE TOWN OF SOUTHOLD January 14, 1997 Steven Stocken Handy Pantry 183 Smithtown Blvd. Nesconset, NY 11767 Re: Site plan for Handy Pantry, Main Rd., Mattituck SCTM# 1000-114-12-3.1 Dear Mr. Stocken: The following resolution was adopted by the Southold Town Planning Board at a meeting held on Monday, January 13, 1997: BE IT RESOLVED that the Southold Town Planning Board authorize the Chairman to endorse the final plans dated May 19, 1992. Conditional final approval was granted on February 24, 1992. All conditions have been fulfilled. Enclosed please find a copy of the plan which was endorsed by the Chairman. Please contact this office if you have any questions regarding the above. Sincerely, Qnett Orlowski Jr. Chairman enc. cc: Thomas Fisher, Sr. Building Inspector �j 765-1802 BUILDING DEPT. INSPECT10 [ ] FOUNDATION IST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A HI NEY REMA KS: DATE INSPECTOR 765_1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: 1i®/ G � �Ga�r DATE �` =%�/� INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ROUGH PLBG- [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE lQbo// INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE Lam-ZV,45- S 7 INSPECTOR M-1802 BUILDING DEPT. INSPECT I0 [ ] FOUNDATION IST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: � iov b/lei✓ - o DATE 7" INSPECTO M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSyLATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: _G ��s � 9 4G c ,r DATE INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [;71NU STION FRAMING [ AL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR ❑❑� pVp t25 i �O. I °BOARD of NRALI'n TOWN OFIiSOFOM U1'NOLD ! } SII RVRY SETSOP Pf. NS. . . . . . . . • . . . . . . . . . . BII ILDING DEPARTHRINT / CIIECR . . . . . . . . . . . . . . . . . . . . . . . . . JU� 2 �9�6 tf TOWN NAi.i, �SIiP'I'IC FORM . . . . . . . . . . . . . . . .. . . . SOUT1101.1), N.Y. 11971 BLDG. DEPT. 'r TEL: 765- 1802_ NOTIFY: TOWN OF SOUTHOLD ��( N71-67x3 L . . . . l:x:rninx'd... 19�z MA TO: . . . . . . . . . . . . . . . . . . . . 19P Permit No LI.�' D .,. .......... .......................... Uisalg)rcrved a/c ............................. ... ............................................. . ....... Oiuilding Lns(mclor) A 1.ICAT10N FOR BUILDING PRIiMIT Date. . . . . . . . . . . . . . . . . 19. . . . INSTRUCTIONS a. 'Ibis aprplicationraust: be conglet:ely filled in by typewriter or in Ink arm] suUrnitted to the lktilding Inspxaclor with 7 sets of: plans, accurate plot: plan to scale. Fee according to schedule. ^ b. Plot: plan sliming locatico of lot and of: Ioildi gs on premises, relationship to adjoining prc+nines or Ixrhlic streety or areas, Firm] giving a detailed description Of layout of property mist lie drawn Out the diagrrvn which is port of this F,kplicaticm. ' c. 'llre work c(rvered by this rg>[dicati(m my not be armeo:ed before issuance of Wilding Permit. d. Opxo aMrrrval of this application, the NIII(Jing lnspec.t.nr will issue a Building; Permit to the nop icant. ^Auh pfnnil, shall he kept an the prc+niaes unvailable for insinetiro 111MIJheoL the wcnlc. 'e. No Wilding shall Iia occupied or used in wiole or in part for any purpose whatever until a Certificn Le of Occagxaxy Filial]. have been granted Iry (lie lknl]ding Inspector. APPI.IMVION IS 111MBY 11AIJr to the ikrilding DeparUrent: for the issuance of a Wilding Pemdt pursuant to the Iknilding Tao Orlivaa.e of tile 'Pown of Soudold, Suffolk ConnLy, New Yolk, arm] other applicable i,aws, Ordinances or Regulations, For tine construction of loildings, anklitions or alterations, or for rermval or demolition, as herein described. '11ne applicant: agrees to carnply with all applicable laws, vrctinox:es, Iilding cane, Ixosing tale, anxl retnlations, end Lo adail: sullarized 'inspectors on premises aal in Wilding for necessary inspections. (SignaUuTe of: snppl' :out, or Flair, if a corporation) (1Gailinig arkiress of applicant) State whether applicant- is owner, lersee., agent, architect, engineer, general contractor, electrician, planner or Wilder. ......Q�1. (\tlfj ...(. lc C••o�Mf ,. .0. .................................. ............................... Nave of owner of preinises ...H'A"'y la.'"'.... o!V� .............................................. ....... (as cin the ix zr)11 or latest (teed) Ifrp)lican 's a cor tion, signature Of duly nullorized officer. .. . . (Nmxa nal le of: corporate officer) )kdiders License No. ......................... I'laduers License No. ......................... Rlearicians License No. ..................... Other 1'ramle's License No. .................... 1. location of laal or which proposal work will lie (lone.............................................................. .. �/ ............... �i.�u�lz.................... House Nrnher Streeytt I4xnt le ('.aunty Tax Kip No. 10(10 Section ..7I.?......... Illock .... Lot ..3t1......... P,rulxlivision ...................................... File(I ]tap No. ............... Lot: ............... (time) 2. !"Late existing use aid occupancy�of pr1onises Film] interx)ed use arxl occupancy of proposed ccoslruc.tion: a. Iixisting use arm] Occupancy .. k1.1 ..... �....... . P . .... ........................... ........ G b. int en(led nse anxl Occupancy ..� �? M�'�.�. .CrnA�:}I...�,\.�:A1ANp�(?.'`^:.':,I.�.........., llt:lolelair II(%Adcl .pl,ilicahle); Wit Building ........ . . AddiLion . . .. .. .... Alteration .. , e Ilt'lnnl iia ou .... ........ 011ier Wolk ..... ... .... ... ....... ... ... . . . .. . . 1. 1.'IUue of (aa l( ((huat ndlich n )I h. EaLinialed (bafy.Pit .... . ... . fee ....... .. . ... . ..... . ... .......... . ...... ...... (lo In. pald on I'i1iull Illi❑ split leaf ion) 'f. 11; (Welillith Ixnlx?r of (hmlifi f units ... .. . ...... Umber of Amalling units of each floor ... . ... . ... .. ... Ifgarage, Ixnher of care .....IL. ... . . ... .. .... I... .... .. ... . .. . G. If boahlean, cannercial or Omit n:culuax:y, speclfY nature and extent' of each type of use..�O ....L)4�410yvj /. Ilinr:nnicim of exifiring altrictul'cn, if any: Front .. ... ... .. . . . ... gear ... . . ..... .... . Deld It . ... . ....... .. .. . IkII , d: ...A .ZI�........ Ik•1 II. M.dx?r of Sl orirs . . . .. . .... . ... . . .�./ ..r (I L 1 /i Iknnllef(xm of ease a(:ruchlrr. hir aller(ddola or (miditiorim Front . .7Q. ��.. .. .. (tear .. . .?�. �Q...... )L ... ... , Moid)er of Stones m:l lon; Fax II: . ... ...C'.'.— . Rear . .. ... 7777 . . Ikplh ... . .. . . .. .--T I Illnr•aailN la n(' enLlrc rmaw rolal r( /. Radver of Stories .... . .. .. . .. . .. .. . .. . < Size lof lot : Fr(Nd ............li. .. . .. ... Pear lkplhcrf.+ QC112S(S .. .... .... .. ... .... . 10. Ikd e of Purchase ..... .........I.. ..... Misr: of Starr Mawr .. ... ..... ..... ... . . . ......... .......... 11. Zone or use dial'rfcL In dilch "lauisea are s't Ulale(I ........ .. . .. ... ..... .. .. .. . .. .A. ... . . ........... .. ... .. .. .. . .. 12. [Wes proltoned rrxm ."wII(>(, viol sue any zoning law, ordhxnx:e or, rogulal.lon: . .. .. .(YO............. 11. Hill of be ere of erns.acs H,...... .... Will excess fill ba removed front Imminent YES 1c7 1 alr• !1 ..... .: �1P:":-r7..'. Cklreaa .1.4�:'.5.... .. . ...... mumu No. e�%/,�,r�".7 I'1. IJill lot Ix regraded IN N A(ktrens l'I uxx: No. I:i. lard la Contrector willlil1 fe I K: A(klresa o Arc l incl O of ...... 9l. nl' d Cldsl caeClalxl"! � YIS .... .. .. .. NO ... .... ... *IF us, WlllKx1) 'Ium *1101SI1a?S I1-mri, my IK; Iogp1di6. I'LO'I' DIAGRAM 1(x:a(e clearly and distinctly all buildings, whether existing or prolx/sed, tax] indicate all setback dbnnnslons flan propelly Ilona. Give street arxi block bolter or description acror(ling to &edi and slow street nnlnes and imlirate Idlelher iol'erlor or corner lof. i GI'A'III, (W Nl14 Y(mfl(, ISI (1K11'IIY IF .. � IrA lift ..... . .(nal signing. .. ..contract- above .. .. . . .bang duly mxun, delxmes and enya that he is the appliranl (Mm, of imHv couU'ur.l above mord, IWis the ... .. .. .. . es r?,..... . ... ... ........ .. . .. ........ ...... .. . . .. ... ......... ...... (.xltractor, agent, ��curl)ornle officer, etc.) or wild (Namur (11' 4"Iers, and In (illy Iauthorized to 1N11"follll or have lm?r 1111 rIY?ll lite aFll(1 1401 It FIINI Will) 11411(C III Nl fila 1111 I1 Flplllneat1O111 that F111 a(Fltf9lr?II(fi l:011l'I'F lord 111 thin npplicuLiou are line to Idle Infill: of Illi, lom"Iedge sod holies{ F)(Nl that. the unit will be performed In the avilawl set: Profit in the application filed tlerevifth. }(kohl to helote lip thin �l .. .... ... ..... . . ... .(lily of: x°.. . .. .. 19.9 . . y . ..... P PATRICIA fk)lar Public .. . .�-,......,ICNERT . . ..o. .... ....... Notary Public,Sit pG01NOW (Sigualur f. lf cant No.qir , 1154 ounlffied in Nassau'/Sulfol Co nnmmisaicn Expirol§ 3 _.b: .. WPMPOM . u�L 14 6TALL5 1,. I PAN A t-1 P I f�ROf .i' -T-ca eirN '•.� I ,� � t. A G K T O P P A �/ E t-'1 g til T �� •.' O. ;II CVAF. E K 4 r- 4 O w . i y�y�a it \t 4'eT �i >at�•t 1 �T t /.a 6t h't � � O 1.3 A. fZ Y iAppaWgi+C M,/v_,;A=a _E : NAGE '?n b V 1v/ri �/ Fiee� � i' -� 3/1 AL)+fTNEt tNE D F,41AI ! LAS L:wa /17`OECP iZ l=T A I L Gr 2�1 000 ,Q/3t71%� R avn:il ' 4.05(0 � �. �. �� ��. "` � �1"-EAGJY. 1'{Z�'p Y_ t T ��� � •�----- L.�. 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I ' , ; (yq CAfJT AC Rb55 5 ¢VC r) F2o ,j 3UeJC1-T PA2CFL weLL + CESSR=L,5 0 .. ' 1'12OV: ppNt;1'1>✓N? a>'(kIF?IPJCa NCTIi:°1N AIS No +TTlf�l-nAL -'ouacFh ITM 41CONTAMINATION WITHIN 8 - : �j � (SGAKLE:T GlA1L� 50OI2 PILNACaE wl �i'1(Z.UG7U1e-F1� Tl-aIN .'�Olr - 1 ' of TNG PFZOl�oS� WEL..L- " © . ISI' �V C�I2b'bN 411e1J� (GAZ WAKL'= Ju1Jlm ) 1 }Q�-tCmOcIJ7?GGIOI2Tpl.)NC�CWa2 N E WS U P P -TI-IFhE NU E- !6 b E M ED LcrPAwa_o_w1 ti_l rouLSAI? mr0 „ - 4V(JIO EXIS-fING'1 GIIr_Pfi, WA1_Kr, UVLITIES, ETC_ E S5 POLn - V-AA IN roL6 4Es0_3T• ,Y EUL_ 2i_Oo + RO- . " -To T STAT ON � 1.7 iirb,LL-5 Iz�-To V /.. 1�;pL WITH / O BE WMOV.� R- 22-ISI vze.,,N vri.^.I U g a, IJ I T A� IC Y CAL C U L A T I p N e�y u'Xlo•' 6T[P_) 41Yt7L2o�aEol-4z�IG zoNE�L- WITH , lel.2 _' 6=�s5 -_ 4l0 LAt C72�AN KE1� ALLOWA IY Y v¢.�.Ir-1 q WITH DOMES io8 2 ?'00- 3-0-4v 7 + -_.-a - fiXISTI mLE D, - wL � PA�KINU STALLS \".9� i 7 r '^ .02 AC_ x � /AC= . rODCP CAV'!r� - s lUJ - -i, s r H .e. 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'SIL�G WAI-K ' 4') 14 PUR�iLw,NT TO TH L _ VESA T1 UN o5E AIZTIc eu rK1JP - :� :.? . ``Jy -�'LOAI7ING� IIy- I�-1Ya,11F-�-�-r- To 12EMAIIJ 1� ' 64� d3 T U FACILITY G'dNEiZ'di mil D T,'t� . tL_ 19_!15 •' LL . e u r11. b pp I.oAI71NCa AGGEh'S vli- itLq-a5 6.N.00 � W.�.�- '- k AK£A FIi�'E hpcl_. �i ¢L_ 23_s5 THE wATEYe ePpLY ANv m1�rrAG-le plypbCck.t_ '' PII(O(os rlol-,. w_ 52 T_Gco' 'rbl^ 29 'h,o'::w' .A>rlJpi�, z :F� : I � � • WMP�L`K-;• . �WJ(I?J�o FOIe 'Mlh hll� G[?MPLY w171-["'ME CdfAN _ 3 �NGt.(Xa617 W Y�'N�-� m"Ap" ANv OeQuI1mC ew-fi� CIO THE %Ljr-KOlx- y ,:. 1'' - ,I Z_ kl SANITA7'r`Y 1 N A L B r-AUNTY � H L G-EI�IIGEGJ. - '"c J_ P m rsPY' - N w e ' HarJHblbs tX• C V4.GAhdT� - - dir " 1 ..- - 6 U I L n I ti c+7NAL[J J_ TAY LAN119 GJUR.\/E - - Mq{L .IAL w L yymo L 'g+ mYa L A �T'� C°P y(ylr D 2.1^ pV�al% NoTrs� SUFFOLK COUNTY DE HEALTH SERVICES pT4clg _ OL1 P1LrO1?rTSEt� ` WELI-_ APPROVED .t o:d 711 con cecTe 41 2' g' ¢' 4' a" aNC IaAD � 0 o.e vl� + D eH ?X I�iT Ncq hdNITAKY I7TbLSEv,Ah nv... ( (IDN ONLY err( } 8 N - 1�1 FHA N � � R Pa,F SI'Iti PLAN Dh 4PPIeOVI� PN I TH6'-paoP1 I7"fa nE A PIZNA-I�.YJ!!l-1.,t'7E13TINrA 'MG G'fA"I� wh-t�'?lgt��ICIr.Crrd! lewcc e1.ocK Mo1cr coVgc HeZLTFa f7' ArzTMI�IT nN MASit 2>i 19 rc2 H.S. REF. NO _CLa=1`L.-.4 r s��r L_FLOW SANITAIeY tOG'B DGFNITON OF 'I.bN COM UNYiI' W4:IEIz SUPVL _ . rrr �: �,-ba.Tae coveaz +'1 cx f INV['.L"7 NO. 1•'14.7-_ NO NEW SANITA¢Y IZ Tb a •rrr A►XM� IN7 a r • PSE INSTALLELZ TYPE 2. `'"WOG-1E vIZGb�.L Z SttE#G.M7IGI7�r'pP wszL i v11?lura 5NAL1. CON IIcM •(O -M� FOLW+'JtIYa, SNI � _ - - .. . 04 "IDICTA - `" 1 6� u ,pile-rANkwi44o cjrP CAFA, .ITY This approval Is ?ra�lri : - -;1'LCtIUn DI the sanitary A :MIN.:Y10.G OF *4 r 6�'M1N.'CAY'oGl'�y'yy oP7, WI4.Jr -(TANK,+:Il OR JO * "fi-IEi W a - PICOr _0p' .7�-'-(IGLl7 WHIGMEV✓CIZ If QI¢I�-A-TWZ• G�`w11N. 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INLG�F�Iz:lENI PIONhAe:11T c' : „Wd�Tp7.7t. � �olaG�(GH gra�IG-'ry, 5N ( '+•i op 5, coMa16F'-DIAL CONyfT1LUGTION ' 'WP.rsi CON4Jfl¢VG�10 c.AAeIG GIhPOhALI I- IA-rot CONr4(TZUGTIDN rin/ICa15 vlr�p04AL, 1-,9-lag 9UPPU pay Lr'gd2q'g. b y,� o'�rL,,bLIG A Ina.1Ns WI-n-IInJ A4[o2 ' - ,/ SITUATE MA..7"TITL_JGK yIYE GA f A OWNd� 1+p 7uvFOLK taIJFJ TY ILevISEYJe TOWN of 2oUT4 TOLD T�PeaaT.',-af-vT uni�TS rn 3>-.9rCf7� uM 17 A�'FA71f , 101 . - 7�,/ ,¢Ce'o,E1Jin� Te SurF �' C ave' TAX MAP NO_" AODH7� 1o2g1 SUFFOLK. GOUt�IT Y, hLE_Yv� YQFZK,,, S7tJ �.j I-Mc. DEA9P7MFNT :/fE.9LTi/ SP.¢r�iCS_, :.Q'nG'C[,TA"w/25111 MAIJ P ' iz ti.!Fs,Y012. " - OVEIKALA, AZK&' 2-02 AGKPh 1i,18VA-I(IOPI t7A-fL1M� lJr� CaS STp Z09A-V5 . Tj//�E of T,e�-y� ' •v'E�rT Nrneh vn�.K lura , -. , - - DUIL771NL1 AKF�.� qro w:_ alp [eX1�iT'IKV IB3 5M[THTown1 REqur2rro aAsl:o o,v 4V4 ---e RNALyS/5 GIoJTIe IGT, 101 4 IC E t--IT fy�. O IaiG.1,G If-,•1�S, IJ_Y 6Frow61 r, 12/211 T3UULE VHS+ APTEe WBGL /5 / sreLeFz• al GTIOLa" 114 EulSloNa. n[ lol�l - - Nr,��l7q-�" 12/le 6LOGW' I2 / <oUILVEYEI?r wj�i'r'F�MY�Jb`VL -'4 Ig9k .- } - (: $ MA.k' ee4 urh'E M/r✓/M U,vi- �/t'u. ,�T. OF Aoo F'e•vi -�ryr/�z _ _+ RE�ASIONSr, 1 1.3�,2 ' aRs;O 'rr'PAVING1+5rolala25_ hF (taCIewit4 1) IV .,'cx* 6ro All ypNl •' FII. l,a (7Uaill�l L'!yl � � 7�� FJCT/riATFP C'A.P.C'ION aND J'/�O/f/ .' LOI-w qj_I w.enale.ve ,_ I � 1 /r7Ah'�'An/EfsE,C>cMO VF�C U+/iT - - ,.1G18!!�, r .;s 171',14-£'n;Y1fi ,..J'..r^+sT I .yB� GQt1yTIA1617 (VACANT) HALL - t5 TAILOFFIC.B ' 'fbWN Or- a7,pU-TNOLtO . n , _ - 1 iV>cIiii-I U r �� � l s r -- - - - - - - - ]L — - -a 2_I El . s3_O• r-tor+_ A7 QCO `� --- -- - - ---- - --- - - - - - - - AS P 0-4 A L•T I is HUNT PH d.LT ¢M E NT 1 1, V QIV V !`/ s�a►t �Au"✓ rtUMrTT 1 1 1 3 ��J !/� EK1�j lh1 Gt MAFSON QY a_� BL 6.G1G T O P �? p rosT 1 Z r W I J Z v 1 OL� - /CDOG DF ?A�/EMGNT 1 r Q W Q �Z / x`04 ro`E • �':.4�` r 3 � s + 23-53 person for whom the soney is prepared, and on his �d- SI P,etlaif to the title compa-w. govern^�ertai agency 52 7-Gl Ce' 31J lending ins*++:j+ir.1 i =r' hareop. "`:'.Kation Is tJ/F' J_ P_ C t2dY a'^c��3. '- i'j,; - 1";, . pons or N/C o,_ GIs,iz t7►lel.6.L E Sitroev Is V9r� State LcalK,a Law, Codes of this surviey mao not tpearing the (..end �'E,2TifiE� TG: Si, ars inked seal ar embo s-A seal shalt not Ot cj.lsiderea to be a valid true copy. MAP 7'/7LS= 2NSr��,=fin x 1�, E-Z 10►j =>ATur--t �o u►z��- use cam HAW 0Y PA N -c' PON ra,eC-D THIS SURVEY IS NOT TRANSFERABLE CERTIFIED WEE TO NAME ON THIS SURVEY. hl TUATE MATT ITUGLL a �O�Y�iG-aHT �uFFoL1� ca�NT`� TAX MAi� t�10_� TOWN OF SoL)T"C)L-t:::) �L7/�tJAL17 J- TA45EzrjUF><OLK couNTY, N_Y_ LtaT�l t7 S UIZ1/>=�(OtZ. �j1;G("10 N 1 1 44- Jolt,?544- a. 1=ILj—= 1(0 -J - 7 �u¢`✓�Y��" SEPT 4, t�t91 2? �� ull U111-1 k LSXMTNG BAC%ROOM K slum �r o 1 yti b 1 in L m F POLOIN6 TABLEcli R r Oder Pik F ipk 11 W=p L UC�Tfl GOL;r rA 1r •�� D R6 ��p xr } ROOM TION �61C p � � .AN - DAM L— A u I Y LJ R 1 I 14 T JANUARY 2. 1991 MAIN ROAD, MATTITUCK, NEW YORK P>i T 011% DRAWN BY: 5FL I CHECK BY: FLOOR PLAN SCAM SHAWN F. LEONARD, ARCHITECT DRAWING #. 320 HAMPTON ROAD, SOUTHAMTON, NY 11968 TEL (516) 287-5557 SK- 1 �R i I fi 5t° 3a IiIN l SACK ROOM � Y� [70LURTN u xx pp pp f m S Fr x Q S m �J 3 ro1-pIN4 TAOLL $ R r r 0 or4ice L 6�1�M [. COLUMN e� s � ROOK ION ROOK rr��r k1 - 3 DAM L ,4 J EDR `r MAT JANUARY 2. M111 MAIN ROAD, MATTITUCK, NF-UJ YORK PST 01.44 DRAWN BY: 5FL CHECK BY: FLOOR PLAN SCAM SHAWN F. LEONARD, ARCHITECT DRAWING #: 320 HAMPTON ROAD, SOUTHAMTON, NY 11968 TEL (516) 287-5557 SK- 1