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HomeMy WebLinkAbout17907-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219530 Date NOV. 23, 1990 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 995 WILLIS CREEK DRIVE MATTITUCK House No Street Hamlet County Tax Map No. 1000 Section 123 Block 10 Lot 02 HARBOR VIEW Subdivision AT MATTITUCK Filed Map No. 8377 Lot No. I6 conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 7, 1989 pursuant to which Building Permit No. 179072 dated MARCH 13, 1989 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING, DECKS, AND GARAGE UNDER. FLOOD ZONE A-4 The certificate is issued to ROBERT & HELEN KEITH (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 88-SO-103 NOV. 1, 1990 UNDERWRITERS CERTIFICATE NO. N116658 MARCH 1, 1990 PLUMBERS CERTIFICATION DATED THOMAS MC SHANE NOV. 8, 1990 Building Inspector Rev. 1/81 f'OB~R NO. f TOWN OF SOU7'HOLD 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~ 017907 Z Date .....~!~...~!-~.........~..3 ~9.~'~ Permission is hereby granted to• ~ x... s-. 9.~ //9 ..~.~..~-..N.:~ s.~-.. . ro ..~;A:~...U.~...V.:~. ?.:~L~S¢. l .,2..V^..4r4~.a..~..~...~.~?:^Q .1~'Y ct premises located at ...q.`~a5c.....~ ~:~:~....~!~-?:K...1~, .~:........:.C..).~I^^^^~:~....... County Tox Map No 1000 Section /a1..3.. Block .../..Q........... Lot No Q.2 pursuant to application dated 19..~' 9., and approved by the budding Inspe'cjtor. Fee $ ~ ..7. ~ . Buil ng Inspector Rev 6/30/80 • Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 st d,'i ~ •.r• ~ ~ 1r701J APPLICATION FOR CERTIFICATE OF OCCUPLt,N~~ ~ BLCG " .1. This application must be filled in by typewriter OR ink an ' CC `to the building Inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2(10 of 1$ lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Uccupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date :.ew Construction.....x Old Or Pre-existing Building ,iVi~Ctc r~~~ C1. ~;;c.~ ~ocatien of Prcperty ...................jF?.......Y~ ~~.~"S. House No.~~~ Street Hamlet Onver or Owners of Property... .K-4`~?'~«.:~::4~. ~~~~?n . Coun[y Tax Ma/p~No ~1r000, Sectiyoy~n,,.,...~0~?l-~.(.....Block..../~.........Lot.....°~.1~." Subdivision./1C~~1Iqq~1..Y1KLt'.G.d~'.it~-~t.YfSG/f......Filed Map............Lot..\...~:5 Permit No...~ ,...Date Of Permit ................Applicant.~4CC~d'1~.4.1.}K~~4~~.~mCl:~ fiealth Dept. Approval...~~s~C~.~d~............Underwriters Approval Planning Board Approval Request for: Temporary Certificate........... Final Certicate. , Fee Submitted: $_~~;?J i~ Y6 ~~z ..~~•.~:u.~? / i / 7. 3/~6 n .r > i4 ~ 3!/ APPLICANT s ~ New York State Department of Environmental Conservation RegUlacory Affairs Unit Bldg. 40, SUNY, Rm. 219 Stony Brook, NY 11794 Thomas C Jorling (516) 751-7900 Commrssloner January 1989 Robert Keith 253 Cold Spring Rd. Syosset, 1\"Y 11791 Re lu-8F-1249 Dear Mr heath In conformance with the reau_reme^t. of ine Slate Uniform Procedures Act (Article 70, ECL) and its [maiement:ng regula Hors (6w^.'CF:R, Part 6°_~; we are enciosvig your permit Please reae alt conditions carefully I' you are unable to comply with any cond_tions, please contact us at the above address. Also enclosed is a perm a sign which is to be conspicuously posted at the pruJect site and protectec from the wea[her. V/,ery trul} yours, Cr~~r~~ 1, Hdmmarili Lm^ i nnmentdl rln alvst enclosure 9'+3U8 E9Itl61-25c nfN iC1RA ST AIL Utf ARi ME NT OF ENViRONnsE nn At CONSEAVATIOn' DI< Pf knslT NUMI4IN ~ FFFE C.7IVE DATE 10-88-1249 ~ ]/5/89 MCICITY~PROGRAM nUMBE RbI PERMIT EXPIRATION DATE(s) Under the Environmental Conservation taw ;~/q li 31/94 Article 15, Title 3, 6NYCRR 327, ~ 6NYCRR 608 ~ Articlz 25 L~ 328, 329 Aquatic Pesticides Water Duality Certrfication N Tidal Wetlands Arucle 15 Title 5 ~ Artlcle 17, Titles 7 8 Article=. 27, Tdle 7, 6NYCRR 360 ~_i Protectmn of Water SPDES ~ Soud Waste Management' Artlcle 15, Tdle 15 Artlcle 19 I I Articlz 27, Title 9, 6NYCRR 373 Water Supply ~ Air Pollutwn Control' u Hazartlous Waste Management ~ Artlcle 15, TPtle 15 ~ Artlcle 23, Title 27 ~ Arucle 34 g 'I water Trans ort Mmed Land Reclamation Coastal Erosion Mana ement r- Artlcle 15, Title 15 Arucle 24 Artlcle 36 Long Island Wells ~ Freshwater Wetlands ~ Floodplain Management Artlcle 15, Title 27 N-New, R-Renewal, M-Moddicauon, Articles 1, 3, 17, 19, 27 37, ~J Wdd Scenic and Recreational C-Construct ('only) 0-Operate ('only) ~ 6NYCRR 380 Radiation Control Revers i IrHMI, H~tdP Iii i Rober[ }:eith Itr.tit t~~+1 i'tRMITIIk ~53 Cold Spr_ng Rd Syosset, NY 11791 -5(,r'.. IuK Jihntl:l[I COnlnu Pl H~pA ' iLIF I'HO~f 'v UnIBLF En-Consul Cants, 1329 lvorth Sea Rd., Southampton, .a 11968 i~'n VI A~.U AD,~RI 11 Ui PROII(1 fACll IT1 11r Ollterent trom Permlrteef lleep Hole Creel., b'illis Creek Dr. SC'TM iro lUC1U-I_'9-1U-2 tot„cn„~IIIACI ~ rl~~)r,~)1v<t(_ I, ,,u,n of I'r rill ,IAr Il 111 Eounit i P.att,turi. I 8ufio1l. Southold i - Uf t~ 61'^ ~ Ur nl 1 r IJR r I r 4t 1 1A ~ I l Construct a single famil}' dwelling, decl.ing, sancta n system and dr; vewa. after placing a75 cubic yards of fill as shown o? tiro ~ttc~hed suwey pr~p.~+-rd b. I Howard H' losing, dated !2/23/87, last rev.sed 5/33/8b I crr.rR.Yt conninoNS II Bt acceptance nt Ihrs permit, thi permrttee agrees that the pr rmrf n rontl ngent upon stmt romph ante with the ECl all apph Ubir reRulaLnns and rta umdrimrn specllred herein or alta Chad he re lu I„ n~,rJ~rru~n, 1, mn„ot rr, ehprnpl~dbr <ml.rrmnnan ~I,lrlgM ~,n!-rlulb~i n.vCnrbflrl'•µuU,1,~~nP,Ir~. lnobu ~+l ,nbnl,m¢~i nrn.rv , u ~ n, .Y Lour. ri ¢ nu, n bi limy n rummy nirnu nr anC .l/, .v +li lir nr 1' ml I ~n ..nl Rq n nn m ar n li nnrv i I•'n~i rt w„r4 ,.I n. .ul.,, rt lr n+pr nbv anauthorped repm..,r+UV •rt 9i. np run.mollruuunn„nL,l(nm,rv, iu ~wrn~rm s~nn.r nu wun u+r ntlr.l,r b Pr, .r ~ In ~ n. mr m .r u , e i 1 §'T-011)1 and ~~P~ GdPi, r 11.r prmn br lei.,,.. prv rr..pn„~ Itd,~..r wLnn nl the dpphcabon ih, rule k!'I,..hnn.nnLtt to, all Oan,dh'r+omU Or mnv.n ..,ahtl• r,nulm mr hs ahnnu air vdnnd + ~xrr of rlu Vwnrr o...nb•~~b.nm and lids aFnrd to mde•mmis and IlnmL mr Sldb nom mrb acnnnr nom ,rr mn~rr r„ rs oar.,, drt[ Nsult. unr a+unml,nr nm ihr tine , rcy, rl irr DeD., rr mr n v.r ~ tn. r,cFl o moCnt u<pr nd or yes oue ilia pwmr, dr do ~ a r eua nm c d rtnurved hoer ~ n. u,np wh,r rbr , „ o. n., t ,t r d«d n ~ v,olannn of an. cnndrrrun nr th. rv nn <r nrrs,sun,• o' th, rr Cl dnd pr nmr. u,l ll no• au n.mo nr bl the I ermn nor In r., L. nu rc prrsrnrauon or tadur, to tlnelo+. re lavrn earn <r , ~ mwh dnz ovr•nd lntor mar,un or vkmrlc dot DM s¢al chanRr's are bnum n a .wc. ihr p. rmn w n uw,d ihr M'rm,nrC r,wMm„h1,Irr 4tePrnglhe lwrm,I dgnebl sUbmnbngdn wx dpph[arlur m(Vd,ng dm lnrm•Iee+nrfUpnrmt°.Idi rninrmzl,nn wnl(h mat hr rcr]untJ L, rtm Dr partment nn Id r Lrn $I drt• (lYU dais for $POCS or Sotld or Frazmdun~n Navc Mane. mcnr Drrmny poor m ihr r• , i u,n ddb r 11,,. p. rmn than nor h. , ~ nvu•r n• v n,l, m the apPl¢ mr am nirn ro trespass upon ,hr dnos o lmr n wrh rh. rmm,an n , or ulhr 1 .n goer r ro p. norm Ili. p.,muRC wod or r our .r r, u~L rru mgnvm nl o• ins nphP n r arm ,yeti m rrn~ r r Pr Ppnnl rynt•eriv h, C nr v tin .n ~ . r nn ~ par ll+ r n p, rm, n. nrrm n.. ~ n.l,r r.. ~ ~ ,_am mhrr rvrmn. don, 1. ~ ~ v ,wn~ , r ~ ~ , .n~ , 1 ~ ~ r nn ,nr „n, .pr ,n li ~ ~ ~ r n,~mr nu, ~ ,i, i , , ~ r l.. ,r, n.. r.. ~ ~ r. n. 1„ r , ~ , 1 a1r4 t3E 'c _r.^ta , r ~ 1 Il Irh .n i. I, f' 1 [m~ una Ga: tupor]r `~I h.l ~ 'I~ nnh ri nt'..I _ - j Pa~!e 1 of ~ ' 9510 to (1;ntJ-15. AOORIONAE GE NLRAt CON~fTkONS fOR ARTICLES t5 (Tgle 5), 16, 25, 33, 36 and 6 NYCRR Part 608 ( 10 Thai rf future operations by the State of New York requae an al- other environmentally deleterious m<tr pals assouated with the tura[ion in the position of the structure or work herein authored or protect if, m the opmwn of the Department of Environmental Conservation 14 Any material dredged in [he prox+uhnn or the work hr i. in pr emitted rt shaft rouse unreasonable obstruction to the free navigation of said shill br «mosed evenly, without h ,n mg I erge relit„ nih~ ridge s acrus, waters or flood flows or endanger the health safety or welfare of [tic bed of a waterway or tla,dpl.nn o• diwp lu+i„ that m.v have a the people Gt the State or cause loss or do arucbon of the natural tendency [o ezuse damage le. nay rt~aLle rhai mi, or e~~ the= banks of resources of ihr State, the owner may br ordered by the Department to a waterway remove or alter the structura! work obstructions or hazards caused 15 There shall be no umeasrxiabie inU rtertaue with n..m itn.n by the work thereby without erpensr to the Stale and rf upon the etpuabon or huem audwnz ed revocation of This permit the structure (d 1, excavation, or other lb II upon the e~pu atiun or re, Deaf wit of N+n p, non di. page r t licit be moddication of the watercourse hereby authorized shall not be ion' authorized has nut been uanpleied qv' aVVhr. ui b.II without ,=xp<m+ pleted the Uw nets sh,gll without expense to the State and to such to the State, and to such extent ml u. vrJi hint and manner as tto extent and m such bmeand manner as the Department of Enwrunmen[al prpartmrnt of Cnvuonmental Qan.•rvatrun ma} n=yuun n nerve alt nr Conservatlon may «quue remove all or any portion of the uncomVie[ed any portion of the uncompleted structura ur tdl and n=s;o« the sit. structure or fill and restore to its former condition the navigable ro its former condition No claim shall br made y: m.t ibi State ui and flood capacity of the watercourse No claim shall be made against New York on account of any such nnunel ,n alto ahun the State of Nrw York on account of any such removal or alteratio° 17 If granted under Article 3b (hu ire mot dues nor signrh in ,•ns ~ 11 That the State of New Vork shall in no case be Gable for any damage that the protest will be fruu iron, •loodmg or injury to the stnu twe or work herein authorized which may be caused 18 If granted under b NYCRR fart butt the hl S D, p. rtin, nt of Em w r, by or result from future oprratwns undertaken by the State roe the mental Conservaton herebs rertrus that the sir ble<t Inop. t will n,rt eonservaUUn or improvement of navigation or for other purposes and contravene effluent hmnati=,m or other lumtatiOllS or standards undo r no claim or right to compensatwn shall aserue from any such da magi $echons 3(11 302 303 306 and 30i of th« Ciedn VY,tr c .1. t nt 1'•D 12 Granting of this perms does not relieve the applicant of the response (PL 95 217) provided that all of th+ sondrtions lutes h. rein m. t bdrtv of obtarrong an} other perm its ron con>ent or approval from 19 All actrvibes authorized by thn p, rout nwst b, m ~,ui t , ootoun. m e the U S Army COipS of Engineers, U S Coast Guard New York $tafe with the approved plans submin, r. by th,• app hsant nr nis agent, s i ,rr Office of General Services or local go. a rnment which may be reyuued of the permit aVPhranon 13 Ali nece>sary precautions hall be ta4 tit to pre etude contamination of an} wetland nr wa'rrw ay f>y >usprnded ,olids sediments fuels Surh approved plans were prepen=d hs solvents lu bncants, cpox} coatings paints cuncrele leach+te or any _ „ ii _ SPECiAI COhQ1710N5 I In protect the vdl ties of the tidal wttl_and, a p(•rnetnent veget.+t ed bu1L~i i„~+ ~h ~II br i~ t I,I, In <I i lbere sl uall be no distarbailce to the natul al vuget at ion or tupngi aplry ~~Ith1 r ar ~ i .ate idl nr 6'. linear ft l.uxlward of The tidal wetland tx xr~dz ry which is located aL [ne 1 S• ,nunt,~ro L sr~l ~ 2. A sncna fe=nce shall he staked m place at the 1a11dward edge of the bultet area hciom rrnnrnu its •nt o` regulated activities ~1d rc'rnavt m place until the prodect 3s cotrlpletrd .L1d all rllstutbrd .ircas .ne , stabilved with vegetation. 3. llnvclday •u1d park, rig areas shall be eonbt ntcted of }x rvious nr~tenal ~ 4. Kuof nuloff shall bo da re~tcd to drywells a train tmtnn of IIX)' landward of tL~ Ltdtl wi•t ]end Ix vita ary ~ £or mmedaate on site recharge. 5 No accessory stnu tutor .n dddl[1un., ,r1116e }xnm ttcd ,da thnut furthsi +ppi's•i]i Ib~ :hpatux rat b Pl ~ilut n11~t calgily with all lire ul riot 1rd,=r it llisidpl alit tc tin'1 at i+m. ~ 7. 111 Sill Sha1L shall iraxl5l ~+t "clo=nl' gt,ivol and Soil (ml .rSpLalt, i', i .i, hr ~'L~n rnnc tc t. ~ .+r denLilrUon debris) i 8 I1 ie stora~,e of corsiructton sgminrnt e1 ~d r>ate1 ia15 shall be confined to WI then tln~ In Iss( wr,il sate and/or up]and areas greater th.n1 65 lnu>ar it distdlri ft cz[t Che Udil vol l,i al h,uu xiaiv I 9 F'r-LOr to the ul t.witr copal at tun of this lx'nnt ths• }x°nintttr wLl] caux +11 1111 and r~41~'•~ri I i,~ to be vegetated to pnve0t smslnn. - i I Suppl rnr=ntary SFx•~~al G~nd~UunS (A) their CI) at [ac tied l~,- - I , N~A I {~a~P JI_S______~ CHARLES T. HAMILTON Chief, hfarine Regulatory Section b1YSDEE, tsureau of Marine Habitat Protection 't31dg 40, SUNY, Room 225 Stony F3rook, N. Y. 11794 Iii:- Permit No Issued Ta. Contr..~toi's Name _ Contractor's Addicss Contractor's Phun~ No De. r Sir. Pursuant to General Condition Number 1 of lk+~ above, referenced ~~rm.it you .~i~~ hereby notified that the authorised activity sh41] ~ormnence on This notice is to be sent at least two da'. s in advance of cotnme ~cc.m~i~t of t}t~ project. TLc pennlt sign will be posted at the sit< and cepv of permit sill L+ availai,le at site fur inspection Submitted u~ Fall urn Lu notify vi pos[ Sign will leave owner ~nd~or cuntc ac t~~r ~uc~l~<t t+~ app7ic+„]~ p~n~+lrics for aun-compli,mce ~atli ~+<+n~L cnndttwn~ CHARLES 7. 1L1Pi1LTON Chief, Marine Regulatory Section NSSDEC, Sure<~u of '1._rir.e Hab~taL Psot~ctux. 131dg. 40, SUNY, Room 225 Stone L'roo4_, Y. ]1794 E, P~rm1L So. C. c.~itl ~ctu, ' i]~._, _ Cants ac Lor'ti Ph,• lluac Sic Pursuant to Cox rdl Cond itron Num6Er 1 07 the aLuve rei ate,n ed neat ~uu .~c< hrrrby not 7.L red th ~t U< uLliuri. ~d actr,i [ti ,._s rntrpl ~ts~ t t n~ t and dot wutr actor sub 7cct L~ ppl i<.~iJ. =<n alt ~<ti :ter no+, ~ pl :,ni, ~ i,lt }~ri rut ~o-+dzrions. a~~o~Erz o ~ ~ ~ CCS ~~o`u~~, > L cts Q ~ ~ - O O i C!) LL1 ~ O p ~ E O ~ ~ ~U O p cpu a~~ ~ _ ~ ctS cCS p O o E ~ ~ ~ C :L O U ~ ~ n C O O C~ O p~ Z ~ ~ Uo~~,vcn L - - ~ C~+-,~ = NLl1 v L C~ y-, x ~ ~ ~ i o cn O c~ 6 Z O v O~ C I ~ O C ~ ~ l' ~ arm, O C O cB ~ ~ O ~ ~ k~ ~ CCS c~ ~ a1 O ; r- N ~ O i C C ~ O) ~ ~ ~ ~ ~ ~ ~ Q ~ ~ ~ ~ Q ~ c ~ ~ G' O ~ ~ t'3 ~ 7 F- ~ 0 Q cn ~ s i f i ~ f t SVEFDGr~ qo,.. cD~ ~ s .r : ~ FRANK A KUJAWSKI, jR , President TELEPHONE ALBERT J KRUPSKI, JR , Vrce-President (516) 765.1892 JOHN M BREDEMEYER, III Off,' ~ ~ HENRY P SM TH KI, JR. y~o BOARD OF TOWiv TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P O Box 728 Southold, New York 11971 March 6, 1989 Robert Keith 253 Cold Spring Road Syosset, N.Y. 11791 Re: Application No. 8-88-123-10-2, Willis Creek Drive, Mattituck Dear Mr. Keith: The following action was taken by the Board of Town Trustees during their regular meeting held on February 28, 1989 regarding the above matter: WHEREAS, En-Consultants on behalf of Robert Keith applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated August 30, 1988 and WHEREAS said applacation was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and WHEREAS, a public hearing was held by the Town Trustees with respect to said application on February 28, 1989 at which time all interested persons were given an opportunity to be heard, and WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the Town, NOW, THEREFORE BE IT RESOLVED that $n-Consultants ON BEHALF OF Robert Keith BE AND HEREBY IS GRANTED PERMISSION UNDER THE WETLAND ORDINANCE TO: construct a single family dwelling, sanitary system, driveway and 475 cubic yards clean fill to be trucked in from an upland source. This permit will expire two years from the date it is signed if work has not commenced by said date. Fees must be paid and permit issued within six months of the date of this notification. Two inspections are required and the Trustees are to be notified upon completion of said project. Please take notice that this declaration should not be considered a determination made for any other department or agency which may also have an application pending for the same or similar project. Permit will be issued upon payment of the following fees: $10.00 Wetland Inspection fee Very truly yours, Frank A. Ku~awski, Jr. CQ'~~ President 1\ Board of Town Trusteea FAK:jas ce: Robert A. Greene, D.E.C., Stony Brook Bldg. Dept. G/ Conservation Advisory Council file 6 c~UFF~(J{C' TEL. 7G5-1802 00 , ooy TOWN OF SOUTIIOLD t? ~ OfTICE OP BUILDING INSPECTOR ~+y+ P.O. BOX 728 ~ TOWN HALL ~~0~ ~ ~a~t' SOUTHOLp, N.Y. 1 1971 July 24, 1990 PECONIC DEVELOPMENT CORP. BO% 594 MATTZTUCR, N.Y. 11952 RE: ROBERT & HELEN KEITH To Pihom This May Concern, We are unable to complete your Certificate of Occupancy because of the following reasons. An application for Certificate of Occupancy • is not on file. (ENCLOSED) No Underwriters Certificate on file. ~//-~Tlte check is (ffiffi8ffiII>{ffiffi%]dot on file. ) $25.00 ,//~No Ilcalth Dept. l:pproval on file. No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Buildi.nq Permit 1 7 9 0 7 Z Dut.ld~ Dept. / No Plumber Solclcr Certificate on file. ,1~ ( all permits involving plumbing being n tssucd after 11pri1 1,1984 ) ~vl ` FORM N0. 11 TOWIJ OF ~OUTHOLD SUILDIIvt3 DEPARTMk:NT TOWN fiALL SOUTfi0LI1, f1Y DEVELOPMf1~i'i' PERMIT No 1 ~ 8 F Date ~ 1 3 ly Yer.niasion is her©by granted to: t o L' o n) ~ e3C- 63 o N ~ ~ro-r,, ; / Y ~ w E f ni Gr at premiaea locatod ct ~I9s C.-t? ~ I(r's CJZ~""~ . ~ ~ uC~ County Tux Map No. 100() Saatiorz /a ~ Bloclc / ~ Lot ~ _ purauunt to applioation doted jVl ~ 19 ~9 , and approved by the Building Inal+ector. iuilding Peraait 2Iu.~ I~~o7 Z ~y iJ~c. Aim a~0~-,. ~._..~o_~. IIuildinR Inapoctor 1}/&J ~ • ~ " H FOUt7DATI0:1 ( 1st) ' i ~ ~ ~ Ter'' c FOUtdDATI0;1 ( 2nd ) a (95' O~ ~J.C ~/e..cv m - r ~ 2 . e` P,OUGH FFtAi~IE & ~1 /e PLUMBING ~ ~ 3. ~ z m c~ IIJSULATIOh1 PER N. Y. STATE ENERGY ' CODE I _ -a' ~ ~ h 4 . FI;IAIY I , 7 ~ o ADDITIONAL C Mh1ENTS: ~ x x H S a H H O Z m r H x v m m H _ _ _ t THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE: 1 l.l)g1071 BUREAU OF ELECTRICITY - 85 JOHN STREET, NEW YORK, NEWYORK 10038 Date NARCH 01,1990 APPlicationNo.onfile 63973989/89 N 116658 THIS CERTIFIES THAT - only the electricd equipment as described below and introduced by the applicant nomad on the abase application number is tA®pram7ses of RUDERT KEITH, MIILLIS CREt:K DR., POf.R.1ti, HA1"P1:TUCK, N.Y. in the olbwin location; ®Boaement GAR/OUT J R © Ixt Fl. ? Pnd Fl. .Section Block Lot rcos examined on FICBRI)ARY 01,1.990 and found Lu be in compliance with the reyuirernentx of thin Board. gxiWE RXTURES RANGES COOKING D[CRS OY DISN WASNRRS EXIUUST FANS v ACLES SWITCHES t tXITIMS INCANDESCENT FIVORESCEM OTNEP AMT. K. W. AMT. K. W.. AMT. K.W. NAT. K. W. AMT. N. P. ~ t;,; 3 88 61 2 1 10.2 1 1.2 B Y DRYERS WRNAC! MOTORS RITURE AM7IANCE Rl0lRS Sr[CIAL RECrT TIME CLOCKS pLL UNIT HEATERS MU114011T1ET gA1MERS e AMi. K. W. Oll N. P. GAS N. P. AMT. NO. A. W.O. AMi. AMP. AMT. AMPS: TRANS: AMT. N. P. t~ ~ AMT. WAffi i h r,• 1 14 6r1D SRRWCE DISCONNECT NO.OF S E R V I C E AMi. AMP. ME METER I $ nV 1 / 3W 10 JW 3 X AW NO. Of CC COND. A. W.O. NO.Or HbIEG A. W. G. ND. OP NEUTRALS A. W. FOUIY. PER 9 OP CC. COND. aF HI~U'.G aF NEVI~AL 1r,0 CB 1 X 2/0 2l/0 OTHER AP?ARATUS: r TUN ATR CUNDITIi)N iJNI'1'-I. - 1 /2 TUN AIR CUNDTTTUN UNIT' -1 - 3 1/2 TUN AIR CUNDITI;t>ti UNI'P-1 HO'PC1RS:1-F H.P.,1-°F H.Y.,1-F H.P„1-I+ H.F'.,'t_F' H.P. '."RAt'K I,IGHTTNG:--64 G & S C<1NTRACTUR LI:C.i~57$ 90X 215 SUUTHULD, NY, 11,971. ORNMA?~MRt4W!! 1.1 `v/ - Prr G~ This certificaM must not bs altered in any manner; rNurn to the office of the Board ii incorrect. InspeNors may be identified by their credeaNals. COPY FOR $UILDING DEPARTMENT. THIS COPY OF CERTI TE T NOT BE ALTERED IM AMY MAlr1ER. - n r TEL. 765-1802 ~~S~Ff~~Cp`? TOWN OF SO~JTIIOd.D " OFFICE OF IlUILDIt•IG INSPECTOR ~ ~ " ~ P.O. BO7{ 728 c°r ~ TOtiVN HALL "p l Y SOUTHOLD, N.Y. 11971 ~.b0 C E F2 T I F I C A T I~,c ,I3 " ~ ~ hl7V 2 t t~9lp ' •d~Tn^. Date y-U, Builda,ng Permit No.17gU!I Owner~}~o~~- ~,ei'4-~ (please print`) Plumber `(~'~rnGti YY1cShc.r~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1~ lead. , ` (plumber's signat(((~~ure) Sworn to before me this day of ~GJE»4~e~. 14~. Notary blic Crotary Public, v-tl ~ ~ K County ' JAMES J.CORC.ORAN NOFARY Na 2. 8~ 6 1NewYOrk QuaAifled in SuNoik Cour„f Canrniaeion £xpirea I~ip 18.'x.. SANSI ~ ~ 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [ FINAL REMARKS: DATE ' INSPECTOR C T65-1842 ` ` l BUILDING DEPT. lNSPECTt~N [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING f INAL R MARKS: DATE INSPECTOR 1 ~ 907 ~~-1802 BUILDING DEPT. INSi~ECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND INSULATION [ ]FRAMING / [ ]FINAL / REMARKS: ~i~~~ D~'K_~`*~ , r DATE ~ INSPECTOR y ~y ~/~i 765-1802 BUILDING DEPT.~~~~J .5-j~'""1r~7~ INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS: .~s~~d~ ~ (7.~ ~ ~ ~j DATE INSPECTORi/. reS-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND (]INSULATION [ ]FRAMING [ )FINAL REMARKS: a u/%Gt-~- < < s C~a~~-ILA- ~ 1 ~ ~ ~ r 'A` DATE INSPECTO r r `~^'I f a SUPPLEMEN'PARY SPECIAL COtJUI'I'1OPJS The Following condrtrons apply to ail peruuls• A. IE any of the pernut condilrons are unclear,lhe peunrttee shall con- tact the Uiv>sicn of Regulatory AECarrs at the address and telephone noted below. B. A copy of thrs permit wrth supplementary condru ons and approved plans shall be available at the protect site whenever authorized work is rn progress. C. The permrt sign enclosed with the permrt or a copy of letter of approval shall be protected from the weather and posted rn a con- spicuous locatron at the work srte until completion of authorrzed work. U. At least 4£3 hours prior to conunence¢renl of the protect, the permrttee shall complete and return the top portron of the enclosed cecerpl Corm certiLyrng that he rs fully aware o£ and understands all provisions and condrlrons of this permrt. Within one week of completron of the pe unitled work, the bottow portron of that Eo un shall also be cony pleted and returned. L. L'or protects rnw lvrny actrvitres to be accompirshed over a perrod of more than one y~•ar, the pernuttee shall notrfy the Regronal Pernut Adminrstrator rn wcrtrng at least 18 hours prror to the couuuencewent of resurrrptron of wor k each yeas . b'. IE protect desrgn nwdrLrcatrons take place after peunrt issuance, the permrttee shall subrnrt the approprrate plan chanyes for approval by the Regronal Pennrt Admrnrstrator pry or to undertakrng any such modr- frcations. 'Phe permrttee rs advised that subslantral modrfrcatron may require subinrssion of a new applrcatron for permrt. G. All necessary precautrons shall be taken to preclude contannnatron of any wetlands or waterway by suspended solyds, sedrment, Fuels, solvents, lubrrcants, epoxy coatrngs, parnts, concrete, leachate or any other envrronmentally deleterious materrals assocrated wrth the project wort. H. Any farlure to comply precrsely wrth all of the teens and condrtions of thrs permrt, unless authorized in wrrtrng, shall be treated as a vrolatron of the Environmental Conservalron Law. I. '1'he pennittee rs advrsed to obtarn any pernuts or approvals that may be requrred Erom the U S. Department of Army Corps of Engrneers, NY District, 26 federal Plaza, New York, NY 10218, (Attention: Regulatory Punclrons Branch), prror to conunencemen[ of wort, authorrzed herern. J. '1'he yranting cf thrs permrt does nut relreve thr permrttee of the resl~onsrbrlrty of obtarnrng a grant, easement, or other necessary approval from the Divisron of Land Ulrlrzatron, OfCrce uE General Servrces, `l'ower Burldrng, Emprre State Plaza, Albany, NY 12242, whrch may be reyurred for any encroaclnnent upon Slate-owned lands underwater. Regronal Pernul l,duunrslrator N'iS Dept of I:nvrronniental Conservalron Bldg. 40, SONY-k2oom 219 Stony Brook, NY 11794 (516) 751-7900 DEC # /J-Ij Page 3 of j Applicanntion Received Disapproval Issued Permit # 1~ 9 U ~ t2 C~cJh 7 19 ~9 19_ ~ . rQ, / 3 19 FORM NO. 10 APPLICATION FDR DEVELOPMENT PERMIT IN THE TOWN OF SOUTHOLD r a 19 ~ 9 1. 't'ype o= Development Proposea: 'true (including storage tanxs Addition and/or Alteration Floo Proof Below Base Flood Elevation Other (specify) 2. Elevation Data in relation to above mean sea level of: (a) Lowest floor elevation, including basement ~ feet o inches (b) In a V Zone, bottom of lowest structural member feet inches 3. FIRM--Flood Insurance Rate Map, Zo~n1e designations f~-~ 8 ~ O 4. Owner of Premises ~o ~L•~.~ 1!- ry E"~c~ 5. Location of Property: Q9~ W ./~~s C,e2~`~~ 1,~L. q i ~c L House # Street xamlet County Tax Map No., Dist. 1000, Section /d 3 Block / D Lot(s) 2 Subdivision ~A~(V~~~'W VE"TU7U~-ES Filed Map# Lot(s) 6. Permission to be granted: Owner as above New Owner Under C^on~tract Lessee Contractor ~ Phone ~~i~coN;c. ~~~s~o~M~7U~ Co~2p• ~I obi S~BI~ ~~c~ Name if not given above Mailing address 7. Approval from other(s) before Permit is issued: DEC Wetlands (Town Board) ~ Health Services 48- so-lo 3 ZBA Building Permit { 9 0'1 Planning Board 8. I, , the applicant, am the Owner Co-Owner ' New Owner Under Contract Lessee Agent Contractor and agree to comply with all applicable sections of the Code of the Town of Southold; County, and State and to admit authorized inspectors to premises 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 my knowledge and belief and that the w~ik will be performed in the manner set forth in the application filed therewith. STATE OF NEW YORK COUNTY OF SS Signature SWORN TO THIS DAY OF 19 Notary public Applicant's mailing address and phone # if not given above 11/85 FORM NO. 10 TOWN OF SOUTHOLD BUILDING DEPARTMENT (516) 765-1802 P.O. Box 728 Town Hall Southold, N.Y. 11971 Main Road Southold,N.Y. APPT,T{'ATTl1N F(1R T1F\TFT,(1PMFNT RFpM?T Instructions: The application to the Building Inspector includes (each in duplicate) 1. Form No. 10 filled out in ink or typewritten, 2. Sur- vey of premises with elevations above mean sea level, 3. Drawings of pro- posed work. The application must give complete information to show that the proposed can comply to the Local Law No. 1-1980, Chapter 46 of the Code of the Town of Southold known as "Flood Damage Prevention Law" of the Town of Southold. The applicant must submit approvals that any other agency requires. General Standards as required in Section 46-17 of the law to minimize flood damage: A. Anchoring of structures, including tanks and mobile homes B. Use of construction material and methods C. Design and location of utilities D. Subdivision proposal with drainage, public utilities design and base flood elevations Specific Standards as required in Section 46-18: A. Residential construction B. Non-residential construction C. Mobile homes The applicant must submit plans and specifications as well as any other information requested by the Building Inspector to substantiate the facts that the structure has or will have the lowest floor, including basement) cellar, elevated above the base flood elevation or; if permitted by the Federal Regulation, that: 1. such structure is flood proofed in such manner that below the base flood level the structure is water tight with walls substantially and impermeable to the passage of water, 2. that structural components are capable to resisting hydrostatic and hydrodynamic loads and effects of buoyancy, 3. applicant must submit certification by a registered professional engineer or architect that the standards set forth in Section 46-18B (1) (2) (3) of the Southold Code are satisfied. Coastal High Hazard area (V Zone) 46-19. Applicant shall submit plans, specifications including the required certifications and such other in- formation as the Building Inspector may require in that the provisions of 46-19 are complied with. Mobile homes are prohibited. The lowest portion of the structural members of the lowest floor cannot be lower than the base flood elevation with all space below open except breakaway walls. Sand Dunes. I£ sand dunes exist on the premises and the applicant pro- poses to alter same, plans and specification must be shown in detailed nature of any alteration submitted. Building Permit. A Building Permit is also required for any structure. Both a Development and a Building Permit must be issued before any work can start in a special flood hazard zone. A written disapproval or a permit must be issued within ten (10) working days. During construction, the inspector shall be notified in time so he may make the required inspections. Upon completion, the required certification of the final elevations and work must be submitted before the approval to use or occupy can be approved. (Fill out the form on the back of this sheet) 11/85 1 Q2~ Q~ ~P m O WATER MAIN '`VW ' O ' ~~P / ~ V ~o o ~ o i ~ ~ 12' DRAINAGE EASEMENT v ~ ~ f ~ I ~ ~ R~ / , _ ~ ~ ~ R=60~ / o ~ F 1N I Y. I v N I LDt I5 IGS zgo 0 5o aVQ 26` ~ 35~~ ap Lot I7 ~s N o i .~o y¢ O o f t JfNOP ~ i e ~O. p ° e E~' I h O Pp F N 56 Zed W O ~ i Lot 16 o Area=42783sf Q CV O I m gym. 2 IN 1 m. I ~ l ~4T O~~Oa i I t 1 weTtAN '`N gy09 N~~OX28"w \ OS S~3e2~48 AF^ oz x~w M X93 ~ DEEP HOLE CREEK or !ylL L /S CREEK SURVEY FOR rAna~ ~;is~s ROBERT W, KE17H & HELEN W. KEITH JAN 3o,lsas SEPT 23, 1988 LOT N0. t6 'HARBOR VIEW AT MAT7ITUCK~I JuI.Y 20 1988 JUNE 2~,L988 AT MATT{TUCK DarE DEC z3,lsa~ TDWN OF 30UTHOLD staLE I"=so' SUFFOLK COUNTY, NEW YORK No e7-laeo N UNAU THOR12E0 ALTERATION OR ADDITION co TH~s GUARANTEED T SVRVEY R A VIOLATION Of SECTION 7109 Of THE ROBERT I'RF flV N W KEITH NEw roRR srAre CDUCATION LAw CENTU ~ '~p ORATION R CO?I E3 OF TNIS SURVEY NOT ~EARWG THE lAMO CHIC O .~y 1r'Q N6U Y COMPANY SUR VE YOR~S INItEtl SEAL OR ENSOSSED SEAL SHALL MOT CONtID ERCD TD tE A VALID TRUE COVV 0 Y(n II •~YTKt Wno-~~fD NEREON SHLLL RUN WI V 10 ~ 'FORM NO. 1 G a~.~ ,~Q.a.«, ly...,< • ~ ~ ~y~~ i TOWN OF SOUTHOLD F~~aG~e~a. l BUILDING DEPARTMENT TOWN HALL ~e~~-G ° 701NNLUF S4JTN!;Lr' SOUTHOLD, N.Y. 11977 ~E,e °'°"°'°"C ~ n TEL.: 765.1802 Tn.~~a Examined ~0:~:~? . 19 Received........... , 19 Approved ~ on ~ ~.3. , 19 $ 9 Permit No. 1 ~ cj ° ~ ~ Disapproved a/c '~y?~ ~ . r..cp.... . ; . a Q~ S4Y~ ~ ~ ~ f acs-,*-,-~. (Building Inspector) APPLICATION FOR BUILDING PERMIT ~ ~ Date ]9 INSTRUCTIONS a. Tlus application must be completely filled m by typewriter or in ink and submitted to the Building Inspector, wig ' sets of plans, accurate plot plan to scale. Fee according to schedule. _ b. Plot plan showing locatron of lot and of build'vigs on premises, relationship to adloming premises or public str. or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this aF cation. c. The work covered by t}us application may not be commenced before issuance of Building Permrt. d. Upon approval of this application, the Building Inspector will Issued a Building Permit to the applicant. Suc}t pei shall be kept on the premises available for inspection throughout the work. e. No building shall be occupred or used rn whole or in part for any purpose whatever untrl a Certificate of Occupa, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Depaztment for the issuance of a Building Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance Regulations, for the construction of buildings, addtt~ons or alterations, or for removal or demolition, as herein descnb The applicant agrees to comply with all applwable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and m burlding for necessary inspections. (Signature of applicant, or name, if a corpo{anon) (Mailing address of applicant) i {R~~ State whether applicant is owner, Lesse a ent architect, engineer, general contractor, etectricuin, plumber or build Name of owner of prem~ses~~~ct.'.~T tl~!. 4C~r~"~ ~ ~~~-~'~?..K~t-r-E-4 . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builder's License No. ~~~i't~~U~~ry ~.j ~.y ~ N,L~E e(~ ~c~o ; +c^w*~ Plumber's License No. . Electrician's License No . R ~ . Other Trade's License No . . I. Location of land on which proposed work will be done . . .............r1. `~:5..... ~!{G(,/s C~~K ~~?U~c..........M.!~T/'/TUCK(!............... . , House Number Street Hamlet County Tax Map No. 1000 Section l Block .....~b . Lot .4,~ Subdivision.~.~~~~i...yl~~.A~.m~'/.~T~-'FiledMa No. Lot..~!.tP p (Name) ' 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction• a. Existing use and occupancy . b. Intended use and occupancy ~i~ti1.-~...~~.~,I,~, 3. Nature of work (check which applicable) }S1tt1 4utt-bang ..J.~'.. .uon Alteratian . Repair . Removal Demolition Other Work . ~ ('~escnphon} 4 Estimated Cost ~'+5 . Fee ' (to be paid on filing this application) 5. If dwelling, number of dwelling unit Number of dwelling units on each floor . ~ If garage, number of cars ~j . 6 If business, commercial or mixed occupancy, specify nature and extent of each type of uss . Dimensions of existing structures, if any• Front Rear Depth . Height ...............Numberof5tories............... Dmensions of same structure with alterations or additions: Front Rear . Depth ......................Height Nuiil„berrof tories 8. Dimensions of entire new construction: Front .....~,~.t.~~~ Rear ....a Depth ~ C~)..... . Height Number of Stones ~I~.ST~P.K-1'.... , ~ y. 9. Size of lot: Front ......~A.i~~ Rear a,~i.~~~. Depth ...~~o. , , , . 10. Date of Purchase .........Name of Former Owner . 11. Zone or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation• , .w-:,-. . I3. Will ]ot be regraded .......~~5 . .Will excess fill be removed from premises. Yes No . a Name of Owner of premises ...Address .......Phone No............... . Name of Architect ...........................Address ...................Phone Na.......... , . Name of Contractor . .Address , .Phone No............. , . . PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from iroperty lines. Give street and block number or description according to deed, and show street names and indicate whether ntenor or corner lot. TATS OF NEW YORK, S.S OUN1'Y OF . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ~uve namea. eisthe (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authonzed to perform or have performed the said work and to make and file this placation; that all statements contained in this application are true to the best of his knowledge and belief; and that the irk will be performed in the manner set forth in file application filed therewith , +orn to before mehthis nary Public, 4 . /1 ~D~--..... Courdy~ HELEN iC DE VOE NOTARY PUBLIC, state of New York (Signature of applicant) No 4767878,SaftotkCaunty~9 Term Lxpues M:rch 3D,19~.- uU $ ~ ~I . ~ 4 ~ry~ i • ~ ~ I~ Qf C~ I ~ r ~ u i ~ ~ '~.7 Jttyy Z Q g~G{ Q WATER MAIN / ~ h~ O / VJ o I ~ ~ 12' DRAINAGE EASEMENT v ~ ~ ply` o R_6pCA / X. I~ \i `AO; I" to I 4z5. N La, ~,~'-OL~s. 4 Qb, i 61 ~6~54 gyp,}~; ~ q` , a 1 9Z aj Lot 15 15's' ' ~ 35%' Lot 17 ? pD ~ > e 2~ s P~µ P e ~f7. 0 ~ Pv `gt1~9A~2C O y N y7, yW D aECa N- - ~1> a n 15 4 pT~k 240 41 > tQ O a li Lot 16 o 'Area=42783sf n _N ' O 1 D 2 t ~ la t LqN 1 ~ rr0~ 4N08 II I WFTLgNDS 9g09 N7gaOX28 ~ S73 A PRO% H~W M t93 DEEP HOLE CREEK or ly/L L /S C/-~EEK 8 ~ ~ lO ~ NOV I,198S _ _ SURVEY FOR MAR ',I SUFFOLK COUNTY DEPARTMFPST GF H: e , . ROBERT W. KEITH & HELEN W. KEITH sEPr2;'i988 SINGLE FAMItY DWELU~fG u^7 r LOT N0. 16 °HARBOR VIEW AT MATTITUCK~~ JULY w leas U j 03 JUNE 2~, I988 DATt`~sU iG~il REF NO AT MATTITUCK DATE DEC 23,1987 The sewagedtsposafandwatersuppfy~~=l~ ~ TOWN OF SOUTHOLD SCALE I"=so' bCatwn have bee, Inspected by this G°:.,~I , . - SUFFOLK COUNTY, NEW YORK No 97- laao pttler agencle`"~~}~R~I f07{~1n~d tD(y`{y' .,2tl~taCiG1,' Y' ~ N uwUTN0111ZE0 ALTERATION OR ADDITION 10 MIS GUARANTEED TO ^•On>n3Y SURVEY M A VIOLATION Of SCCTION 7209 OF TNC ROBERT W KEITH & HELEN W KEITH Ch1ef of Qurc YJa..te*'1" ' NEw YORK STATE EDUCATION LAW CENTURY ABSTRACT CORPGRATION K coPl ES OF Mls sU11v Er NOT fEARwO rNE LAND CHICAGO TITLE INSURANCE COMPANY SUR VE YOR'3 INKED PEAL OR EM\OSSED SEAL SNALL MOT CON SIDE RED TO \E A VALID TRUE COPY N GUARANTEES INOICA TEO NER[OM SNALL RUN ONLY TO HEALTH DEPARTMENT-047A FOR APPROM4L 70 CONSTRUCT T~ PERSON FOR WHOM TNf SURVEY IS PREPARED Sf Of NEW /I ANO 011 HIS \EIU1Lf 10 THE TITLE COMPANY, GOVERN- .~P F- N NEARElT WAT[R \AIN EMI S NSOURCE OF 'MATER PRIMITE ~?U\LIC i MENTAL AGENCY ANO ECHOING INS itTU7i ON Lt STfO S O N SUFF CO, TA%MA? pfT IDOO SFC TION JZ1_ flacK _LG_ L07 HEREON, AND TO ME ASf I9NE[S OF THE LENOINB O~'•~D W yoG g'1' N M[R[ ARC NO OWELLIN\f WITHIN 100 FEET OF TNIf PROPERTY INSTITUTION 6UARANT[ES ARE NOT TRAM SFERA \LE TO ADD1710NAL INSTITUTIONS OR SUfSEQUlNT OTHER THAN THOSE SHOWN HEREON S = N TNC wATCR 3UPPLY AND fE11MfE DIfPOfAL SYSTEM FOR MIS RO10[NC[ * DMST NOES SHOf/N HEREON FROM PROIERiY LIMES ~ WILL CONFORM M THE STANDARDf OF TNF SUFFOLK COUNTY DEPARTN[NT TOE%ISTIN6 STRUCTURCS ARE fOR A 3?fCIfIC M ~ ~ OF NGLTN fERVIC[f FUR P03E AND ARE NOT TO \E USED TO ESTA¦LIfN ARLICANi ~~,QEQ~ fl .IiI C y(~,.r.l, PROPERTY LINES OR FOR THE ERECTION Of FENCEf A0011Efi qq 5- W til ~g CK S~k ~n Fr a, 3 ~~,~y• Ili ~Lcc.:~~`M~•a~~9-~ YOUNG a YOUNG ~ I~ EW YOR: NOTE ! :MONUMENT ALDEN W YDUNG,PROFESSIONAL ENGINEER SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON AU G, 21,1887 AND LANG SURVEYOR N YS LICENSE NO 12845 A$ FILE NO 8377 HOWARD W YOUNG, LAND SURVEYOR N 711E LOCATI011 OF WELUW),fEPTIC TANKISTI\CEffP00LS(CPt fNONN HEREON N Y S LICENSE NO 4Sa93 ARE FROM FItLD OpERWTN7Nf AND OR DATA O\TYMED FROM OTN[Rf BAANDIS A SONS INC. Q~ rJ Q~ ~Q m p WATER MAIN ~ . ~~Q ~o o ~ o I J ~ 12 DRAINAGE EASEMENT v _ \ ~ J \ ~ p`'Q` ~ ~ - cSI R=60~ / o ~ n~ k 9 u~ jr/ N II ~ I LOt 15 IG s~ ° av H To ~ ~5:' eA LOt 17 0 2 c NOp~\ WO. O 40JfNO > ~ ry ~ ~V O Pp ar N se o 2A6 0 w li Lot 16 0 1 Area=42783sf. ~Q N I O I ~ A~. 2 1;, 1 1 , 1 , ~gT~NDi 11 1 WeTLgryDS .p2t`~~ g609 N~~28`tiV CJ?7 IE LINE AAANG J~pp..~~ APPRO% H W M "G` v e DEEP HOLE CREEK o~ WlL L lS CREEK SURVE`! FOR MA ,i RO~~RT 1N. KEITH & HELEN W. KEITH JAN 30,1989 S E PT 23,1986 LOT NO 16 "HARBOR VIEW AT NIATTITUCK" JULY 20 1988 JUNE 27*,L988 AT MATTiTUCK DATE DEC 23,1987 TOWN OF 30UTHOLD St ALE I"e50' SUFFOLK COUNTY, NEW YORK No 87-I46o Y U/MUTNORIZED ALTERA 710M OR ADDI710N TO TIIS GUARANTEED T fullv[r a A v10LAnoN OF f[cnoN 7109 OF THE ROBERT kRF` ~1 N W KEITH NEW TORN fTATE EDUCATION LAW CENTU ORATION NCO?1 ES aF THI3 SURVEY N07 iEARWG TXC LAND CHIC O LQ EtN4{/ COMPANY SUR VE TOR'S INKED SEAL OR ENiOSSEO SEAL SHALL ~ T~" ',G~* NOT i[ CONi10LRE0 TO iE A VALID TRUE COPY ~ N GUARANT[[; INOIGTCD X[REON SMALL RUN ONLY TO HEALTH DEPARTMENT-DATA FOR APPROWU_ TO CONSTRUCT T~ PERSON roR WHOM THE SURVEY IS PREPAR[O ) IMO ON HIS iE111 LF TO THE TITLE COMPANY, GOVERN- O N NEAR[Si WAT[lt r111N.NI ' NSOURCC OF WATERS MIWITF ~PUiIIC .Y. MENTAL AGENCY AND IENOWG INSTITUTION LISTED ~ N f4FF C0 TAX NAI OIfT mDb fCCT10N 123 MOCK J.O..-LOT ,T ~ HEREON, ANO TO THE ASfIBN EES OF iNE LENDING R TN[IIC ARC MO pWLLLNMf WITXIN 100 FFCT OF TMf PRO?[RTY WSTIiUTld1 GUARANTCES ARE NOT TRANSFERA iLE OTHCR TXAN TXOfE fMOWN X[RLON TO ADDITIONAL INSTITUTIONS OR SUiSEOUENT ~jy M TN[ YYET[R fUPFLY A/RJ fLWAi[ Df[POLAL SYiT'[M FOR THIS ROIbENCF 10, DMSTANCE3 SXOWN HLREON FROM PROPERTY LINI!S ~ 4b89~ WILL CWFORM TO T/IF STANDARDf OF TN[ SUFFOLK COUNTY DEPARTMLNT TO [x IfTINi fTRUC TURCf ME FOR A S?ECIFIC ~O O~ O? NGLTN f[RVICLf PURPOS[ AND ARE NOT TO BE USED TO ESTA[LIfN (AND $URVE'~ APPLtGNT. PROPERTY LINES OR FOR THE ERECTION OF fENCEf AOOR[ 6 "L YOUNG & YOUNG'`°~~E~"~w roR E NOT ¦ =MONUMENT SUBDIVISION MAP FILED IN THE OFFICE OF THE ALOEN WYOUNG,PROFESSIONAL ENGINEER CLERK OF SUFFOtN COUNTY ON AU 8.21,!987 AND LAND SURVEYOR N Y.S LICENSE NO 12843 0.8 FILE NO 8377. HOWARD W YOUNG, LANG SURVEYOR r Tr[ LOCJTTIGN OF W6L(W)sp[1TIC TANK(fT)i QifPOa-iK•TI M101FM NpHpf N Y S LICEMS E NO 45843 ARC FROM FS[LD OMLRMTIONf AMO OR DATA /MTNN[D FROM OTHERS Ty BRNfDIi i fONi iNC ~ rl k ~ h (c. Nr.7 `V~~. [~joaa ~ E C.~t-I4~ GtzaA:J:. Spy °.>te.~: r d' Q" d t, g'-Q" ~~G Z~l ~Q ` F~V~o n 'r--- ~ ~ (3c~-..~ Psi ca~c;~ (2)1~ 5 des ~ - - , ?,4ux i2~ c~~,T, i RC,o~a~ Ffi~a. Ini1Lw.~i-^P F-re~ w. .