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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22332 Date MAY 17, 1993
THIS CERTIFIES that the building ADDITION
Location of Property 410 AIRWAY DRIVE MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 123 Block 1 Lot -2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 15, 1990 pursuant to which
Building Permit No. 19567-Z dated DECEMBER 7, 1990
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is ADDITION TO HANGER FOR STORAGE & TESTING PURPOSES
The certificate is issued to J. PARKER WICKHAM
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. H-034284 - APRIL 12, 1993
PLUMBERS CERTIFICATION DATED N/A
* THIS CO IS FOR THE OUTSIDE SHELL ONLY. BUILDING NOT TO BE USED
UNTIL A NEW BUILDING PERMIT TO FINISH INSIDE IS ISSUED.
~
Building Inspector
FORM NO. S
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)
N2 1 9 5 6 7 Z Date Wis. 19.19
Permission is hereby granted to:
. -Q-.
r..-
to ...C c r 1 e`!?.... .....75f Rs~ ` . ~ r.
.....D............
at premises located at .....`~~.......L,'t~!'~ .....Y~..'4r~il Cam......
X'..1...... i r-4 ...1.,1,?. s.....
County Tax Ma No. 1000 Section a Block 5;?.!.......... Lot No....
to application dated ..O. ......L-5 191A., and approved by the
Building Inspector.
Fee 5..° B
Building Inspector
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 OF, ink and submitted to the building
inspector with the following: for new building or new use:
1. Final survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 17 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 Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15..0/0, Commercial $15.00
5!i ~L ~iU~ y Date ...J~..1 .G
New Construction... 14...... Old Or Pre-existing Building
/
Location of Property ....'7E~1'.C.?~r:, liy7.T.(/.,7 0 ,
House No... /Street
,y~ Hamlet
~
Onwer or Owners of Property....-:7.%..
V!.:
2 /
County Tax Map No 1000, Section Block .....Q f .......Lot.... Q d 2-.r
Subdivision........// ................................Fi/lled Map........../...Lot......................
Permit Nolq 1. ~`P7.~t..Date Of Permit. J z.~~•[ 7•Q ..Applicant./J.~
Health Dept. Approval ..........................Underwriters Approval.. ~<~.z...,.......
Planning Board Approval --xx//
Request for: Temporary Certificate........... Final Certicate..J..1r... ON %I
Fee Submitted: $ / c
zc , 4 S9 .S"
C O 2'n ~ ~ APPLICANT
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
8939544 BUREAU OF ELECTRICITY -
88 JOHN STREET. NEW YORK. NEW YORK 10038
Date APRIL 12,1993 Application No. on file 04311493193 H 034284
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application mswtber in thepramiset of
MATTITUCK AIRBASE,INC., AIRWAY DRIVE, MATTITUCK, N.Y.
in thefollowinR location; ? Beesment ® w n ? Ynd Fl. Section Block Lot
was examined on MARCH 2 9 , 19 9 3 and found to be in compliance with the National Electrical Code.
MIXTURE RX UN OM COOIaNDDECES OVENS DBN WAfBNRS EXHAUST FANS
tWTIRTS ACS ~YITQ~ INGNOESCEM PlUpESCTNT OTHEIN'4 W. K. W. AMT. K. W. AMT. K.W. AMT. K. W. NAT. X. P.
t'
11OWYERS RJRNACE MOTORS NITUM AIKIANCE PIPERS SMCIAI UC'Ff TIME CUKX5 NU UNIT HEATERS AItATI:L% 1 WAVMRS
'V NAT. K. W. Olt K F. aA5 H. P. AMT. NO. A. W. a. AMT. AW. AMT. AAVS. TRANS. AMT. H. F. NO.p t~T AMT. WAM
Snvia DISCONNECT NO.O/ S E R V 1 C E
AMT. Me. Trn 1 A tw 1 / 3W ]\M t,I ~W ~ItlctCeCOnN. OF Ar.. O. NO. OF HHEG Oi X & ,A. W WWRAet 01
OTMiR APPARATUS:
DEFECTS REMOVED LETTER OF 12-10-84-1
AIRCRAFT HANGER-1
HATTITUCK AIRBAS6,INC 4w,
.
AIRWAY DRIVE
MATTITUCK, NY, 11952 ~,,,4 ''~RAAEIMY
Per.
This certificate must not be *bored in airy manner; return to the office of the Board if incorrect. trapoclors any be idAatifled by their credentials.
COPY FOR BUILDMIG DEPARTMENT. TARS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
BOARD OF HEALTH
3 SETS OF PLANS
FORM NO.1 SURVEY
TOWN OF SOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL
$OUTHOLD, N.Y. 11971 NOTIFY I
TEL.: 7G5-1802 CALL
J ^ 7 19y9 MAIL T0:
Exam ine~d~
;approved lJRaAat\k4t..7.., 199. Permit No. 1.9.7. ~4
Disapproved a/c
(Building Inspector)
APPLICATION FOR BUILDING PERMIT /
Date 15~~.
INSTRUCTIONS
3. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
of plans, accurate plot plan t&scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
cas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
;.on.
The work covered by this application may not be commenced before issuance of Building Permit.
Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
be kept on the premises available for inspection throughout the work.
No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
..:::ave been granted by the Building Inspector.
PLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Lone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
!:ons. for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
itcant agrees to comply with all applicable laws, ordinances, building code, housim: code, and regulations, and to
=stt:orized inspectors on premises and in building for necessary inspections.
i i . l. u? ..+4SG J N G,
(Signatures of applicant, or name, if a corporation)
...........gV? A.Y.. f.> !1I tK(~ y'.
(Mailing address of applicant) ~rss 2-
.:.ether applicant is caner, Ies e, agent, architect, engineer, general contractor, electrician, plumber or builder.
..........................................'...J...............................................
i owner of premises .A/~~~Fl~...4G!(C .
(as on the tax roll or latest deed)
-nr is a co o atio , si ature of duly a orized officer.
(Na e a d title of corporate officer)
L-O /J6~e2e2{L ?yQ S G~~~i ~c-, C,C) ` 4 I"-
.'Jet's License No.
rnber's License No .
--:rician's License No . .
.:':er Trade's License No .
tion of land on which proposed work will be done;
...`7..........!(!Gt~Q,Y..~~:... f~t'(TiTL^C/L,s..rt!•.:.....
i.•use Number Street Hamlet
_unty Tax ,Mip No. 1000 Section .....3........ Block 1n./............ Lot ...c`7~:
-,bdivisi Filed Map No. Lot
(Name)
-'ate existing use and occupancy of premises and intended use and occupancy of proposed construction:
A. Existing use and occupancy HtTI
8. Intended use and occupancy lr7z/Z • p5.F • . AV L D i I....... X . `/.q
Nature'of work (check which applicable): New Building
Repair/Additicn Alteration .
Tennis Court . ' ' ' ' . Rpmoval , , , , , , , , , , Demolition .Swimning pool.
Accessory Building Fence Estimated Cost .a.'p a-o"Q Other Work .
Fee . l.o~.?~..
If dwcllin~ (to be paid on Filing this application)
number of dwelling units Number of dwelling units on each floor .
If garage, number of cars
If business, commercial or mixed occupancy, specify nature and extent of each t e of use
l
Dimensions of existing structures, if any: Front . YP
Hci=ttt Rear Depth .
• • • • Number of Stories . . .
Dimensions of same structure with alterations or additions: Front
Depth . Height . Rear .
Dimensions of entire new construction: Front ' ' • • • Number of Stories .
Height y Nuf SI ries . Rear Depth
1 *N $ /,/,Z1
Size of lot: Front • • - • - .
Date of Purchase /gC.'Q. ~ Rear Depth , .
7RV. ,Fpry/~ Name of Former Owner
Zone or use district in which premises are situated
Does proposed construction violate any zoning law, ordinance or regulation: NO
Will lot be regraded WO . Will excess fill be removed from premises: Yes
Name of Owner of premises sfr t No
Name of Architect k/r~lCi~lA Address ..{'41 ~7PQy -e , , , , , Phone No. ~ Fzf (
Name of Contractor L.Qt~-~,~?~T; cL Nai • - ' ' ' ' • Address . ................Phone No...
S.Is this ~-Address .~QA?, f+~-)A-Q..... Phone No...7(C p -/q~(~ +
property loc4tted within 300 feet of a tidal wetland? *YES NOy
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly.all buildings, whether existing or proposed, and. indicate all set-back dimensions from
operty lines. Give street and block number or description according to deed, and show street names and indicate whether
tenor or comer lot.
-ATE OF NEW Y
)UNTY OF [ S.S
(Name of individual signing contract) being duly sworn, deposes and says that he is the applicant
ovc named.
is the O-O vf Qe~
. Br`-
tractor
(Con
said owner or owners, and is dui + gent, corporate officer, etc.)
tlication: that all statements contained in authorized
cation are ttr ave ed the said work and to me and fi this
a to the b st of his knowledge and belief; and hat the
rk will be perforated in the manner set forth in the application filed therewith.
om to before me this w
........day of.. G 19.1~.~
'arY Public.
County
VtRONICA C. TABORSKY
NOTARY PUBLIC, State of New York
No. 52.4519999 Suffolk Courttlr '
Commission Expires Nov®mb8r 3Q . • .
(Signature of applicant)
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\ j pCCUPANU~ UR ~UL APPROVED AS flOTff3 o t q f
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US DisTUCE IT FICATE DATE -U a &P a 195~~ „ ~.•~~y ~s~Ai~ y ~ -gyp Mavff ~o
WIT O~OC`.uPANC+y FEE: BY ~..~Y~ + ya 3n oA. 032254-1 hatl
NOTIFY BUILDING DEPARTMENT AT 765-1802 R AM TO 4 PM FOR THE DPgOFE55\OH~e
DIY FOLLOWING INSPECTfONS PuMgING
U MSM~4 k 604 P• 1
1 _ 1. FOUNDATION - ALL PLUM Uf FOR POURED CONCRETE REQUIRED
_ 2. ROUGH - FRAMING & PLUMBING _ &V*lEA bow ~p To Lma B ED:IJl--f IV Nop
- 3. INSULATION 'TESTNO BQpECO'rt~ 4. FINAL - CONSTRUCTION MUST _
BE COMPLETE FOR C.0-'
ALL CONSTRUCTION SHALL-MEET
THE REQUIREMENTS OF THE N.Y. .eW ys ,a 96
STATE CONSTRUCTION & ENERGY KK^^,, su . APPROVED &Y aee x
CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS EE ORE O&Q OF OCCUPANCY Pt. REVISED
SWLqEg)lNWATER
CANIW7
Info" Puw WARNER
0/10 OP t% LEAD.