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Home My WebLink About44548-Z �4\pSUFF°�'�COGy, Town of Southold 9/4/2020 y P.O.Box 1179 o S{ 53095 Main Rd 4% �ap�it+li Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 41390 Date: 8/29/2020 THIS CERTIFIES that the building COMMERCIAL ALTERATION Location of Property: 10095 Route 25, Mattituck SCTM#: 473889 Sec/Block/Lot: 142.4-26 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/25/2019 pursuant to which Building Permit No. 44548 dated 12/20/2019 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: alterations to an existing commercial unit(restaurant-Lucharitos)as applied for. The certificate is issued to Mattituck Plaza LLC of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 20-66478 8/21/2020 PLUMBERS CERTIFICATION DATED 8/9/2020 B lumbing YTeating Inc A d Signature �guFFo1,� TOWN OF SOUTHOLD CAP BUILDING DEPARTMENT TOWN CLERK'S OFFICE "� • SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 44548 Date: 12/20/2019 Permission is hereby granted to: Mattituck Plaza LLC PO BOX 77 Mattituck, NY 11952 To: make alterations to an existing commercial unit (restaurant - Lucharitos) as applied for. At premises located at: 10095 Route 25, Mattituck SCTM #473889 Sec/Block/Lot# 142.4-26 Pursuant to application dated 11/25/2019 and approved by the Building Inspector. To expire on 6/20/2021. Fees: COMMERCIAL ADDITION/ALTERATION $426.80 CO-C IAL $50.00 Tota $476.80 Building Inspector Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following. A. For new building or new use: 1. Final survey of property with accurate location of all buildings,property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. 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 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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy- $25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00 Date. New Construction: IV/� Old or Pre-existingBuilding:g: (check one) Location of Property: f ex)I�� n g:V aj #(�- I l��Y1' �- \�%� House No. (� Street Hamlet Owner or Owners of Property: l Gtcj�l,i,ll1 y C1-fwy (L-( 2- Suffolk County Tax Map No 1000, Section Block �` Lot Z� Subdivision Filed Map. Lot: Permit No "1 Date of Permit. Applicant:_ M(�((_ f'�of Health Dept Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final Certificate: I/ (check one) Fee Submitted: $ 5V Ap icant Signat 1 Certificate of Compliance L� V CERTIFIED ELECTRICAL INSPECTIONS, INC. 188 PARK AVENUE X02® AMITYVILLE, NY 11701 pVG P: (631) 598-5610 CERTIFIES THAT Upon the application of Upon premises owned by vz Lucharito's Lucharito's 10095 Main Road 10095 Main Road Mattituck, NY 11952 Mattituck, NY 11952 Located at: 10095 Main Road, Mattituck, NY 11952 Application Number#:20-66478 Certificate#: 20-66478 Electrical License#: Section: Block: Lot: Building Permit#: 44548 Described as a Commercial occupancy,wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Interior Renovation-Restaurant J A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein,was conducted in accordance with the requirements of the applicable code/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 21st day of August 2020 Name QTY GFI Receptacle-20 Amp, 120V 14 Comb Emerg/Exit- 15 Amp, 120V 2 Switch-20 Amp; 120V 4 Exit= 15 Amp, 120V 1 Duplex Receptacle-15 Amp, 120V 4 Incand. Fixture- 15 Amp, 120V 14 Paddle Fan-15 Amp, 120V 2 Exhaust Hood- 15 Amp, 120V 1 Electrical Inspector:Anthony Giordano �"Aa APPROVED This certificate is not valid unless raised seal is present. Certificate of Compliance CERTIFIED ELECTRICAL INSPECTIONS, INC. 188 PARK AVENUE AMITYVILLE, NY 11701 P: (631) 698-6610 CERTIFIES THAT Upon the application of Upon premises owned by Lucharito's Lucharito's 10095 Main Road 10095 Main Road Mattituck, NY 11952 Mattituck, NY 11952 Located at: 10095 Main Road, Mattituck, NY 11952 Application Number#:20-66478 Certificate#: 20-66478 Electrical License#: Section: Block: Lot: Building Permit#: 44548 Name QTY Emergency Light- 15 Amp, 120V 2 Electrical Inspector:Anthony Giordano • ��4APPROVED�o_ _ This certificate is not valid unless raised seal is present. D COAL D A UG 2 4 2020 3UMD1WC DEPT. Tov',w C'TT H01X K- OF SOGTyOIo 1 5L4 1 o o g 5 - # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ } FIRE SAFETY INSPECTION- [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ed ELECTRICAL- (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: DATE INSPECTOR ---- # # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPEC ION [ ] FOUNDATION 1ST [ ROUGH,PLBG. [ ] FOUNDATION 2ND - [ ] INSULATION/CAULKING [ -FRAMI STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY-' [ ] ,FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION ' [ ] FIRE RESISTANT PENETRATION - [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: wit k (wi Tim r DATE INSPECTOR OESOGTyO * * TOWN OF SOUTHOLD-BUILDING DEPT. 765-1802 t INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ]' FRAMING /STRAPPING FINAL [ ] FIREPLACE & CHIMNEY , FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION= [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: F 2p�gLa�- a N 4- ,,E-gag owl AA)q)L DATE5- ' INSPECTOR OF SOOj lq2 - 1- 2-6 hoy�� Hp� �✓! J # TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION 1�qy [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [' ] -INSULATION/CAULKING [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY : ��J FIRE SAFETY INSPECTION- [ ]_ FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ["= ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: �� DATE �7217 &) INSPECTOR of soulyo6 # TOWN OF SOUTHOLD BUILDING DEPT. °`ycomm '' 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ` [ ] FOUNDATION"2ND [ ]- INSULATIOWCAULKING [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: Ste' DATE �� INSPECTOR SOGIyo<o TOWN OF SOUTHOLD BUILDING DEPT. - �o,rm��'� 765-1802 INSPECTION � [ ] FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] SULATION/CAULKING ] FRAMING /STRAPPING FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION j ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: O.q c ' .4jjj� ��Wo G I,� re. DATE INSPECTOR I rnNL. ew» S 4 d r S ie- ik �-Y� l .. I - 7r y G4 ��., ,, .;. - ; r�� ;. ,.: \ .,+ . .__ _' __P, , P �,,+ ..�,i { 4 ^ - `. a� � �, ,kt _ t .� .� � �. � . Food Establishment Inspection Report Suffolk County Department of Health Services Page 1 of 2 360 Yaphank Avenue Suite 2A Yaphank,NY 11980 Date: 04/30/2020 631-852-5999 www.suffolkcountyny.gov/heafth Establishment Name Establishment Address City/State Zip Code Telephone LUCHARITOS BURRITO BAR 10095 MAIN RD UNIT 15 MATTITUCK,NY 11952 Facility ID# Permit Holder Purpose of Inspection Inspection Result FA0002414 LUCHARITOS BURRITO BAR INC Premise/Facility Inspection Permit Issued Owner Owner Address Permit Restrictions Capacity LUCHARITOS BURRITO BAR INC 119 MAIN ST, GREENPORT NY 11944 S Z 16 seats Inspection Violations Comply By Date Degree of Violation:GOOD RETAIL PRACTICE 55 55-PERMIT OBTAINED,PLANS APPROVED 5128/2020 Violation Description/Inspector Comments: 760-1303.2-Any person desiring to operate a food establishment shall make written application for a permit on forms provided by the Department. Such application shall include the applicant's full name and post office address and whether such applicant is an individual,firm or corporation,and if partnership,the names of the partners,together with their addresses;acceptable documentation that demonstrates compliance with NYS Workers Compensation Law;the location and the type of food establishment;and the signature of the applicant or applicants. If the application is for a temporary food establishment,it shall also include the inclusive dates of the proposed operation. THE OPERATOR FAILED TO SUBMIT PROOF OF POSSESSION OF DISABILITY INSURANCE AND WORKERS COMPENSATION INSURANCE. 760-1304.1.b-All construction,remodeling,or alterations shall be done in accordance with the approved plans. THE FRONT COUNTER SNEEZE GUARD WAS NOT INSTALLED AT THE TIME OF INSPECTION. —Overall Inspection Comments PRE-OPERATIONAL INSPECTION CONDUCTED VIRTUALLY. RE:FRONT COUNTER SNEEZE GUARD NOT INSTALLED – DUE TO COVID 19 PANDEMIC,ESTABLISHMENT IS RESTRICTED TO TAKE-OUT AND DELIVERY ONLY.AS PER OPERATOR,PATRONS PICKING UP TAKE-OUT ORDERS WILL WAIT OUTSIDE OF THE ESTABLISHMENT AND WILL NOT BE ALLOWED INSIDE.THE SNEEZE GUARD MUST BE INSTALLED PRIOR TO PATRONS BEING ALLOWED INSIDE THE ESTABLISHMENT.PROOF OF SNEEZE GUARD INSTALLATION SHALL BE FORWARDED TO CHRIS KANDELL. ESTABLISHMENT BUILT SUBSTANTIALLY ACCORDING TO APPROVED PLANS. OKAY TO ISSUE PERMIT ESTABLISHMENT MAY OPEN ONCE ALL FOOD CONTACT SURFACES HAVE BEEN THOROUGHLY WASHED,RINSED AND SANITIZED. INSPECTION CONDUCTED BY- Christopher Kandell Senior Public Health Sanitarian Suffolk County Department of Health Services Bureau of Public Health Protection 360 Yaphank Avenue Suite 2A Yaphank,NY 11980 Desk:(631)852-5864 Cell:(631)834-3044 Fax:(631)8525871 i Food Establishment Inspection Report ' Suffolk County Department of Health Services ' Page 2 of 2 360 Yaphank Avenue Suite 2A Yaphank,NY 11980 Date: 04/30!2020 631-852-5999 www.suffolkoountyny.gov/heafth Establishment Name Establishment Address City/State Zip Code Telephone LUCHARITOS BURRITO BAR 10095 MAIN RD UNIT 15 MATIITUCK,NY 11952 Facility ID# Permit Holder Purpose of Inspection Inspection Result FA0002414 LUCHARITOS BURRITO BAR INC Premise/Facility Inspection Permit Issued Owner Owner Address Permit Restrictions Capacity LUCHARITOS BURRITO BAR INC 119 MAIN ST, GREENPORT NY 11944 S Z 16 seats �3 EE0000859-Chris Kandell 'The items noted above are violations of applicable laws,rules and regulations found during an inspection of the operation of the facilities in this establishment which must be corrected as indicated Failure to comply may result in the initiation of legal action against this establishment as provided for in Articles 2 and 13 of the Suffolk County Sanrtary Code including a hearing,possible suspension of your food operation,and/or the publication of the violation and fines" 5002 v5 STCVOI6�JtS ICMLSLIOMNntCp.IAD,MCX�MpL,l.6W IV�IGLNCgINN pICNTNC .,}� LOMMISSIONCR 0CPARfN6'/TOl H[ALTN lCIlLYCS COMMENTS FOUNDATION (IST) ---------------------------------- FOUNDATION 1 • -� 1!� .,! . �/�tJ . � �1.�� 11`ate`L��.- ROUGH FRAMING& PLUMBING rNSULATI • • • STATE ENERGY CODE �V ' `. lmwk ir ADDITIONAL • : ► 01 - r rd-RAWNZ •• ME t it NI"11,119o]ME -no ORSINI TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL:(31)765- 02 Planning Board approval FAX: 631)765-959502 � Survey_ Southoldtownny.gov PERMIT NO. Check Septic Form NY.SDEC Trustees C O Application Flood Permit Examined 20 Single&Separate Truss Identification Form Il �/ //�� q Storm-Water Assessment Form �V / Contact: �q Approved 20 ` Mail to k,c Lz R( JL-,— Disapproved a/c0'^ �• G-f 2.¢� alk j f j Lf 4 Phone- 6`l6 I — Expiration- Building Inspe r jj lt5 •� NOV 2 5 2019 APPLICATION FOR BUILDING PERMIT q Date 20 j l INSTRUCTIONS a:'This'application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans,accurate plot plan to scale Fee according to schedule. b.Plot plan showing location of lot and of buildings on premises,relationslup to adjoining premises or public streets or areas,and waterways c The work covered by this application may not be commenced before issuance of Building Permit d Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant.Such a permit shall be kept on the premises available for inspection throughout the work e No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy f.Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an addition six months Thereafter,a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold,Suffolk County,New York,and other applicable Laws,Ordinances or Regulations,for the construction of buildings,additions,or alterations or for removal or demolition as herem described The applicant agrees to comply with all applicable laws,ordinances,building code,housing code,and regulations,and to admit authorized inspectors on premises and in building for necessary inspections t (Si ure of applicanf or name,if a corporation) (Mailing address of applicant) State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder Name of owner of premises (As on the tax roll or latest deed) If ap ca s a co ignature of duly authorized officer ame and title of corpora S officer Builders License No. }}' ?j ✓�j Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: �ovtis fV\K\jjC 2 House Number Street Hamlet County Tax Map No. 1000 Section Block Q , Lot -26 Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy PC.&`�V b. Intended use and occupancy I 1� se'vs 3. Nature of work(check which applicable):New Building Addition Alteration 1✓ Repair Removal Demolition Other Work (Description) 4. Estimated Cost 0y Coo o Fee �� (To be paid on filing this application) 5. If dwelling,number of dwelling units Number of dwelling units on each floor If garage, number of cars C�, 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. 1��•� A- 7. Dimensions of existing structures,if any:Front 12—o Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front ZjD Rear Zt�� Depth Height Number of Stories 8. Dimensions of entire new construction:Front Rear Depth Height Number of Stories 9. Size of lot:Front Rear Depth 10.Date of Purchase Name of Former Owner 11.Zone or use district in which premises are situated '712 �'� 'L k 12.Does proposed construction violate any zoning law,ordinance or regulation?YES NO t,-" / 13.Will lot be re-graded?YES NO V Will excess fill be removed from premises?YES NO V 14.Names of Owner of premises ( &ra�t`-�/� Address Go f/vlc.N ✓e4 • Phone No. 6-�i Name of Architect A-J" -bw'�21 Address " k'l 2 Phone No (�3 i -7 6 (67 Name ofContracto-\o�, wo Address u—c '^Phone No. 01 15 a.Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES NO �^ *IF YES,SOUTHOLD TOWN TRUSTEES&D.E.C.PERMITS MAY BE REQUIRED. b.Is this property within 300 feet of a tidal wetland?* YES NO_z *IF YES,D.E.C.PERMITS MAY BE REQUIRED. (31ovide survey,to scale,with accurate foundation plan and distances to property lines. 17.If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. 18.Are there any covenants and restrictions with respect to this property?*YES NO *IF YES,PROVIDE A COPY. STATE OF NEW YORK) COUNTY OF_:�C&o being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the (Contractor,Agent,Corporate Officer,etc) of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief,and that the work will be performed in the manner set forth in the application filed therewith Sworn teforda e t s 20 's 6 y "• Its �` t{ No.01'.irr4��' is QldaKod in SuftlkW1.1 r'gnatureofApplicant Go, -nicsion Expires Fabr=Y 22 TOWN OF SOUTHOLDDo you have or need the following,before applying? BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT g TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Budding Plans TEL:(631)765-1802 Planning Board approval FAX:(631)765-9502 uc' Survey Southoldtownny.gov PERMIT NO. Z 15 � Check Septic Form NYSDEC Trustees C 0 Application Flood Permit Examined 20 Single&Separate Truss Identification Form Storm-Water Assessment Form 7- -7 / Contact: Approved l 20 Mail to Disapproved a/c i M f�.cG•ck 1 Phone (s 3 L'Q 3 1" Sg as it Expiration 20 Building Inspector Existing Building Dept APPLICATION FOR BUILDING PERMIT Permit#44548 Date ,20 INSTRUCTIONS a.This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans,accurate plot plan to scale.Fee according to schedule. b.Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas,and waterways c.The work covered by this application may not be commenced before issuance of Building Pemnt d.Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant.Such a permit shall be kept on the premises available for inspection throughout the work. \ e No building shall be occupied or used in whole or m part for any purpose what so ever until the Building Inspector J issues a Certificate of Occupancy. f.Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an addition six months Thereafter,a new permit shall be required -t P/ ICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the �ib"eIIIQrdm ri of the Town of Southold,Suffolk County,New York,and other applicable Laws,Ordinances or io fdr the clo. s action of buildings,additions,or alterations or for removal or demolition as herein described.The l applicant agrees to compjy lwith all applicable laws,ordinances,building code,housing code,and regulations,and to admit JU L authonze�gdectors on premises and in building for necessary inspections (Signature of applicant or name,if a corporation) TC '� 1149 OLD COUNTRY ROAD SUITE D-5 RIVERHEAD,NY 11901 " (Mailmg address of applicant) State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder FIRE ALARM INSTALLER Name of owner of premises LUCHARITOS BURRITO BAR (As on the tax roll or latest deed) If applicant is a corporation,signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No.12000022174 1. Location of land on which proposed work will be done: 10095 MAIN ROAD MATTITUCK,NY 11952 House Number Street Hamlet County Tax Map No. 1000 Section 142 Block 1 Lot 26 Subdivision Filed Map No. Lot 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 REsrauRANr 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work NEW FIRE ALARM SYSTEM 4. Estimated Cost Fee (Description) (To be paid on filing this application) 5. If dwelling,number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. 7. Dimensions of existing structures,if any:Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction:Front Rear Depth Height Number of Stories 9. Size of lot:Front Rear Depth 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?YES_NO 13.Will lot be re-graded?YES_NO Will excess fill be removed from premises?YES_NO 14.Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a.Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES NO *IF YES,SOUTHOLD TOWN TRUSTEES&D.E.C.PERMITS MAY BE REQUIRED. b.Is this property within 300 feet of a tidal wetland?*YES NO *IF YES,D.E.C.PERMITS MAY BE REQUIRED. 16.Provide survey,to scale,with accurate foundation plan and distances to property lines. 17.If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. 18.Are there any covenants and restrictions with respect to this property?*YES NO *IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS COUNTY OF_� being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, CONNIE D.BUNCH (S)He is the WntarM public,State of New York (Contractor,Agent,Corporate Officer,etc.) No.0 Qualified In Suffolk County 2 ba l l of said owner or owners,and is duly authorized to perform or have performed the said work��flItl�$ lic�afion; that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed therewith Sir taorn to before me th' ( _day of 20� OCN 71 ^-0 '��Iva SQA:S� Notary Pub is Sign e of Applicant COUNTY OF SUFFOLK STEVEN BELLONE SUFFOLK COUNTY EXECUTIVE DEPARTMENT OF HEALTH SERVICES JAMES L.TOMARKEN, MD, MPH, MBA,MSW Commissioner Your application received on �6GHlg. 22, Zai° for L_ue,HA 2N-Ft $ I2,>,eZAT0 F/{( C3,Z`ld , located at N l p Igt'. atj if 15 (9AV-_TVT1jC.,(.,1 is missing the information indicated below: Tax map number Pro f of corporation(either a business certificate or incorporation papers) Proof of workers compensation and disability insurance;The following forms must be provided: 49- Workers' Compensation—Form C-105.2 OR Form U-26.3 OR Form SI-12 OR Form GSI-105.2 Disability Benefits=Form DB-120.1-OR Form DB-155 calf-1-866-805-3630 or online at http://wtivtiv.wcb.state.ny.us/. If non-community water supply("a well"), a copy of last water analysis Email address not provided Business street address is different than Department records Home street address and telephone number of applicant is not provided Application not signed by corporation officer A floor plan detailing the equipment lay out of the entire establishment(pre-existing establishment but no plans on file) Floor plan shall be drawn to 1/4 inch equals 1 foot scale and shall include the kitchen,front counter/service areas,patron areas,restrooms,food storage areas, bar area,prep and dishwashing areas. This plan is for a file reference only NOT for review. STOPN RENOVATIONS WERE MADE TO THIS ESTABLISHMENT, OR A CHANGE OF USE IS NOTED. Plan review set up package given and discussed. All plan review forms are to be completed and returned along with two sets of plans and a brief letter describing the changes you are makinn / HW 5 -1u 5C V),4 n ,-V, YOther: ?1001 e 5 �lo�-i v, �r2-i v,�4u Ilei loq FYI: Designated persons in charge of the food establishment hold a valid food safety_/_f_ood protection certificate issued by an authority approved by the Commissioner during all hours-of operation. Food Manager Class Registration https://apps2.suffolkcouniyny.gov/health/foodtrainin-/OR On Line Food Manager Class Registration https://apps2.suffolkcountyny.gov/Health/FdOniine/default.aspx Faxed information must include the STORE(D/B/A)NAME and Facility Code, not just the corporation name. Bruce Johnson Lisa Kolody Amanda McDonnell Lisa Potopsingh Christopher Kandell BUREAU OF PUBLIC HEALTH PROTECTION 10 360 Yaphank Avenue, Suite 2A,Yaphank NY 11980 PwidicHealth (631)852-59991852-5873 FAX(631)852-4824 I I Tz. Ivy •<<- ` � �'; [-'1± '�,1 SVfFQ��' TBUI�LDIfNG DEPARTMENT- Electrical Inspector C O CGy�, DEC 3 ® 19 S TOWN OF SOUTHOLD C wn Hall Annex - 54375 Main Road - PO Box 1179 y _ - Southold New York 11971-0959 ,;"t_°Teld hone (631) 765-1802 - FAX (631) 765-9502 ;_;:t , rogerr()-southoldtownny.gov sea nd(cDsoutholdtownny.gov APPLICATION FOR ELECTRICAL INSPECTION ELECTRICIAN INFORMATION (All Information Required) Date: ( ie' a Company Name: Acldeilyez/ Z- �.rf Name: r� ri�i.>zofGt,- License No.: rt'el= email: r1Z1- Vtt T-1VvV e—i -rayl Address: 3zi y -&7 pie. Cu/Z�vGko cry 5"' Phone No.: �3/ fv� 1130 JOB SITE INFORMATION (All Information Required) Name: -k" G 1--kr/h wvl oS> Address: 0 6 10 04I- 1QF z �f�rfzruc Cross Street: Phone No.: . Bldg.Permit#: �� 4�' email: Tax Map District: 1000 Section: Block: Lot: ?� BRIEF DESCRIPTION OF WORK (Please Print Clearly) AV MI��12�ltRlf/f tiG�dt/G Gni?zv�, /1CFUZ/vb 4- &OPT/V[ cyu---AMT rx'XE)-xWa(.E1vcr LrbNr2N6 Circle All That Apply: Is job ready for inspection?: Y9/ NO R ugh Final Do you need a Temp Certificate?: YES / NO Issued On Temp Information: (All information required) Service Size 1 Ph 3 Ph Size: A # Meters Old Meter# New Service - Fire Reconnect- Flood Reconnect - Service Reconnected - Underground - Overhead # Underground Laterals 1 2 H Frame Pole Work done on Service? Y N Additional Information: PAYMENT DUE WITH APPLICATION f576 f Request for Inspection Form As y li SOVr�,®l Town Hall Annex ~ ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 0 iQ �yC®UNT1,� BUILDING DEPARTMENT August 19, 2020 TOWN OF SOUTHOLD Mattituck Plaza LLC PO BOX 77 Mattituck, NY 11952 Re: Picture required for corrected vertical bar in bathroom. TO WHOM IT MAY CONCERN: The items marked below are required to obtain your Certificate of Occupancy Application for Certificate of Occupancy. (Enclosed) X Electrical Underwriters Certificate. Energy test results and Manuals J & S. Final Survey with Health Department Approval. Plumbers Solder Certificate or Pex Affidavit Trustees Certificate of Compliance. (Town Trustees # 765-1892) Final Planning Board Approval. (Planning # 765-1938) Final Fire Inspection from Fire Marshall. (631-765-1802) Final Landmark Preservation approval. Final Elevation Certificate required. Final Storm Water Runoff Approval from Town Engineer Spray Foam Insulation certification from a NYS licensed architect or Engineer BUILDING PERMIT: 44548-Z Alterations WIRE SPEC. CHART #18 AWG FPL WIRE:ADDRESS LOOP #14 AWG FPL WIRE: SIGNAL CIRCUIT #12 AWG FPL WIRE: 120VAC/ GRD. SITE PLAN I TYP. DEVICE LOCATION Alr I.TGI5T�P? IV 3 0"Mln 5mm HorN/ 5TP.om ADJOINING THEATER pUl.l,5rA110N AS EXISTING EXISTING U EX Fly ADA RESTROOM 15/75 AREA OF WORK l P N FLOM 0 AL F O W E r,\ RATIONS OF SEQUENCE OPE DETAILS: Q 1. WHEN ANY INITIATING DEVICE IS ACTIVATED,THE 3. WHEN THE F.A.C.P.IS RESET,THE FOLLOWING WILL OCCUR S.R.SHEET ROCK FOLLOWING WILL OCCUR: A.INITIATING DEVICES WILL RESET ..___,z A.HORNS WILL O ® B.STROBES WILL Ff pggAMEORAL 3 CODE B.FANS WII L RESET C,T,CEILING TII P C.FANS WI L SHUT DOWN D.THE DEVICE IN ALARM WILL BE LISTED AT 4. TROUBLE AND SUPERVISORY SIGNALS WILL SOUND A TONE THE ANNUNCIATOR AT THE F.A.C.P.ONLY.NOT AN ALARM.THE F.A.C.P.WILL F— E.AN ALARM SIGNAL WILL TRANSMIT TO THE TRANSMIT A SIGNAL TO THE CENTRAL STATION ALSO O.T.D. OPEN TO DECK CENTRAL STATION 5. CARBON MONOXIDE DETECTORS SHALL SOUND A SPRINKLER SYSTEM R 5TORAGE/ f1_ 2. WHENTHE ALARM IS SILENCED,THE FOLLOWING TEMPORAL 4 SEQUENCE AT DEVICE AND A TONE AT THE JANITOR Q R'II.L OCCUR: ALARM AND ANNUNCIATOR.CCEENTRAL ATcio.HvAc ANAND�s CO NON PLENUM CEILING CLOSET A.HORNS WILL SILENCE LL B.STROBES WILL STOP FLASHING SHALL SHUTDOWN. RISER DIAGRAM WALK IN COOLER5/7 FIRE ALARM NOTES SEAL: mC 5' prep I. ALL SMOKE DETECTORS SHALL BE MOUNT NO CLOSER THAN 8. ALL WIRING SHALL BE SUPPORTED SO AS NOT TO REST ON THE `R A table 36" FROM ANY HVAC SUPPLY OR RETURN DUCT DIFFUSER. HUNG CEILING ,CE �C( PULL STATIONS TO BE MOUNTED 4'0"A.F.F.TO CENTER OF 9. ALL MANUFACTURERS INSTALLATION REQUIREMENTSSHALL BE 27"cold DEVICE AND WITHe IN 5' OF ASSOCIATED DOORWAY. STRICTLY ADHERED TO � (� '✓/ work station HORN/STROBE AND STROBE DEVICES TO BE MOUNTED 6'8" 10. ALL N.F.P.A.72,LOCAL,STATE,A.D.A,AND VILLAGE CODES SHALL Or 'i �Q A.F.F.TO CENTER OF DEVICE.HORNS RATED AT 85 DB AND BE STRICTLY ADHERED TO ^ STROBES ARE 15/75 CANDELA 11. PROJECT ARCHITECTSMUST APPROVE ANY CHANGE IN THE �) 2. ALL DEVICES SHALL BE MOUNTED ON APPROPRIATE BOXES DRAWING r SO THEY ARE ELECTRICALLY AND MECHANICALLY SECURE 12. ALL WORK SHALL BE DONE BY A NEW YORK STATE LICENSED FIRE 3. ALL EXPOSED WIRING UNDER EIGHT FEET SHALL BE IN ALARM INSTALLATION COMPANY _ 29"commeraa PROTECTIVE CONDUIT. 13. ALL WORK SHALL BE COMPLETED IN A CRAFTSMAN-LIKE MANNER N 4. ALL FIRE ALARM WIRING SHALL BE APPROVED FOR THE AND SHALL BE PLEASANT TO THE EYE 3— oven ROOFy--=� --�� SPECIFIC TYPE OF JOB CONDITION 14. CENTRAL STATION MONITORING BY STATE WIDE MONITORING 0 5. FIRE ALARM INITIATING CIRCUIT SHALL BE MINIMUM 18 (631)-23240900 3E)4 5 O GAUGE SOLID 15. 24 HOUR CENTRAL STATION AND ALARM REPAIR Q CONTACT 15/7 WP 16 GAUGE SOLID TELEPHONE N 6. ALL NOTIFICATION APPLIANCE WIRING SHALL BE MINIMUM UMBERS ARE TO BE DISPLAYED ON THE ALARM 1` Ne PANEL ALL SMOKE AND HEAT DETECTORS MV Z 7. MOUNTED IN HUNG 16. SYSTEM MODIFICATIONS AND COMPONENTS ARE SUBJECT TO 0 O CEILINGS SHALL BE MOUNTED AT THE HIGHEST POINT ADDITION, DELETION, MODIFICATION, OR ALTERATION AT THE FRYER ATTACHED TO THE UNDERSIDE OF THE ROOF DECK FIRE MARSHAL Q_Z W Z 4 15 /7 FF300 O (4) 15/7 (2) TIME A FINAL INSPECTION,IF FOUND TO BE INADEQUATE BY THE cz I— BAR ' ) O (() TOP CO 'O Q � w P S C FIRE MARSHAL STAMP It BURRITO BAR p (2) 15n5(j) REVISIONS ef # DATE ISSUE/REVISION/NOTES 1 7/6/2020 SUBMITTED FOR REVIEW LINE TI FIRST LINE: CENTRAL STATIONBUILDINGSPRINKLERSECOND LINE: SACK UP ANSUL ALARM 120 VA1ST FLOOR tL-1O DEVICE LEGEND APPLICANT:LIGHTHOUSE SECURITY INC. 109 EDWARDS AVE CALVERTON,NEW YORK 11933 SYMBOL QTY DESCRIPTION PART NUMBER PHONE:(631)-727-2728 O \ INFO@LIGHTHOUSESECURITYINC.COM N.Y.S.LICENSE#12000022174 FACP 1 FIRE ALARM CONTROL PANEL VISTA 128FBPT PA—Al DRAWN BY: 4 FAA 1 ANNUCIATOR 6160CR R Q c o TOP SECi7RlTY JYS'I'F,MS INC. Q 2 PULL STATION BG12L/4193SN 471 TOWNLINE ROAD 155/7 WF HAUPPAUGE,NEW YORK 11788 EXISTING DOOR Q 4 SMOKE DETECTOR 5193SD PHONE:(631)-979-4500 TO SIDEWALK TO DRAFTINGC ALARM-TECH.COM REMAIN ® 1 CARBON MONOXIDE DETECTOR C01224TR/ 4193SN SCALE: 1/8"=1' DRAWN BY: GM ® 1 HVAC SHUTDOWN RELAY 4101SN JOB: LUCHARITOS PROJECT NAME: ANSUL 1 ANSUL MONITOR 4193SN =n�. 2 CEILING MOUNT HORN STROBE PC2RL LUCHARITOS 10095 MAIN RD#15, x(�5 1 CEILING STROBE LIGHT SCRL MATTITUCK, NY 11952 FIRST FLOOR FIRE ALARM PLAN 1 WATER PROOF HORN STROBE P2RK SHEET: F ^ _ I SCALE: 1/4"=l' /�-� FIRE ALARM FLOOR PLAN uc ari Diumto 5gr r7 •:'P', t2�Z0'�� . : ,; -14'✓ `��1 v E��SPEF ADJOINING THEATER 0 EEFO� A5 EXISTING g — QPE RLNW µ DEC 2 0 i2 �n N rte. PROVIDE UL RATED, THEATER Q z F tu. n r' , MINIMUM I HOUR ENTRANCE E 'h FIRE DOOR JAMB - e §. QD I 1. ASSEMBLY DOOR TO ILLJ LU — 4. Ti:!P,-M1 z I N EX EXISTI G U HAVE SELF CLOSE I:^\' ^' J kADATROO M a Q VI IBE � HI NGES AND DRAFTI— S L 4'4 - r U Y;T, I CONTROL BOTTOM M SEAL e f A IB E SIG ICO"! UD L .. vt" 6" Y' S Pk° .q I. I I i . . i, a 4` f P x 9` I d P : .. it 1 . , IL._ . ., t 068 13 ( n� r , y : DOUB E SCO ..:. °.:... ..• ... y �e h, NO N - � Al, + ;. r�- W IT HEN Fes;. t ,dw z u 1i 1Hi .a r ti A.• w - .o-. : ,a! EMELe 7 RGE C L G s_ ENT NCE RA O TYPICAL ALL SHOWN I I '••, QE6 w Y ITH ALL CODES OF ~ I I 2668 w ; Lu < Cr �I�L W _ I R'K STATE= & 4 7 0c TOWN CODES -- --� 5TORAGE/ � \ � :i^;i ��bd t � � 4u � � 3 � � a � .• ` z Q U U N r_,yV Y JANITOR — FREEZER h, C 1RLD A 4 1 CLOSET HF51HC-IS / \ f, :'a py. Q J ��` 1 I VIH I N lfl ` �� `, j - - a to LC 3 MERCHANDISE CC CC CC CC Y;..,,•,;:N; � '�.;, .::•1,3�` t:I m..ww...� - S PAPER WALK-IN D CHEF BASE -^. N `F; .::y. ad.: P 1,,/ FLAN I sroRAG �z py=<:��:;> �:+� •„�;,-'r.. �� L I�/IF v.8: I:• f't.: 14, ,C. .2ta: �.� v V v f r AUC48R a.9. ,h'rS: '�, .�.; `• '-gaa6,.?:�,' s,..i,..;,-.; UNIT so?"N ao+: e't. - . "`Ni?'a�py ;'u° .x�:'"; rm••5' if �2,`y .µs� �I*:,':�•'� ��. 'y„,: , SSU- ' O O y ,r r ..d4 i�'#t .;#'' a•. t ”, R � 4� I -"v ��\J � l��. ib'a jp�4°2�� 1�`I.V._ _� OUNTER TOP �° f L_ _� TEAM TABLE �: } "° ,..x•,;i`. uiw^ .er ,m 'A 1 C 062A 9,;r•; ,, I 1 PROPO QED RESTAURANT �� Wks:::.• '. .� ,:gig:, t I a. a ;a A PLAZA � 2'�° WITHIN EXSTING M a: as +°�t�:•:i<. . x. r. 2 9 .ft. f:xlstln Footprint of Unit ..�..1� .+•.»' �.� .�:�;:,";-�� _ N :�• O �'�'��+tt �•h.vi �` 'rk{ I r I Area I c e v ce 3 I s .'t. Pub S FF300 r`a ;4a.� Q -�-� J R ..p°�,•^ — ': >.. B- Iasslflcat4on A r� ,.+. :•, is"" ° '�: HO T LE `: • »> ..t ;fin ,(� :i. -�r.'.�- .;)r�...t�.`. ( N f'fis: '._'P'r"•L, 1,• 'L» t...e%� •'Ike.:. ,5�1'�. d,u•a p....w vi. _ Occupancy: m l n� n rated :�.. ��• N , Asse b U once t 1 71 9,_811 = .; 4445.1. 15 29.6 I f `Y{J GRILL rg'••d. ,dew r. e„��'•��'^`..it',:3,e, N I ,'t e•, »� 1 �... .s t.'<'': �`ay� :SC^�.'.r:•:''..din:gt.• , , M P 4 _ '' 35 G C 6 .. '..ru:::;pf...�"° .:av>< .. w..":,,, ,-,.. :xar. :.'�i'�:.cs¢x,.�� +t�. J s...+�-:e.0 ;,t xway�G�: ."can'':+ n':-�''.;ww�-� �Z ADJOINING I� 4 4 0,��:•x.tom:•� +;.:;� �- _; I c`.. SIGN w/EN.IE4ZGENCY ;� � "�, .;i S�'°',�,. r ca 4 U i �i Mv. V "TGI�E r<� - I , Ex T A N A B E I LMIN TIO � UD L M, T A5 _ BAR �•. p:a qid O' ^tea O z�''i2i +S aAv`Xie.°°a&.ifo::�. Y`. :.d6i:°d.:'S t»': "" °`m`:,+ 4-� EXISTING TOP � � w/ DIRECTIONAL ARROWS � I CHEF BASE URRITO B R o 62" L M EMERGENCY LIGHT WORr,TOP PRI GE CHEF BASE ` TWT-60-HC AUC48R PO?TABLE FIRE EXTINGUISHER V 1^ ACCORDANCE w/ 2015 IFC I SECTIONS 906.3. I-906.3.4 J I - `SD SMDKE CARBON DETECTORS r � CO co v TABLE OO JBT 72- °' II TRASH WALL LEGEND: BENCH At -- ------ sEAr N - `--- EX15TING PERIMETER WALL STRUCTURE KEGERATOR 6 I (� auuo6o TOREMAIN W \ EXISTING PARTITION TO REMAIN z COUN IER OP TO E 34" (� OV FLOOR , O EN •74.I FE EXISTING PARTITION TO BE REMOVED m AREA UNDERNE T TRAVE ______ W r` S151LITY S OWN AOA DI5TA C Accessi,LE Q m TO CO PLY w/THE ICC ° o CouNrER NE1/CONSTRUCTION: Z" x 3 8” METAL STUD ANSI Ill 7 I- 09 m REGISTEP 5ERVICE PA,,TITION w/ I LAYER 811 FIRE RATED GYPSUM S _ COUNTER BCARD ON EACH SIDE W y I N --T NEV CONSTRUCTION: i" x 3 5" METAL STUD 3 SDRE AIL 2 8 Q Z � CO 2'o" - \ RE RIGERAroR PARTITION w/8" FIRE RATED GYPSUM o sELF BCARD ON SERVICE SIDE 4" DECORATIVE U cou TER I WOOD FINISH ON PUBLIC SIDE. TOP OF WALL z HEGHT TO BE 42" ABOVE FLOOR Q � ENTRAI�C 4F77 Z 16-0 AR TOP IFYIT EXISTING DOOR TO SIDEWALK TO OF NE REMAIN 5� o "Alteration of this Document except by an Architect or Licensed Profes- sional Enineer, is illegal." Section 7209, Subdivision 2, sF No, os o 5 c� ,: PAGE: N. Y. State Education Law. FLOOR PLAN ,oROFEss►ONN\- SCALE: 1" = 11-011 I 4