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Home My WebLink About34966-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-34419 Date: 06/28/10 THIS CERTIFIES that the building RECONSTRUCTION Location of Property: 18200 MAIN RD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) Co%ulty Tax Map No. 473889 Section 115 Block 4 Lot 18.1 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 7, 2009 purs,,mnt to which Building Permit No. 34966-Z dated AUGUST 31, 2009 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 RECONSTRUCTION OF THE 1760 SCHOOL HOUSE AS APPLIED FOR. · ~ne certificate is issued to MATTITUCK HISTORICAL SOC ( OWNER ) of the aforesaid building. SUFFOLK COUNTYDEPARTMENTOFHEALTHAPPi~O~-AL N/A RT.R~-rKICAL c~KTIFICATE NO. 34966 06/23/10 PLI~ERS C~u(TIFICATION DA'rmu N/A Authorized Signature Rev. 1/81 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 Departmeat with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, street~, and unusual natural or topographic features. 2. Finnl APproval from Hendth Dapt. of water supply and sewerage-disposal (S.9 form). - 3. Approval of electrical installation from Board ofFfl-e Undenvriters. 4. Sworn statement from plumber em~ifyiag that the solder used in system contains lesa than 2/10 of 1% lead. 5. Commoroial building, industrial building, multiple residences and Similar buildings and installations, a C~rtiflcate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planaing Board Approval o f completed site plan rlx/uh oments. B. For exisfing-buildin~s.(prior to April 9, 1957) non-eanforming nses, or buildings and ,,pre. existing- land nses: 1. Accurate survey ofpropertyshowing all property lines, shn~ts, building and unusual natural or topographic features. 2. A properly completed applieatinn 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 $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimmlng pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate afOccupaneyonPre-,existing Building - $100.00 3. Copy of Ceffificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commemial $15.00 New Construction: Location of Property: ] ~ ~) 0 House No. Owner or Ownem 0f Property: · Suffolk County Tax Map No 1000, Scction 11 ~ Subdivision Old or Preexisting Building: Street Date of Permit. Perinit No. ~' c'~q Ltg~ Health Dept. Approval: Plarming Board Approval: Request for: Temporary Certificate Fee Submitted: $ Date. (check One) Block ~( Lot Filed Map. Lot: Applicant: Underwriters Approval: Final Certificate: X~ (check one) Applicant Signature qk~wn 1 tall Annex 54373 Main Road P.O. Box 117!} Southohl, NY I I !t71-0959 Telephone (631) 765-1802 (631 ) 765-9502 ro.qer.dchert~,town.southold.ny.us BUIL1)ING I)EPARTMENT TOWN OF $OUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION ssued To: Mattituck Laurel Hist. Society--school house ~,ddress: 18200 Main Rd City: Mattituck St: NY Zip: 11952 3uilding Permit #: 34966 Section: 1 15 Block: 4 Lot: 18.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE 3ontractor: as built DBA: License No: SITE DETAILS Residential Commedcal New Addition Service 1 ph Service 3 ph Main Panel Sub Panel Transformer Disconnect Other Equipment: Indoor Outdoor Renovation Survey Hot Water NC Condenser NC Blower Appliances Switches Office Use Only ~ Basement ~ Service Only ~ 1st Floor Pool 2nd Floor Hot Tub Attic Garage INVENTORY Duplec Recpt ~ Ceiling Fixtures J~ HID Fixtures ~r~L~I~~~ GFCI Recpt Wall Fixtures 121 Smoke Detectors Single Recpt Recessed Fixtures I 31 CO Detectors Range Recpt Fluorescent Fixture L I Pumps Dryer Recpt Emergency Fixtures~ J Time Clocks Twist Lock Exit Fixtures I I TVSS Notes: histodc building Inspector Signature: Date: June 23 2010 81-Cert Electrical Compliance Form FORM NO. 3 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) PERMIT NO. 34966 Z Date AUGUST 31, 2009 Permission is hereby granted to: HISTORICAL SOC MATTITUCK PO BOX 766 MATTITUCK,NY 11952 for : RECONSTRUCTION OF 1760 SCHOOL HOUSE ON SITE PER APPROVED PLANS & LANDMARK PRESERVATION COMM. at premises located at 18200 MAIN RD County Tax Map No. 473889 Section 115 Block pursuant to application dated JULY 7, 2009 Building Inspector to expire on FEBRUARY 31, MATTITUCK 0004 Lot No. 018.001 and approved by the 2011. Fee $ 0.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ~"'FOUNDATION 1ST [ [ ]'FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]RRB RESISTANT CONSTRUCTION ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] F~RE RESISTANT PENETRATION REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION 1ST ~x~ FOUNDATION 2ND ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTAI~r PENETRATION REMARKS: TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING / STRAPPING FIREPLACE & CHIMNEY FIRE RESISTANT CO#STRUCflON [ ] ROUGH PLBG. [ ] INSULATION [/~ FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION REMARKS: DATE INSPECTOR ~ ~ coMMENTS .......... ____- .... ~'~ v · ROUGH mumul~G & PLYING ~8~ P~ N, Y. STA~ E~ CODE . .. , . , Mattituck.-Laurel Historical Society and Museums P.O. BOX 766 MATTITUCK, NEWYORK 11952 631 ~298~5248 June 12, 2009 Damon Rallis Building Dept. Southold, N.Y. SUBJECT; 1760 School House, Mattituck Dear Damon, Enclosed is the building permit concerning dismantling and reconstructing the 1760 school house at the Mattituck-Laurel Historical Society grounds. We have given the information you requested at each item you checked for us. Thank you for your assistance in this important project. If you need to call me, my phone number is 298-8461. Norman Wamback Curator/Historian cc: file Listed in National Register of Historic Places and New York State Register of Historic Places Designated Southold Town Landmark www .mlhist oricalsociety .org FORM NO. 3 NOTICE OF DISAPPROVAL 2009 TO: Mattituck Historical Society C/O Norman Wamback P.O. Box 766 Mattituck, NY 11952 Please take notice that Location of property: 18200 Route 25 NY County Tax Map No. 1000 - Section 115 Lot 18.1 Is returned herewith and disapproved o The proposed relocation is not Landmarks Preservation New York State and/or the National ¥ithout review and approval by the Southold Town property is listed on either the Southold Town, isters of Historic places and requires review by the If the requirements of the town to Landmarks (Local Law No.22) are met, a Certificate of Appropriatenes~ will be issued. The C of A is required before a Buildin~ aPvear~l~;~ilalt ~ aPnPrfoOV2ad.tii~5~ :eOUl~]~/ne~UiDree[t~ertntrr;5~.r applying fora C of A is/~ N r°::ut~reAfPuPlic s°orudt ~ ov t~onwtn° ;h~l~bin°: ;~ ~L°n m a Y~ ~(~ Telephone (631) 765-1802 Fax (631) 765-9502 Town Hall, 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 SOUTHOLD TOWN LANDMARK PRESERVATION COMMISSION ADMINISTRATIVE PERMIT Applicant: Norman Wamback for the Mattituck-Laurel Historical Society Date of Receipt of Application: July 7, 2009 SCTM#: 115.-4-18.1 Project Location: 18200 Route 25, Mattituck, NY Date of Resolution/Issuance: August 31, 2009 Reviewed by: Damon Rallis, Commissioners Project Description: Locate historic schoolhouse to the above referenced property. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 170 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as described in the application received on August 5, 2009. Special Conditions: No additional work permitted beyond the scope of that outlined in the above referenced application. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in the Southold Town Code, a Certificate of Appropriateness will be required. ation from any other agency. Administrative Assistant ~ Landmarks Preservation Commission TOWN. OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork. net Examined Approved ,~' /7 / ,20 ¢9 Disapproved a/c Expiration ~// ,20// PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Surve3( Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: /I [ Mail to:/V0}r'~ Building Inspector APPLICATION FOR BUILDING PF~MIT / ' Date INSTRUCTIONS ,20 O? 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 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. fi 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 herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name, ifa corporation) Bo Tdd P/A/'Tiruc/< IV?' l/fs-z (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ameofownerofpremises PTfirTTtTOak-LAOf~: [,~lSFO(~lCt4rz_ ~.~OC/~T.)~ (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. ether Trade's License No. Location of land on which proposed work will be done: House Number Street / PlA T7 ITacl Hamlet County Tax Map No. 1000 Section I1~'- Block ff Subdivision Filed Map No. 2 State existing use and occupancy of premises and intended use and · ,~a. Existing use and occupancy b. Intended use and occupancy 3~Nature of work (check which applicable): New Building ,. Repair Removal Demolition ' Estimated Cost Fee If dwelling, number of dwelling units If garage, number of cars occupancy of proposed construction: Addition Other Work Alteration ot?A 7'/ (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height. Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Dimensions of entire new construction: Front Height Number of Stories Rear .Depth Size of lot: Front Rear .Depth Rear 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__ Will lot be re-graded? YES__ NO__Will excess fill be removed from premises? YES __ NO__ lm/'~j~,~fOwnerofnremises 5trt~Fy Address~O,gJ~q~/d PhoneNo. ~qf~.C2~ ~;~o}'A'~c'~i'-tect ¢^tl u~. 5_ ,~ SfE~_L~tV Addre,' ~K~Alt~ .~hone No ~3q~ 5 q or Nme of Contractor ~ff ~N~c~o DA~ ~cAddress ~.o,~ox Iqq~ //Phone No. (~ ~l- ~q~- Iqgl a. Is th~s pmpe~y within ] 00 f~et of a tidal wefi~d or ~ ~eshwater w~tl~d? *YES. NO IF YES~ SOUTHOED TO~ T~USTEES ~ D.E.C. PERMITS MAY ~REQUIRED. b. Is th~s p~ope~y within 300 feet o~ ~ tidal wetland? ~ YES NO ~F YES~ D.E.C. PERMITS MAY ~E ~EQUIRED. 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__ · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) s: /~ Jtl~ ~jL[~t~l~O~ beingaulyswom, deposesandsaysthat(s)heistheapplicant (Name of individual signing contract) above named, ~NNIE D. BUN~ N0tely.,Public, State of New York NO. 01BU6185050 (S)He is the (Contractor, Agent, Corporate Officer, etc.) Comn~i0n Expires April 14, of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this appli?tion; that all statements contained in this application are tree to the best of his knowledge and belief; and that the work will be ~ performed in the manner set forth in the application filed therewith. Sworn to before me this .~ 2q--I¢.~ day of .,,4~ (,c~-_x-~ 20_0c] Notary Public Signature of Applicant Town Hall Annex 54.375 M;dm Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (~1) 765-1809 ro~er, ri~ertd~ ~wn~!~g~o~ .nv. us BUll,DING DEPARTMENT TOWN OF SOUTHOLI~ APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Company Name: Name: License No.: ~ddress: Phone No.: Date: JOBSITE INFORMATION: *Name: *Address: *Cross Street: *Phone No.: Permit No.: Tax Map District: (*Indicates required information) 1000 ' SeCtion: l{ ~ Block: *BRIEF DESCRIPTION OF WORK (Please Print Clearly) Lot: /~', / (Please Circle All That Apply) *Is job ready for inspection: *Do you need a Temp Certificate: Temp Information (If needed), *Service Size: 1 Phase 3Phase *New Service: Re-connect Additional InfOrmation: 100 Underground ~/NO Rough ln ~ YES ~ 150 200 300 350 400 Other Number of Meters Change of Service Overhead PAYMENT DUE WITH APPLICATION Final 82-Request for Inspection Form Telephone (631) 765-1802 Fax (631) 765-9502 Town Hall, 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 SOUTHOLD TOWN LANDMARK PRESERVATION COMMISSION ADMINISTRATIVE PERMIT Applicant: Norman Wamback for the Mattituck-Laurel Historical Society Date of Receipt of Application: July 7, 2009 SCTM#: 115.-4-18.1 Project Location: 18200 Route 25, Mattituck, NY Date of Resolution/Issuance: August 31, 2009 Reviewed by: Damon Rallis, Commissioners Project Description: Locate historic schoolhouse to the above referenced property. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 170 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as described in the application received on August 5, 2009. Special Conditions: No additional work permitted beyond the scope of that outlined in the above referenced application. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in the Southold Town Code, a Certificate of Appropriateness will be required. ination from any other agency. Administrative Assistant Landmarks Preservation Commission Town 1 lall Am*t,x .5 ~375 Maiu Road P.(). Box 1179 Southold, Nh' 11971-0959 Telephone (631) 7fi5-180~2 Fax (631) 7fi3-9,502 BI !ILl)IN(; 1)EPAI/TMENT TOlfirN OF SOUTHOLD June 16, 2010 Mattituck Historical Society PO Box 766 Mattituck, NY 11952 RE: 18200 Main Road, Mattituck TO WHOM IT MAY CONCERN: The following items are needed to complete your Certificate of Occupancy: ~ Application of Certificate of Occupancy. (Enclosed) "~ Electrical Underwriters Certificate. __ Final Health Department approval. __ Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) __ Trustees Certificate of Compliance. __ Final Planning Board approval. __ Final Fire Inspection from Fire Marshal. __ Final Inspection from the Building Dept. __ Final Landmark Preservation approval. Building Permit: 34966-Z Re-build structure MAIN ROAD (NYS ROUTE N 88'08'20" E 1760'S SCHOOLHOUSE, NEW LOCATION OF= RESTORED HISTORIC SCHOOLHOUSE, ON NEW t=OUNDATION. Z E~XGAVATE FOOTINI~5 TO ~EPTH AP~.OF'~,IATE FO~. TOP OF: ~=OUN~ATION 8" ALCOVE F:INISH ~AID~ 200.0' LA~N ~ LANOSGAPE ~ EXISTIN~ HILt~ LAWN SITE PLAN SCALE: 1" = 20'-0" 267.86' SITE DATA SCTM # PROPERTY: ADDRESS OWNER: SITE: ZONING: 1000-115-4-18.1 18200 MAIN ROAD MATTITUCK, NY 11952 MAI ' ,TUCK-LAUREL HISTORICAL SOCIETY PO BOX 766, MATTITUCK, NY 11952 82,128 sf = 1.89 ac R-40 BLDG DEPT. TOWNOFSDUTHOLD ALL CONSTRUC't ION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. OCCUPANCY OR USE IS UNLAWFUL , WITHOUT CERTIFICATE OF OCCUPANCY CERTIFICATION OF NAILING & CONNECTIONS REQUIRED. APPROVED AS NOTE~D,., DAT~:~O~~ B P.# ~ ~--.~ RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE, REGULATORY APPROVALS o0 PRNECT NO: DRAWN BY: UT CHECKED BY: TCS DATE: 8114109 SCALE: 1" = 20'-0" SHEET TITLE: SITE PLAN SHEET NO.: 12' t-II ~TO~.IC la..L=PLIG~ PIOOl:7 BUILDING SECTION I~E~TOII~ATION C.~11eJkGTC~f~ f~TOla~l:7, ~ ~m HI~TOI~IG TI~ t~, la~-CX~N~TIll~TE~7 ~ ~ EEPLIGAI~D ~ r~ E~" THt(. ~,hILI ~ L,~q~ATION I,flA.U. ON · ~ / HO~TAFI~:~ .C~ .gTOt~ PAGIN~ ON .-. ~_.~_~._~___/_ ...... _-__,_-_ ....... , I ~ cRAWL i ~_-, . PLASIER FINI~'I ON PiOOD LATH ~ ON Jfl¢:7OD ::.~ATHIN~ ON Tlt4t~q~ ~HE, ~t/A~O'l BL.O~K~ IxlO-I~" ~1~1 I ~ifl PINE FL~3f~IN~ ON %" PLYing. I::~=G~IN~ ON 2x~l&· ~:LR. ~::71ST~ 2.x6 ~ Ifl~. 5ILL PAGIN~ C, ONll~TC~ F-~3UN~ATION ~ON~. F're. ~) e4 FOUNDATION PLAN SCALE: 114" = 1" -0" ~,'lla~,'ll.lle~ 15 A NON-HA~ITA~L.~ HI~'ro~IG ~TOf~ATION ~ ~JNC..,IPAL US~ IE~ DI~/.AY' C~ HI~TOf~IG ,a~TIFA~'i~. ~ IE, NO ENVII~I~II"AL CONOITIONIN~, t40~ F'L.UMBIN~. FOYER ~ ON STOOP ON FLOOR PLAN SCALE: 114" = 1' -0" · 3Of=INE~ ON INOOO LATH ON ~-~TOfe~ TI1~4~1~ ~ GON~-.~T~ ~lllV~t.C-~ -- RL=PLIGA 1~1~. IqlNDOPE, ~,,u~/.4.~' GAClN~ ~ fa~--~TO~a. ATION I FOUIV~ATIOH v~TONE TC;vP -- I I FOUNDATION R~/~TC:~IE P,~IN~ -- I EAST ELEVATION SCALE: 1/4" = 1' -D"' SOUTH ELEVATION SCALE: 114" = 1" -0" WEST ELEVATION SCALE: 114" = 1" -0" NORTH ELEVATION SCALE: 1/4" = 1' -0" REGULATORY APPROVALS )RAWN BY: UT :)ATE: 8114109 SCALE: AS NOTED SHEET TITLE: PLANS ELEVATIONS SECTION SHEET NO: