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Home My WebLink About36305-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 11/19/2012 CERTIFICATE OF OCCUPANCY No: 36050 Date: 11/19/2012 THIS CERTIFIES that the building RESIDENTIAL ALTERATION Location of Property: 18200 Route 25, Mattituck, NY 11952, SCTM #: 473889 Sec/Block/Lot: 115.-4-18.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 3/29/2011 pursuant to which Building Permit No. 36305 dated 4/7/2011 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: alteration to existing historical building (library) as applied for. The certificate is issued to Mattimck Historical Society (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 36305 11/15/12 ~ttJ~re TOWN OF SOUTHOLD 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 #: 36305 Permission is hereby granted to: Mattituck Historical Society PO BOX 766 Mattituck, NY 11952 Date: 4/7/2011 To~ Alteration to an Existing Historical Building; Library Room, as applied for. At premises located at: 18200 Route 25, Mattituck, NY 11952 SCTM # 473889 Sec/Block/Lot # 115.-4-18.1 Pursuant to application dated To expire on 10/612012. Fees: 3/29/2011 and approved by the Building Inspector. NEW COMMERCIAL, ALTERATION OR ADDITIONS CO - COMMERCIAL Total: $262.80 $50.00 $312.80 , Form ~o. 6 TOV~N OE $OUTHOLD 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, pvoperty 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 o f 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 Pl.anning 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. Tetnporary Certificate of Occupancy - Residential $ l 5.00, Commercial $15.00 New Construction: Location of ProPerty: · Owner or Owners 0f Property: / Old or Pre-existing Building: House No. Street Date. Suffolk County Tax Map No 1000, Section Subdivision Permit No. ~_~0 ~-%"~ Date of Permit. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Block Filed Map. Applicant: (check one) Hamlet Underwriters Approval: Final Certificate: /A~licant Signature Lot ~"' / Lot: Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY l 1971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 ro.qer.ddhert~town.southold.n¥.us BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Mattituck Historical Society Address: 18200 Main Rd City: Mattituck St: NY Zip: 11952 Building Permit #: 36305 Section: 1 1 5 Block: 4 Lot: 18.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: REP Electric License No: SITE DETAILS Office Use Only Residential [~ Indoor ~ Basement [~ Service Only ~ Commerical Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 3 ph Hot Water GFCi Recpt Main Panel NC Condenser Single Recpt Sub Panel NC Blower Range Recpt Transformer Appliances Dryer Recpt Disconnect Switches Twist Lock Other Equipment: one room Notes: Ceiling Fixtures ~r~l[~ HID Fixtures Wall Fixtures I I Smoke Detectors Recessed Fixturesl 71 CO Detectors Fluorescent Fixture Pum ps Emergency Fixture Time Clocks Exit Fixtures TVSS Inspector Signature: Date: Nov 15 2012 81-Cert Electrical Compliance Form.xls TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [~INSULATION ] FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION [ ] FRAMING / STRAPPING [ [ ] FIREPLACE & CHIMNEY [ [ ] FIRE RESISTANT CONSTRUCTION [ [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: .//~ ~ _/~< ~-~-~ DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-t 802 [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY INSPECTION [ ] R/~K~H PLBG. [ '"'J' INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE .F. SlSTANT CONSTRUCTIO. [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: ..~.F~ ~ ~- DATE INSPECTOR~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] F~RE RESb'TA.T CONS~UCTIO. [ ] ELECTRICAL (ROUGH) REMARKS: [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION ~E.~ECTRICAL (FINAL) DATE ~ INSPECTOR~' TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FIREPLACE & CHIMNEY [ ] FIIIEllESlSTAHTC0m~UCTION REMARKS: /~t~ ROUGH PLBG. INSULATION FINAL FIRE SAFETY INSPECTION RRE HESITANT PENLmMTI0fl DATE ~ INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS~ON [ ] FRAMING/STRAPPING [,~'INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELEmlCAL (ROUGH) [ ] ELEmlCAL IFINAL) REMARKS~~--~~~._ DATE ~ INSPECTOR l~°mr°A~°~ (~s~ FOUNDATION (2ND) ~ {' ~ 8TA~ ~ cOD~ TOWN H~ALL SOUTHOLD, NY 1197~ TEL: (631) 765-1802 FAX: ~(631) 765-9502 SoutholdTown.NorthFork.net PERMIT NO. Examined ~'- ~O ,20 {l Approved l.~._ 7 ,20 [I Contact: Mail to: ~)':aapp~ u v~d a/c Expiration lO .~- 6 ,20 [~ Building Inspector BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Phone: 75q- 6 ¢05- APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ,,27/o~,.5' ,20// 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 ~treets 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 workl e. No building shall be occupied or used in whole or in part for any purpose (vhat 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 within4 8 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 alt 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) (Mailing address of applicant) State whether applicant is owner, lessee, agent, ~architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises /~'~ --~ /~ ~'~..~ C~C2~,~?Z~.~ (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 LicenseNo. Plumbers License No. Electricians License No. Other Trade's License No. Locat~gn of land on which prop, osed~work.will House Number Street be done: Hamlet County Tax Map No. 1000 Section Subdivision Block 4 Filed Map No. Lot /d~, /' Lot State existing use and occupancy ofprem!ses and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy Nature of work (check which applicable): New Building Repair Removal Demolition Estimated Cost ~/gpO~ Fee Addition Other Work Alteration (Description) (To be paid on filing this application) If dwelling, number of dwelling units ,/Cz/z/- If garage, number of cars Number of dwelling units on each floor If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front ~ ~'. Rear He ght ~¢7 ~¢t'. Num. ber of Stories Dimensions of same structure with alterations or additions: Front Depth Height 8. Dimensions of entire new construction: Front Rear Height Number of Stories 9. Size oflot: Front Ot9OO ~'~'' Rear o~7 Number of Stories Depth G,'~/'rq .~- Depth ~/~-'~ - 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 V 13. Will lot be re-graded? YES__ NO /will excess fill be removed fi.om premises? .YES__ NO / R 14. Names of Owner of premises ///]/,-~'/ Address NameofArchitect cPd-//]{,/o~7,~ ,~ ,q'"F'6c~d'l~Zf/Address Name of Contractor Address 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES__ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE.,g, EQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. Phone Phone Phone No. NO 16. Proyide 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 V · IF YES, PROVIDE A COPY. STATE OF NEW YORK) COuNTY OFSofG[~S: ~/~O//k'/~,ff /-~-~ C..~tSgP/q/-~'~.~,.ff being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the .,/~C~ '-~"~ ~/X- (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 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 thi~ To~n Hall Annex 54.375 Main Road P.O. Box ,.5ou~old, NY 119714~59 Tdcphone (6,31) 765-180~ REQUESTED BY: Company Name: rqame: License No.: Address: Phone No.: BUn 33EGG DEPARTMENT TOWN OF SOUTHOLn ,APPLICATION FOR ELECTRICAL INSPECTION JOBSITE INFORMATION: (*ln, dicates required information) ~,~_,~ _-/-o~L~,/.,t~l/ $ . . *Cross Street: . ' ' * ' ' *~ Permit No.: Tax-Map Distda: 1000 Section: I [_~ Block: ~ Lot: ]~'. I *BRIEF DESCRIPTION OF WORK (~ease Pdnt Clearly) ' (P!e~e C~le NI That A~ly) *Is ~b ready for inspe~i0n: ~ NO Rough In F~al ~.~u n~ a T~p Celeste: YES / NO Temp Information (If needed) *Service Size: 1 Phase 3Phase ~New Service: Re-connect Additienal Information: B2,-Request for Inspection Fern 100 150 200 300 Under,qmund N,,,-~--~f Metem Change of Service /I: ~ ~ ~ ~^~IDUEWITH^PPLICATION 350 400 Other Overhead Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 Fax (631 ) 765-9502 BUILDING DEPARTMENT TOWlq OF SOUTI-IOLD June 11,2012 Mattituck Historical Society PO Box 766 Mattituck, NY 11952 RE: 18200 Route 25, Mattituck TO WHOM IT MAY CONCERN: The Following Items Are Needed To Complete Your Ceffificate of Occupancy: Application for Certificate of Occupancy. (Enclosed) ~ Electrical Underwriters Certificate. (contact your electrician) A fee of $50.00. __ Final Health Department Approval. __ Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) __ Trustees Certificate of Compliance. (Town Trustees # 765-1892) __ Final Planning Board Approval. (Planning # 765-1938) __ Final Fire Inspection from Fire Marshall. __ Final Landmark Preservation approval. BUILDING PERMIT: 36305 - Alteration Applicant. ,/~"r~--~ ~-~r~txa~ _Owner: 7~~ ~ ~~: ~ ~ Estimat-'-ed Cost: SCTM# 1000---/]-'~-- ~[- --- / ~, I Subdivision: ' Property Address: ] ~-0 0 /~ ~ ~ Building Permits (Open/Expired): tip ~ -z / ~0 z- ~ ., Info: BP ~ -Z / ~0 Z- , Info: BP~-Z / C/0 Z-__ 8ingle & Separate Search Required? Y Determination: ~Q. ~t Size: ACT. ~t Size: ~Q. Front ACT. Front ~Q Side ACT. Side ~Q. Height ACT. Height_ R~. ~ 51~5 Project Description: Waterfront? Y or ~. If yes, water body: Zone: t~-~O Conforming? City:/F/~ PreCOs?~ · -- - BP __ -Z / C/0 Z- , Info: Info: BP -Z / C/0 Z- ~ Info: _ REQ. Lot Cov. __ ACT: Lot Cov. REQ. Rear__ PROP. Rear __ Panel# ~ Flood Zone: ~ Bulkhead/Bluff Distance: ADDITIONAL APPROVALS REQUIRED Suffolk County Health: Y or~- If yes, *Bed#: *Date: / / *Permit#: - If no, certification required: Y or N Received: Y or N By: NYS DEC: PRE-DEC9/1/75 Y or~- Date: Southold Trustees: Yor~- Date: /__ __ Southold ZBA: Y 0~- Date: / / / / Permit #: / Permit #: Permit #: Town Septic: or NJ Letter - Notes: or NJ Letter - Notes: - Notes: Southold Planning: Y of.~- Date: / / Permit #: Town Landmark C of A: Y o~)DTE: __/__/__ - Notes: *NYS CODE Compliance (page 2~or N Notes: Fee Structure: Foundation: SF First Floor: ,~ SF Second Floor: SF Other: SF Total: SF Calculation: + Initial Fee: $ ~q'o, OO + Additional Fee ( ): $ SF X $.__ =$ + Initial Fee: $ + Additional Fee ( ): $ TOTAL: $ NEW YORK STATE CODE COMPLIANCE CHECKLIST CLIMATIC/GEOGRAPHIC D'~SIGN CRITERIA: · Grountl Snow Load: gO. Weathering: Severe .Frost Depth: 36" __ Design Temp: 11 · Ice Shield Underlay: YF_,S . USE/OCCUPANCY CLASSIFICATION: · HEIGIZtT/FltkE AREA: ., TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE FULL FRkAMING DESIGN ELEMENTS: Y/N HEADERS: Y/lq WALL STtrDs: CEILII~IG JOISTS: Y/N FLOOR JOISTS: Y/Iq LU'BIBER SPECIES AND GRADE: Y/N Wind Speed~ IZOMPH__ Seismic Design Category." B . Termite: M-H' Decay: S~M Flood Hazai'ds: GERDIgRS~ YiN ROOF RAIiWERS: ¥/N WINDOW AND DOOR SCHEDULE: d?~r .MISSLE TEST REQUIREMENTS: Y/N EGRESS 5.7 S.F.: Y/N LIGHT 8%: Y/N 5rENT 4%: Y/N NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: Y/N PLUMBING RISER DIAGP,-~: Y/N LOCATION OF F[ID~ PROTECTION EQUiPMENT: Y/N TRUSS DESIGN: Y/N CIERTIFICATION: Y/N ENERGY CALCS: Y/N TOTAL COMPLIENcE]i/~/N (RETURN TO PAGE ONE) SITE DATA MAIN N 88'08'20" E (NYS ROUTE 25) scTM# PROPERTY: ZONING: ROAD LAY~N ~ ADDRESS OWNER: 200.0' SITE: ~ENOYATE SIN~Lr= ~OOM IN i~XISTIN® I~UILOlN~. LAND¢OAPE EXISTIN~ MILK t'IC~,~t' HC~JSE I LAI~N ~ LANDDC, APE ITE PLAN ~ S CA~.' 1'-~-- 20'-~~ 267.86' : 1000-tt8-4-18.1 18200 MAIN ROAD MATI'ITUCK, NY 11952 MATTITUCK-LAUREL HISTORICAL SOCIETY PO BOX 766, MAI-rlTUCK, NY 11952 82,t28 sf -- 1.89 ac R-40 ELECTRICAL INSPECTION REQUIRED COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED-AND-CON~F // ~Ln~OLD T0w~ z,A ~ APPROVED AS NOTED NOTIFY BUILDING DEPONENT AT 765-1802 8 ~ TO4 ~ FOR THE FOLLO~NG INSPECTIONS: I FOUNDATION. ~ RE~D FOR POURED CO~ 2 R0UGH- F~ING, ~UM~, ST~PPING, ELECTRICAL ~ C~LKING 3 INSUliN 4 FINAL - C0NS~UCTION ~ E~CT~C~ MUST BE C~PL~ F~ C.O. ALL C0N~N ~ ~I ~ REQUIR~EN~ OF ~ ~S 0F ~ YORK ~A~. ~T ~ ~ ~SmGN ~ ~ ~. REGULATORY APPROVALS DATE: 3125111 SCALE: 1" = 20'-0" SHEET TITLE: SITE PLAN SHEET NO.: 1 POST E~AI'4, , (2)l~"x~," t=LUS{-I LVL ~/~" .~TL. PL. L I BI, AIn't' GUT ~XISTIN~ I,'~LAJ..L ~ ~t~ILING FINI."dHES~, PEOVIDJ~ INSULATION * NEY'I ~ ~7' ~' FINISHES PLAN 112" 1' -0" ' Is/ol ELECTRIC LAYOUT PLAN E!XlDTIN~ STALE TO BASI=HENT TO ~EMAIN I ~) ELEVATION Ol~R HOLDPROVI~E -OPEN -- (~ ELEVATION ELECTRICAL LEGEND PUPLEX PJ=C..EPTAC..LE OLr'r'LET 5PilTC, H TELEPHONE 4" [2lA. HIgH HAT PIXTU'P<E 5U~A~E ~OUN~ GEILIN~ FIX~ //i~ / i\\ / \ \ \ // \\ // \\ // NE~ ~00~ II II (~) ELEVATION Il II x, 'x (~) ELEVATION I~00~ PIAINSCO i I IN~ ~/I'OP C, OV~ ~ C~AP NOTt~5: PROJEGT INC,.LUDES ~ ENC, LOSIN~ EXISTIN~ STALE TO NON-HABIT~LE, ~ BA~."'HENT. THEEE P, IILL BE ANOTHEE FIXED STALE FOE A~ESS TO ~A~NT. 1001 TCS ;)ATE: 3121111 SC;ALE:: 112" = 1'-0" Jill=El I II LE: LIBRARY RENOVATIONS REGULATORY APPROVALS