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Town of Southold Annex 12/16/2013
P.O. Box 1179
r 54375 Main Road
't5 } 70ex
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 36645 Date: 12/13/2013
THIS CERTIFIES that the building ACCESSORY
Location of Property: 13200 Route 25, Mattituck,
SCTM 473889 Sec/Block/Lot: 114.41-9.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
11/15/2013 pursuant to which Building Permit No. 38512 dated 11/15/2013
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:
repairs to existing accessory two car garage and demolition of accessory shed as applied for
The certificate is issued to 13200 Main Road Corp
-(OWNER)-
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Aut a ignat re
BUILDING DEPARTMENT
(4t*4 TOWN OF SOUTHOLD
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 38512 Date: 11/15/2013
Permission is hereby granted to:
13200 Main Road Corp
13235 Main Rd
PO BOX 65
Mattituck, NY 11952
To: repairs to existing accessory two car garage and demolition of accessory shed as
applied for.
At premises located at:
13200 Route 25, Mattituck
SCTM # 473889
Sec/Block/Lot # 114.-11-9.1
Pursuant to application dated 1/1/1900 and approved by the Building Inspector.
To expire on 5/17/2015.
Fees:
DEMOLITION $202.00
ACCESSORY $352.00
CO - ACCESSORY BUILDING $50.00
$604.00
i
Buildi ns ector
~pn TOWN OF SOUTHOLD ~ O I
r BUILDING DEPARTMENT
~ TOWN CLERK'S OFFICE
"ate~q SOUTHOLD, NYC
a
IZ F ,,1m
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 37443 Date: 8/15/2012
Permission is hereby granted to:
13200 Main Road Corp.
13200 Main Road (Route 25)
Mattituck, NY 119520036
To: Repairs to Accessory Structures; 2 Car Garage (22.1'X 28.5') &
Shed (17'X 20'), Both Non-Habitable, Storage Only, as applied for.
r
At premises located at:
13200 Main Road (Route 25), Mattituck
SCTM # 473889 ~p
Sec/Block/Lot # 114.-11-9.1
Pursuant to application dated 8/2/2012 and approved by the Building Inspector.
To expire on 2/14/2014.
Fees:
ALTERATION OF ACCESSORY BUILDINGS $488.00
CO - ACCESSORY BUILDING $50.00
Total: $538.00
i
Buil ing 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. November 13, 2013
New Construction: Old or Pre-existing Building: X (check one)
Location of Property: 32oo main goad Mattituck
House No. Street Hamlet
Owner or Owners of Property: 13200 Main Road Corp.
Suffolk County Tax Map No 1000, Section 114 Block 11 Lot 9.1
Subdivision N/A Filed Map. Lot:
Permit No. 37443 Date of Permit. R/t 5112 Applicant: t a2nn Main RnaA, rnrp
Health Dept. Approval: N/A Underwriters Approval: N/A
Planning Board Approval: N/A
Request for: Temporary Certificate Final Certificate: x (check one)
Fee Submitted: $ 50.00 13200 Main orp
By
:
Applicant Signature
FIELD INSPECTION REPORT DATE COMMENTS
~ W
FOUNDATION (1ST)
FOUNDATION (2ND) .
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ROUGH FRAMING &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY CODE ~t--
4
41 1
FINAL
ADDITIONAL COMMENTS
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following, before applying?
TOWN HALL 4 Board of Health
SOUTHOLD, NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502Survey
SoutholdTown.NorthForLnet PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
LL Trustees
Flood Permit
Examined I 20 Storm-Water Assessment Form
Contact:
Approved 20 Mail to:
8iszpprtiv~ifa/e--
UU Phone:
Expiration 20 T
D it M E Building Inspector
- 2 2012 ICATION FOR BUILDING PERMIT
AUG
Date July 31 20 12
BLDG DEPT. INSTRUCTIONS
_ TOWN Of WRHOLD
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.
£ 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, hoX de, W7
d to admit
authorized inspectors on premises and in building for necessary inspections.
(Signature of applic or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
OWNER
Name of owner of premises 13200 Main Road, Corp.
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
WILLIAM C. GOGGINS
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
13200 Main Road, Mattituck
House Number Street Hamlet
County Tax Map No. 1000 Section 114 Block 11 Lot 9.1
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises .nd Aftrided use and occupancy of proposed construction:
a. Existing use and occupancy one-family dwelling
b. Intended use and occupancy Multi family subject to approvals
3. Nature of work (check which applicable): New Building Addition Alteration
Repair __X _Removal Demolition Other Work *SEE ATTACHED
(Description)
4. Estimated Cost $5,000.00 Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units 1 Number of dwelling units on each floor
If garage, number of cars Two
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front 25.3 Rear 21 Depth 36
Height 30 Number of Stories 2.5
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 72.5 Rear 123.63 Depth 168.75
10. Date of Purchase 7/2112 Name of Former Owner Grabie
11. Zone or use district in which premises are situated Hamlet Business
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_ NO x
13. Will lot be re-graded? YES_ NO X Will excess fill be removed from premises? YES_ NO X
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 x
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES NOS
* 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 OFSUFFOLK )
WILLIkM C. GOGGINS being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)Heisthe corporate Officer
(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 o before me this
day of August 0 12
- LMNt York
Notary Pub is OdiarY ° 01k Coun Signature if App
t
NO.01PA50699f 6,p~ember9, It
^ommissior Exp
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AVOIF s
MICHAEL Z. HERBERT`
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SOUlyolo
Town Hall Annex Telephone (631) 765-1802
54375 Main Road Fax(631)765-9502
P.O. Box 1179
Southold, NY 11971-0959 i~
o~y00UI~f1
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
November 8, 2013
13200 Main Road Corp.
PO Box 65
Mattituck, New York 11952
RE: 13200 Main Road, Mattituck
Dear Mr. Goggins:
On August 15, 2012, we issued a Building Permit, #37443, for repairs to
accessory structures. This permit was never paid for. To pay for the garage
repair the fee is $402.00. The fee for the shed demolition is $202.00. One check
can be submitted for both permits.
If you have any questions, please contact me at 631-765-1802.
Respectfully,
Southold Town Building Dept.
tzr,".4 61-~
Connie Bunch
so
Town Hall Annex Telephone (631) 765-1802
54375 Main Road Fax (631) 765-9502
P.O. Box 1179 co
Southold, NY 11971-0959
Own
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
November 8, 2013
13200 Main R d Corp
13200 ~=c) CD
Mattituck, NY 11952
TO WHOM IT MAY CONCERN:
The Following Items (if Checked) Are Needed To Complete Your Certificate of Occupancy:
Since the shed has been removed, you would need to apply for a demo permit so that it would be
taken off your tax bill
Application for Certificate of Occupancy. (Enclosed)
Electrical Underwriters Certificate. (Contact your electrician)
A fee of $50.00.
Final Health Department Approval.
Plumbers Solder Certificate. (AJI permits involving plumbing after 411/84)
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.
Final inspection by Building Dept
BUILDINGPERMIT: 37743- Repairs to Accessory Structures
WILLIAM C. GOGGINS
ATTORNEYAND COUNSELOR AT LAW
13235 Main Road, P.O. Box 65
Mattituck, New York 11952
Phone: (631) 315-5300
Fax: (631) 298-4214
williamgoggins@yahoo.com
WILLIAM C. GOGGINS
Attorney at Law
DONNA M. PALMER
Paralegal
November 13, 2013
Southold Town Building Department
53095 Main Road
Southold, New York 11971
Attn: Connie Bunch
Re: 13200 Main Road Corp.
13200 Main Road, Mattituck, New York;
SCTM No. 1000-114.00-11.00-009.001
Dear Mrs. Bunch:
Enclosed please find a check in the amount of $604.00 as and for payment
for the garage repair fee of $402.00 and the shed demolition fee of $202.00.
Enclosed please find an application for a Certificate of Occupancy for the
repairs to the garage and the fee for same.
Thank you.
r Very truly yours
William C. og Ins
WCG\
enclosures
C~30
G g oil/-//i~B/~jfBC~ ~ccFSSa,Ay sTRQcT
Repair rotted wood; - d VL
Replace et'~i 7asphaltshingles; s7JCAOe 0,1
Repair and/or replace facia and damage eave ,
Replace garage doors.
Shed: 7 a o
Repair rotteReplace riX
with asphalt shingles;
Repair an
a and damaged eaves;
Replace dInstall cem
l ~,a X,'-(0 3S~ i o D
0 0
TOT/FL 0 00
S
CHW LjW FENCE ON WOOD 14)
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HERBERT
MICHAEL Z. o or 6r
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Repair rotted wood; ~
Replace the alt shingles; s7ad2A G~ "14-Y 141.63 ~z STOCVME
Y ° , . 7 b Mae GN PORT < FENCE AAOIMD
Repair and/or replace facia and damage eaves, a STONE DR"S"" V FENCE 2'
SHOWER h
Replace garage doors. 4wiRE
g,o=
!I ui
/ FENCE
O.q'W-
~ j os'w -o o
Shed:
~ a
10.3 + 5.
s
Repair rotted wood; 25N o
Replace roofing material with asphalt shingles; \ z ST NpUSE ,n
Repair and/or replace facia and damaged eaves; Yt~~ vRAME s-D' p 00
Replace doors; and m <
N
Install cement floor. P4AA3 ,
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D,,-, . , r I~ _ 30 0 I o 0 i 1 ~ 0p{JErIAY '
/0'a, 00 a • NEB NOM ::::rte. 68 7 5, o
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APPROVED AS NOTED 54B r4L c---j g , o 0 66 Y Y SV~z
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DATE-w 1s r' B.P. # C Q
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FEE 00 • .
BY N O~F
NOTIFY BUILDIN DEPARTMENT AT
765-1802 8 AM TO 4 PM FOR THE ~oTj¢~ I Y M, JAaUIUII,~v
FOLLOWING INSPECTIONS: O O 0 ~HfTE E. JA4
1 FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
Z ROUGH - FRAMING, PLUMBING, COMPLY WITH ALL CODES OF
STRAPPING. ELECTRICAL & CAULKING NEW YORK STATE & TOWN CODES
3. INSULATION AS REQUIRED
4. FINAL - CONSTRUCTION & ELECTRICAL
MUST BE COMPLETE FOR C.O. S OLD TOWN ZBA
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW SOUTHOL NNIN6 BOARD
YORK STATE. NOT RESPONSIBLE FOR SOOT TOWN TR
DESIGN OR CONSTRUCTION ERRORS.
S. DEC
SURVEY OF PROPERTY
SITUATE
MATTITUCK
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-114-11-9.1
SCALE 1"=20'
JANUARY 11, 2012
AREA = 13,568 sq. ft.
0.311 ac.
CERTIFIED TO:
13200 MAIN ROAD Corp.
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a . ,m1m vo~€ - '.~ma*„w w~ES, 2 50
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\
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PREPARED IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR T SURJEIS AS ESTABLISHED
BY THE JAL.S. AND APPROVED AND ADOP FOR SUCH USE BY THE NEW FORK STATE AND
$ w 67.64' TITLE ASS0CM0N.
^ 86-11 40 GW.GE•=0 OPIVYMAT C] g,~P'CE OF 1V(z
. N.15'E POfR (n y FWNO 1.4' FENCE,'
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\ 10.5' • • v MME FENCE o. N./s. O: p~M F N v • I dsxFV.
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N o .3 n}P p a FRAME u mom X467
GARAGE 00 ~~A11Vm S J`_ N.Y.S. Lis. No. 50467
O Im 3.1'E UNAUTHORIZED ALTERATION OR MOTOR - TO THIS SURVEY IS A NOTATION OF
MOTION EDUCATION CON A72OSW. OF THE NEW YORK STATE R
UP BY 22. u mm Nathan Taft Corwin III COPIES OF THIS SURVEY MVP NOT BEARING
MON. THE SLAND SEFD SEAL SURVEYOR'S NOT INKED SEAL SI Land Surveyor CONSIDERED TO TO BE BE A VALID TRUE UE C OM
OC1oW5,ENE k LM1L. NON. Sf 123.63' 4.. fp1N1o
~~77 \ • C N NON. f CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY
WIPE FENCE W N IS PREPARED. AND ON HIS BEHALF TO THE Successor To: Stanley J. Isaksen, Jr. LS. TNLE COMPANY, GOVERNMENTAL AGENCY AND Joseph A nge9no LS.
S 84!50'00" LENDING INSRMION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INBTIABLE,
THOMAS FCpRTHY TUTON. CERTIFICATIONS - rifle Surveys - Subdivisions - Site Plans - Construction Layout ARE NOT TRANSFER
G~O'+ & SUSAN WA LS cCARTHY PHONE (631)727-2090 Fax (631)727-1727
THE EXISTENCE OF RIGHTS OF WAY OFFICES LOCATED AT MAILING ADDRESS AND/OR EASEMENTS OF RECORD, IF 1586 Main Road P.O. Box 16
ANY, NOT SHOWN ARE NOT GUARANTEED. Jamesport, New York 11947 Jamesport, New York 11947