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HomeMy WebLinkAbout37719-Z �SUFFo TOWN OF SOUTHOLD moo �c�ay BUILDING DEPARTMENT y a TOWN CLERK'S OFFICE 01 . SOUTHOLD NY y� os f 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#: 37719 Date: 1/2/2013 Permission is hereby granted to: Finora, Robert & Finora, Deana 264 Princeton Rd Rockville Centre, NY 11570 To: Demolish a garage 16' X 24' as applied for At premises located at: 165 Orchard St, New Suffolk SCTM # 473889 Sec/Block/Lot# 117.-5-33 Pursuant to application dated 12/12/2012 and approved by the Building Inspector. To expire on 7/4/2014. Fees: DEMOLITION $215.20 Total: $215.20 Building Inspector DECE � WE TOWN OF SOUTHOLD 1'fC 12 2012 B L G PERMIT APPLICATION CHECKLIST BUILDING DEPARTMEN 4� W F �U o you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL:(631)765-1802 BLDG.DEPT. Planning Board approval FAX:(631)765-9502 L TOWN OF SOUTHOLD Survey SoutholdTown.NorthFork.net. PERMIT NO. 257719 Check — . Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined ( 20 Storm-Water Assessment Form Contact: Approved 20_1.3 Mail to: Disapproved a/c Phone: Expiration ,20 Building Inspector APPLICATION FOR BUILDING PERMIT Date 120 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 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 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,if a corporation) C�PLI Pr o cego,,L 1?oYqcl Rcc4l, Ile Ce4i(e, (Mailing address of applicant) State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder ' 45)© 0 w VyeP, Name of owner of premises Rbheyi R yi1c)R yq (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. 1. Location of land on which proposed work will be done: IC5 06yChP}rd V. IyeW SU-C4a1K House Number Street L Hamlet County Tax Map No. 1000 Section Block Lot Subdivision Filed Map No. Lot r ' 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy S-l&ey,,w Shf T��Vi✓v1�� - b. Intended use and occupancy S 14✓1 e 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition X Other Work (Description) 4. Estimated Cost 101,000— #q OX 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 /-7- 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. d ,J a /1 -P 7. Dimensions of existing structures,if any:Front L(�-L� Rear �6�% Depth Height /7' Number of Stories / ; Lai't 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 9 7- aO Rear 87+75 Depth 9 01 10.Date of Purchase M Py aF,3Gt78 Name of Former Owner Y 1-0+('4 i o 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 JR010 r fet rl'VOROAddress Phone No.9 17.670J,3/ell/ 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 X 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 X *IF YES,PROVIDE A COPY. STATE OF NEW YORK) COUNTY OF SU�'CC) qtj-^k 4t-11� being duly swom,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 to before me this t /Of day of (�Cs c 20 e 4— of Now Yolk Signature of Applicant No.0211V 5919 ()UetlNed In&tt &COU* Commid6lon 6Vhee FOIXL ►0.2016 r ' U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Management Agency I Expires February 28.2009 National Flood Insurance Program Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name r+ r Policy Number A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number. S City A )010 C J01 J� State A)e, / /\ ZIP Code A3. Pro erty Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) 1 'I S�, k d l�'� cz,,, Tc.. Z�f Flo, I o'0 r 11_7 _01, -23 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) A5. Latitude/Longitude:Lat. 4W 37" Long. -7 a' ZA'.2-0 Horizontal Datum: ❑NAD 1927 f'NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number o A8. For a building with a crawl space or enclosure(s),provide: A9. For a building with an attached garage,provide: a) Square footage of crawl space or enclosure(s) 700 sq ft a) Square footage of attached garage sq ft b) No.of permanent flood openings in the crawl space or ff_� b) No.of permanent flood openings in the attached garage enclosure(s)walls within 1.0 foot above adjacent grade �U walls within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b f80 sq in c) Total net area of flood openings in A9.b sq in SECTION B-FLOOD INSURANCE RATE MAP (FIRM)INFORMATION B1.NFIP Community Name&C mmum y Number B2.County Name 63.State -rOL.) l 0 n Sa�Ift'�0 J 0$�3 Sv' ®I B4.Map/Panel Number B5.Suffix 86.FIRM Index B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO,use base flood depth) 2 G102C_05'01 G I MCI 4 9 1 W A )ter. B10. Indicate the source of th Base Flood Elevation(BFE)data or base flood de th entered in Item B9. ❑FIS Profile FIRM ❑Community D termined ❑Other(Describe) B11. Indicate elevation datum used for BFE in Item B9: 1W NGVD 1929 ❑NAVD 1988 ❑Other(Describe) B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes [R44o Designation Date ❑CBRS ❑OPA SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑Construction Drawings' ❑ Building Under Construction' gFinished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations-Zones Ai-A30,AE,AH,A(with BFE),VE,V1430,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-g below according to the building diagram specified in Item A7. Benchmark Utilized Al.7 3"1 No, " 1533 Vertical Datum Conversion/Comments Chh k the measurement used. a) Top of bottom floor(including basement,crawl space,or enclosure floor) u feet ❑meters(Puerto Rico only) b) Top of the next higher floor f feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) - _❑feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) - ❑�{feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building ? .3 u feet ❑meters(Puerto Rico only) (Describe type of equipment in Comments) f) Lowest adjacent(finished)grade(LAG) ►�feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade(HAG) (p .O ®feet ❑meters(Puerto Rico only) SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. 1 certify that the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001. Q•�S OF NeIV'0 Co JAFr c� .0 Check here if comments are provided on back of form. r Certifier's Name Licenser L���r� r S License Number N 6 7 7 (A li 5-D l� Title Company Name � �, / � e Lti�J� s� -aelV f7lF�a.1 l�o � co,-VJkt� � "^ S�PJ�40/ •�J Address P.0. ao 031 3 Y city Krv�/ �ej State /� ZIP Code g� [1 S Signature V f� l Date Z Telephone -ZO 9 �a ��r C tv�1" Z,7 !� FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions b IMPORTANT: In these spaces,copy the corresponding information from Section A. Fort isurarice Company Use:_. ; T Buildin Street Address including pt.,U it,Suite,and/or Bldg.No.)or P.O.Route and Box No. Pblic�!Number d r �T 4 City State ZIP Code Company NAIC Number SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments 71�te P✓rnyap� / c.c4 t ti �e C ci re 4 o-A 4<_ �IfS L3 �� IkLQ 6, /C, Signature eAl Date y liCl v ❑ Check here if attachments SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQ IRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items E7-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C. For Items El-E4,use natural grade,if available. Check the measurement used. In Puerto Rico only,enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawl space,or enclosure)is _❑feet ❑ meters ❑above or ❑ below the HAG. b)Top of bottom floor(including basement,crawl space,or enclosure)is ❑feet ❑meters ❑above or ❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Section Items 8 and/or 9(see page 8 of Instructions);the next higher floor (elevation C2.b in the diagrams)of the building is _Elfeet 0 meters ❑above or LJ below the HAG. E3. Attached garage(top of slab)is ❑feet❑meters ❑above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑feet ❑meters ❑above or ❑below the HAG. E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑Unknown. The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A,El,and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Cade Signature Date Telephone Comments ❑Check here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8.and G9. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3. ❑ The following information(Items G4.-G9.)is provided for community floodplain management purposes. G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7.This permit has been issued for: ❑ New Construction ❑Substantial Improvement G8.Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters(PR) Datum G9.BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR) Datum Local Official's Name Title Community Name Telephone Signature _ Date Comments ❑Check here if attachments FEMA Form 81-31,February 2006 . Replaces all previous editions FEB. 27. 2008 12:06PM IIV, I " N1 FuoJInrsk S•. 63° 47 2' z0 MON. FNo. eT- 7S Qz Nt y'pOp pE�•R, 2 %4 Sr a r. roe . • � 1 FR.G,4R. ti � � , • FND. I /Q q � tij ' . N. a3 W 8T �O, W, MON• FND i ORCHARD STREEr• ' "•; eERT/FLED TOE MA P .O'P* - S0U rHOL 0 SAVINGS BANff DESCRIBED. PROPERTY. me rtrLE. GUARANTEE COMPANY AT. NE6Y $UFFO.G K roHN r0i/HE Y PA rR/C/A LOWREY . , TOWN OF. SOUTHOLD, 'N.Y. SUFF'OL IBC 'CO.; . I Y OF. NEw rp AREA� 7, 899 S(�. FT, • y�o�'°w�°h� 0. 1813AC -* donack associates • ,� 11 t 313 west maln'street riverh•ead, new york 11901 'VO a97-6'� w'°¢ _ (516) 36971717 SFO NO - MAR. 21, 1904 Job No, 84- 460 •.... .z 1�." /�- 9'0 •S 1000-117-05-33 SC0I$: I"= 201 t ` Ara-, Jr 1 . r CD j w f f r��� o