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Home My WebLink About28178-ZFORM NO. 4 TOWN OF SOUTNOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-30144 Date: 04/19~04 THIS CERTIFIES that the building ACCESSORY Location of Property: 370 HOBART RD SOUTHOLD (HOUSE NO.) (STREET) (HA~4LET) County Ta~Map No. 473889 Section 62 Block 3 Lot 6 Subdivision Filed Map No. Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 19, 2002 pursuant to which Building Permit No. 28178-Z dated MARCH t5, 2002 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 ACCESSORY GAkAGE AS APPLIED FOR. The certificate is issued to ROBERT & DONNA M MOSQUERA (OWNER) of the aforesaid builiing. SUFFOLK COUNTY DEPARTMENT OF ~2~LTHAPPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION D~r~u Rev. 1;81 N/A 85429H 03/10/04 N/A Authori~ 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) PEPd~IT 'NO. 28178 Z Date MARCH 15, 2002 Permissmon is hereby granted ROBERT & DONNA M MOSQUERA 2595 VILLAGE LA ORIENT.,N~f 11957 for CONSTRUCTION OF A 15 X 20 FOOT GARAGE AS APPLIED FOR MAINTAINING REQUIRED SETBACKS AND CONFORMING TO DEC AND TRUSTEE CONDITIONS W/ FLOOD PERMIT at premises located at 370 HOBART RD SOUTHOLD County Tax Map No. 473839 Section 062 Block 0003 Lot No. 006 pursuant to application dated FEBRUARY 19, 2002 and approved by the Building InspecEor. Fee $ 175.00 i 2/I9/98 ORIGINAL Form No. 6 TOWN OF SOUTItOLD 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 whh accurate location of all buildings, property lines, streets, and unnsual natural or topographic features. 2. F/-ual. Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. A~ pprgyal of electrical installation from Board of Fire Underwriters. S*ror~, s~t~ment ~romplumber certifying that the solder used iu system contains less than 2/10 of 1% lead. 5. Q~,m"c:ciall,:;kl~:v_'.~cd,~h'a building, multiple residences and similar buildings and installations, acerfificate ~,~' ( t.d, t ',,~ .pi ::.~'cc: ;,~l', :, ,':~ tect or engineer responsible for the building. 6. 8rrb~t~g BOarc~ Approvai of completed site plan requirements. B. For existing b~ddings (prior to April 9, L957} non-conforming uses, or buildings and "pre-existing" ~and uses: 1. A¢cura*e sm~ey of property showing all property lines, streets, building and unnsual natural or topograptdc features. 2. ~ proper~y completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is 6~nied the Building Inspector shall state the reasons therefor/n writing to the applicant C. Fees 1. Certificate of Occupancy - New dwelling $25.00. Additions to dwelling $25.00. Alterations m dwelling $25~0, Swimming pool $25.00, Accessory building $25.00. Additions to accessory building $25.00, 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 Ocenpancy - Residential $15.00, Comm~cial $15.00 House No~ New Construction: Location of Property: Date. Old or Pre-existing Building: V,'/ Street check one) Hamlet Suffolk County Tax Map No 1000, Section i 0 0 0'~(~92 Block PerruitSo. ~ { 7~ 'Z.- _DateofPe~rdt. ~-"]~-0 ~ Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submkted: $ c~'. ~ Final Certificate: Lot (check one) pp icant Signafe / Issue .Date 3/10/2004 Issued To: Street: Village: Section: Contractor:. Commercial ~-~ResidentJal Switches 2 Dishwasher Furnace Meter Amps Electrical ln, llection Cert [icate Electrica[ Inspection Service, lnc Application 375 Dunton AvenUe 85429H East PatchogUe, New York 11772 (631) 286,6642 Robert Mosquera 370 Hobart Roa~l Southold Zip: 11971 Block: Lot: Lic. # Was examined and found to be in compliance with the NaUonal Electrical Code. Town: Southold ~ NVDefects [] Pool ~ lstFIoor [] Indoor [] Basement [] HotTub [] Der. Garage ~ Attic ~ 2nd Floor [] Outdoor [] Addition [] Survey Receptacles Fixtures GFI Heaters A/C Fans 2 3 2 Washer/Amps Dryer/Amps Oven Range/Amps Microwaves Oil Gas Circulators Smoke Detector Bell Transformer Phase UG/OH Jacuzzi Television CO Detector Bldg. Permit: Other Equipment ~-40Amp subpanel Hugo S. Surdi President P. ough Inspection: Inspector: Final Inspection: 03/0912004 Inspector: John Mc Mahon III This certificate must not be altered in any manner. Inspectors may be identified by their credentials. Albert J. Krupski. President James IgJng, Vice-President /Ar tie Foster Ken Poliwoda Peggy A. Dickerson February21,2002 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. BDx 1179 Southold, New York I1971-0959 Telephone (631 765-1892 Fax (63I] 765-1366 Mr. Robert Mosquera 2595 Village Lane Orient, NY 11957 RE: 360 HobartRd., Southold SCTM#62-3-6 Dear Mr. Mesquera: The following action was taken by the Sotithold Town Board of ~rustees at their Regular Meeting held on Wednesday, February 20, 2002: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Permit #5297 to constm~c_t_a 20'X 20' extension to the dwelling and a 20'X 21' garage, with the condition of~5' non-disturbance buffer, drywells to contain the roof ran-off, and hay bales placed down at the 25' non-disturbance buffer l'me before any activity begins, all as depicted on survey dated ~e ~.mberfl~/2000 and last revised November 9, 2001 This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, Albert J. Krupski, Jr. President, Board of Trustees AJK:lms · New O ~ewal ~ ~r~icle 15, Title 27: Wild, Scenic and Recreational Rivers ~o Construct ! ~rticle 19: Air Pollution Control ~ Article 23, Title Mined Land Reclama- tion ~ Article 24~ Freshwater Wetlands · Article 25: Tidal Wetlsz~s PERMIT Robert and Donna Mos~uera ITELEPHONE ~VJMBER {531) 323-0~2 ,2595 village Lane, Orient NY 11957 ~NTACT PERSOS FOR PERMITTED WORK AND AI~DRESS OF FROJECT/FACILITY TELEPHONE Nt~BER ~era Prc~, 370 Hob~r, t Road, Southol~ NY L(~TYON OF P~C~/FACZLI~ ~outhold Descril~tio~ ~o~ Authorized Acti~ty .] Town' Creek E:?16.6 N:4549.2 Construct an addition to the exiSting single family dwelling, finish renovations to the dwelli~, Construct a garage, andu~rade the ea~ltaz~f system. All work shall be perfoz~?d in accordance with the plans stamped NXsDEC a~pr~vedon 11/20/0t. ~y acceptance of this permit, the ~ermittee agrees that the ~ermit is contingent upon strict c~m~p!&anc~ with the ECL. all applicable xe~ulations, the ~enerat Co~dit&ons speoifie~ (sos ~a~s 2 & 3) an~ any SpOil1 Con~itions included as part of this permit. S~Y, Stony Brook, ~Y 11790-2356 IPage I of 4 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSUR~ANCE PROGRAM ELEVATION CERTIFICATE O.M.B. No. 3067-0077 Expires December 31, 2005 Important: Read the instructions on pages 1~- SECTION A'- PROPERTY OWNER INFORMATION BUILDING OWNER'S NAME ..... o r h¥ BUILDING STREET ADDRESS ncludJng Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX'NO. PROP~ DESCRIPTION (Lot and Bilk Numbers. T~ Pardi Number, Legal D~cripfion, etc.) BUILDING USE (e.g., ReSJdenfial. Nonzmsi~en~a], Addition, Accusal, etC. Use a Commen~ a~a, ~ necess~.) ~TITUD~LONG~UDE (OPTIONAL) r RORIZO~TAL DATUM: ~O..~E ..... ~ . (~-~.~ ~ ~.~l~?) I~I~AD1927 ~I~A~1983 ~ U~ : ~ I~Uype~: ,L[ USGS u d U O er BI0. Indicate th.e soume of the Base Flood Elevation I__1F!S Rmfile L~. FIRM I__l Community Bll. Indicate the eleva'~ion datum used for the BFF_ B12. Is the building located in a Coastal Battle, ResoUrces System _l Yes I,,,~ No Designation Date: SECT ON C ~ BUILDING ELEV,AT ON NFORMAT ON (SURVE~ REQU RED) C1. Building elevations are based on: L:_tConstmction D.rawings* ]~JBuildi~g U~der Construction* ~l~inishe'd Construction 'A new ~levafion Certificate ~yiil be required when construction of the buil~!ng is complete. C2. Building Diagram Number/' 'Select the, building diagram most similar to the building for which this certificate is being completed - see page~6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations - Zones A1-A30 AE. AH A (w th BFE), VE, V1-V30, V (wth BFE)~ AR, ARIA, AR/AE, AR/A1-A30, AR/AH, APJAO Complete Items C3.a-! below according to the building diagram specified in Item C2. State the datum used. If the datum is different fram the~datum used for the BFE in Sebtio0 B convent the datum~ to that used for the BFE Show field m~asurements and datum convers on calca~t~o~ Use the;space provided or the Comments area of Section D or Sectiea G, as app?opnate, to document the datum convera~on. Datum /,/G/z'/~ 10~-~' Con~er~ion/C0mme~s Elevation reference mark .used Does the elevation reference'mark used appear on the FIRM? I_ ~'es }'~1 No Q a) Tbpofbottomfloo~(ncludngbasemeetorencosure) i[.)/~ . ff.(m) ~- E] b) Top of next [ligher floor /J-,~,~ . .~ · O 'c) Bottom of lowest horizontal struclural member (V zones only) /~7~/~, ft.(m) ~.~ servicing the building (Describe in a Comments ama.) '~]j/~ . ft.(m) ~ ~ ~1 0 Lo,vest adjacent (finished) grade (LAG) ' .~_~//~ . ft.(m) ~ Q g) Highes~ a~Jjacent (finished) gra~te (HAG) . -~ . ~f/~ . ff.(m) ~ ~ O h) No. of permanent openings (flood vents) within 1 f~. above adjacent gra~e ~ - ~ Q ()Total of all permanprit ~l~enings in C3.h ~ in. ~m) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This cer~fication is to ,be signed and sealed by a land s~rveyor, engineer, or architect authorized by law to certify elevation informatior,. I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. I un.cierstand that any false statementmay be punishable by fine or imprisonment under 18 U.S. Code, Section lOOt. CERTIFIER'S NAME LICENSE NUMBER ~_~,.~ TELEPHONE SI NA U.E DATE Y FEMA Form 81-31, January 2003 See reverse side for continuation. Rep aces a prey ous ed t OhS .IMPORTANT: In those.spa.cps, copy the corrosponding information from Section A. ~J,.l=:.[.)!'~;',; S'~'~:,~ =' I' .',"):~, F~';S :h':: "h m A':,.. 'f'~ ,q' :" ;!.' ~'~: '=,':'!' 'la.!!.~' '~ IL:~.~,,,' ~" ...... ,,'. ~'.)/,~N",, CITY ¢c~.)oc) ,~&,~.j.~/, STATE /~.~. ~/( ]/ ~[' ZIP CODE .S.ECTION D -'SURVEYOR, ENGINEER, ,01~ AR~HI~E~t ~ERTIFICATION (CONTINUED) Copy both sides of th s Eleva(i0u C~diflcate for (1) community official, (2) insurance agentJcompany, and (3) build ng owner SECTiON'E'-.BUII.DINO =.LEW.~TION INFORMATION (SUR~/~EY N.OT. R.,E~UIRED) FOR ZONE.An ~ID.ZONE A (WITHOUT BFE) For .7cnn An m;(I Zone A (wiUmul Er E).' cm~lpl-;:!,.: I[,,)'us !: I. II uoiJ~,,;ll I;b.'ql ';n'!!,.-~'lc m.;,m (,;efli;icnt:; i~ in~.nndn.:l Icr use Its suuperling 3r LOMR-F. SecfionC mu ;t becom ,leted ,.-~ , ,(Select the bnlding diagram most ~m~ ~ir to the be~ldlng for which ~his ce~fice~ s bemg.~omp 6~ed see Irn., al,.,granl ,]t,.ura.,,.y ,(,01,.so,l,s th,. )mlld,l.g. p o. ,,,(, ,. ~ (,,,(,h ¢. ~,hul,.g~..p.L) --E2. [i10 Lop ol)he boltorn Ilo:ir (!r,.;hldhig basonlop.[ or em;Iosu;o) of Lbo buiklirLq is ~__ J .'. ,.T (mi L J ..J irt. (cra) J J ~ibovn ar J ': below · ) tho hi,qbes.', adjacml[ f~rede. (Use n,'..!hm!l grade, ii Building Diugmm. s 0-8 will1 upofiings (s(:,,.i pago 7) .tim m;xl ifigber Iloar o' ~levalcd qoer (c;::.vnlion b) o[ riff.; boildin!,l is j ~' J_,! {J. Jr}l) i ~ Jin. [nm) ~[)ovo IJlg JrigbosJ ~!(Ij~lGcfl[ ,g'.~-~dg: Culrll)l(;Je Ilnms C3.h ~li'.d ('~3.i Ull Iron[ o[ ir)rm. gu:~chinnry agd/,.)r oquil)lllgn[ sorvicJl!g Lite building is ~_ J ' II. (tru J_. i ] in. (cra) ~.. I ,'.fl)nye or L.. J boJow (I )lh,";llnJ'ost Jj;~borLgfed (IJ.~(: )lL:f~irndn ~'.'.i~ lc) ES. roi ,/one AO on!y: g ro-Ilone dGpLlYtlunlnor is av,q:lablo.' is' the h;.r; or II'o boUem .qol,i oleval,,:d r ¢ Jpl~ ,'-,m e~,,.ua~ 1 ore iha~ ;c/.,,) I v~:s. I ,I N,. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION H e p.o[!¢.rty,.,.wn,~r ol o m,i sm. honz...1. !¢.,,i.r~,o,.tl;ql., i, ,.~11o C,Jlnl,l,.t,,s Si.cool .~ [~. ~. (; d~ol=m C3.i~ and C:] i only). :..;nd ~: icl Zcne A (w[{Itrm[ [~ r-EMA-N,qued or c~mmun![y-i.m~uod !'~=E) or Zeno A,") rnu,,~: ,~i',m hnm. Inn s!al,';m~n~ in Sccficns A. B C. and E m'e ~;'..',noc; lu . the,be,stP;of fny~.know, ledge= ~'. PRO~:P~'~'O~NER'S OR OWNER'S AU~.~IORIZED ,EEPRESENT~TIVE'S NAME SIGNATURE . COMMENTS L, J Check here if attachmenta Ct SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local officia! Who is authorized by,laW or Ordinance to administer the community s floodplain mar[agement ordinance can comp ete Sec)ions A. B. C (or E), and G Of thi§ J~le~afioh Certificate. Complete the applicable item(s) and sign below. ;ab Gl, J J The information in Sec[io~ C~va~ taken from other'~ocumentation that ha§ been signed and embossed by a licensed surveyor ~architectwho is~au~hodzed by state or local law to certify elevation informaflon: (indicate the soume and date of the Le · .~F~fi'~'~..,'.~,iq [ho Cmnmdnts m;ea below.) G2z'l ; A ,,:un~n;unity o'.fi;;ial completed Section.E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or ?(,It,, AO. [ti G~.rj~/*l~'Tl,(? rcil6Wiuq'irl[o~hhatk;n (ITems G4-Gg) is I,nwid!.~d E)r co,n'nu,fil', ,qoodplhin ....... I I~1 .11.l pU )CS 'is ; ":;S', I~ .; ~co G?; TI~ s er t h. s [ o ss od for: L_[ New Construction I~1 Subeientral Impm~,ement GS. l:lc,.,.t}!ion c; as-bl;iit Iov,',~;st root 0ncluding basement) of the building is: · ff. (mi Datum: ha G9. BFF ~ 0J~ 7o e 'An) p h:of flood)rig at the building site is: . ff. (m) Datum: cu LOCAL OFFICIAL'S NAME- TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS J__J Check here if attachments FEMA Form 81-31. January 2003 Replaces all previous editions SEALED WOOD TRUSS DESIGNiS for RESIDENCE athold Village, NY prepared for: Robert Mosquerna 2595 Village Lane Orient, NY 11957 prepared by; NASSAU SUFFOLK LUMBER & SUPPLY CORP. TRUSS DIVISION 517 LONG ISLAND AVENUE, MEDFORD NY 11763 Attn: Brian Mooney (631) 289-6900 FAX (631) 289-6907 EXECUTIVE OFFICES LOCATED AT 2000 OCEAN AVE., RONKONKOMA, NY 11779-6534 PURCHASER IS ADVISED TO OBTAIN AND FOLLOW TPI-HIBgl BRACING AND ERECTION RECOMMENDATIONS AND TO DISTRIBUTE TPI-HIB91 TO ALL PARTIES Eql/'OLVED IN THE CONSTRUCTION OF THIS PROJECT. TRUSS StlOP DRAWINGS WILL BE THE SOLE SOURCE FOR TRUSS FABRICATION, PURCHASER MUST SIGN FOR APPROVAL TO FABRICATE AS PER NAS, g4U SUFFOLK LUMBER TRUSS SHOP DRAWINGS. Mitek® Re:atoz MiTek: Industries, Inc. 14515 Na~ Outer For~ Ddve Suite 300 Chesterfield, MO 63017-5746 Telephone 314/434-1200 Fax 314/434-5343 The truss drawing(s) referenced below have been prepared by MiTek Industries, Inc. under my d/rem supervision based on the parameters provided by Nassau Suffolk Lumber Pages or sheers covered by this sealt3935500 ffaut3935504 My license renewal date for the state of New York islune 30, 2005. October 10,2002 Garcia, Juan The s~al on these drawings indicate acceptance of professional engineering responsibility solely for the m~ss components shown. The suitability and use of this component for any particular building is the responsibility of the building designer, per ANSUTPI-1995 Sec. 2. T51 MONO TRUSS 39'75 lr~- LOADING {psf} SPACING 2-0-0 TCLL 30.0 F~ates Increase 1.15 TCDL 10.0 Lumber Increese 1.15 BCLL 0.0 Rep Stress Incr /YES BCDL 10.0 Code BOCA/ANSI95 cs, TC 0.53 BC 0.37 WB 0.18 {Matrix) LUMBER TOP CHORD 2 X 4 SYP No.2 '., 2 X 4 SPF Stud Except REACTIONS {l~/siz~):~4L-383/0-3-8, 5=439/0-3-8 Max Horz 5'=835(Ioad case 8) . · ~ Max Uplift4 =-330(Iced case 3), 5 ---113(Icad case 2) FORCES (Ib)'~ First Load Case Only TOPCHORD 6-7--49, I-7=-190, 1-2=-101,2-3=23.3-4=-131,5-7=-237 2-~-=-231, 2-5=-158 NOTES DEEL in {Icc) l/de8 PLATES GRfP Vert{LL) 0.06 4-5 >999 MIl20 197/144 Vert(TL) -0.08 4-5 >999 Horz(TL) -0.00 4 n/a 1st LC LL Mia I/deft -- 240 Weight: 82 lb BRACING TOP CHORD Sheathed or 6-0-0 oc purlins, except end verticals. 8OT CHORD Rigid ceiling directly applied or 10~-O oc bracing. 11 This truss has been designed for the wind I~ads generated by 90 mph winds a~ 25 ft above ground level, using 10.0 psf top chord dead iosd and 10.b psf bottom chord dead toad, 0 mi from hurricane oceanline, on an occupancy category I, condition enclosed buEdlng, of dimensions 4-5 ft by 2~ ft with exposure D ASCE 7-93 pe£ BOCA/ANSI95 If end verticals or cantilevers ex~st they are exposed to w nd f porches exist, they are ~t exposed to wind, The lumber DOL incresse is 1,18,~nd the plate grip increase is 1.15 '- ' 2) Four RT7 USP connectors recommended to connect truss to bearing wa[is due to uplif~ at iris) 4 and 5. 3) '~is~{r~s_s has been designed with A~SIJTP! 1-1995 criteria. , ....... LOAD CASE{S] Standard October 10~00~ MiTek® ,~ NA~E~I~I '$UFFI ~.~. LUMBER, MEDFORD, NY 11 TOE CHORD · 2 X 4SY~ ~o~,2 . Max Horz 6~229(Ioad case 4) : · 1 ) ~ truss has been checEea for U~Sa~nced ~oading condA~ons. LOAD CASE(S) Standar~ ~" ..~-. '~ ;, ' ~tober 10 2002 D~n Vei~ ~r ~ ~ W.h MEek ~nn~lors, lhb'de~n (o~onal) NA~SAU SUJ;t= iLK LUNIB~. MED~GRD, NY t1763 TOP CHORD 1-2=5. 2-3=-2014~ 3-4-=-1761.4-5=-1761, 5-6----2014,'6-7--5 ,~ , October 10,2002 MiTek® ATOZ T54 .' FIN~ 9 1 R~CTIONS ~lb/s~ze) ~. 2 ~ 827/~3-8, 6 = 827~-8 .,, ' O~ober"10 2002 ATOZ T55 M_~ONO TRUSS . _ 13 I (optfonal) ' 4 LO~ING (psf) SPACING 2-0-0 CSI DE~ in (loc) I/deR ~8 GRIP TCLL 30.0 ~ates Increase 1.15 TC 0.29 Ve~(~L) n/a n/a MR20 197/144 TCDL 10.0 Lum~r Increase 1.15 BC 0.36 Ve~(~} -0.17 2*5 )537 BCLL 0.0 Rep Str~s Incr ~ YES WB 0.16 Horz~) -0.~ 5 BCDL 10.0 Code BOC~ANSI95 1 LUMBER B~CING TOP CHORD .2 X 4 SYP No.2 TOE CHORD Sheathed or 6-~0 oc purlins, except end ve~icals. 8OT CHORD 2 X 4 SYP No 2 BOT CHORD Rigid ceiling directly applied or 1 ~0 oc bracing. WEBS ' , ~:2 X 4 SPE Stud : ,' · Max Horz 2 = 303(load case 3) Max Uplift2 =-219 load case 2 ~ =-142 load case 8 FORCES {lb) ~ First Load ~ase Only TOP CHORD 1-2=5, 2-3=-423, 3-4=0, ~5=-157 BO~ CHORD 2-5=393 NOTES ' ' 1) ~is tru~ has ~en designed for the wind loads generated by 90 mph winds at 25 ~ a~ve ground level, using 10.O Psf top ' ~c[osed ~ilding, of dimensions 45 ~ by 24 ff with exposure D ASCE 7-93 pe[ BOC~ANSI95 plate grip ~crease is 1.15 : · 2) Four RT7 USP connectors recommended to co~ect ~ss to bearing walls due to upl~ at ~(s) 2 and 5. LOAD CASE(S) Standard October ~0,2002 TOWN OF SOUTHOLD APPLICATION PAGE 1 o[ 4 FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This form is to be filled out in dupIicate. SECTION 1: GENERA_L PROVISIONS (APFLICANT to mad and si~: iL No work may start tmtil a permit is issued. 2_ The pcrmk may b~ revoked if any false statcment.s are made herein. 3. If revoked, alt work must cease until peaunit i~ re-issued. 4. Developmeut xkail not be used or occupied until a Certificate of Comp[lance is issued_ .5. The permk will cx2~ixe if mo work is commcnca:d within slx months of issuance. 6. Applic~nt is here. D/~d'otmed tha.t other permits my be rexluired to fulfill loc~., state and federal regulatory requkemeats. 7. App~t hereby ~ive~ cot:~ent to the Local AdminNtrator or his/her representative to make reasonable inspections r~quired to verify compliance. 8. 1, T~E APPLICANT, CERTIFY THAT ALL STATEMENTS [~EREIN AND LN ATTACHMENTS TO _ TF~S ~PI~CATION ~ TO THE BEST OF MY KNOWLEDGE, TRUE AND ACCUP-.ATE. f SECTION 2: PROPOSED D~bOPMENT fTb be completed bY APPLICA/~UD NAME ADDRESS TELEPHONE ENGINEER ~ ~ PROSECT LOCATION: To avoid delay ia proce~ing thc appllcadon~ pleazc provide cnou_~h information to ~fly iden~ ~c project l~fiom Pro.de ~e ~t addr~ lot numar or le~ d~pfion (a~a~) ~d, outside ~an ~. the dkt~ to ~e n~ ~t~se~g road or ~-~o~ ~k A sket~ atta~ed to tM~ appEmfion sho~g the projem l~fiou ~d be helpS_ FOP(93) A~PLIC~TIO N ~ PAGE 2 OF ~ DESCRIPTION OF WORK (Check all appficable boxes): STRUCTURAL DEVELOPMENT ACTIVITY STRUCTURE ~TYPE [] Addition [] Relocation [] Dem6litio~ [] Replacement [] Residential (14 Family) [] Residential (More than a Family) ~1 Non-residential (Iqoodproofmg? U] Yes) [] Combined Use CP, csidential & Corr~merc52]) [] Manufactured (Mob~Je) Home (In Manu- factured Hbme Park? [] Yes) ESTIMATED COST OF PROJECT S ~ O (~50 B. OTHER DEVELOPMENT ACTIVI. t IE.S: 121 Fill [] Mi~ing ~ Drilling [] Grading [21 Excawation (Except for Structural Development Checked Above) ' [] Watercourse Alteration (Including Dredging and Chmmel Modifications) [] Dra. ktage Improvemena 0ududing Culvert Work) [] Road. Street or ~X~lge Co~tructtou [] Subdivision (New or E~, ansion) [] Individual Witter or'S~:r Syst6m [] Other (Pie.axe Specify)t~' After completing SECTION 2, APPLICA/:4;F should submit form to Loeal Administrator for review. ~ECTION 3: FLOODPLAIN DETERMINATION (I'o be completed by LOCAL ADMINISTRATOR) The proposed development i~ located on FIILM Panel No. , Dated The Proposed Development: El IX ~ located in a Spedal Flood H.:mrd Area (Notify the appllcant that the application review i~ complete and NO PLOODPLAIN DEVELOPMENT pERMIT IS REQUIRED). El Ix located in a Special Flood Hazard A.r~a. PIRM zone dexlgnation is 100-Year flood elevation at the site iii Ft. NGVD (MSL) [] Unavailable The proposed development is located in a floodway. FBFM Panel No. Dated [] See Section 4 for additional instructions. AJ>PLICATION ~ PAGE 3 OF 4 SECTION 4: ADDITIONAL INFORMATION P-~QUIRED~I'To he completed bv LOC/,.L ADMINISTRAT(')R~J. Thc appLicam must submit the documents checked below before me application can be processed: A site plar~ showing the location of ail crtstmg structures, water bodies ad]~ :ent roads, lot dimensions and proposed developmexat. Development plans, draw~ to scale. ~d spedficatiorm, including where applicable: details for artchoring structures, proposed elevatmn of lowest floor (including basement), types of water resistant materials used below the first floor, details of floodprooFmg of utilities located below thc ['mst floor and dermis of eudnsures below the rust floor. Also, Subdivision or other development plates (If the subdivision or other development e×cecds 50 lots or 5 ac~es, whichever is the lesser, the appliea]at must provide 100-year flood elevations il- they are not otherwise avai/able). Plans showing the extent of watercourse relocation md/or lmadform alterations. [] Top of new f~ elevation Ft. NGVD (MSL). [] Flood. proofing protection level (non-residential only) Ft.'NGVD (MSL). For flc~l~Sfoofed structures, applicant must attach certhqcation from registered engineer or [] Certificatmn from a registered engineer that the proposed actimcy in a regulatory floodway wi]/not result in a_~ increase in the height of the lO0-year flood. A copy of all data and cmlculations supporting~.his Finding must also be submitted. [] Other:. SECTION $: PERMIT DETERMINATION (T9 17e completed bY LOCAL ADMIN[~'TRATOR) I have determined that the proposed activity: A. [] Is B. [] Is not in conformance with provisions of Local Law ~ , 19 attached to and made part of this permit. . The permit is issued subject to the conditions SIGNED , DATE If BOX A is checke4, the Local Adminktrator may issue a Development Permit upon payment Of designated fee. ff BQX B i~ ch~.nke4, the Local Admin/strator will provide a written summary of deficiencies. Appllc2m may revise and resubmit an application lo the Local Administrator or may request a hearing from Ike Board of Appeals: APPEDeO~: Appealed to Board of Appeals7 O Yes [] No Hearing date: Appeals Board Decision --- Approved? UI Yes Conditions [] No APPLICATION PAGE 4 OF ~ .SECTION 6: A~-BUILT ELEVATIONS (To bc sUbmitted by APPLICANT before Cert~cate of Cgms~liance is issued) The following hafOrmat/0n mUSt be provided for project sta-uctures. Th/s section must be comPly, ted I~y a registered professional engineer or a licensed land surveyor (or attach a certification to thJ~applicatmn).'~ ' ' Complete i Or 2 below. Actual (As-Built) Elevation of thc top of the lowest floor, including basement (in Coastal High Hazard Areas, bottom Of lowest structural member of the lowest floor, exdudlag pillrtg and column) is: .Fr. NGVD (MSL). 2. Actual (As-Buil0 Elevation of floodproo£mg protection is Fl'. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. SECTION 7: COMPblANCE ACTION (To be completed by EOCAb ADMINISTRATOR) The LOCAL ADMINISTRATOR will compleT'th/.s section as ap-l~licable based on'inspection of the project to en~ure compliance with the community's local law for flood damage prevention. INSPECTIONS: DATE BY DEFICIENCIES? [] YES [] NO DA'IW. BY DEFICIENCIES-'/ [] YES [] NO DATE BY DEFICIENCIES? [] YES [] NO SECTION 8: CERTIFICATE OF COMPLIANq]E(To be completed ~¥ LOC, A.L ADMINI!~;TRATOR) Certificate of Compliance issued: DATE: BY.'. Attachment B SAK~LE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD FLa. ZAJLD AREA (O~4rtNER MUST RETAIN THIS CERTIFICA'IEE PR~MISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: [] NEW BUILDING [] EXISTING' BUILDING [] VACAINW LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A~ OR B. BELOW: COMPLIANCE IS HIEREBY LOCAL LAW # , 19 SIGNED: CERTIFIED WITH THE REQUIREMENTS DATED: OF Bo COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW #.__., 19__, AS MODIFIED BY VARJANCE # , DATED SIGNED: DATED: C/C(93) DATE IS'SUED: / /02 DD. ATE REVIEWED: , ,_~.//.-~/02 AT'SUBMITTED: 2 /Iq/02 SCTMg DIST~CT: 1,000, SECTION: SZ~T ~V~SS: Z~ ~a~ PRO,CT DESC~TION: ~%o~ ~st~t~v ~oJ~cr cost:$ SINGLE & SEPARATE CEKTIFICATION-REQUIRED? fiffo NOTES: -- LOTS40.0005F-t00-24. Lotre¢oguit/on 2KEATBDbeffore June30. 1983j, UNDERSIZED LOTS FP~OM $AN.1097 100-25. Merger.kAnen¢onforn:angaranytinseafter7~l/83 ZONING DISTRICT: ~-q[O CONFORMING? REQ. LOTSIZE: ~./~,oo~ ACT. LOTSIZE:q tz~ REQ. LOTCOV. ~_,o~ ACT. LOTCOV. REQ, FRONT ,~, PROP. FRONT aa..- REQSIDE REQ. REAR c_3 ' PROP. REAR ~,~ ' WATER FRONT? ~O~r'~v~J DESCRIPTION: PA~L~: /X,~ FLOODZON~:,*~/~, APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT~ ~85 or Q (BED #): DTE: ,. ; PERMIT #:RI0- TOWN SEPTIC RECEIPT: Y o(~ "~--~ , , . NEW YORK STATE DEC: vw-~c~n/Ts~,~orNO ~[:~-e~e,Q~O~ b/~-°/~ SO~HOLDTO~TRUSTEES: ~orNO ~ ~j~6]/ ~ ~4,~ TO~ ZO~G BO~ ~PROV~: ~S o~ TO~ PL~. BO~ ~PROV~: ~S or~ TO~ HISTO~C~ P~ (SPL~): ~S or ~ NYS ENERGY: YES ORO: __ / EGRESS (18 H min.? 4 sq tOtal) ~/~ VENT(SQ. FT. x4%) ~,/,~. LIGHT(SQ. FT. x8%) BUILDING PERMITS OPEN/EXPIRED: BP -Z / C/0 Z- , HAVE PRE CO'S: Y OR N BP -Z / C/0 Z- , NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST,FLOOR: 2~} '~ SF SECOND FLOOR: SF OTHER: SF INIT OTHER TOTAL: Z.~ ~ SF FEE FEE TOTAL FEE · ( SF)- ( _SF)= SF X $__=$ +$ +$ -- $ ~'~' 2.( SF)-( SF)= SFX$ =$ +$ +$ Albert J. Krupski, President James t~2ng, Vice-President Ariie Foster Ken Poliwoda Peggy A. Diekerson February 21, 2002 BOARD OF TOWN TRUSTEES TOWN OF SOUTt{OLD Town Ha]~ 53095 Route 25 ~ P.O. Box 1179 Southold. New York 11971-0959 Telephone (631,765-1892 Fax (631) 765-1366 Mr. Robert Mosquera 2595 Vi~Aage Lane Orient, NY 11957 RE: 360 Hobart Rd., Southold SCTM#62-3-6 Dear Mr. Mosquera: The following action was taken by the Sotithold Town Board of Trustees at their Regular Meeting held on Wednesday, February 20, 2002: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Permit #5297 to construc~t_aZ0'X 20' extension to the dwelling and a 20'X 21' garage, with the condition oFa 25' non-disturbance buffer, drywells to contam the roof nm-off, and hay bales placed down at the 25' non-disturbance buffer line before any ac(~;vitybegins, all as depicted on sur~ey~dated D~ce ~mberq:l, 2000 and last revised November 9, 2001. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, Albert J. Krupski, Jr. President, Board of Trustees Board Of $Outhold Trustees SOUTHOLD, NEW YORK PER.iT NO.. ROBERT & ?~O;.NNA MOSQUERA ISSUED TO ................................... , ................................................................................ fit~ ."RE~U~TI~ A~D-THE P~CJN~ OF OEaTRUCT~S I~ ~D O~ TOWN WA~S AND PUBLIC L~DS a~ ~'~ R~OV~L ~ SAND, '~V~'OR OTHER ~ATERI~ FRO~ ~DS UNDER TOWN ~e~ion o~ The ~a~d. ~op~d ~t ~ meeting ~ld on .~.~5,~,..~.~,~. ~p~?y~.. a Donn~ ~'.~r.~. ................................................................. ~ ................... ~ So~o~ Town [~A~t.~s ~Ve~.n~ Pe~mi~ ~o ~epl~e e~i~g dwelling and septic system:. ~ith the stipulalio~ tha~ there be a 25 foot non- disturbance buffer (no driveway in b~ffer area) roof run= %~f. be contained ~ ~'' 'l ~' '* iN. ,WITNESS WHEREOF, T~e s,.atd Bo~rd o~ Trustees · by ~e, ~t~ CorPOrate.' Seal t? be afl,xcel, and the~e- pres?hr, to be ~b~l~d b~ a'me~J~ of ~ sa~ ~ard as of fh;s date. ?ert J, Krupski, President mos King, Vice-Presiden~ Henry Smith ~r~ie F~s~er Ken PoHwoda BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hail 83095 Route 25 P.O, Box 1179 Southeld. New York 119710959 Telephone (631] 765-1892 Fox (631] 765-1366 April 26, 2001 RE: 370 Hobart Road, Southotd 8CTM~62-3-6 Dear. Mr. M0squera: On a recent field inspection the Southoid Town Board of Trustees inspected your property and the property to the north, It ~ppears that the fill that you placed will block the natural flow of water kern the north to the south. The re-grading of a ve.ry small amount of the northwest comer of your p'ropeny would allow for the natural flow to continue_ · ~ e would apprecmte your cooperation in this matter. Very truly yours, Board of Trustees AOK:lms 765-1802 BUILDING DEPT. SPECTION DATION 1ST [ ] ROUGH PLBG, FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING [ ]FINAL FIREPLACE & CH IMNEY INSPECTO~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION DATE ..................................... FOUNDATION (2~) RO~G~ F~G & /D/ ~ ,. ., ~S~A~ON PER N. Y. STA~ E~RGY CODE ~D~ION~ TOWN ]ai4X,~ SOUTI~OLD, _N~f 11971 TEL: 765-1802 . ~-pproved ~{sapprova--d aye I'ER/UlT ~0. and title of corporm:o offing) Lic~ts~ No. Electricians License No. Oth~ T~ade s ~lcense _No, Coun%' Tssc M~p Not t000 Subdivision Pi]~ Ma~ No. Dimensions of Same stru~'e ~ a~rations or additions: Front · ~. ~ ~ Rear Depth ' ~l:tt Number of Stories ~ n/mens~ons of Height $ 5c ~6,5b ~s' ' 'NUmber,ofStori~ ' .O-'~ 9 Size o£bt: 1 1. Zone or 1}. W~ lotbe ~ ~-O ' ~ ~.~~.~~"~ NO N~e.of~oNt~ ~ ~' P~eNo SS: ~ OT~tFFY OF~___!_~. .. (~)Heis~e' " ~ , " ' ' '2 ' " ' ' }' '"" " ' ' ~ ' < -~'~~~.~-.. . BARBARA ANN RUDDER - Notary PuMic, S~ate of Now York Nd. 4855805 JU~ i,~ aoo'z s Fc~x (6~l)727'- t727 SURVEY OF PROPERTY SITUATED AT SOUTHOLD TOWN OF $OVTHOt. O ' = S~ 1' =30 , AREA = 9.~.7~, ~- - TEST HOLI~ DATA BOARD Or . TOWN, OF SOUl ARE TO N.G.V.D. 1929 DATUM ARE .f~IOWN THUS:~ CONTOUR =UNES ARE SHOWN THUS: .... ZONE ~NFORUATION TAKEN FROM: INSURANCE PATE MAP ~o, ~103C0158 g A. Ingegno F~x (6~1)727-1727 P.~. Box lJ~1 SEPTIC SYSTEI~ DETAIL.. (Not TO SC,'Z~3 L .g 6,61. T ? ? -S,6L