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HomeMy WebLinkAbout33332-ZFORM NO. 4 TOWN OF soUTHOLD BUILDING DEPA=RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33594 Date: 03/16/09 THIS CERTIFIES that the building ACCESSORY Location of Property: 37725 MAIN RD (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 15 Block 2 Subdivision Filed Map No. __ Lot No. __ ORIENT ( H~d~LET ) Lot 15.7 conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 21, 2007 pursuant to which Building Permit No. 33332-Z c~ated AUGUST 21, 2007 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 TENNIS COURT AS APPLIED FOR. · ~ne certificate is issued to AMELIA MENDOZA of the aforesaid building. (OWNER) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICA3~ c~KTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/~ N/A 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. 33332 Z Date AUGUST 21, 2007 Permission is hereby granted to: for : CONSTRUCTION OF A TENNIS AMELIA MENDOZA PO BOX 36 ORIENT,NY 11957 COURT AS APPLIED FOR at preraises located at 37725 MAIN RD ORIENT County Tax Map No. 473889 Section 015 Block 0002 Lot No. 0~8 pursuant to application dated AUGUST 21, 2007 and approved by the Building Inspector to expire on FEBRUARYFee $ 1OS.S0~~~~21t ~ 9'~/ ~i.a/tur ' S' e ORIGINAL Rev. 5/8/02 Fr~,I,'D I~SPECTION REPORT [ DATE [ COMMENTS FOUNDATION (1ST) ROUGH F~G & PL~G _ - ~S~ATION PER N.Y. - ~- STATE ENERGY CODE F~ }k[,DiTiON~ COUNTS TOWN OF SOUTHOLD BUILDLNG DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 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 n~vw. northfork<~l~t~old/ PERMIT NO. ~ Examined ,20 _ ~:ar;;;cdved a/cO / ~ ,201 Expiration 20__ JUL Z 5" 7 Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: APPLICATION FOR BUILDING P~I~VIIT' INST.UCTIONS 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 namc~f a corpo~i/~o ·(I~lailing ad'd~'ess of applicant) State whether applicant is owner, lessee, agent, architect, enginee g~eral contractopelectrician, plumber or builder Nameofownerofpremises ~l.~_.i [ ~ ~¢~i ~ ~e~AO~ (As on the tax roll or latest deed) If applicant is %co~pCtion, si~ature~authohzed officer nflh r fO ) I Builders License No. ~ I BO N Plumbers License No. Electhcians License No. Other Trade's License No. Lo~ti.~n_~f?~ on which proposed ~ork will l~e done:_ . __ House Number Street oc;e Hamlet County Tax Map No. 1000 Subdivision (Name) Section IS Block Filed Map No. Lot i '.1 Lot 2. State existing use hnd occupancy of premises and intended use and occupancy of proposed constmcSon: a. Existing use and occupancy b. Intended use and occupancX Nature of work (check which applicable): New Building Repair Removal Demolition Estimated Cost If dwelling, number of dwelling units garage, number of cars Fee Addition Alteration Other Work"'~ ~ ~ (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_ 8. Dimensions of entire new construction: Front ~.~gX ~ 20 Height Number of Stories 9. Size of lot: Front Rear Number of Stories Rear .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 taw, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO'Will excess fill be removed from premises? YES NO - ~- ~l'g L~d}:~o~c~.~c~c ' ' ', · Lo~ao~ W I 14. Names of Owner of premises ~\ ~(~ddress E~ ~ Phone No. OI ~ ~O 77Z7 Name of Architect Address Phone No Name of Contractor ~~ ~~ddressuO' ~ ~ Phone No. . 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet ora tidal wetland? * YES 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) SS: COUNTY OF ) C~("~"~dx ~ (--, ~ ~~t'~t''~ being duly sworn, 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 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 tq J~efore me this//-~ ,~ Notary Public 2or ? DENISE KING Notary Public, State of New York Registration #01KI6041757 Qualified in Suffolk County My Cornrn ss on Expires May 15, ~/9 ( TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING / STRAPPING [/~ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ~-~ ~ DATE Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M. #: District Section Bloc[ Lot THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER, GRADING~ DRAINAGE AND EROSION CONTROL pLAN CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. Item Number: (NOTE: A Check Mark (~) for each Question is Required for a Complete Application) Ye__~s N~o 1 2 3 4 5 6 7 8 9 Will this Project Retain All Storm-Water Run-Off Generated by a Two (2") Inch Rainfall on Site? (This item will include all run-off created by site cleadng and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFIow! Will this Project Require any Land Filling, Grading or Excavation where them is a change to the Natural Existing Grade Involving mom than 200 Cubic Yards of Matedal within any Pamel? Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000) Square Feet of Ground Surface? Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Beach? Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vertical Rise to One Hundred (100') of Horizontal Distance? Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Off into and/or in the direction of a Town right-of-way? Will this Project Require the Placement of Material, Removal of Vegetation and/or the Construction of any Item Within the Town Right-of-Way or Road Shoulder Area? (This item will NOT include the Installation of Driveway Aprons.) Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse? NOTE: tf Any Answer to Questions One through Nine is Answered with a Check Mark ia the Box, a Storm-Water, Grading, Drainage & Erosion Control Plan is Required and Must be Submitted for Review Prior to Issuance of Any Building Pen~itl EXEMPTION: Ye~s N~o Does this project meet the minimum standards for classification as an Agricultural Project? Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan is NOT Required! ~_ __ STATE OF NEW YORK, . [ Notary Public, State of New York [ CO~NT~ O~~ ! Registration #01KI604175! ~0~ ' , .' . ......................... SS / Qualified in Suffolk County . I c for Penmt, (Name of individual signing Document) And that he/she is dze .................................................................................................................................................................... (Owner, Contracton Agent, Corporate Officer, etc.) Owner and/or representative of the Owner of Owner's, and is duly authorized to perform or have perfortned the said work and to make and file tiffs application; that all statements contained in this application are U'ue to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed bere~4th. S~vorn to before me this; '°~/7rTv'~L day of ·~ ,20ff.. ~7 .......................... /;../...; ...................... Nomw Public: ~.......~ ................................................. FORM - 06/07 M BI,dg Extension Extension 15-2-15.1 guest house 2/04 7 PC Foundation CB Fin. B. Bath FULL COMBO Basement CRAWL PARTIAL F~oors Ext Walls Interior Finish Fire Place , -'2 15-2-15.1 garage 9/03 M: B.I~dg. Extension Extension Extension M Bldg Extension Patio 15-2-15.1 9/03 ? Foundation Pc CB Basement Ext Walls Fire Place Fin. B. ULL COMBO ~ ~F/oors ] . ., Interior Fi~s~-` ~: Heat / -- ~ J COLOR TRIM 15-2-15.1 2/04 1st 2nd ~J~[dg' ~, ~',~ I~ ~--~ jF~2 5 ~ 8 Foundation Fin. B. Bath ~ Dinette ~ ~ ~ ~ ~ ~ FU~ COM~ Extension Basement ~ PARTIAL Floors ~ ~ Kit. Extension ? ~ ~ : ~ ~ t~ ~ E~ ~7 ~ -$3 :~ ~ ~ ~2 ~? Ext. Walls Interior Finish ~ ~ L-R- Extension Fire Place :~ ~ ~ ~ Heat ~ DR Patio ~ ~ ~ ~*%~ Woodstove BR Porch ~kl~o~ ~ T~ ,~o 5~? Dormer Baths Deck ~ w ~: T~ [ Dock Faro. Rm. / Pool g~ ~ f OWNER STREET VILLAGE DIST SUB. LOT ACR. REMARKS TYPE OF BLD. PROP. CLASS LAND IMP. TOTAL DATE FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOT TOTAL 15-2-!5.1 pool 2/04 M BI,dg. Extension Extension 15-2-15.1 garage 2/04 PC Foundation ce Basement Ext Walls Fin, B. FULL COMBO CRAWL PARTIAL SLAB Bath Floors Interior Finish KEY MAP SCALE 1"=600' SURVEY OF PROPERTY PREPARED FOR AMELIA MENDOZA SITUATED AT ORIENT TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-15-09-15,1 SCALE 1"=100' OCTOBER 11, 2001 TOTAL LOT AREA = 1.t62.605.00 eq. fl, 26.690 TEST HOLE DATA CURB SECTION GRADE NL6A' / / / / / DRIVEWAY PLAN NTS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CCNDITIONS OF SOUTHOLDTC,VNZBA SOZ!4RLDTuWNPLANNtNGBOARO $OUTHOLDIOWNTRUSTEES N,¥.S, DEC RETAIN sTORM WATER RUNOFF PURSUANT TO SECTION 45-10C OF THE TOWN cOD~" APP~OyED AS NOTED '~ 3 fEE: '~:~_~J~ BY:~J;Zg~ NOTIFY BUILDING DEPARTMENT AT 765-1802 8AM To 4PM FOR THE FOLLOWING INSPECTIONS: 1, FOUNOATION- TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C O. ALL CONSTRUCTION SHALL MEBT THE REQUIREMENTS OF THE CODES OF NEW YORK STATE, NOT RESPONSIBLE FOR ~ESIGN OR CONSTRUCTION ERRORS. O~ HOle LOT 00 Tie LINE) 7.0~4 OCCUPANCYOR USEIS UNLAWFUL WITHOUT CERTIFICATE OFOCCUPANCY ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. STEp5 LOT :2 '% DRIVEWAY SECTION MIN, SLOPE 1/4" PER FOOT NTS NEW YORK STATE HIGHWAY WORK PERMIT NOTES: 1. THE CONTRACTOR TO CLEAN EXISTING DRAINAGE BASINS ALONG AND ADJACENT TO THE ROUTE 25 SITE FRONTAGE AT THE COMPLETION OF CONSTRUCTION. 2. REPAIR EXISTING SHOULDER, SIDEWALK AND CURBING AS ORDERED BY STATE ENGINEER. 5. ANY TRAFFIC SIGNS DAMAGED SHALL BE REPAIRED TO ORIGINAL CONDITION. 4. ALL LANES MUST BE OPEN TO TRAFFIC BEFORE 9 AM AND AFTER 3 PM. NO LANE CLOSINGS ARE PERMITTED ON WEEKENDS OR HOLIDAYS. NIGHTTIME LANE CLOSINGS WILL NOT BE pERMITTED WITHOUT PRIOR APPROVAL FROM THE STATE PERMIT INSPECTOR. 5. THIS SITE FALLS BETWEEN HIGHWAY REFERENCE MARHERS No. 25 07041745 and No. 25 07041744 ON N.Y.S. Rte. 25. Nathan Taft Corwin III Land Surveyor PHONE (631)727-2090 Site Plons -- Construction Loyout Fax (631)727-1727 MA~ING ADDRESS P.O, Box 1931 Riverhead, New York 11901-0965 p ARK n FLAGGERS 0 LEGEND: u--C) FLAGOER MAINTENANCE AND PROTECTION OF TRAFFIC PLAN (SEE NOTE No. 5) N.Y,$, LIc. No. 50467 '"