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Home My WebLink About35844-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-34679 Date: 11/15/10 THIS c~KTIFIES that the building ALTERATION Location of Property: 12800 MAIN RD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 114 Block 11 Lot 15 subdivision Filed Map No. __ Lot NO. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 27, 2010 pursuant to which Building Perm_it No. 35844-Z dated SEPTEMBER 9, 2010 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 REPAIR AND ALTERATIONS TO A BUSINESS FOR A BARBER SHOP AS APPLIED FOR. The certificate is issued to 12800 MAIN RD LLC (BARBAR SHOP) (OWNER) of the aforesaid building. SUFFOLK COU~FTY DEPARTMENT OF HEALTH APPROVAL N/A ~.R,:~rKICAL u~KTIFICATH NO. 35844 10/29/10 PLieRS C~u(TIFICATION DA'r~o N/A Au~norized Signature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUIDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35844 Z Date SEPTEMBER 9, 2010 Permission is hereby granted to: 12800 MAIN RD LLC (RENE ZEPEDA PO BOX 1456 MATTITUCK,NY 11952 for : REPAIR ~kND ALTERATIONS TO A BUSINESS FOR BARBER SHOP AS APPLIED FOR. at premises located at 12800 MAIN RD County Tax Map No. 473889 Section 114 pursuant to application dated JULY Building Inspector to expire on MARCH MATTITUCK Block 0011 Lot No. 015 27, 2010 and approved by the 9, 2012. Fee $ 250.00 ORIGINAL Rev. 5/8/02 Form No. 6 TOV~rN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPA? This application must be filled in by typewriter or ink and submitted to the Building De A. For new building or new use: ~art ' o I ' : BLDG. DEPT. TOWN OF SOUTBOLD I. Final survey of property with accurate location of all buildings, p?operty 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 2Yl 0 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.anuing 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 New Construction: Old or Pre-existing Building: Location of erope~' / ~SLl~ ~k. (--~'1 (~ (check one) House No. Street Hamlet Owner or Owners of Prope~-~ Suffolk County Tax Map No 1000, Section ~ \ q Block \ I Lot I c3~ Subdivision Filed Map. Lot: Pe~it~t~ _~.~ ~k{ ~ Applicant: Date of Permit. Health Dept. Approval: Underwriters Approval: Planaing Board Approval: Request for: Temporary Certificate Fee Submitted: $ ._~c~ , (~(~ Final Certificate: (check one) Applicant Signature Town 1 lall Annex 5~373 Main P, oad P.O. Box 1179 Soulhold, NY 11971-t)939 Telephone (631) 76.5-1802 Fax (631) 765-9502 ro.qer, richert~town.southold.n¥.us 1H ;ILl)lNG I)EPARTMENT TOWN OF $OUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Rene Zepeda Address: 12840 Main Rd City: Mattituck St: NY Zip: 11952 Building Permit #: 35844 Section: 114 Block: 11 Lot: 1.~ WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: GSL Electric Inc LicenseUo: 36273-me SITE DETAILS Residential Commerical New Addition Service 1 ph Service 3 ph Main Panel Sub Panel Transformer Disconnect Other Equipment: Office Use Only Ind°°r ~ Basement [~ Service Only i~ Outdoor 1st Floor Pool Renovation 2nd Floor Hot Tub Survey Attic Garage INVENTORY Hot Water GFCI Recpt NC Condenser Single Recpt A/C Blower Range Recpt Appliances Dryer Recpt Switches Twist Lock Ceiling Fixtures [E~ HID Fixtures Wall Fixtures ~ Smoke Detectors Recessed Fixtures[~ CO Detectors Fluorescent Fixture ~ Pumps Emergency Fixtures~ Time Clocks Exit Fixtures ~ TVSS Notes: add 4 recpticles and 4 CFCl recpticles only Inspector Signature: Date: Oct 29 2010 81-Cert Electrical Compliance Form 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 CONSTRUC'nON [ ] fiRE RESISTANT PENETRATION ELECTRICAL (ROUGH) ~] ELECTRICAL (FINAL) REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY ~] FIRE SAFETY INSPECTION [ ] ~E,m'r~'r~m'~u~'ml [ ] FIRE RESISTANT PENETRATION INSPECTOR/~~, .//~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ ] F~lIE,~"r~rr~i~li~mON [ REMARKS: [ ] ROUGH PLBG. [ ] INSULATION [.~FINAL [ ] FIRE SA~, f INg~CTION ] RRE RES~TANT PENETRA110N DATE .INSPECTOR FOUNDATION STA~ ~ ~TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Examined ~ ~ ..~ ,20 /O Approved ~ r q 20 ]0 Expiration ~.~ sets of PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of H~alth 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 Contact: Mail to: ia. This apl~10~~ be eompl Building Inspector LICATION FOR BUILDING PERMIT Date '.~ot.-'..~ 7 7 ,20. I o INSTRUCTIONS ~tely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 fi.om 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 applicam or name, ifa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~ ~r~ ~'~'~ (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. Location of land on which proposed work will be done: House Number Street Hamlet Lot I ~-- County Tax Map No. 1000 Section I I ~ Block I I Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy ofproposed consmaction: a. Existing use and occupancy b. Intended use and occupancy 'i~c~->,:> (i~o~' 5 - Jzz~q~ g/faf 3. Nature of work (check which applicable): New Building. Repair e/ Removal Demolition Addition Alteration Other Work 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cam Fee (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 Z ~. 5" Depth Dimensions of same structure with alterations or additions: Front Depth ~- Height, -~-- Number of Stodes 8. Dimensions of entire new construction: Front -- Rear Height ~- Number of Stories ~ 9. Size of lot: Front la%' Rear b~' Depth Depth 10. Date of Purchase Name of Former Owner l 1. Zone or use district in which premises are situated HAP/c~ t~o~;, ,~ ~%% 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 Name of Architect Name of Contractor Address I~,~o ,~ ~> Phone No. Address ~/~ ff-o~otc~c ~,~£ Phone No Address 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 B~ REQUIRED. b. Is this property within 300 feet of a 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 __ · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) COUNTY 0F~: ~ Z ~- being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, C0NN!~ 8UJ"ICH ~il~y Publk .~tate of New YoI~ No ~1~ !~; ~050 (S)He is the n,,~m.,. ~,; :,.,. ;; ........ (Contractor, Agent, Corporate Officer, etc.) Com~iii~'~.~.~'~l~i ~0_1~ 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 ~ dayof Q~_ 2o10 Notary Public Signature of Applicant BUILDING PERMIT EXAMINER CHECKLIST Applicant: , . ~-P-~/ ~'-~ Owner: Architect/Engineer: ~ ~-- ~ SCTM#1000- lit3L- {I I,''~- Subdivision: ' Property Address: I 0'~r o 0 /a~ ~ /~ *Date Submitted: Building Permits (Open/Expired): BP__ BP.__-Z / C/0 Z- , Info: BP__ Single & Separate Search Required? Y o Nt~e~ertnination: REQ. Lot Size: 0< ACT. Lot Size: REQ. Front ACT. Front REQ Side ACT. Side ILEQ. Height Date Reviewed: ~ -'~ Estimated Cost: ~q-~o oo -- Zone: ~ Conforming? °~tU City: ffP/~ Pre COs? Project Description: Waterfront? Y o~ -z/c/oz- ,Info: -Z / C/O Z-__, Info: -Z / C/0 Z- , Info: BP__-Z / C/0 Z-__, Info: REQ. Lot Coy. __ ACT; LOt Cov.. REQ. Rear__ PROP. Rear ACT. Height_ ~ ~.~, ~L $t~5 . A CT If yes, water body: Panel# Flood Zone: Bulkhead/Bluff Distance: -- ADDITIONAL APPROVALS REQUIRED Suffolk County Health: Y o~(..~- If yes, *Bed//: *Date: / / *Permitit: Town Septic: Y - If no, certification required: Y or N Received: Y or N By: NYS DEC: rRe-oecga/*s Y or~- Date: / / Permit it: or NJ Letter- Notes: Southold Trustees: Y o~- Date:. Southold ZBA: Y o~- Date: / __ Southold Planning: Y o~- Date: /__ Town Landmark C of A: Y o~)TE: / Permit #: / Permit #: Permit #: / or NJ Letter - Notes: - Notes: - Notes: *NYS CODE Compliance (page 2):(~or N Notes: Fee Structure: Foundation: ~ First Floor: ,5- ~ O Second Floor: ~ Other: ------'- Total: Calculation: SF 1.(_ .~'a .SF)-( {0OO SF): O SFX$0~'a=$ SF + Initial Fee: $ SF + Additionol Fee ( ): $ .SF 2. ( .SF)- ( SF)= SF X $ =$ SF + Initial Fee: $ + Additional Fee ( ): $. 0 TOTAL: $ g/' .5-~> o ~9 o · Ground Snow Load: 20 Weathering: Severe__ Design Temp: 11 ~- NEW YORK STATE CODE COMPLIANCE CItECI~LIST CLIMATIC/GEOGRAPHIC DESIGN CRITERIA: Wind Speed~ 120MPH__ Seismic Design Cat~gory." B. · Frost Depth: 36" 'Ice Shield Underlay: YES~ USE/OCCUPANCY CLASSIFICATION · HEIGI~IT/FIRE AREA: ~ ~[ Termite: M-H' Decay: Flood Hazai'ds: TYPE OF CONSTRUCTION: DESIGN CPaTEP : ENGn'm m D SC___ FULL FRAMING DESIGN ELEMENTS:{~N HEADERS: Y/N WALL sTUDs: Y/N CEILING JOISTS: Y/N FLOOR JOISTS: LUiM[BER SPECIES AND GRADE: Y/N GIRDERS: Y/N ROOF RAFTERS: Y/N WINDOW AgqD DOOR SCHEDULE: 0 7L-( .MISSLE TEST REQUIREMENTS: Y/N EGRESS 5.7 S.F.: Y/N LIGHT 8%: Y/N VENT 4 %: Y/N NAILiNG/CONSTRUCTION SCHEDULE: Y/N o r~ MEANS OF EGRESS: Y/N t9~7 PLUMBING RISER DIAGRAM: y~) 0~ LOCATION OF FII(E PROTECTION EQUIPMENT: Y/N 0/q TRUSS DESIGN: Y~5~ 0 ~ CERTEFICATION: Y~) o ( ENERGY CALCS: Y/O °{7 TOTAL COMPLIENCE?0N (RETURN TO PAGE ONE) NEW ..OUFFOLI4 AN/E- SURVEY FOR LAURENCE .C.. $CUDOER. H AT &tAFT/FUCK TOWN OF $OUTHOLD SUFFOLK ~OUNTY. NEW YORK O&TE NO. 78 - I. ,ALL ~ .GHALL CONIPLh' $NITH THE 200'~ BUILDIN~ COiDE OF N~H ¥OPJC, STATE. CONTRACTOR 5HALL 64N2P~:qNATE ANY AND ALL IN~PEOTIOND A5 P4EGUI~I2 TO OBTAIN ~E~TIDI~A~ OD OO~PAN~ ON ~H~F OP ~ OMNi. A~NGIE5 5~L BE BY 0~ AND ED PR OR TO I0. ~L [~O~lO HORK ~&L GO~L~ ~1~ ~ NATIO~ ELEO~IO OODE FOR THIS IN~ED U~. ~EO~ G AN 5H~L ~TAIN Fl~ U~RI~ OERTIFIOA~ FO~ ALL ELEO~IO ~R~ A~ ~ ~HIT TO 0~. ~OVIDE ~L HOT ~R OR AIR, ~0¢ INGLUDIN¢ Al* OONDITIONIN¢ ~UI~HENTS. HUN¢ LAV. TO BE P, EpLACED BY LINE OF OVERHAN¢ ABOVE EXIDT. MINDOIN DISPLAY NEM 12"XI2"% VCT, FLOORINE, ,Q EXIST. HINDOM DISPLAY BARBER STATION y (TYP, 4) i ~k, IAITIN~, APdA TO REMAIN ~) /~ EXIDT. 12"xl2" CELOTEX TTPE CEILINe$ TILE E44ALL P-.EHAIN. 5AID TILE .5HALL BE CLEANED AND PRIMEP AND PAINTED. FAN TO P. EHAIN. OSD Ol¢. HT. q'-O" AFt= ~ FINISHES TO HATCH EXIST. ~JAGENT OCCUPANCY OR ~ USE IS UNLAWFUL / / ~N~: WITHOUT CERTIFICATE ~* ~,~. NO~, OF OCCUPANCY ~ PAIN~ ~ 5ELEO~ BT ~NT. EXlSTIN¢ PARTITION 2.6EILIN5 ~&L BE ~1~ A~ ~ ~ EXIT 5f~N COMPLY V CODES OF ~NANT. NEW IK = 30DES 5TATIO~ 5H~L BE ~00~1~ FL~ HOUN~ ~P. MITH ~NANT AND FABRICATOR A~ , DEC PLAN t" = 40'-0" EXI$TINe CHITCH TO P-.Bi-lAIN EXISTINg9 GAST IRON RADIATOR EXISTIN~ BATHROOH EXHAUST FAN ~lTE PATA: TAX MAP NO,: USE AND ~C,C, UPAN~,¥ ~LA~51PI~ATI~N: 5~UA~I~ ~OOTA~E : 1000-114.-11-15 IDUSINt~5~ ~I~<:3UP ID 9~o APPROVED AS NOTED FE~ BY~ NOTIFY BUILDING DEPARTMENT AT 765-1802 8 ~ TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2 ROUGH-FRAMING, PLUMBING, STRAPPING, ELECTRICAL & CAULKING 3. INSULATION 4 FINAL - CONSTRUCTION & ELECTRICAL MUST BE COMPLETE FOR C O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. UNDERWRITERS CERTIFICATE REQUIRED FIRE INSPECTION REQUIRED BEFORE OPENING A