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HomeMy WebLinkAbout36256-ZTown of Southold Annex 54375 Main Road Southold, New York 11971 5/5/2011 CERTIFICATE OF OCCUPANCY No: 34932 THIS CERTIFIES that the building Location of Property: Date: ALTERATION 5/5/2011 12800 ROUTE 25, MATTITUCK, NY 11952, SCTM #: 473889 Sec/Block/Lot: 114.-11-15 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore 3/21/2011 pursuant to winch Building Permit No. 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: Alteration to a Barber Shop; Hair Washing Sink. Lot No. filed in this officed dated 36256 dated 3/22/2011 The certificate is issued to 12800 Main Road LLC (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Autllffrized Signature TOWN OF SOUTHOLD BUILDING DEPARTMENT 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 #: 36256 Permission is hereby granted to: 12800 Main Road LLC Date: 3/22/2011 PO BOX 1456 Mattituck, NY 11952 To: Alteration to a Barber Shop; Hair Washing Sink. At premises located at: 12800 Route 25, Mattituck, NY SCTM # 473889 Sec/Block/Lot # 114.-11.15 Pursuant to application dated To expire on 9/20/2012. Fees: 3/21/2011 and approved by the Building Inspector. CO - BUSINESSES NEW COMMERCIAL, ALTERATION OR ADDITIONS $50.00 $250.00 Total: $300.00 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 New Construction: Location of Property: Old or Pre-existing Building: House No. Street Date. (check one) Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Block // Lot /~-- Subdivision Permit No. .~ ~ ,3 ?;'-~,~ Date of Permit. Filed Map. Applicant: Lot: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Sabmitted: $ -5'-~) ' ~/"eq~-- Final Certificate: (check one) Applicant Signature TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ ] F~mTMr~uc'rm~ [ ROUGH PLBG. INSULATION ,[~FINAL [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION REMARKS: DATE ~ '-/( '''-// INSPECTOR~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING ~.~'FINAL ~ [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTIOfl [ ] RRERESlSTI~i'r~IISTRU~'rlOll [ ]RRERESlSTANTI~IETRATION REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Examined 3~-~'~L- ,20 {/ Approved 3'~ ~-'o9'-- . 20 / { Disapproved a/c Expiration ~ ,20__ PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying'? Board of Health 4 sets of Building Plans Planning Board approval Smwey Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: IVl~ail to: ~1 q V{ S~O,.~ ~ Building Inspector APPLICATION FOR BUILDING PERMIT Date ~\ ck(c~ V'-/ ,20 [ [ 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 Deparhnent ~br the issuance ora 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 Ibr 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, ifa corporation) ishe_[ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises S' Od{' So..,l,q (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. L~c_~t~o~.['land on whictkpropo~ed wqrk will be done: House Number Street Hhm[e5 .... County Tax Map No. 1000 Section II q Subdivision Block__,,'<'.'}'{ · ..... .. ,,,. Lot Lot /5 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy k'~_ac %e~' c~k~o Q b. Intended use and occupancy ~-\d~w 3. Nature of work (check which applicable): New Building Addition Alteration v'/ Repair Removal Demolition Other Work 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Fee (Description) (To be paid on filing this application) Number of dwelling units on each floor N IA 6. if business, commercial or mixed occupancy, specify nature and extent of each type of use. ~2~r:t¢ b.e.c g~ao o · 7. Dimensions of existing structures, if any: Front bi ~ ~Rear ~ I ~ ~ Depth Height_ Number of Stories Dimensions of same structure with alterations or additions: Front Depth_ Height Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear .Depth 9. Size of lot: Front 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 law, ordinance or regulation? YES NO3L/~ 13. Will lot be re-graded? YES __ NO ~/' Will excess fill be removed from premises? YES x./NO__ 14. NamesofOwnerofpremises ~3Je bUSCh Address I~l~00 M~ Rd. PhoneNo. 3-1~'-o Name of Architect )~,[1~. ~. 'Z~ctvx Address~Phone No{(~31~ '7 Z'7- Name of Contractor Address ......... Phone No.' 15 a. ls this property within 100 feet cfa tidal wetland or a freshwater wetland? *YES__ * 1F YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet cfa tidal wetland? * YES NO__ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO 7 16. Provide survey, to scale, with accurate tbundation 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 4' STATE OF NEW YORK) SS: COUNTY OF ~[tJ~'0[[~.- ) ~2 being duly sworn, deposes and says that (s)he is the applicant (Name o£ individdal 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 l_o. befbre me this Notary'P~'~'c 8ol~in K. ~ Notary Public - State of 81ew York NO. 01 SC6129246 Qualified in SuffOlk Counlv My Comm/ssi0n Expires _~o~'~/~, Signature of Applicant Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M. #: ae~n~ I( } ~'* THE FOLLOWING ACTIONS MAY =QUIRE THE SUBMISSION OF A STORM-WATER, GRADING; DRAINAGE AND EROSION CONTROL PLAN Di~blct BlOck L~t CERTIFIED BY A RESIGN PROFESSIONAL IN THE STATE OF NL=W YORK. SCOPE OF WORK - PROPOSED CONSTRUC'I'ION J'II~ ~ / WORKASSESSMENT I Yes No a. What is the Total Ama of the Project Parcels? I W/ti this Project Retain All Storm-Watar Run-Off (Include Total Ama of all Parcels located within Generated by a Two (2") Inch Rainfall on Site? the Scope of Work for Proposed Construction} (This item will include all mn-off created by site b. What is the Total Area of Land Cleadng tS.F. / Aa~ss) cleating and/or construction activities as well as all and/or Ground Disturbance for the proposed Site Improvements and the permanent creation of construction activity? impervious surfaces.) (s.F.,^~.) 2 Does the Sita Plan and/or Survey Show AIl Proposed__./ PROVIDE BRIEF PROJECT DE$CR1PTION tP~e ~d~m.~ ~. ~ ~ Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and -- Slopes Controlling Surface Water Flow. 3 Does the Site Plan and/or Survey descdbe the ems/on r~ and sediment control practices that will be used to conb'ol site erosion and storm water discharges. This -- item must be maintained throughout the Entire Construction Period. 4 Will this Project Require any Land Filling, Greding or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards~J. __ of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five ThousandL.~ (5.000 S.F.} Square Feet of Ground Surface? -- 6 is there a Natural Water Course Running through the ~ Site? Is this Project within the Trustees jurisdiction General DEC SWPPP Requirements: or within One Hundred (100') feet of a Wetland or Submission of a SWPPP is required tar all Construction activiUes involving soil Beach? disiurbances of one (1) or mom acres; including disturbances of less than cne ac~e that 7 Wilt there be Site preparation on Existing Grade Slopes ~ am pad °f a larger c°mm°~ Plen that will urdrnatalY disturb °ne °r m°re acres of land; which Exceed Fifteen (15) feet of Vertical Rise to ~ including Consth~cflon activities involving soil dleturban~ss of less than one (1) acre where One Hundred (100') of Horizontal Distance? the DEC has determined that a SPDES permit Is required tar storm waist discharges. SWPPP's Shall meet the Minimum Requirements of the SPDE$ General Permit 8 Will Driveways, Parking Areas or other Impervious ~ / tar Storm Water Discharges from Construction activity. Permit No. GP-0-t0-001.) Surfaces be Sloped to Direct Storm-Water Run-Off 1. The SWPPP shall ha prepared prior ta the suhrniital of the NOI. The NOI shall ha into and/or in the direction of a Town right-of-way') submitted ta the Deparb~e~t pher to the commencement of consbuctlen activity. - 2. The SWPPP shall describe the erosion and sediment contr~ practices and where 9 Will this Project Require the Placement of Material,L~ raguJ~nd, posheonalmcfion storm water management practices that will he used and/or Removal of Vegetation and/or the Construction of any constractnd to reduce the pollutants in storm water discharges and ta assure item Within the Town Right-of-Way or Rood Shoulder compliance with the tsmm and co~difions of this permit. In addition, the SWPPP shall ffl'ATE OF NEW YORK, cou n- OF ................ ss That I .....~......~......~.....~:......~.......~-...~..~.-..~...~. .................. being duly sworn, deposes and says that he/she is the applicant for Permit, And that he/sbe is the ....... ~..~.~..~_.~....~.. Owner and/or representative of the Ova]er 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 herewith. Sworn to before rnc Ibis; . FORM - 06/10 Qualified in Suffolk County My Commission Expires ~ BUILDING PERMIT EXAMINER CHECKLIST Applicant: i SCTM# 1000-- lie -- [/ ., Property Address: /~L~ tTL-O /-~'- Subdivision: Estimated Cost: ~<,~ Zone: fi/~ Conforming? Building Permits (Open/Expired): g? __-z / c/o z-__, Info: BP __ -Z / C/0 Z- , Info: BP__-Z / C/0 Z-__ Single & Separate Search Required? Y o~ Determination: City: Pre COs? BP__ -Z / C/0 Z-__ Info: , Info: BP __-Z / C/0 Z- , Info: REQ. Lot Size: ACT. Lot Size: REQ. Lot Coy. __ REQ. Front ACT. Front REQ Side ACT. Side REQ. Rear REQ. Height. ACT. Height Project Description: d~~7 ' ~ If yes, water body: -------'------ Panel# -' Flood Zone: -- Bulkhead/Bluff Distance: ACT: Lot Cov. PROP. Rear ADDITIONAL APPROVALS REQUIRED Suffolk County Health: Y or N- If yes, *Bed#: *Date: / / *Permit#: - If no, certification required: Y or N Received: Y or N By: Town Septic: Y o~ NYS DEC: PRE-DEC9/I/75 Y or N - Date: / / Permit #: or NJ Letter - Notes: Southold Trustees: Y or N - Date: Permit.#: or NJ Letter - Notes: Southold ZBA: Y or N - Date: / / Permit #: - Notes: Southoid Planning: Y or N- Date: /__ __ Town Landmark C of A: Y or N DTE: Permit #: / - Notes: *NYS CODE Compliance (page 2): Y or N Notes: Fee Structure: Foundation: SF First Floor: SF Second Floor: SF Other: SF Total: SF Calculation: X $__.=$ + Initial Fee: Additional Fee ( ): SF X $ + Initial Fee: Additional Fee ( ):$ TOTAL: $ ~-0 , OO NEW YORK STATE CODE COMPLIANCE CHECKLIST CLIMATIC/GEOGRAPHIC D~SIGN CRITERIA: · Grouml Snow Load: 20 Weathering: Severe ·Frost Depth: 36" __ Design Temp: 11 - 'Ice Shield Underlay: YE8 ~ USE/OCCUPANCY CLASSIFICATION: · HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED/pREscRIPTIVE FULL FR~RvIING DESIGN ELEMENTS: Y/lq ItEADERS: Y/N WALL STUDS: Yfi'q CEILING JOISTS: Y/N FLOOR JOISTS: ¥/N LU'I~BER SPECIES AND GRADE: Y/N Wind Speed~ 120MPH__ SeismlcDesign Category~ B . Termite: M~H' Decay: S-M ltlo~d Hazai'ds: GIRDERS: YfN ROOF RA3[ZTERS: Y/I'4 WINDOW AND DOOR SCHEDULE: NIISSLE TEST REQUIREMENTS: Y/N EGRESS 5.7 S.F.: Y/N LIGHT 8%: Y/N VENT 4%: NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: YfN PLLrMB[NG RISER DIAGILAM~ LOCATION OF FIICE PROTECTION EQUI3?MENT: Y/N TRUSS DESIGN: Y/N CERTIFICATION: Y/N ENERGY CALCS: Y/N TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE) Town Hall Annex 54375 Main Road P.O. Box 1179 Southold~ New York I 1971-0959 Telephone (631 ) 765-1802 Fax (631) 765-9502 BUILDING DEPARTMENT TOWN OF SOUTHOLD May 2, 2011 Rene Zepeda 319 Fishel Avenue Riverhead, NY 11901 RE: Barbershop, 12800 Route 25, Mattituck TWO WHOM IT MAY CONCERN: The Follow~ng Items Are Needed To Complete Your Certificate of Occupancy: ~' Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. A fee of 50.00. Final Health Department Approval. ~' Plumbers Solder Certificate. (Ail permits involving plumbing after 4/1/84) __ Trustees Certificate of Compliance. (Town Trustees#765-1892) __ Final Planning Board Approval. __ Final Fire Inspection from Fire Marshall. __ Final Landmark Preservation approval. BUILDING PERMIT: 36256-Z sink for barbershop PLUMBING RISt~R DIAGRAM SLOPE' .I~/'4" PER FOOT P~TON TO DRAIN F_.XPGT. t,,IIN~OI~I -- EXI'GT. H, INDOI"I DI~PLA'f' DISPLA'f' RAI~IATOR ! PLUMBING i ALL PLUMBING WASTE ~ & WATER LINES NEED TESTING BEFORE COVERING PL UMBER CER TIFICA TION _ ON LEAD CONTENT BEFORE = ~ '-- | F CERTIFICATE OF OCCUPANCY S,,OLDER USED IN WA TER ' S~UPPL Y SYSTEM CANNOT ,-XCEED 2/10 OF 1% LE~j~R STATION-/ i Cr~.4) 'r_.~..=------~- ~ F y BUILDING DEPARTMENT ' ~02 8 AM TO 4 PM FOR THE · , · i)WING INSPECTIONS: : C, UNDATION - TWO REQUIRED F©R POURED CONCRETE -~3UGH - FRAMING, PLUMBING, STRAPPING. ELECTRICAL ~ CAULKING ~ $ ~NSULATION 4 FINAL. CONSTRUCTION & ELECTRICAL ~ ~ ~us~ ~E CO~L~rE ~0. C.O. . ~o~,~j~ ALL CONSTRUCTION SHALL MEET I~E : - -~ I ~ K' REOU~REME.TS OF TUE CODES OF N~ YORK STATE NOT RESPONSIBLE FOR DESIGN OR CONSTRUC]ION ERRORS, ,//~-EXIST. 5HEL¥1N~ ' TO -.~ NEIN 1:2"XI2" "J~ /'-' C,T. P.,A~IATOR IIII IIII ~XIST. l:~ P.E~RA~EE