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HomeMy WebLinkAbout37719-ZTOWN 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 #: 37719 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 Date: 1/212013 At premises located at: 165 Orchard St, New Suffolk SCTM # 473889 Sec/Block/Lot # 117.-5-33 Pursuant to application dated To expire on 7/4/2014. Fees: 12112/2012 and approved by the Building Inspector. DEMOLITION Total: $215.20 $215.20 Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMEN3 TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 Sour holdTown.NorthFork.net Examined Approved Disapproved Expimtion ,20 DEC 122012 BLD6 D~ [. PERMIT NO. · Building Inspector , PERMIT APPLICATION CHECKLIST :, ~eforc applying? Board of Health 4 sets of Building plans Planning Board approval Phone: APPLICATION FOR BUILDING PERMIT Date ,20 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to thc 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 luspactor will issue a Building Permit to thc applicant. Such a permit shall be kept on the premises available for inspection throughout thc work· e. No building shall be occupied or used in whole or in part for any purpose what so ever until thc Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if thc work authorized has not commenced within 12 months aBcr the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting thc property have been enacted in the interim, the Building [nspoctor 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 ora Building Pennit pursuant to the Building Zone Ordinance oftbe Town of Southuid, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions, or alterations or for removal or demolition aa herein described. The applicant agrees to comply with all applicable laws, ordinances, building cede, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. 9~O_~ ~ (Signature of applicant or name, ifa co~poration) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder © veR Name of owner of premises ~C) b~¥"~ ~1 g~/(-/~ ~} (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: House Number Street County Tax Map No. 1000 Section Subdivision Hamlet I}7 Block ~" Lot ~L-__ Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existinguseandoccupancy .~q(,,~'~.~. ghed /G-r~,rL5¢ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition )~ Other Work (Description) 4. Estimated Cost ~ttq~OOO~ tlt/~61£'0 Fee (To be paid on filing this application) 5. I f dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 1~, 6. If business, commereial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensionsofexistingstmctures, ifany:Front lt.t'/I Rear /6*q' ~Depth Height. 17t Number of Stories ! ~ 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 oflot: Front ~:~'~'80I Rear ~7,'~St Depth ~Ot 10. Date of Purchase D~ ~ °3~ Name of Former Owner ~r~ ~'~'[qOet ~/ 11. Zone or use district in which premises are situated Rear Depth 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 ~:>b°'°l- ~'Oc-.'~/:)Address Phone No. ~ Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. ls this property within 100 feet ora tidal wetland or a freshwater wetland? *YES NO K * 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 I0 feet or I~low, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES__ NO )~ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) COUNTY OF ,~U ~' I~ I ~S: (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 thc said work and to make and file this application; that all statcmenls contained in this application are true to thc pest of his knowledge and belief; and that the work will be performed in thc manner set forth in thc application filed therewith. Sworn to before mc this I0~'n dayof. ~ecc.~,,r' 20 ~Y7 '~-- ~ ~' ~ ' Signatorc of Applicant U.S DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Read the instructions on pages 1-8. OMB No. 1660-0008 Expires February 28. 2009 SECTION A - PROPERTY INFORMATION A2 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. A3. Pro~perty Description (Lot and Block Numbers, Fax Parcel Number, Legal Description, etc.) A4 Building Use (e g., Residenfla,, Non*Rgsidenlial. Addifion, Accessory, etc., A5. Latfiude/Longitude:Lat. ~O' ~'~ ~37"' Long -7~'_' Z.~ ~," A6 Attach at least 2 photographs of the building it the Cediflcale is being used to obtain flood insurance A7 Building Diagram Number ~ A8 For a building with a drawl space or enclosure(s), provide: a) Squarefoolageofcrawlspaceorenclosure(s) 700 sqft b) No of permanent fined openings in the crawl space or enc osure{s) wa is within 1 0 foot above adjacent grade _~ c) Total net area of good openings in AS.b IQ O sq in For Insurance Company Use: Policy Number Company NAIC Number ZIP Code Hodzontai Datum: [] NAD 1927 A9 For a building with an attached garage, provide: a) Square footage ot attached garage [~NAD 1983 sq fl b) No. of permanent flood openings in the attached garage walls within 1 0 toot above adjacent grade c) Total net area of flood openings in Ag.b __ sq in SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1 NFIP Communily Name & Community Number I B2 County Name B4. Map/Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel B8 Flood G Date Ettecflve/Revised Date Zone(s) io36o5%1 -- H. F- B10. Indicate the source o[ thee Base Flood Elevation (BFE) dala or base flood del~h entered in Item B9. [] FIS Profile [] FIRM [] Commungyr~termined [] Other (Describe) B 11. Indicate elevation datum used for BFE in Item B9: L[J NGVD 1929 [] NAVD 1988 [] Other (Describe) B12. Is Ihe building located in a Coastal Barrier Resources Syslem (CBRS) area or Otherwise Protected Area (ePA)? Designation Date [] CBRS [] ePA B9. Base Rood Elevation(s) (Zone An, use base flood depth) [] Yes [~"~1o SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevaflons are based on: [] Construction Drawings* [] Building Under Construction* [~Finished Construcflon *A new Elevation Certificate will be required when conslruction of the building ts complete C2 Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, AR/A, APJAE, AR/A1-A30, AR/AH, AR/An Complete Items C2.a-g below according to the buildin diagram specified in Item A7. BenchmarkUlilized }~J'.~.'~ -~ J~o,2 ')cJ~X VerficalDatum H~"Vl~ Conversion/Comments a) Top of bottom floor (including basement, crawl space, or enclosure floor)__ b) Top otlhe next higher finer c) Bottom of the lowest horizonlal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type o1 equipment in Comments) f) Lowest adjacent (finished) grade (LAG) g) Highest adjacent (finished) grade (HAG) /'~ &'~ ~-feet [] me ers (Puerto R co on ~:~ teet [--] meters (Puerto Rico onlt~)) -- -~[] feet [] meters (Puerto Rico only) -- - [] feet [] meters (Puerto Rico only) teet [] mete.s (Puerto Rico on y) ~' / _[~ feet [] meters (Puerto Rico only) ~ . 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 cedify elevaflon information I certify that the information on this Cedificate represents my best efforts to interpret the data available unders and ha any false s atement may be punishable by fine or imprisonment under 18 U.S Code, Section 1001. Check here, CO--hiS are p ovided on back of for ~ifle Company Name Signature Date ~elephone FEMA Form 81-31, February 2006 See reverse side for continualion Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding Information from Section A. I For Insurance Company Use: Bulldino Street Address (including~pt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. I Policy Number ' City p~/ ~-~1~,~ / ~ State /~.~,/ ~/,.~r~k ZlPCodet~l~, Company HAlO 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. SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQOIRED) FOR ZONE AC AND ZONE A (WITHOUT BFE) For Zones AC and A (without BFE), complete Items El-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 lhe measurement used. In Puerto Rico only, enter meters. E 1. 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 adjacenl grade (LAG). a)Topofbogomfloor(inciudingbasement, crawlspace, or enclosure) is __ [~feet r'-~meters {'~aboveor m] 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 previded in Sectioj~.A Items 8 andlor 9 (see page 8 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is . [] feet [] meters [] above or E] below the HAG. E3. Attached garage (top of slab) is [] feet [] meters [] above or [] below the HAG. E4. Top of platform of machineP/and/or equipment servicing the building is [] feet [] meters [] above of [] below lhe HAG. ES. Zone AC only: If no flood deplh number is available, is the top of the bottom ifoor elevated in accordance with the community's floodplain management ordinance? [] Yes [] No [] Unknown. The local official must certifythis information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authodzed representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AC must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representeflve's Name Address City State ZIP Code Signature Date Telephone Commenls [] Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is aulhorized 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. Gl. [] The information in Section C was taken from other documentation thai 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 tocated in Zone A (without a FEMA-issued or community-issued BFE) or Zone AC. G3. [] The following ini=ormalion (Items G4.-Gg.) is provided for community floodplain management purposes. IG4. Permit Number J G5. Date Permit Issued IG6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: [] New Construction [] Substantial Improvement G8. Elevation of as-buiif lowest floor (including basement) of the building: G9. BFE or (in Zone AC) depth of flooding at the building site: [] feet [] meters (PR) Datum [] feet [] meters (PR) Datum Local Official's Name Title Community Name Telephone Signature Date [] Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions FE8.21.2008 12:0OPM NX~. FUD JIN"S ffl: '1 ORCH4~D , MAP .O'F " sour~o~o ~4wN~s 313 '~est' main'street (5i6) $69,i717 '.... ' ' MAR. ZI, I~64 &ob No, 84-460"