HomeMy WebLinkAbout33877-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-33079
Date: 06/06/08
THIS CERTIFIES that the building ALTERATION
Location of Property: 175 DIAMOND
(HOUSE NO.)
COunty Tax Map No. 473889 Section 68
LA
(STREET)
Block 2
PECONIC
(HAMLET)
Lot 14
subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
MAY 7, 2008 pursuant to which
Building Permit No. 33877-Z
dated
MAY 7, 2008
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 "AS BUILT" PORCH ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED
FOR.
The certificate is issued to JAMES & NANCY P ROSCOE
(OWNER)
of the aforesaid building.
SUFFOLK COUIIlTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
4000004
05/15/08
PLUMBERS CERTIFICATION DATED
N/A
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Rev. 1/81
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This applicatIon must be filled in by typewriter or ink and submitted to the Building Department with the following:
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
:J I: TOWN HALL
.....J. 765-1802
".~~PPLICATION FOR CERTIF1CATE OF OCCUPANCY
i ~
A. For new building or new use:
I FIll31 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 fonn).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Swam statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead.
5. Conunercial 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:
I. 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
I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
Swinuning pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00.
Certificate of Occupancy on Pre-existing Building - $100.00
Copy of Certificate of Occupancy - $.25
Updated Celtificate of Occupancy - $50.00
Temporary Celtificate of Occupancy - ResidentIal $15.00, COlTunerClal $15.00
2.
3
4.
5.
Date.
s/s J; ---L-.
Ne"\v Constnlction:
:'" LocatIOn of Propeliy:
/ z,,?
House No.
Old or Pre-existing Building:
D \'c... ""'0 V''''-\ Le....
Street
...............
(check one)
~Can/c--
Hamlet
Owner or Ov.mers of Propeliy:
-----~--._---
-,Suffolk County Tax Map No 1000, Section ()b 8
Block
6'L-
Lot -_----.DI L.-j
SlIbclIVISIOIl~____.______ __. Flied Map. _____ Lot:
.J'ellllllNo :33'8 72_ DateofPcn11lt-.SNLLAPPlicant:_J<'l~_-.l1a..s_coC_
Health Dept: ApPloval. _.~____~__.. Underwriters Approval: _____
Plal1J1ing Boald Approval:
Request fOI' Temporary Certificate ___'_ Final Certificate:
,.-
Fee Submitted $ __~ 00
~ ~ :,3D1'1
Lv '1~l{d-~
/ (check one)
~
pplicant Signature
@].[!
~ ~
~ BY THIS CERTIFICATE OF COMPLIANCE THE ~
~ NEW YORK BOARD OF FIRE UNDERWRITERS ~
~ @
~ BUREAU OF ELECTRICITY ~
@J 40 FULTON STREET - NEW YORK, NY 10038 @
~ @
@J @
~ CERTIFIES THAT ~
~ @
~ Upon the application of upon premises owned by ~
@J ~
~ ~
~ JAMES ROSCOE JAMES ROSCOE ~
~ 175 DIAMOND LANE 175 DIAMOND LANE ~
~ PECONIC, NY 11958 PECONIC, NY 11958 @
~ @
F.!J ~
~ Located at 175 DIAMOND LANE PECONIC, NY 11958 ~
~ ~
~ Application Number: 4000004 Certificate Number: 4000004 ~
I Section: Block: Lot: Building Permit: . BDC: ns11 I
I~ ~:~~;:~:~ dae~i~es and ~~;ii:;n:::~ribed below, located i~/~~ufhaen~~~~s~:'~the premises electrical system consisting of I
'~ Outside, ~
~ ~
I A visual inspection of the premises electrical system, limited to electrical devices and wifing to the extent detailed ~
~ herein, was conducted in accordance with the requirements of the applicable code andlor standard ~
~ promulgated by the State of New York, Department of State Code Enforcement and Administration, or other ~
~ :~::ority having jurisdiction, and fO:~to ::t~n compliance ~:~:~ith on the ':i::UilSDay of ,,::y, 2008. I,
~ AdditionalCharges ~
~ install 1 light an front porch ~
~~~~ ~
~ Fixture 0 ~
~ ~
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~ seal iii!
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~ I of ~
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~ IS certl Icate may not be altered in any way and IS validated only by the presence of a raised seal at the location indicated, F.!J
~ ~
G!lG!I~Jr.lJr.I~
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.
33877 Z
Date MAY
7, 2008
permission is hereby granted to:
JAMES & NANCY P ROSCOE
PO BOX 485
PECONIC,NY 11958
for :
AS BUILT RECONSTRUCTION OF AN EXISTING COVERED PORCH AS APPLIED
FOR
at premises located at
175 DIAMOND LA
PECONIC
County Tax Map No. 473889 Section 068
Block 0002
Lot No. 014
pursuant to application dated MAY
Building Inspector to expire on NOVEMBER
7, 2008 and approved by the
Fee $
400.00
ORIGINAL
Rev. 5/8/02
33~77Z.
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING D<r FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUC'nON [ ] FIRE RESISTANT PENETRAnON
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REMARKS: _ ~
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DATE S- i - 0 g
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INSPECTOR . ....
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FIELD INSPECTION REPORT DATE I COMMENTS (
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971"
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdT own.NorthFork.net
PERMIT NO.3 3~9-:r ~
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
Check 0.;"C'\ on .~?..:()\)
Septic Form ~ u
N.Y.S.D.E.C.
Trustees
Flood Permit
Storm-Water Assessment Form_
Examined
,20_
Expiration
,20_
Contact:
Mail to:
Approved
Disapproved ale
5' Jr' 20~
Phone:
;'~G-~
f-:" "r \' 'A~pLI~TION FOR BUILDING PERMIT
\ APR 2. 9 i Date ~~ r ,20_
I I INSTRUCTIONS I
a. This ap~~~ca~;.M~J'.,be';~itiPre~lled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of plans, accur e p ot plan to scale. Fee according to schedule.
b. Plot plan showing location oflot 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 name, if a corporation)
'PQ.(0)( i-{??':;- PecOV\\L.i\Jr:' 11'15Y
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
C) '^"' '^ EO- ..-
Name of owner of premises --.')'" \IV"Ie.-.s. Ko S LaC--
(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.
I. Location of land on which proposep work will be done:
/7S D lO"vy\O....J,.." L__,
House Number Street
';::::> ,
( Ce-Oh/C-
Hamlet
County Tax Map No. 1000 Section 06 <t
Subdivision
Block 02.-
Filed Map No.
Lot
Lot
/ t--/
2. State existing use and occupancy of premises and !ntended use and pccupancy of proposed construction:
a. Existing use and occupancy P Y I '^"' <^r ~I !:::i:2.}Yl r" - .
I '
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost S LOCO .60
Addition
Other Work
/
Alteration
(Description)
Fee
5. If dwelling, number of dwelling units
If garage. number of cars
(")
(To be paid on filing this application)
Number of dwelling units on each floor
6. Ifbusiness, commercial or mixed occupancy, specifY nature and extent of each type of use.
7. Dimensions of existing structures, if any: Fro~ee.- RClI.~ ]tear Depth
Height Number of Stories
_Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: FrontlSee. f>\o.'-\S ') Rear Depth
Height Number of Stories
9. Size oflot: Front
Rear
Depth
10. Date of Purchase
I () II '19 <)/ Name of Former Owner
I
;(/- IA Ie
k? es '\ ol~,",,~ iG.J
II. Zone or use district in which premises are situated
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 -/
J;;> rl,s- O""'W\~ La..
14. Names of Owner of premises "'W\~~ l'-..oSCoe..Address Pe-coV\;{ Phone No. /6S~'l'i?'7c;
Name of Architectti.i.k~ u....J-.. ~..wa'" ~..s.I:::..,' Phone No
Name of Contractor Address Phone No.
IS 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 of a tidal wetland? * YES v' 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 . /
--
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF<;v...+-c'l!Q
j(!l..\;v\ E2b ~o SCO(" being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
OVVlAey- - Lovr-lro-..c.--!-or
(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 to before me this
~4'" day of At'rv\: I 20~
~e;-'tr}
NOTARY pu8L1c. State of New York
No. 01 JU6059400
Quatifi~d ,In Suffolk County
Comm~~~on Expires MaY_~9. 20.!..!-
Signature of Applicant
..
.
I sL TOWN OF SOUTHOLD PROPERTY RECORD CARD
STREET / ~ DIST. SUB.
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ACR.
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OWNER
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F BUILDING
~A
TYPE
kt. Value
LAND
IMP.
100
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AGE
NEW
FARM
BUILDING CONDITION
,
-
NORMAL BELOW ABOVE
Acre Value Per Value
Acre
FRONTAGE ON WATER
FRONT AGE ON ROAD
DEPTH
BULKHEAD
-- DOCK
--
-
Tillable
Woodland
Meadowland
House Plot
Total
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M. B1diY 1; ..2 f,( '). r = 7Jf)
Ext . r J f'</v 5~' L/ ~ .2, 01 IS (.,
en'slo,,;.? ,5)(/2-, ,~ Irv
Extension
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'Extension
, I,) ,f ,.;5' Foundation , Bath L. Dinette
JW. ; ,/j.1J.." I 3~1 / ' ,,~
~ rA-r1o f,?~~= ~ > g'~ @) .2/5 2r~ Basement I Fu If Floors 0<< ?- K.
Por-l Le./(, 1 - ... - (,{1), - / Ext. Walls 1€,( I 1/ Interior Finish 51''':' LR
T ~, / . / ~ . ,.^ /UQ
DR. (" X f2 .,~ 1-/ Il f~cf
-72- ' \ 3<;, Fire Place Heat DR
(0'1, IJO -
Garage 1hi<.lh =- J.,,01-. (US) /.ZS' ::2,z,o Type Roof Rooms 1 st Floor BR
Patio Recreation Room Rooms 2nd Floor FIN. B
O. B. Donmer Driveway
Total ./-
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James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTH OLD
April 25, 2008
Mr. James Rosco e-
P.O. Box 485
Peconic, NY 11958
RE: 175 DIAMON LANE, PECONIC
SCTM# 68-2-14
Dear Mr. Rosco:
The Southold Town Board of Trustees reviewed the survey prepared by Robert A. Kart,
last dated October 1, 1983, and received on April 9, 2008, and determined that only the
existing front covered porch is out of the Wetland jurisdiction under Chapter 275 of the
Town Wetland Code and Chapter 111 of the Town Code, and in accordance with Permit
# 6806 as issued on January 23, 2008. If any work is to be performed on any part of
the dwelling in the future, a permit must be applied for.
Therefore, in accordance with the current Wetlands Code (Chapter 275) and the
Coastal Erosion Hazard Area (Chapter 111) no permit is required. Please be advised,
however, that no construction, sedimentation, or disturbance of any kind may take place
seaward of the tidal and/or freshwater wetlands jurisdictional boundary or seaward of
the coastal erosion hazard area as indicated above, or within 100' landward from the
top of the bluff, without further authorization from the Southold Town Board of Trustees
pursuant to Chapter 275 and/or Chapter 111 of the Town Code. It is your responsibility
to ensure that all necessary precautions are taken to prevent any sedimentation or other
alteration or disturbance to the ground surface or vegetation within Tidal Wetlands
jurisdiction and Coastal Erosion Hazard Area, which may result from your project. Such
precautions may include maintaining adequate work area between the tidal wetland
jurisdictional boundary and the coastal erosion hazard area and your project or erecting
a temporary fence, barrier, or hay bale berm.
This determination is not a determination from any other agency.
Town
of Southold
Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM
PROPERTY lOCATION: S.C.T.M.#:
, 0 00 .t2M{ ....Ql:- -.L.!i.
District Secllon Block Lot
THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OFA
STORM.WATER, GRADING, DRA'':'AGEAND EROSION CONTROL PLAN
CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK.
----------------------------------------------------
Item Number:
("OTE: A Check Marl< (.() for each Question Is Required for a Complete Application)
Yes
li2
-------------------------------------------~--------
1
Will this Project Retain All Storm-Waler RunMOff Generated by a Two (2") Inch Rainfall on Site?
(This item will include all run-off created by site clearing and/or construction activities as well as aU Site
Improvements and the pem1anenl creallon of Impervious surfaces.)
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2
Does the Site Plan and/or Survey Show All Proposed Drainage Structures lndlcaling Size & Location?
This lIem shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFlow!
3
Will thisPi"oject Require any land FlUlng, Grading or Excavation where there Is a change to the Natural
Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel?
4
Will this Application RequIre land Disturbing Activities Encompassing an Area In Excess of
Five Thousand (5,000) Square Feet of Ground Surface?
5
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?
6
Will there be Site preparation on Exisling Grade Slopes which Exceed Fineen (15) feet of Vertical Rise to
One Hundred (100') of Horizontal Distance?
7
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?
8
Will tllis 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.)
9
Will this Project Require Site Preparation within the One Hundre(j (100) Year Floodplain of any Watercourse?
NOTE: If Any Answer to Questions Olle through Nine is Answered with a Check Mark In the Box, a Storm.Water, Grading,
Drainage & Erosion Control Plan is Required and Must be Submitted for Review Prior to Issuance of Any Building Permit!
----------.------------------------------------------
EXEMPTION:
Yes
J:!2
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 NE\V YORK,
COUNTY UJ'
J."" VY\ C-5:'?
S~-<'b(~
..RP5Q.)~
..... SS
Thal !,
being duly swom, deposes Ztnd says that hehhe is the ;lppUGUll fur Pcnnit,
(Nan-,., ,,1 irHJividual signing Documenll
And LlHt 11(' slH' )' tlh'
OlAJl0~
(Owner, Con(ra<;(Q[, A.gent, Corporale OfrlGer, c(e)
Owner <lnd,:ol lCPICSCI![;\uve or the Owner of OWTler's, and IS dul)' authoriz.ed to perrorm or have performed the sajeJ work and to
make and Ilk tlw; application; that all statements contained in this application are true to the best of his knowledge and belief; cU1d
that the lVork will be performed in the 111(lJ11ler set forth in the application /lIed herewith.
Sworn to bdore llH'. tIllS;
.q.~:t'" ..... ......qq.. .. day of .Arre,'qlq..qq, 200:,
Notary PUbIICq~.q.~*
qq..,...." ...~
(Signature of Applicant)
\.
FORM. 06/07
~o~f A~Y J~8~~IC Slate of New York
No 01JU6059406
Qualilied In Suffolk COMunt~9 20 II
Commission Expires ay . -
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