HomeMy WebLinkAbout40151-Z Ft GL' Town of Southold
9/23/2016
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P.O.Box 1179
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53095 Main Rd
rjQlQ Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38531 Date: 9/23/2016
THIS CERTIFIES that the building PORCH
Location of Property: 2855 Boisseau Ave, Southold
SCTM#: 473889 Sec/Block/Lot:' 55.-5-12.1
-Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/16/2015 pursuant to which Building Permit No. 40151 dated 10/5/2015
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:
PORCH ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to Norcross,Kenneth
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
a a
Autho e Signatur
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERKS 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#: 40151 Date: 10/5/2015
Permission is hereby granted to:
Norcross, Kenneth
532 Pacific St Apt 8
Brooklyn, NY 11317
To: Alterations to front porch on existing single-family dwelling as applied for.
At premises located at:
2855 Boisseau Ave
SCTM # 473889
Sec/Block/Lot# 55.-5-12.1
Pursuant to application dated . 9/16/2015 and approved by the Building Inspector.
To expire on 4/4/2017.
Fees:
SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $286.40
CO -ALTERATION TO DWELLING $50.00
Total: $336.40
Building nspector
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
Date. = f�7_ Is-
New Construction: Old or Pre-existing Building: 1/ (check one)
Location of Property: 2 PU ESeA- J /kV — �'bcTf CiZ
House No. Street Hamlet
Owner or Owners of Property: 9EN UES 0RCK0 9
Suffolk County Tax Map No 1000, Section 55- Block Lot j r2
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
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Fee Submitted: $ �-���
pIcant Signature
®/ ��OF SOUTyO
o�yc00M`1,��
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
-,INSPECTION , ,
G ] FOUND ON IST [ ] ROUGH PLUMBING
[ ] FO DATION 2ND [ ] INSULATION
[ RAMING / STRAPPING [ ] FINAL
[, ] FIREPLACE.A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[, ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATI N [ ] CAULKING
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DATE ` INSPECTOR
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TOW F SOUTHOLD BUILDINIG� DEPT.
765-1802
INSPECTION. ' '
FOUNDATION,I ST ] ROUGH PLUMBING
FOUNDATION 2ND INSULATION
FRAMING / STRAPPING FINAL
FIREPLACE & CHIMNEY FIRE SAFETY INSPECTION
FIRE RESISTANT CONSTRUCTION FIRE RESISTANT PENETRATION
ELECTRICAL,(ROUGH) ELECTRICAL (FINAL)
CODE VIOLATION CAULKING
REMARKS:
ziDATEI INSPECTOR
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TOWN OF SOUTHOLD BUILDING,DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ XROH PLUMBING
FOUNDATION 2ND [ LATION
FRAMING /STRAPPING �[ L
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
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DATE r INSPECTOR
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] P9JULATION
[ ] FRAMING / STRAPPING [ FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD, NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
South oldTown.NorthFork.net PERMIT NO. D, Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
/c Flood Permit
Examined ,20 /, J Single&Separate
Storm-Water Assessment Form .4
Contact:
Approved ,20 Mail to: V(�
Disapproved a/c Po ecx_�, 4-CA alxmt L-0
Phone: 03 L—ZCL4 4'7'f
Expiration 120
�1 Buildi ector
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LPPLICATION FOR BUILDING PERMIT
SPP 1 S 2015
Date Sevr(- V,:� , 20 l57
zLoc oEF r INSTRUCTIONS
I�f.Or ,gl'I'Iti'f,'
--a-Thi-s pp ica ion T e 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.
( g ture of applicant or name,if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
&-G_B4T_
Name of owner of premises K_�A t4UTI* K)Cw_C-(Z.0S_S
(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:
15,55 Bre 168'eAU &J I SC)UTE- L_o
House Number Street {, ;,:.,Hamlet
County Tax Map No. 1000 Section ;Block:; ..r. i Lot 2
l
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy 'S t JF�Arnl lw( R�='S L o EIQC e
b. Intended use and occupancy IE 1>0KCt$
3. Nature of wor check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor k1i
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 1S, h
7. Dimensions of existing structures, if any: Front S -° ( Rear -3s . 1 Depth 38, 3
Height '2,,,2J—0 Number of Stories 2i
Dimensions of same structure with alterations or additions: Front 14 CtW3Cu-Rear c ',J1ft
Depth cSmyl,el Height !E /A G Number of Stories SAM G
8. Dimensions of entire new construction: Front Rear r e Depth
Height Number of Stories
9. Size of lot: Front 19-4 . 91 t Rear l S ( 18)9'1 Depth 24 -71 qS l
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated 90
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_
Ave
14.Names of Ow er of premises Q ORCCOZ Address 225'6' c� 065W Phone No. SUO
Name of-A� �0� C1� 3ee5 Address P08tKA <S29LTW&WPhone No ��1
Name of Contractor ?�,t LL., 'MTI* 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 BE 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 NO
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF )
OPK� C' IB4BRS being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the 1
(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 methis
1 ( day o 20J
� P CONNIE D.BUNCH
Public ` tewyy PubNi:,&&te of Now
Notary No.01BU81SMO Signature of Applicant
Qualified In Suffolk County
commission Expires April 14,2L
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J�1
Scott A. Russell
SUPERVISOR MAN A\(G IENCEN T
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SOUTHOLD TOWN HALL-P.O.Box 1179
53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of Southold
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT )
DOES THIS PROJECT IN-VOLVE A:'YY OF THE IEOL,1LOWUNG:
Yes No (CHECK ALL THAT APPLY,,
A. Clearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surface.
❑�, . Excavation or filling involving more than 200 cubic yards of material
within any parcel or any contiguous area.
❑ C. Site preparation on slopes which exceed 10 feet vertical rise to
100 feet of horizontal distance.
❑W. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area.
❑RE. Site preparation within the one-hundred-year f loodplain as depicted
on-FIRM Map of any watercourse. -
❑RF. Installation of new or resurfaced impervious surfaces of 1,000 square
feet or more, unless prior approval of a Stormwater Management
Control Plan was received by the Town and the proposal includes
in-kind replacement of impervious surfaces.
If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name,
Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project.
If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan
and a completed Check List Form to the Building Department with your Building Permit Application.
APPLIC.AVT (Plopelty0"nerDesign Profes--onal gent,Contracto. Otheo S.C-•T.IVI. $: 1000 Date
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Property Address/ Location of Construction Work: — — — — — — — — — — — — — — —
ZC �Ol EE �J � Appio\ed fol processing Building Pel mit
�L 91 Sroi mNratel Management Control Plan Not Regwi ed
d�� L-'� ❑ Stoim�\atei iNianagement Contiol Plan i>Retlfiiied
iF of\\arci to Engmeei inr, Depai hTient for Re•.ie",i
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Garage r 4 �� Type Roof Rooms 1st Floor BR.
Patio f .rY r Recreation Room Rooms 2nd Floor FIN. B
p, B. 'Dormer Driveway
Total
S.C.T.M. NO. DISTRICT: 1000 SECTION: 55 BLOCK: 5 LOT(S): 12.1 MIDDLE ROAD
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X LAND N/F OF DONALD & LORNA TUTHILL �� UP
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C.E THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL
0 5'N LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS
AND OR DATA OBTAINED FROM OTHERS.
LAND N/F OF JOHN & TERESA QUINN
AREA: 40,001 S.F. OR 0.92 ACRES ELEVATION DATUM• ______________
UNAUTHORIZED'ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION
LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE.
THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
NOT INTENDED i,TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS EASEMENTS
AND/OR SUBSURFACE S7RUC-TURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY
SURVEY OF: DESCRIBED PROPERTY CERTIFIED TO: KENNETH NORCROSS;
MAP OF: ! WELLS FARGO BANK, N.A.;
FILED: FIDELITY NATIONAL TITLE INSURANCE SERVICES, LLC;
1
SITUATED AT: SOUTHOLD
TOWN OF: SOUTHOLD ' KENNETH M WOYCHUK LAND SURVEYING, PLLC
SUFFOLK COUNTY, NEW YORK Professional Land Surveying and Design
P.O. Box 153 Aquebogue, New York 11931
PHONE (631)298-1588 FAX (631) 298-1588
FILE #15-88 SCALE:1 =30' DATE-JUNE 10, 2015 NYS LISC. NO. 050882 maintaining the records of Robert J. Hennessy & Kenneth M. Woychuk
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NORCROSS RESIDENCE
2855 BOISSEAU AVE.
SOUTHOLD N.Y.
FOOTING REVISION
12.11 15
EXIST WALL OF HOUSE
SCALE AS NOTED
EXIST ROOF FRAMING-NO CHANGES
EXIST HEADER-NO CHANGES
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