HomeMy WebLinkAbout23383-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24755 Date NOVEMBER 20, 1996
THIS CERTIFIES that the building ADDITION
Location of Property 175 CLEARWATER LANE CUTCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 118 Block 5 Lot 2.2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 12, 1996 pursuant to which
Building Permit No. 23383-Z dated APRIL 22, 1996
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 TWO LEVEL ELEVATED BLUE STONE PATIO ADDITION TO EXISTING ONE
FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to MARK & ELAINE McDUFFEE
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Building fnspecto6r
Rev. 1/81
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) QQ
N2 23383 Z Date ................... L�............, 19.../.
.................. .
.f"-p
Permission Is hereby gran ed to,
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to .... .. jam,,,..,../�:.��.�....�%�.�3
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.......... � ....... .. ......' � ..-.. ..: -......
.........z ....laox .X...... .. ...� ..
ell �.................. I. ........................................
at premises located at.............�/ ... �/�.��. ..... .. .W.r..........................I........
........................................................... // ... ..........
County Tax Map No. 1000 Section ........�l.,. . ....... Block........ ............. Lot No. !.. .............
pursuant to application dated ........................ ... . ...P.....1.. 19...7...Sr .... and approved by the
Building Inspector.
Fee$. . .w '•'
..... . ....................... ....,...�eectior
........uilding
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building or new use:
1. Final survey of property with accurate location of all buildings, property lines,
street's, 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 a 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 $25 .00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildine - $100.00
3. Copy of Certificate of Occupancy - .25i
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . . .Noxembex. .15,. .1.996. . . . . . . . . . . . . . . .
New Construction. . . . .4. . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . .
Location of Property. . J.7.5 .O1.eaxwat.Qr. T, ne, . CutehAgue. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
House No. Street Hamlet
Onwer or Owners of Property. . . . . .I lame MoDUf. fee. ,
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. . 11.8. . . . . . . .Block. . . .5 . . . . . . . . . . .Lot. . . . ,?. . . . . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
Permit No. . . 23383E , . , , ,Date Of Permit. . . 4/2296 . . , ,Applicant.JAMS. A.... .k'!�z, ,QrRld, .Jr...
Health Dept. Approval. . . . . . . . N/A . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . N1/.A . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicat'e. . . . . . . . . .
Fee Submitted: $. . . . 5'00 . . . . . . . . . . . . . . . . . . . - �
APPLIT
Proper-T Permit Services
POST OFFICE BOX 617, CUTCHOGUE, NEW YORK 11935-0617 (516)734-5800
November 15, 1996
Senior Building Inspector
Building Department
Town of Southold
Town Hall, 53095 Main Road
Southold, New York 11971
Re: Certificate of Occupancy; Elaine McDuffee. SCTM#1000-118-5-2.2
Dear Sir:
Attached is a completed Application for a Certificate of Occupancy submitted on behalf of
Mrs. Elaine McDuffee for the newly constructed stone patio on her property at 175 Clearwater
Lane in Cutchogue.
Also enclosed is a check in the amount of$25, the fee for the Certificate.
If you will call me when the CIO is ready, I will pick it up at your office.
Sincer4Fitzgera
J es
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a subsidiary of
THE PECONIC EASTERN CORPORATION
O��SyFFO(,f-�O
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N y.
Town Hall, 53095 Main Road p • Fax(516) 765.1823
9y�Ol �.a0� Telephone(516) 765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
June 20, 1996
Mr. James E . Fitzgerald Jr.
P.O. Box 617
Cutchogue, NY 11935
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons :
xx An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
xx The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984) .
BUILDING PERMIT # 23383-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
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Albert J. Kiupski, President p� OG Town Hall
John llolzapfel, Vice President = 9� 53095 Main Road
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Jiro King i P.O. Box 1179
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Martin 11. Garrell O ye Southold, New York 11971
Peter Wenczel y�0� �p0` Telephone (516) 765-1892
Fax (516) 765-1823
BOARD OF TOWN TRUSTEE'S
TOWN OFSOUTHOLD
April 2, 1996
James Fitzgerald, Jr.
Proper-T Permit Services
P.O. Box 617
Cutchogue, NY 11935
RE: Elaine McDuffee
SCTM #1000-118-5-2 . 2
Dear Mr. Fitzgerald:
The following action was taken by Southold Town Board of Trustees
on Thursday, March 27 , 1996 ;
RESOLVED that the Southold Town Board of Trustees grant a waiver
to to construct a bluestone patio on two-level elevated bed, not
exceeding 18" above grade; stones set steps to grade. Total area
approx. 517 s.f . Located 175 Clearwater Lane, Cutchogue.
Enclosed please find a check in the amount of $110. 00
representing a refund from a full application.
If you have any further questions, please do not hesitate to
contact this office.
Sincerely,
Albert J. Krupski, Jr.
President, Board of Trustees
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Garage 2 1 X 2 5041 1 oe' 5or! Driveway Rooms 2nd Floor �Amr FoUtiu S�.x1c i>
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Proper-T Permit Services
POST OFFICE BOX 617 CUTCHOGUE, NEW YORK 11935-0617 (516)734-5800
April 11, 1996
Senior Building Inspector
Building Department
Town of Southold
Town Hall, 53095 Main Road
Southold, New York 11971
Re: Application for Buildings Permit for Elaine McDuffee, SCTM#1000-118-5-2.2
Dear Sir:
Attached is a completed Application for Building Permit submitted on behalf of Mrs. Elaine
McDuffee for the construction of a stone patio on her property at 175 Clearwater Lane in
Cutchogue.
Also enclosed are a number of supporting documents and a check in the amount of$75, the
fee for this project.
If there are any questions, please call me.
Sincere*Fitzgeffr
a es
Enclosures:
Application
Permit Fee ($75) "
Bn91
Project Sketch
Survey APA'
Trustee Waiver l ;r i
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-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH P G.
[ ] FOUNDATION 2ND [ ] INS ATION
[ ] FRAMING A41NAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
i
DATE INSPECTOR
BOARD OF HEALTH . . . . . . . . . . . .
` 3 SETS OF PLANS
FORM NO. I SURVEY . . . . . . . . . . . . . . . . . . . . .
R 2 l TOWN OFSOUTHOLD CHECK . . . . . . . . ' . . . " : . . " ; . .
�.Y BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL
BLDG.DEPT. SOUTHOLD, N.Y. 11971 NOTIFY
TOWN SOUTHOI-D�w, TEL.: 765-1802 CALL . . . . . . . . . . . . . . . . . . . . .
� '
Examined . • • . . • • MAIL TO :
'
y 191 , 3
Approved . . . . . . . . . . . . . 19 . �Pennit No.�. . . .`�
Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . .
(BuildingInspector)
AP (CATION FOR BUILDING PERMIT
Date . . .A}?ril 11. . . . . ., 1596-
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets of plans,accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of tot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
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 issued a Building Permit to the applicant. Such 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 whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
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.
Jamey ;Fl. Fit2�gerald ,, Jr;.. .
James EFI$ygS4r4rl{I Jr. (Siggature'oi applicant, or name, if a corporation)
P,O. tx.as 617, CuTchague, NY 11935 P.O. Box 617, Cutchogue NY 11935
t^Izssc: (516) 734.5300 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
. . . . Applicant. As .the .4gpAt .of Vie. .o.v er..:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Name of owner of premises . .Fii7.a Aq XQN— PP . . . . . . . . . . . . . . . . . . - . . .
as on the tax roll orr llaatest ed R �Stib
- (y3
If applicant is a corporation, signature of duly authorized officer. DATE' B.P. d f�
FEE: BY:
N/A NOTIFY BUILWLD DEP
t .# . .`Y . . . .
(Name and title of corpomt�pffifery 7t15 1802 9 AM TO RI• FOR 7HE
p, _ FOLLOWING INSPECTIONS:
as s � A 1. FOUNDATION - I WO REQUIRED
Builder's License No. . . . . .
(;®s` FOR POURED CONCRETE
e° FUL
2. ROUGH - FRAMING tri PLUMBING
Plumbers License No.
`.. u. (�, sl"" 3. INSULATION
Electrician's License No. . . . . r:>•a• L•�U L ICATE �' FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
T � yALL CONSTRUCTION SHALL MEET
Other Trade's License No. . . . t _. • - krC THE REQUIREMENTS OF THE N.Y.
1. Location of land on which proposed work will be done. -STATE CONSTRUCTION & ENERGY
.CODES: ' NOT ' RESPONSIBLE• 'FOR. . . . .
DESION O.R�RJ,CT94 FRR9RS
175 Clearwater Lane.,. .Qut,chRgAe. . . . . . . . . . . . . . . . . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . . . . ..
House Number Street Hamlet
County Tax Map No. 1000 Section . . . . . .118. . . . . . . . : Block . . . 5. . . . . . . . . . . . . . Lot . . 2.2 . . . . . , . . , . . .
Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . .
(Name)
2. State existing use and occupancy of premises and intended use and Occupancy of proposed construction:
a. Existing use and occupancy . . . . . . . . ,Single-family x ggjderiee
b. Intended use and occupancy . . . . . . , ,Single7family, residence , , , , , , , , ,
( pp
3. Nature of work check which a Iicabie): New Building . . ... ... . . . . Addition .PfttA4 . . . Alteration ; . . . . . . . . .
Repair . . . . . . . . . . . . . . Removal . . . . . , . . . . . . . . Demolition . . . . . . . . . . . . . . Other Wolk;,-. . . . . . . . . . . . . .
'(Description)
4. Estimated Cost . . . . . . . . . . $G5e900 . . . . I . . . . . . . . . . . . . . . Fee . . . . . . . $75. . . . . . . . . .'. ,, . . . . . . . . . .
5. If dwelling,number of dwelling u �\ (to be paid on filing this application)
g nits . . . . . . . . . . . . . . . Number of dwelling units on each floor. . . . . . . , . . . . . . . .
Ifgarage, number of cars . . . . . . . . . . . . . . . i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . .
7. Dimensions of existing structures,'if any: Front . . . . . . , , .\. . . Rear . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . .
Height . . . . . . . . . . . . . . . Number ofStories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . .
Depth . . . . . . . . . . . . . . . . . . . . .b Height . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . .
8. Dimensions of entire new construction: Front .See. below. . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . .
Height . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Size of lot: Front . . 1.7.4! . . . . Rear . . . . 122.'. . . . . . . . . . . . . . Depth .46_q� .r. 519!. var. . .
10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Name of Former Owner . . . . FX10W.o . . . . . . . . . . . . . . . .
11. Zone or use district in which premises are situated . . R':49. . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . , , , , . , , ,
12. Does proposed construction violate any zoning law, ordinance or regulation: . No
13. Will lot be regraded . . . . . . . NQ . . . . . . . . . . . . . . . . . .Will excess fill be removed from premises: Yes No
14, Name of Owner of premises . . .UP. IIQIQW. . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . .
Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . '
Name of Contractor . . . . . . . . . . Address . . . . Phone No. .
15 .Is this property located within 100 feet of a tidal wetland? *YES . .X .No. . . .
*If yes , Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
The application is , to construct a Bluestone patio 18' x 33' overall,
on two levels, on sand base with mortared joints, with steps to grade.
Height will not exceed 18" above grade. Total area approx 517 sq. ft.
See attached sketch (J. Fitzgerald, 3/6/96)
Owner of premises Mrs. Elaine McDuffee
175 Clearwater Lane
Cutchogue NY 119.35
NOTE REGARDING DEC' NON-JURISDICTION: Attached is the survey of
Van Tuyl, Mar. 79 99 , upon w ich are shown the 10' and 15f
contours. The entire. project proposed here is inside the 15'
contour and therefore is not subject to DEC jurisdiction.
ACTION 13Y SOUTHOLDITRUSTEES: Attached is a copy of the action of
t e Southold Trustees who have granted a waiver for this project.
STATE OF NEW YORK
COUNTY OF . Al=PA , , , , , , S S
g contract)
. Jx, . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant
above nam (Name of individual signined.
lie is the . . . . . . . . Agent. . . . . . . .
(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
. . . . . . . . .day of. . . .�`I'�l.l . . . . . . . . .. 19 q.
Notary Public, Ja,u a . . f!. . .iu ^OMi� , , , , , , County
.JANE R. St . .. . ..; .:
NOTARY PU6LICIC,Stateate of of Now York
J
No.Mafoa,Suffolk County �/ (Slgnature of applicant)
Commissloo Expires,February 15,197
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