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Town of Southold Annex 1/28/2014
P.O. Box 1179
54375 ® Main Road
Southold, Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 36662 Date: 1/28/2014
THIS CERTIFIES that the building AS BUILT ADDITION
Location of Property: 3502 Private Rd #13, Mattituck,
SCTM 473889 Sec/Block/Lot: 105.-1-5
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
12/17/2013 pursuant to which Building Permit No. 38576 dated 12/17/2013
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" addition and roof overhang to existing accessory garage as applied for
The certificate is issued to Jaques, Melinda Brady
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
AuthorizK Signaturooo'
K Jr TOWN OF SOUTHOLD
BUILDING DEPARTMENT
® TOWN CLERK'S OFFICE
'S 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 38576 Date: 12/17/2013
Permission is hereby granted to:
Jaques, Melinda Brady _
45 Main St
Dennysville, ME 04628
To: as built" additions to an existing garage as applied for.
At premises located at:
3502 Private Rd #13, Mattituck
SCTM # 473889
Sec/Block/Lot # 105.-1-5
Pursuant to application dated 12/17/2013 and approved by the Building Inspector.
To expire on 6118/2015.
Fees:
ALTERATION OF ACCESSORY BUILDINGS $455.42
CO - ACCESSORY BUILDING $50.00
Total: $505.42
uilding Inspec o
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. Swom 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. l a ~l (o 13
New Construction: Old or Pre-existing Building: X (check one)
Location of Property: 3502 Ruth Road Extension Mattituck
House No. Street Hamlet
Owner or Owners of Property: Melinda Brady Jaques
Suffolk County Tax Map No 1000, Section 105, Block 01 Lot 05
Subdivision N/A Filed Map. Lot:
Permit No. Date of Permit. Applicant: Melinda Brady Jaques
Health Dept. Approval: N/A Underwriters Approval: N/A
Planning Board Approval: N/A
Request for: Temporary Certificate Final Certificate: X (check one)
Fee Submitted: $
Applicant Signature
.3857 ~ o~aoFSOa,H°6
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] IN ULATION
[ ] FRAMING / STRAPPING FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: 4<,~
e o
Ii 7A
DATE 0~ t7 INSPECTOR '
Condon Engineering, P.C.
New York State Licensed Professional Engineers
1755 Sigabee Road 631-298-1986
Mattituck, New York 11952 Fax 631-298-2651
condonengineering.com
January 18, 2014
Mr. Mike Verity
Chief Building Inspector
Southold Town Building Department
53095 Route 25
P.O. Box 1179
Southold, New York 11971
Dear Mr. Verity :
I inspected the garage at the residence on Ruth Road Extension in Mattituck. The additions on
the eastern and northern sides of the garage are wood framed structures with 2 x 4 inch stud
walls and 2 x 6 inch roof rafters. The southeastern addition is installed on a poured concrete on
grade foundation and the northern addition is installed on a concrete masonry unit foundation and
a poured concrete slab on grade. Inspection found the structures to be structurally sound. It is my
understanding that the additions were constructed in the 1965-66 time frame and to the best of
my knowledge the additions were constructed in accordance with the building code that was in
effect at that time.
If you have any questions please call me at 298-1986.
Yours truly,
nr.
C- 1011 ,
rQ 051684
p~OfESS1O~N~
JAN 2 7 2014
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
SoutholdTown.NorthFork.net PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees
jj Flood Permit
Examined Ci 20~ Storm-Water Assessment Form
Contact:
Approved 20-L Mail to: Charles R. Cuddy
Disapproved a/c PO Box 1547. Riverhead, NY 11901
Phone: _(631)369-Rgoo
Expiration , 20
Bu d' Inspector
APPLICATION FOR BUILDI ERIT.~
Date December 16 2013
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 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.
7^
r .
( nature of-applicant or name, if a cor ration)
Pn Rnv 1587, Rinprhpad- NY 11901
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Owner
Name of owner of premises Melinda Brady Jaques
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
N/A
(Name and title of corporate officer)
Builders License No. N/A
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
3502 Ruth Road Extension Mattituck
House Number Street Hamlet
County Tax Map No. 1000 Section 105 Block 1 Lot 05
Subdivision N/a 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 aingt P farm 13r Meal l i ng ~,i th garage
b. Intended use and occupancy same
10'± X 23'11"
3. Nature of work (check which applicable): New Building Addition X Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost N/A Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units N/A Number of dwelling units on each floor
If garage, number of cars 2 rnr garage
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. N/A
7. Dimensions of existing structures, if any: Front Rear 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: Front Rear Depth
Height Number of Stories
9. Size of lot: Front 200 ' Rear 200' Depth 1052'
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated R-80
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO X
13. Will lot be re-graded? YES NO X Will excess fill be removed from premises? YES NO X
45 Main St. 04628
14. Names of Owner of premises Melinda B. Jaque sAddress Denny svi lle ME Phone No.
Name of Architect N/A Address Phone No
Name of Contractor N/A Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO X
* 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 X
* 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 X NO
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTYOF snffnllj
Charles R. Cuddy, Agent for Owner/App4fii libly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He 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
tto~(k dayof npramhcr 20 13
Notary Public IWONA KODYM Signatur of Applicant
Notary N Public,
o. 01 KO6088386
Qualified in Suffolk County
h
Commission Expires March 3, 200
CHARLES R. CUDDY
ATTORNEY AT LAW
445 GRI FFING AVENUE
RIVERIIEAD,NEW YORK
TEL: (631)369-8200
1'.0. Box 1547 PAX: (631) 369-9080
Ri...6.,1, NY 11901 E-mail: cliarles. cuddy@verizon.net
December 16, 2013
Michael J. Verity, Chief Building Inspector
Town Hall Annex Building
54375 Route 25
PO Box 1179
Southold, NY 11971
RE: Melinda B. Jaques
Premises: 3502 Ruth Road Extension, Mattituck, New York
Dear Mr. Verity:
Pursuant to our conversation concerning the addition to the
garage at 3502 Ruth Road Extension, Mattituck, my client has
prepared the enclosed drawing showing the dimensions of the
addition to the garage.
Also, enclosed is a Building Permit Application and Application
for Certificate of Occupancy together with a check in the sum of
$50.00.
Please advise if any additional sum is owed.
If the above documents are in order as well as those sent with
our prior application, would you please issue "as built"
Certificate of Occupancy or a combination of Pre-Existing
Certificate and "as built" Certificate of Occupancy for the
addition.
Thank you.
Very truly yours,
Charles R. Cuddy
CRC:ik
Enclosures
CHARLES R. CUDDY
ATTORNEY AT LAW
445 GRIFFI NG AV E NUE
RIVERHEAD,NEW YORK
to I ~gAdd ess: TEL: (631) 369-8200
P.O. Box 1547 FAX: (631) 369-9080
Riverhead, NY 11901 January 23, 2014 E-mail: charles.cuddy@verizon.net
Michael J. Verity
Chief Building Inspector
Town of Southold
P.O. Box 1179
Southold, NY 11971
Re: Melinda Jaques -Ruth Road Extension, Mattituck
Dear Mr. Verity:
In accordance with your request, I had John J. Condon of Condon Engineering of Mattituck, a New
York licensed professional engineer, examine the garage at the property owned by Melinda Jaques,
located at the end of Ruth Road Extension, in Mattituck. Mr. Condon's report is attached.
Please issue a pre-existing/as built CO for the garage.
Thank you.
Very truly yours,
Charles R. Cuddy
lCRC:ms
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