HomeMy WebLinkAbout7183-zFORM NO. ·
TOWN OF SOUTHOLD
BUH,DING' DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
THIS CERTIFIES that the building located at .F&il~&y ~r/[.v~ ........... Street
Map NoF&imm~..El~Block No ........... Lot No.. 16 ..... ~tchog~.,e .... l~ ,][., ......
conforms substantially to the Application for Building Permit heretofore fried in thi.~ office
dated .......... .Ma.lt. .... .~.6.., 19 ~... pursuant to which Building Permit No.. ?.l.8.~Z.
dated .......... .Ap.r.~.3.....1.~..., 19.7.~.., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which thi.~ certificate is
issued is P~'iva.te. o~.e .family. dwelling .......................................
The certificate is issued to . ~41~s. Catherine. D~'ake ..... 0~na~ .....................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval NOv... 2.~... ] 97.~... bY..R~.V~],~.& .......
UNDERWRITERS CERTIFICATE No..N.~.8.7..2.~ 9. .... .0.c.~..~.0.. ] 9.~. .................
HOUSE NUMBER .3.0~.0. ........ Street . .F..a.i..r~.a.y..D.r.i..v~. .........................
Building Inspector
leO~.M NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWH CLERK'S OFFICE
SOUTHOLD, N~ Y.
BUILDING ~PERMIT
(THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
7183 Z
Permissio~ is hereby granted to:
...... 8~.~....,le~.~h~ ..~k ................................. ~
............. .~mll~.u~y., .....It ,.~., ...............................
at premises located at .~.t,..J.~. ....... ~v.~13ff~&Y...~'l~. ...................................................... ~'. ..............
............. [ .................... EatzwaT...l~rJ. wa ............Cu.teh~gGe .....I~,,Y.., ...................................... ........
pursuant to application dated ........................... ..~..~.~.~.....~.~. ....... 19..~$.., and approved by the
Building Inspector.
Fee ~.e.t~.~. ............
' ' TOWN OF SOUTHOLD -- - -~,
BUILDING DEPARTMENT/~'~.
TOWN CLERIC'S ~FICE ~"
~UTHOLD, N.Y. ~'~ ,~ .'
Exam ned . t d 19 /~.. ~.. t_
..... ~.~ ............ , .... ,_. __. -~ - _: ................. :; .................
~prov~Disapproved ............................... ~ ...... , 19.~..~ ~it ~o.~..~..~..~ ......
..... ................................
~~ ~ ~ ~, ..... ~..~..~.. ......... , ~....~....,.~
INST~U~IONS
o. lhis a~lic~tion must be compl~tel~ filled in by ~pewritor o~ in i~k ond
Insp~tor, ~ith ~ ~ o{ plonk, ~ocumt~ pl~ plan to ~al~. F~ ~oco~in~ to ~ch~ulo.
b. Clot plon showin~ Io~ation o{ Iot ond o{ buildings on premises, relotionship
ore,s, ~nd ~ivi~ ~ dotoil~ d~cription o{ layout o{pr~e~ must be drawn on the di,0mm which
c. The work cowred by this ~pplicotion moy not bo commenced before issuonce o{ Buildin
d. Hpon ~proval o{ this ~Pplico~on, th~ Buildin~ In*p~tor'will issue 0 Bu[Idih~ ~erm~t 1o the opplicont. Such permit
sholl bo kept on the premises *v~iloble for in*paction throughout the work.
e. No buildin0 sh~ll b~ ~cupied or used in whol~ or in Part {or ~ny pu~ose wh~tover until
sh~ll h~ve beon ~rent~d by th~ Buildin~ Inspector.
B ~PkICATIO~ IS HfiR[BY ~Dfi to tho Buildin0 Depa~ment {or the issuanc~
ui~oinO Zon~ Ordinance of th* Town o{ Southold, Suffolk Count~, ~ew York, ~nd other ann
Regulations, {or the con~tru~ion o{ budd'n0~, ~ddition~ or *l~rat~on~, or {or removal or
The applicant agrees to comply with oil applicable laws, ordinance, building c~, h~si~ c~e, and reguloti~s;' a~ to
admit authorized inspecto~ ~ premises and in buildings for n~es~ in~ections.
Flmeer Hill Building Corporation
...................... Thames..E~..Uh~ ~..Rres [dat~ ...........................
(Signature of applicant, or name, if a corporation)
............ 82.~3 .. J er. i cho..TurnpJ.ka..J~mdbn~...NtZ.....I..1292.
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.................................. BuJ.lde. c .................................. ~ ...............................................................................................................
Name of owner of nrem ses " Hr.s. Ca~herlne Drake
If applicant is a corporate, signature of duly authorized officer.
.................. iR~;g;'~;~Li";i~i';'g~'
Builder's License No...~.. ................................................
Plumber's License No ............ ~.7...P. ...........
Electrician's, License No ........
Other Trade s License No ...............................................
1. Locat on of and on wh ch p~ropased work w b_e done. /V~ap No.~.~..~...~Z~a .......... Lot No...!~ ..................
Street and Number ..~....~ o~:~- ~~,
Municipality
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
o. Exisiting use and occupancy ................................................................................................................................
b. Intended use and occupancy ............... ~I4~,e ..............................................................................................
3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ......... .-..~.~
t'
Repair Removal Demolition .................... Other Work
(Description)
4. Estimated Cost ..... $~ZJ).,J)J)~l.,J)J) ................................... Fee ....7..~..~......~. ................................................................
First FlOOr (to be paid on filing this appli~.~d FlOOr
5. If dwelling, number of dwelling units ........... ~.. ............. Number of dwelling units on each floor .~ .......... ~. ..............
If garage, number of cars ............................. .2.. .............................................................................................................
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 of Stories .................................................................................................................
Dimensions of some structure with alterations or additions: Front .................................... Rear ............................
Depth ................................ Height ............................ Number of Stories ................................
8. Dimensions of entire new construction: Front .............. ~. .................... Rear ......... .8.~..~. ............. Depth * 29 t
Height .....Z~ ........... Number of Stories ...... .2. ...................
9. Size of lot: Front ............ i ............... .1.~. ...................... Rear ........ .2..0..0. ............................ Depth .....2..2.~ ......................
10. Date of Purchase ........................................................ Name of Former Owner ........................................................
11. Zone or use district in which premises are situated ........ J~si~ence..JJ~ ....................................................................
No
12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................
13. WJIJ lot be regraded ..Yes ..................... Will excess fill be removed from premises: ( ) yes (~X) No
14. Name of Owner of premises .~.....~.~Address ................................ Phone No .......................
Name of Architect .............................................................. Address ................................ Phor, e No .......................
Name of Contractor ..F~o~el,..Nj~t{..~tdg.~..(;ee, p~ ............ Address ..~g~li~.r:.f.r.~l,Y. ...... Phone No. ~,9~,-..~.5~.~. .....
PLOT DIAGRAM
Locate clearly and distinctly oil 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.
STATE OF NEW YORK, ! S S
COUNTY OF ..................
..: ........... : ...................... .~.~,~' ........ "~/~..~, ./... ................... being duly sworn, deposes and says that he is the applicant
(Name of individual .signing contracf)
above named.
He is the ..................... ~ ................................. ...~ .~......~..~......-~..-,~--~ .........................................................
(Contractor, a{~ent, corporate office'S, 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 gre 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 therewit~ '
Sworn to before me this
........ ........ ..... ................. .
Notary Public, . ............................ t' ....... ~ ...... ../C. County ............................. ."~....{~...~...~ ...............................
/3, · j__ ~ ~ ~t ,~ / (Signature of applicant)
NOTARY PUBLIC, ~ta~e of New York
No, 30-2622700
~uaJlfied in Nassau Counfy
Term Expires March 30, 197S
FORM NO. 6
TOWN OF SOUTHOLD
Building Deportment
Town Clerks Office
Southold, N. Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building
Inspector with the following; for new buildings or new use:
I. Final survey of property with accurate location of all buildings, property lines, streets, and
unusual natural or topographic features.
2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and
installations, a certificate of Code compliance from the Architect or Engineer responsible for
the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1~ Accurate survey of property showing all property lines, streets, buildings and unusual natural
or topographic features.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in-
formation required to prepare a certificate.
C. Fees: 1. Certificate of occupancy $§.00
2. Certificate of occupancy on pre-existing dwelling or land use $,5.00
3. Copy of certificate of occupancy $1.00
Date ..~O.¥.e~l~F..~.:~,...1.]7..~ ............
New Building .......X. ........ Addition ................ Old or Pre-existing Building ................ Vacant Land ..............
Location Of Property ...... EaJ. r.~a~/..F, ar. ms.,..f;g.t.ch~g.~.¢.,...L.o, og..I.$.].~.ad.,..N~..~Q£k ................................
Applicant ..........................................................
Owner Or Owners Of Property ....C;a£her. J. ne..and,.~.e~.rg.~..$....D.r.a, ke, ........................................................
Subdivision ........ .F..a.!..r..w..a.y....F..a...r~...s. .............................. Lot No.....I..7.. ..... Block No ............. House No .............
Permit No ......... 7. J.~3.[.. Date Of Permit ..~LI. 5/.7..~....Applicant ..EI.~.¢.r....H. LI.L.~..u. IJ.¢.[n....c.~.r...: ............
Health Dept. Approval ...... ~..S..0.T.~.~. ......................... Labor Dept. Approval ................................................
Underwriters Approval .............................................. Planning Board Approval ........................................
Request For Temporary Certificate ........................................ Final Certificate ............ .X. ............................
Fee Submitted $ ....~,.Qfl ........................
Construction on above described building and permit meets all applicable r ~
Sworn to before me this
' J HEALY
Notary- P~gH~ ... ..................................
~0~ Public, State of New York
~ ~ualified in Nassau County
~ommission Expires March 30, ID ....
Flower Hill Bulldlng Corp. Thomasl
~, ~,~1~-~ (stomp or seal)
APPLICATION FOR APPROVAL TO CONSTRUCT
A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY
1. Applicant Flower Hill Bld~. Corp. Phone (~1~) ~q2-4~
Address 82qt Jericho Turnpiker ~odhur¥: NY 11797
2. Property Location Fairway Farm~
Cutchoaue. NY
Villag6 ' Cutchmgu, Township Rn,,thnld
3. Public Water Company Name
4. Lot size: Width 22~ feet Length ~nn feet
lO. Sewage Disposal System:
A. lJ~:O~gallon septic tank:
Precast x_Equivalent Block
B. Leaching pools:
Number of pools ~
Precast" x Block .Special
ll. If private well, fill in the
fol 1 o~i ng blanks:
A. Tank capacity
B. PU~ap G.P.M.
~2 gallons
360
5. Subdiv. Fmlrwmy Fmrm~
6, Section I
7, Lot Number
8, Private Well X
9, Public Water
Distance to main
(For Health Dept.,Use)
C. T~tal well depth
D. D~pth to ground water
E. Amount of water in well
)
The undersigned CERTIFIES: "Construction of authorized installations in accordance
with the Suffolk County Department of Health's current standards thereto. This application
will be valid for one year from the date of approval indicated below and may be renewed if
a current local Building Department Permit is in effect. ~
FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the
opinion of the Health Department that an adequate and satisfactory Sewage Disposal System
and Water Supply can be installed on this pl~ot.
APPROVAL DATE
S-15
Rev. 4/1/73
, New York State Department of Environmental Conservation
50 Wolf Road, Albany, New York 12201
James L. B~ganc'
March 12, 1974
Ms. Catherine Drake
424~ East Hill Road
Southbury, Connecticut
06488
RE: Petition No. %W-15275-0058
Petition for Moratorium Permit
Dear Ms. Drake:
Your petition has been forwarded to this office by the Local Tidal Wetlands
Permit Administrator who has made a review and site inspection. As a result
we have determined that construction of a single family dwelli[~g, in the
Town of Cutchogue, Suffolk County, New York will have no adverse affect
adjacent tidal wetlands.
Therefore, pursuant to Section 25-0202 of the Environmental Conservation
Law and the Commissioners Directive dated November 12, 1973, you are hereby
notified that no permit will be necessary.
Very truly yours,
Louis M Concra, Jr
Central Tidal Wetlands
Permit Administrator
LMC:SJZ/scs
cc: D. Larkin
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~ BUREAU OF ELECTRIC, FrY ,.. '. ~''
! 85 JOHN STREET, NEW YORK, NEW'YORK:IOO3H.. ~
THIS CE~IFIES THAT
in the following location; [] Basement ,~ Ist FI. [] 2nd Fl. O ~t e ~ ~ Section Block Lot16
.as ,=.mined o. 0 e~ ob e r 7, 19 7 ~ Gnd/o..d to be in complio~ee with the requirements of thi~ Board.
RXTU~E RXTUEE$ RANGES OVENS
OUTLETS SWITCHES
FLUORESCENT
DRYERS KIRNACE MOTORS FUTURE AFflJAN~E FEEDERS TIMECLOCKS
EXHAUST FANS
DIMMERS
SERVICE DISCONNECT S E R
OTI~'~S: 011 1-1/8hp, 1-1/2hp
Water he~ter~ 2-1;.Sky
l~otor/e: 1-~hp
P~elboar~s: 1-220~. 125a~s.
1 Poet ll~t
1-5 Ton A.C.Unit
1
C
1 ~/0 1 2/0
Peter Bo~ovic
~aAn ltoad,
5outhold, L.I. 11971
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTE~D I~Y MANI~IE,R.. ~
Lot 15
·
-/,,,~'/o w. ComponY
--- s.~ Fork
Norfl~ #or£~
· :~NUM~Nr
~U~OlVI~ION MAP ~1~ ~D IN THE OFFICE
P~B. I~ 19Y4 FILE NO,
.EWS~O.$ YOUNG & YOUNG
400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK
SURVEY FOR:
GEORGE ~ DRAKE,JR.
LOT NO. 16, "FA ~ RwAY FARMS"
.
AT GUAR · ,
CUTCHOGUE M0~~~s0
TITLE INS~
Yow. o~ SOUTHOLD
m
ONAUTHORIZED ALTERATION OR ADDITION TO
THIS SURV£Y IS A VIOLATION OF SECTION
TEE LAIVE
L at 15
I
~ .~. ,~/ -~ ..... ~ ....
~'to" ~ For~ Company
North
NOF£,
· -' MONUMEN~
SUBOIVI$10N MAP
OF TH£ CL~BK OP$~I~FO£K ~OUNT Y ON
FEB, I~ 197~ F1££
REVISIONS YOUNG & YOUNG
MAYSt1974 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK
ALDEN W. YOUNG HOWARD W, YOUNG
SURVEY FOR: ~ o~
GEORGE B D,,RAKE,JR ,,
AT GU
CUTCHOGUE .o IE~ kT~ ~f~F C~l ~
, TI~Z~N~
TOWN OF SOUTHOLD
co.,
SCALE: I" : 50' DATE: ~R. 14, 1974 NO.
SUFFOLK CO~-~ Y EIEAL~H DEPART2~iEN~
The sewage dispozal and water supply
facilities for tL[s location havo been
inspected b~ th2s department asd found
~ Chl~f'of General Engineertn~ Servioe~
lot I~
r'- S'89°12'10"E' 225. 59'
MAY 8,1974
MAY 31,1974
JUNE 18,1974
OCT 31,1974
NOV. 19, 1974
DRIVE
AT
CUTCHOGUE
TOWN OF
SOUTHOLD
SUFFOLK CO., N Y.
SCAL~: I" = 50~' J DATE'
HOWARD W. YOUNG
14, 1974 JNO. 121
SURVEY FOR:
GEORGE B. DRAKE, JR.
LOT 16 "FAIRWAY FARMS
ALDEN W. YOUNG
YOUNG & YOUNG
400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK
NO rE:
· = N'ONUt4ENT
SUBDIV/SIO/V /ffAP FILED I/V rife OFFICE
OF THE CLERK OF SUFFOLK COUNTY ON
FEB. 15, 1974 AS FILE NO 80~8.
SEOW~ ~EREIN ARE FROM FIELD~BSER~A~O~E
/,-
NOTIFY BUILDING DE;PARTMENT ~'. .
765-2660 9AM TO 4P~ FO¢, ~¢QL'IK- .
ED INSPECTIONS: , ,
1. BEFORE BACKFILLIING' FCUNOA-.. ":
TJON-O~ 5TAP, T FRA,'v¢.ING
2, BEPOfiE COyEP4NG pIPELINE .
3. FINAL WHEat JOB (COMFLETED
/
·
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