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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: 06/13/08
11I0: Z-33093
THIS CERTIFIES that the building ADDITION
Location of Property: 870 FAIRWAY
(HOUSE NO.)
County Tax Map 11Io. 473889 Section 109
DR
(STREET)
Block 5
CUTCHOGUE
(HAMLET)
Lot 14.5
SUbdivision
Filed Map 11I0.
Lot 11I0.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
FEBRUARY 28, 2008 pursuant to which
Building Permit 11Io. 33719-Z
dated
MARCH 3, 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" DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED
FOR.
The certificate is issued to JAMES & SUSAN TRENTALANGE
(OWNER)
of the aforesaid building.
N/A
SUFFOLK COIlNTY DEPAR~ OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE 11IO.
N/A
N/A
PLUMBERS CERTIFICATION DATED
~ ~ '/lkb
~
uthor1zed S1gnature
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802 ~ J I .
APPLICATION FOR """IFICATE OF OCCUPANC~ J ~,J
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
i
! (.,
A. For new building 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 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 I % 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:
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 dwellin~ 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 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. 9~ II,' Jj)D f?
Old or Pre-existing Building: t 't (check one)
$i;~ ~~ B.:ta~~t
---
Owner or Owners of Property: I ~~ .t.-
Suffolk County Tax Map No 1000, Section 10,/
New Construction:
Location of Property:
(?1(J
House No.
Block
5
Lot
1'1- {]tJ S
S
Subdivision
:j.1WJ':J $~
3311~Dateofpermit. 33 -off
Filed Map.
Applicant:
77~"'f
Lot:
Permit No.
Health Dept. Approval:
Underwriters Approval:
Planning Board Approval:
Request for:
Temporary Certificate
Final Certificate:
}(
.
( check one)
Fee Submitted: $
l1{
UtC~ f- ~flll..'tJ G S
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.337/9 2-
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Applicant Signature
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.
33719 Z
Date MARCH
3, 2008
permission is hereby granted to:
JAMES & SUSAN TRENTALANGE
PO BOX 918
CUTCHOGUE,NY 11935
for
"AS BUILT" DECK ADDITION AS APPLIED FOR
at premises located at
870 FAIRWAY DR
CUTCHOGUE
County Tax Map No. 473889 Section 109
Block 0005
Lot No. 014.005
pursuant to application dated FEBRUARY 28, 2008 and approved by the
Building Inspector to expire on SEPTEMBER 3, 2009.
Fee $
400.00
&~~~ ~
I Authorized Signature
ORIGINAL
Rev. 5/8/02
+
~
I()WN OF SOUTHOLD
'BUILDlNG DEPART.MENT
TOWN HALL
SOUTHOLD, J:'IY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.netlSouthold/
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
Septic Form
NYS.D.E.C.
Trustees
Contact:
.
"337/96
PERMIT NO.
Examined---A20 0'/
APproved~2o D~
Disapproved ale
Mail to:
/A)OvK
Phone~1 ~ 4:- ()OO~
'\ Expiration
<t(3 ,20Jf1
f~
Building Inspector
i8
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ct'd~
,20.) \;;
L.
APPLICATION FOR BUILDING PERMIT
'."
Date
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.
h. 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 South old, 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 ousing code, and regulati and to admit
authorized inspectors on premises and in building for necessary inspections. f
I
\I c( 3 5
\,OY'> (\,~ ('\A.l,(V\[)C~lt,\l...)Y
. (Mailing address of appl ant)
State whether applicant is owne~r, lessee ,4ent, arChitect: engineer, general contractor, electrician, plumber or builder
The applicant is the owneL ~/' ~ ~
Name of owner of premises T talange
(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 ofland on which proposed work will be done:
870 Fairwav Drive
House Number Street
Ci-lT<..HOt'--llG'
Hamlet
County Tax Map No. 1000 Section 109
Subdivision
Block 1:lt:5- .s
Filed Map No,
Lot"+- [11, <;
Lot
(Name)
~.
, .
..
2. State existing use ~nd occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy Main residence.
,
b. Intended use and occupancy Deck
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition
Other Work
Alteration~
of /VIA.1JT1tvJ f.//ECI<
(Description)
4. Estimated Cost
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: Front 78.7'
Height Number of Stories 1
Rear 78.1'
Depth 53.4'
Dimensions of same structure with alterations or additions: Front 78.1'
Depth 54.1' Height Number of Stories
Rear 78.1'
8. Dimensions of entire new construction: Front 13.5'
Height 18" Number of Stories 0
Rear 13.5'
Depth 11.3'
9. Size oflot: Front 200.02'
Rear 200'
Depth 200'
10. Date of Purchase
Name of Former Owner
11. Zone or use district in which premises are situated 1000
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 ~
14. Names of Owner of premises AEFE Address Phone No.
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a.ls this property within 100 feet ofa tidal wetland or a freshwater wetland? *YES_NO ~
. IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUtRED.
b. ts this property within 300 feet of a tidal wetland? . YES_NO_
· tF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. Ifelevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
SS'
COUNTY oBufIV IlL.) .
.J;.44 u l' vV, '!/? 4-v-/)LlC:~c:r being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
(Contractor, Agent, Corporate Officer, etc.)
of said owner or owners, and is duly authorized to perfonn or have perfonned 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.
PENNY BEDEU.
Notary Public~ of NIw 'Ibdl
No.OI"E609931T
Qualified in SufIJlk CalM
Commission ExpQt Sept 29, ZUJ.!
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,/ / ature of Applicant
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3371(Z
TOWN OF SOUTHOlD BUilDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
REMARKS:
[ ] ROUGH PlBG.
[ ] INSULATION
P<[ FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
~
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-.,
DATE
{.~/,-or
INSPECTOR ~~
..
FIELD INSPECTION REPORT DATE I
I. .
COMMENTS
FOUNDATION (1ST)
----~-------------------------------
FOUNDATION (2ND)
ROUGH FRAMING &
PLUMBING
LNSULATION PERN. Y.
STATE ENERGY CODE
FTh' AL
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ADDITIONAL COMMENTS
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IRMER OWNER
...AND
IMP.
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TdWN OF SOUTHOLD PROPERTY RECORD-CA~
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VI LLAGE
DIST.
SUB.
LOT .-
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TYPE OF BUILDING
~
,
FARM
COMM. CB.
MICS.
Mkt. Value
TOTAL
DATE
REMARKS
k- ()('j
t7 !'.,'Jo ./
~
/0,300
'j 700
~tf 'I z. 73LO, FvT, 7)w. f: ,'.
fo
FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
I
/5.9
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-.. -
I COLOR
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'M'J;: .,. '-~';'X'3Y -:- .F%' " 3:'::- 313.5i~ , "',' . ~ c-
Exl~on J~;'xJ'/~9/~
. E~efon ' ---
1'1/ It - ':Ill r /3rf 3~ 1/.5 / ~
,'" .
I
Ex~~'jon II j/ ..u ~}(3... I .
Foundation Pc Bath J~ Dinette
Porch la;l/C~ Itt, ..)?,3 .!/Vc/ Basement /kif: ~ ('~6..1 Floors (J. k K,
Porch Ext. Wolfs b../'Jj, . %~J;'I, Interior Finish \' ;) LR.
...,tC,
Breezeway Fire Place Uf<? :, J Heat c?i/ DR.
Nw. .
Garage );/1'..13:- S?JC ;l.~ It, 3 2-' Type Roof '1 "'o.k. J Rooms 1 st Floor SR.
I.
Patio Recreation Room , \ Rooms 2nd Floor FIN. B
O. B. Dormer 1'" .,1"."''''''1 Driveway
~ ,]?1 " (..
Total 1f'7,f/ A5S<~ V"lG JoJ'72..f
/OS-"OO
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MIV -<r<:,,.~lJt-r. eN~ - 800