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Home My WebLink About28502-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date: 07/08/02 No: Z-28574 THIS CERTIFIES that the building ADDITION 3050 FAIRWAY DR CUTCHOGUE Location of Property: (STREET) (HAMLET) (HOUSE NO.) County Tax Map No. 473889 Section 109 Block 5 Lot 14.16 Subdivision Filed Map No- Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 26, 2002 pursuant to which Building Permit No. 28502-Z dated JUNE 26, 2002 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 PERGOLA ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to CATHERINE W DRAKE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A A oriF ed Signature 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) PERMIT NO. 28502 Z Date JUNE 26 , 2002 Permission is hereby granted to: CATHERINE W DRAKE PO BOX 807 CUTCHOGUE,NY 11935 for . CONSTRUCT A PERGOLA TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP#16374-Z. at premises located at 3050 FAIRWAY DR CUTCHOGUE County Tax Map No. 473889 Section 109 Block 0005 Lot No. 014 . 016 pursuant to application dated JUNE 26, 2002 and approved by the Building Inspector to expire on DECEMBER 26, 2003 . Fee $ 150 . 00 2 Authoriz6d Signa re COPY Rev. 5/8/02 FORM NO. 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) N° 16374 z Date ....... . .. .... . ....I..V......... Permission is hereby grant o: ....5�'9.. ......................................... to ..� a [�0.r......�i�.....a-!.I... ... 7�R... NtJk►!�!�-1� 77" !..1. ..,. .. ............................................................................... of premises located at ...w�Q.s�D ... Q ... �. ............. .... . ...... ... '..—IL ......... ` �.... ..... . .. .�:�...................................................................................................... County Tax Map No. 1000 Section .....1..5;...1......... Block ......�?.r� ....... Lot No. AY/1.4.......... pursuant to application dated ...... I. I...;?':1...................... 19AI, and approved by the Building Inspector. Fee $..bll.............. iding Q'G aL! ............ .. .. ...... .. Buspector Rev. 6/30/80 Form No. 6 M TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN.HALL 765-1802 f- 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: 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 12 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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15..00,, Commercial $15.00 xx Date . .W. [,Z YA L New Construction. . .< . . . . r. Old Or Pre-e fisting Building', . . . ./. . . . . . Location of Property. . . . . .lU. 1 . . . . . . . . . . ! �! ' " . . . . . . . . . House No. S reet Q f� Hamlet Onwer or Owners of Property. . . . . . . . . . . . .ff. . . . . . . . . . . . . .". . � .'` .�. . , , . . . , ,(/. . , . . . . . . . , . . County Tax Map No 1000, Section. . . . . . l.U.�. .Block. . . . . . .�. . . . . .Lot. . . . . . �y, ,��? Subdivision. . . . . . . . `G . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. .P�. 4�� Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . �.!�(.454.,-1• . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate.K. . . . . . . Fee Submitted: co c- . . . . . . . . . . . A'APPT,TCANT. . . . . . . TOWN OF SOUTHOLD PROPERTY RECORD CARD ..100*1 "low, -OWNER STREETVILLAGE DIST. SUB. LOT �Uic170 U 0—' FORMER OWNER N E S TYPE OF BUILDING RES. SEAS. VL. FARM comm. CB. mics. Mkt. Value LAND IMP. TOTAL DATE REMARKS mod ?d e — 1/7�/' le w p —�gJ/— ' F 4—/5 2 W. D f" 1600 1 /000 g7o o 15-0 C? 3Z21 7 -illable FRONTAGE ON WATER FR( Voodland FRONTAGE ON ROAD Aeadowland louse Plot FRONTAGE BULKHEAD oto I 765-1802 BUILDING DEPT. 114SPECTION C ] FOUNDATION 1ST [ ] ROUGH PLBG- C ] FOUNDATION 2ND C ] 1 ULATION C 7 FRAMING FlNhL REMA KS: J ® �5 7 INSPECTOR DATE /�. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLOD. [ ] FOUNDATION 2ND [ ) INS ATION ( ] FRAMING f [ FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE - oz INSPECTOR FIELD INSPECTION JDATE CONi; ,�YS ro Lp y 1. FOUNDATION ( 1st ) c FOUNDATION ( 2nd ) -- f 2 . z O iy aG ROUGH FRAME & PLUMBING moi,• 3 . x r� INSULATION PER N . Y. -3 STATE ENERGY CODE x a �— x -3 17 FINAL E z ADDITIONAL COMMENTS : to -. X H Y H H z �a C - x m a � C' r H � x b ro H BOARD OF HEALTH . . . . . . 3 SETS OF PIANS . . FORM NO. 1 ^ SURVEY . . . . . . . . . . TOWN OFSOUTHOLD CHECK . . . . . . . . . . BUILDING DEPARTMENT SEPTIC FORM . . . . . . . . . . . . . . TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL . . . . . . . . . . . . . . . . `' MAIL TO : 24f-r- T7yT Examined((. A"Y .A1., AT pc Q,�,c�.'7)L2! - 4 i (e2. Approved 191�. Permit No. .4.la. y.zt Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . 2 i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . . . . . . . _0 . ., 1e7. 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 lot 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 nece=ry inspections. y (Signature of applicant, 'or name, if a corporation) . . . . . . . . . . Ty\iom (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . . +1ri'.- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicantis�gr�pratio , signature of duly authorized officer. . . . . . . . . . . . . (Name and title of corporate officer) ALL CONTRACTOR' S MUST BE SUFFOLK COUNTY LICENSED Builder's License No. . .l3'Z.4�Q . . .N- Z_L . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done.`. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Sm" 0 . . . . . . . . . . . . . . . . ITL . . . . . . . . . . .�? . . ... . . . . . .Cw . 'louse' NuberStre t F{amlet County Tax Map No. 1000 Section . . 10.(I. . . . . . . . . . . . Block . . . . . . . . . . . . . . . . . . Lot . . . 1 141: . . . . . . . . . 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 . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy > ,m�e . .�! �. . . )-a . . . , , . . , . . , 3. Nature of work (check which applicable): New Building . . . . . , . . . . Addis . . . . . . . . Alt e tion,, / Re airy . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work, ►t. . . . . . 94 (Description) 4. Estimated Cost . . . . . . . .z �.. . �?.•. . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling, number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . Ifgarage, number of cars . . . . . . . . . . . . . . . . . . . . . 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 somf structure with alterations or ac4itibns: Front . . . .4.�. . . . . . . . . ... . . . . . Depth . . . . . .��. . . . . . . . . . . . H •`� Rear . . . . . . . . . Height . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . S. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth Height . . . . . . . . . . . . . . . Number of Stories . . . . 9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . . . . • . . . . . . . . . .Depth . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes N 14. Name of Owner of premises . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . .. . . . . . . . . . . . . . . Phone No. 15. Is this property located within 300 feet of a tidal wetland? *Yes . . . . . No . . . . . *If yes, Southold Town Trustees Permit ma be reqyu�ired. PLO DIAGKAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions frog property lines. Give street and block number or description according to deed, and show street names and indicate wheth interior or corner lot. O f t I ti I d , STATE OF NEW YORK, S.S COUNTY OF . . . . . . . . . . . . . . . . . • • • • • • • • • • • • • • • • • • • • • • • • • • • being duly sworn, deposes and says that he is the applicar (Name of individual signing contract) above named. lieis the . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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 th application; that all statements contained in this application are true to the best of his knowledge and belief;and that th work will be performed in the manner set forth in the application filed therewith. Sworn to before me this . . . . . . . . . . . . . . °? .y . . . . . .day of. . . . . . . . . 19F*, Notary Public, . . .�(=— . .z_. .po-.U.&e . . . . . . . County (:) HELEN K DE VOE . . . . . . . . . . . . . . . . . . . NOTARY PUBLIC,State of New Yuk Signature of a ]r No.4707878,Suffolk Countp !!AA pp 'cant Term Expires Merch 3U,19 ted-' J S,99°/2A/OAE' 225.59' , t 3 �L 7 � I \ e Q I 1 774 _ V) s r 10 Q31 ,� f. 1 r1��9 Sea sr�pr a� I �t Q N 3 Q Z Q QTAUIHOREZED ALTERATION OR ADDITION n TO THIS SURVEY IS A VIOLATION OF ¢ECTION 7409 OF THE NEW YORK STATE O t�' 3y. ` h Is p ED h \ UCATION LAW. Q 1`1 B h Q COPIES OF THIS SURVEY MAP NOT BEAWNG Q $ THE LAND SURVEYOR'S INKED SEAL OR W J EMBOSSED SEAL WAL n T EF CONSIDERED C k�v JO U A VALID I. �.."ri• 4ZI2Q Q O 3 GUARANTEES INut�n ! =Y.ALL RUN ONLY TO THE VL;: )�.E i;!E SURVEY IS P.EF.`..',ED, AND ON H,! - '- 'HE TITLE COM:Ft:i, GOV,':RNMLNI,%L A--1 ANE p c LENUI�G I:.Ci.l-••: L_STLD HEREON,A,.D 228.46 TO THE ASS;GNLLL L:E LE:-,-DING INSTI- TUTION.GUARANTELS A... . I I AN.SFERAUE ## TO ADDITIONAL INSTITUIIO.d Jw:-".QUEM S.g1•42r10 W Cornpony NOTE OWNERS. Fork • =NcwuovENT North SUBDIVISION NAP FILED/N THE OFF/CE OF THE CLERK OF SUFFOLK COUNTY ON FEB./5,/974 AS FILE NO. 6066. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREIN ARE FROM FIELD OBSERVATION$ AND/OR FROM DATA OBTAINED FROM OTHERS REVISIONS YOUNG & YOUNG MAY 8,1974 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK MAY 31,1974 JUNE 18,1974 PROFESSIONAL W. YOUNG HOWARD W. YOUp OCT JI 19;4 PROFESSIONAL ENGINEER AND /�,, SURVEYOR I LAND SURVEYOR, N.Y.S. LIC. NO, 12845 '`L 0FN'�IC , NO. 4589: NOV. 19, 1974 tP SURVEY FOR: o�PEtD K, y :hAU'MOk;LED AL iE RAT ION ;.�R ADDITION TC _ `..JRVLv ,5 A VIOLATION TA OF SECTION GEORGE B. DRAKE , J R. .. AWb "•F II,E NEW YORK STA7t EDJCATIgN �� ... .. LOT -16 11 FAIRWAY FARMS11 �� "��` F••t' 'F TIiIS S!iNYLY ?AAM NC'T NEAR!Nti iT.MU. S 'if 4, $H4IL N,I U� ;ON5iDI HED j [ 9F A .A_li) TRUF. COVY �AT" � E CUTCHOGUE H 1 ON F �. - .. ,I. ,ATED .F RL N S••�._ quN TOWN of CH ANCE CC A;,. „ ..,, SOU 4S BANK . : ,.;4,. SOUTHOLD SUFFOLK CO., N. Y. .�� DZtl� F-A (te. 22 v APPRUVED AS WC�g _5'0 NOTIFY BAJILDING UEPARTMWT AT 8ye? 6z4&;L&x-Vmj-j 5 766-1902 4 CAP, TO a PM FOfI TRE FOLLOW1W.' W-'PECTIONS: -o'WO �tiQUIRED FOP (E t*A P .UMBWG ---f U 4 HN ALL, I :, :'%'iA LL Vlt- T THE ;,, .. Ot',- HE N,Y STATV --- CODES --4 ' P F ZCR -A 12. -J I fi vs �.� �ER� r �,t � of oc�U