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Home My WebLink About16109-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy July 13, 1987 No ..... g. 1..5.9.4.4. ...... Date .......................... ~ ..... THIS CERTIFIES that the building accessory shed. Location of Property 8415 Bay Avenue Cutchogue h3~s'o ~o~ ....................... 's't/e3i ....................... hb3M County Tax Map No. 1000 Section 104 .Block 3 .Lot 12 Subdivision ..... ,N.a.s.s.a.u...F.a.r..m.s ............ Filed Map No. l179Lot No. lA & 2A conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... J.u..n,c, ,2. ~ . .1.9.8. 7. .... pursuant to which Building Permit No. 16109Z dated ..... .J. un..e..2.2. ,. 3.9.8.7 ....... 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 ......... The certificate is issued to .................. .~.L.E. ,X..& SUSAN HILLENBRAND {owner, of the aforesaid building. Suffolk County Department of Health Approval ................ .N [.A. ...................... UNDERWRITERS CERTIFICATE NO ........................ ,N/.A. ...................... PLUMBERS CERTIFICATION DATED: N/A / B/~lldin'g Inspector Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ..... .................. et premises located at ...~....~..!...~.. ........ ~..~.: ............. ~~.~ .................... County Tax Map No. 1000 Section ..... .J...~....~. ......... Block ....... .,~',.,,,'~- ...... Lot No...~....~...: ............. ~-' 19..~..7.., approved by pursuant to application dated ........... ~ ......................... , and the Building Inspector. Fee $...~...~.. ............... Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings 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 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 installa- tions, 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pm-existing" land uses: 1. Accurate survey of peoperty 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 bu ildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: /)~ ~ (" ~ ,4 /5- C 0 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use Ijg ~',~ ~ ~"(.~ ,. d~ ~ (') ~ ~g", 3. Copy of certificate of occupancy $1.00 Date ...July..2,. 19.87 ......... New Building . ..~-. ......... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ...~.~.1..~ ............... B.~y. A~,e. .................... Cutckague ....... House No. Street Ham/er Owner or Owners of Property . .A,],e.~..~ .~.ar~. ~L],le gl)~..A nd .............................. County Tax Map No. 1000 Section . 10~ .......... Block ,~ ............. Lot ....... 1~ ....... Subdivision ,~T~Au, F~,ms .................. Filed Map No...~ .... Lot No, 2&-[A ........ Permit No. ~IQg. Z;. Date of Permit . .6/2~Applicant E ~v~.~e.n~ *E~s ~. *I.~e- ~o~ * Owne rs Health Dept. Approval ...... N/~ .............. Labor Dept. Approval .... ~/~ U~ri~rs ~proval...N~ .................. Planning Board Approval .. N~ ......... ' ....... R~ue~ for Tempora~ Certificate ..................... Final Certificate ...... ~ ................ ............ Cen~uction on above de~ribed building/a~ meaSUre/cpSc,nd regulations. / ........... ..... n~.l~l~Te ~gvfrogmegt East, Igc.'~ U~4DATION (1st) UNDATION (2nd) UGH FRAME & PLUMBING SULATION FERN. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: WHOLESALE ° RETAIL OPEN 7 DAYS storage game room boat house cabana play house workshop utility fire wood 765-3090 Finest Quality · Custom Built ® Discount Structures NEW LO(MNTION -,J~' R ~ ;".' ~ N EAD , · ALL THf~RIGHT REASONS FOR PURCHASING A NORTH FORK WOOD DESIGN STORAGE SHED Delivery is FREE* Customized designing to your specifications Completely constructed and assembled Ready for immediate use No middle man - all work done at our shop Many stylc~ available - all sizes All wood construction - stronger, longer life Fully painted and trimmed Cabot stain paints, exclusively - choice of colors Foundation is 4X4 pressure treated timbers Floor: 5/8 or 1/2 inch ~" x~rior ply, Floor joist 16" on center Maintenance free 5/8" exterior grade texture T 1-11 siding Aluminum jalousie window or wood window Screened vent Reinforced and flamed double swingin§ doors Heavy gauge §alvanized hinges and door Latch RooLIrusses 2X6 and 2X4 double §usselted for./ maximum strength Maximun head room 5/8 Exterior grade plywood roof Self-sealing 240 lb asphalt shingles All wood corner molding Weather tight Immediate delivery from invento, y. 3 to 4 weeks on custom orders "OUR" BARN "OUR" QUAKER COMPARE BOTH OUR QUALITY AND PRICE Examined .5~....~..~.., 19 .~.~ Approved .. ~,~..'~...~,-. , 19~'~ Permit No.]. (~./..~ . .~.'. Disapproved a/c ..................................... BOARD OF HEALTH ...... 3 SETS OF PLANS .-~'~-.-. Fo.M No. SURVEY TOWN Or SOUT.OLD C ECr BUILDING DEPARTMENT SEPTIg t~OR~ ............. : TOWN HALL NOTIFY SOOT.OLD, N.Y. 11971 TEL.: 765-1802 CALL MAIL (BmTding Inspector) APPLICATION FOR BUILDING PERMIT 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 a.~l~d of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed descripti~lay )~!t of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by ~lil~catio~ %itSttl~l~, enced before issuance of Building Permit. d. Upon approval of [l~il ~l~a.t~,~B~. kl~I~l~ector will issued a Building Permit to the applicant. Such permit shall be kept on the p~rta~l~ ~il~,t~it~ [l~t~h}'~ughout the work. e. No build~- ~lp~d~o} ~ ~v~t~le or in part for any purpose whatever until a Certificate of Occupancy shall have been gra}~t~b~'*~ APPLICATION I~l~-~l~ t,~]}l~.ti~l~ ~i{ding Department for the issuance of a Building Permit pursuant to the Building Zone Ordinan~q[~ ~ft~_l~q~o~it}lold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the cof~ff )rb~,hk~'hiifigs, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to cifm , ~1~. a'll applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors{ >remises and in building for necessary inspections. ~ . ..~..~. g. ! .4,. ~..m.~. ?X. ~'..~_~.~..~.<?.c..; ........... (Signature of applicant, or name, if a corporation) (Mailing address of applicant) · ,~eneral con~ State whether applicant is owner, lessee, agent, architect, engineer electrician, plumber or builder. Nme of owner of premises ~;~j;~/~q~ ~' '[; X '~'}~ ..... ~ (Nam~itle of co,rate officer) - 7b~:~ '~ ~o,v ALL CONTRACTOR'S ~UST ~g SUF, FOLK COUNTY LICENSED [:OV O~"h~)FOOr,~:~,'~ <:~m~fiCrlO~'~*' -;w~O ~q~QUt~ED Other Trade's License No. '~ ~ ALt l;~:)a~r¢,;CT~ON l. Location of land on which proposed work will be done ................... 'G~q' }':;{{ ~t::{g': ,4~T~O~ ~' House Number Street Hamlet County Tax Map No. I000 Section . . . l.O.~ .......... Block ......... ~ ....... Lot .... (.~. ........... (Name) 2. State existing use and occupancy of premises and in,tended use and occupancy of proposed construction: / a. Existing use and occupancy I ~ ~ ~, I~ ~ P~ ~d ~ '~ d ~ b. Intended use and occupancy ............... t.' ........ -...~ ~7-.'~:~ ~ ~:~.~ ............... 3. Nature of work (check which a'pplicable): New Building ?.'71 .' ..... Addition .......... Alteration ?..'.·..' .... Repair Removal Demolition Other Work -' · 4. Estimated Cost ............................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, numbe¥ of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars .... i .................................................................... 6. If business, commercial or mixed occupancy specify na~rj~ and extent of each tyAoe,of use .................. 7. Dimensions of existing structures, if any: Front ..... (O ........ Rear ..... .~..'. .... Depth . .. ~.. f. ...... Height .... ~ ........ Number of Stories ... ~.. ~. ................. ' .....~:- ................ Dimensions'of same structure With alterations or additions: Front ................. Rear ................. Depth ...................... Height ......... er.af Dimensions 9~enttire new cons/ruction: Front .. ff~( i ........ Numba°'t Stories ...................~. · i . . ..... ' .... Rear ............... Depth .... t Height ... ~'. ......... Nm~ber of Stones ..................................................... 9. Size of lot: Front ~ Depth ..................... ...................... Rear ............... . ....... - 10. D i ate of Purchase .......... ................... Name of Former Owner ............................ 11. Zone or use district in which p~emises are situated. ~-~ ~ .~.c~..~.~. ?? .~/! .................................... 1 2. Does proposed construction vic>late any zoning law, ordinance or regulation: ............................. ~ .... i ............ . ........... Will excess, fin be removea ~rom premises- ies No 1~. W~I1 (or be regraded .~. 14. Name~f~wner~fpremises~.~Y~.S.~t~..~.~.~q.~.6t~q~nAddress~.~jf.~..~.~.~.~.6~.~h~neN~. .-7..,~,..~..0~..~?... Name of Architect ......... i .................. Address ................... ~.rO/n~ecNo. Name of Contractor ~..~.4.L~..~?..~...t~a~7....~.. ...... Address--~oJT..3~.. ! .~...~..~..l-~. ~r~nn~ No. 5 ~ ~i~ .:'/'~. i i i i 15. Is this property located] within 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town TrUstees Permit maybe required. ' PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex]sting or proposed, and~ indicate all set-back dhnensions from number or description~ accordingto 4ced, and show street names and indicate whether property lines. Give street and blocb interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. S.S (Name of ~nd~v~dual s~g~ng contract) above named· : being.duly sworn, deposes and says that he is the applicant He is 'the ..................... i .................. , ................................................. · ; (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 cont'ained 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 ............. t?~. '. ....... day of....~'~-~ ............ 19~. N0taly Public,·· ;~.~...~.~. ~ ~ I~a~l~.~ ~ ~gna[ure of applica'nt)