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Home My WebLink About22350-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23411 Date DECEMBER 15, 1994 THIS CERTIFIES that the buildin~ 805 GRIGONIS PATH & Location of Propert~ 440 JERNICK LANE House No. County Tax Map No. 1000 Section 70 Block Subdivision Filed Map No. ACCESSORY SOUTHOLD NY 3 Lot Lot No. Street Hamlet 18 conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 6, 1994 .pursuant to which Building Permit No. 22350-Z dated SEPTEMBER 26, 1994 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 AN ACCESSORY SHED AS APPLIED FOR. The certificate is issued to RONALD & JEAN YEDLOUTSCHNIG (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A Building Inspector FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUIHOLD, N.Y. N£ 22350 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ............................................ Z Counly Tax Map No. 1000 Section,,,,',.~..~ ...............Block ...... pursuant to application dated ....~/¢(T..~. ........................................... 19...'~....Z';......., Building Inspeotoi'. Fee ................ and approved by the Building Insp6~ctor Rev. 6/30/80 Form No. 6 TOW OF SOHT,,OLD BUILDING DEPARTMENT ,i BLD~ DFPT APPLICATION FOR CERTIFICATE OF OCCUPAgCY A. Thls application must be filled in by typewrfter OR ina and submitted to the bullding inspector with the f~llo~ing: for new buildlng or ne~ use:, 1. Final survey of property wlth accurate location o{ all buildings, property lines, streets, and unusual natural or topographic features. 2. Flnal Approval from Health Dept. of water supply ~nd sewerage-disposal(s-9 fo~). 3, Approval o~ electrical installation from Board of~Flre Underwriters. 4. Sworn statement from plumber certifying that the ~older used in system contains less than 2/10 of I% lead. 5. Co~ercial bnildfng, ~ustrtal building, multiple residences and similar buildings and installations, a certificate of Code Compliance ~rom architect or engineer responsible for the bulZding. 6.Submit Planning 3oard Approval of completed sit~ plan requirements. B~ For exlsting buildings (prior to April 9 1957) nonrconformlng uses, or b~ildings and .pre-ex~sting" land uses: ,~ 1. Accurate survey of property showing all property lines, streets, buildin~ " 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, Swiping pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2,Certificate of Occupancy on Pre-existing Buildin~ - $100.00 3.Copy of Certificate of Occupancy - $20.00 4,Updated Certificate of Occupancy - $50.00 5,Temporary Certificate of'Occupancy - Residential $15.00, Co~ercial $15.O0 House No. Street Hamlet 0~ o~ 0~ o~ ~o~e~ County Tax Map No 1000, Section ........ Block ..... Filed M p Lot Iealth Dept Approval ' · ............. Underwriters Approval ~lanning Board Approw~l ....................... :equest for: Temporary Certificate ........... Final Certicate..:. .. ..................... The The Quaker ~is is the roomiest shed going. It uses are anythi sales office to pool 9 or even = are endless, Gable, A~Frame or Cottage An excellent addition to your property. Great for storage space and comes in a var ety of ,sizes. Window is included for that extra special look The The High Side Barn High sides and double dutch doors make this shed great for storing light equipment and tools of all sorts. Dutch Barn This Colonial looking barn has enough space for the modern day homeowner. The usable space includes room for shelves, a loft, and even a work station. You'll enjoy the look and get the space. WE BUY THE BEST MATERIALS, TO BUILD THE BEST PRODUCTS, TO SELL TO THE BEST PEOPLE - OUR CUSTOMERS The Gazebo Special attention to quality sets the North Fork Wood Design Gazebo apart from the rest. Our Gazebo is not only beautiful, but each gazebo is hand-built by skilled craftsmen. Only the finest, most durable wood is used in Construction. Fragrant Cedar or Pressure-treated Pine. Both are long-lasting and will maintain their natural beauty for generations~ Precise attention is given to every detail......right down to the steel galvanized screws. These screws will insure yo~ gazebo will maintain its structural integrity and will weather the years without rusting. The Mini Barn Another very popular model, which will surely complement the natural landscape of your property. Like other models, the doubl~ doors are 5' wide and 6' high which will accommodat? everything from tools to heavy lawn & garden tractors; The Carriage House Our most popular model, An excellent "on location sales office", pool house, or general storage are for your home. A beautiful way to meet your storage needs. Single or double doors are available on ALL MODELS. FOUNDATION 1 st_~_) FOUNDATION 2. ROUGH FRAME & ~PLUMBING (2nd) INSULATION FER No Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ;ZND [ ~ ~kTION FRAMING [~FINAL DATE ./:~/~//' INSPECT+ BLDG. DEPT. TQWN OF SOL Examined ......... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-18013 B~3AKD OF ttEALTH ........ 3 SETS OF PLANS SURVEY · . ~ .............. CIlI;CK '.,,; ............... SEPTIC ~I; 0 R:! ............ t:OTl FY ~ . c^LL II ........ HAIL TO: Disapproved a/c ..................................... , ~ ( B),qlding I~:~ecto() '~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tills application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with · 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 sfi'eet or areas, and giving a detailed description of layout of property mu~t be drawn on the diagram which is part of this appli ca¢ion. . : c. The work covered by this application may not be commenced before issuance of Bui/ding Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permi sha~l 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 Occupanc~ shall have been granted l?y 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 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 c/qde, and regulations, and to admit author/zed inspectors on premises and in building for ~>e~a'~nsp~,g~.~:~ J_ /~' , . -- · . z ~./~o f applicant, or.narde, if a~ corporation) . ' (Mailing address of :fpplicant) State whether applicant is owner, lessee, agent, architect, engineer, generai 'contractor, electrician, plumber or builder· (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer.' : ' (Name arid title of corporate officer) Builder's License No Plumber's License No ......................... Electrician's License No Other Trade's License No ...................... I. Location of land on wliich proposed work will be done ................................. ~ ................ House Nulnber Street Hamlet County Tax Map No. ]000 Section :... :.~.O'. .......... Block . .~ ...... · Lot /~' Subdivision .... ~.;~/'~.P'~-<~rT. .~.~).~...~.. ........... Filed Map No. ,~..~r~...~ ....... Lot...,~.~. ......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing Use and occupancy ///..~.~.~... ~.~z~..~..~.~..,~..C..C~2 .~ ................................... b. lutended use occupancy ..... . . . :' ' (check whmh}applicable): New Building . ..~.. '~n' Addition .......... Alteration : ....... Repair .......... ReMovaI ............ Demoliti ~.~.~j~ ~ . ....: ......... Oth~:r Work ......... 4. Estimated Cost (Description) }Zee ..................................... ~ (to be paid on filing this application) 5. If dwelhug, number of dwellinig units Number of dwelling units on each floor ....... · If garage, number of cars ; ............... ' . · occupancy, spec nature and extent Of.each e of use ............ 7. s , if any: Front ............... Rear ......... Depth ........ l._~mght ............... NnmberofStories ..... '. . ... '. ' ............ Dimensions of shine structure vith alterations or additions: Front ' ' .................... Depth ' ~ ,, . . ........... Rear .. . D:mens:ons of entire ne ....... ; .. ~ /;/z' '7' · · >' · ·; · · Num her of Stones ......... ~.. /~O~ ............... ~'r'''~' .'-.~.: ....... Depth . ./.~7.0., .O0..'~..~..e~'.. 10. Date of Purchase . /t~./¢.~. ) -' · · · ''. ..... I ................... r~ame of Former Owner .. ' mtnct :n wluch premises are situated. ./~...~7~..' ' ' ' 1 I. Zone or use d /~St~x3c~ . ' ' ': ....... 12. Does proposed construction vidlate an .... :-_ ,~... ':. ' ............... · · '.. · .. ........................ · . --.. ~ ~' ~:m~ ~aw, oruulance or regulation. /_~o ....... 13. W,II lot be reeraded .. zoo, ................... ........... .,.),V ~/s~,fi~ll ~ r_e fr9m premises: .- Yes ....... 14. Name or Owner of premises/~?&'-~'~t~'?~x' ill exc morned ~ No Name of Architect i .................. ^ouress . .-t.h~(4.O.~.. '.g~.~.c(c. l-.fl. Phone No. '~6. ......................... ' ' ' 'Address , ................... Phone No ............ . .... Name of Contractor ........ , ................. Address ............ ; ...... Phone No ........ ' . 15.' I9 this property within !300 feat of a tidal wetland? *Yes ........ No.~.. ' ...... · If yes,~Southold %own Trustees Permit may be required. ' .... .... PLOT DIAG RAIvI Locate clearly and distinctly all buildings, Whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block aumber or description according to deed, and show street names and indicate wh~ther interior or corner lot. . ,55' 7'65-18{2)2 g ~M TO 4 PM ~ THE FOL[ OWING INSPECTIONS: t, [.~NDA'rlON - ~0 REOUI~fiD 3. INSO~TION FINAL CONSTRUCTION MUST BE COMPLETE FOR ~LL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE 'N,~ STATE CONSTRU~ION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONS~UCTION ERRORS ~TATE OF NEW YO~RIC ' : -oU,NT¥ OF.., . .... S.S (Name of individual signin .boys named. contract) being duly sworn, depose~ and says that he is the applicant le is the ~ ~..e_...~..0..~,~.. " (Contractor agent corporate officer,'e't~') ........................... f said owner or owners, and is duly mtt~orized to perform or have performed the said work and to make and file this *plication; that all statements contalnfid in this application are true to the best of his knowledge and belief; and t mt the ork will be performed in the manner set Yortb in the application filed therewith. ' .,,'om to before ~ne this .......... al3, pubhc, . ~.~...~.~?q-O.~x ...... County : - . ":"'.--".: N0.4725089, ~,, // // ,.~,,~.,,.,,tu.=: oza ~ cant