HomeMy WebLinkAbout6773-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Off'me of the Buildin8 Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Zl6806 Date April 20, 1988
THIS CERTIFIES that the building a c c e s s o r y s t o r a ~ e b u i 1 d i n g
Location of Property 9305 B.a.l? .Aye Cutchogue
Hous~ No. Street Haml~
County Tax Map No. 1000 Section I 04 .Block 03 ..... Lot 19
XXXXXXXXXXXXXXXXXXXXX XXXX XXXXXXXXXX
Subdivision ...... Filed Map No ........ Lot No, .
conforms substantially to the Application for Building Permit heretofore fried in this office dated
August 3, 1973 pursuant to which Building Pennit No. 6773Z .
dated August 3,' 1973
............................. 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 .........
accessory storage buildin.g, .
The certificate is issued to Joseph & Vivian Cornacchia
(owner, I~ or tenant)
of the aforesaid building.
I'I/A
Suffolk County Department of Health Approval ...................................
N/A
UNDERWRITERS CERTIFICATE NO ..................................................
N/A
PLUHBERS CERTIFICATION DATED:
· ...........
Building Inspector
1/81
FORM NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N~ Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N.° 6773 Z
Date ........................ ,~1J~....3 ................. , 19~...
Permission is hereby granted to:
· J.o~pb..& ..V~w'I.,~ .... ¢o~t~h$& .............
................ ~'~toho~uo ...........................................
to
at premises located at ...~.~....~k3R~..~...(B&~...&~...~..~O~C..~i~'
pursuant to application doted .......................... ~ ....... .~ ............. , 19..?.~.., ond opproved by the
Building Inspector.
Fee $...t.~eO0 ..........
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765- 1802
'LICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted m ~ 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.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of p~'operty 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 informa-
tion required to prepare a certificate.
C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00
1. Certificate of occupancy New Dwelling $25.00, Accessory ,$t0.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00
4.Vacant Land C.O. $ 20.00 APRIL 20, 1988
5.Updated C.O. $ 50.00 Date ..........................
NewConst, puction.. ;~.x.. Old or Pre-existing Building ............ Vacant Land .............
9305 BAY AVE CUTCHOGUE
Location of Property ...................................................................
House No. St~*et Hamlet
O O tty JOSEPH & VIVIAN CO~ACCHIA
wner or wnersof Prope ......
County Tax Map No. 1000 Section 104 03 I 9
............... Block Lot
Subdivision ................................. Filed Map No ........... Lot No ..............
PermitNo. 6773Z Date of Permit 9/3/73 Applicant Ph. il.ip .J. Cardlnale
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ..................... .
Request for Temporary Certificate ..................... Final Certificate
Fee Submitted $..1.0.: .09 ......................
Construction on above described building and permit me,ets all applicable codes and regulations.
Applicant ....................................................
Rev, 10-10-78
/ ,,~,.~ ~ -.~
Approved ............. .z). ........... ~ ........ , ,9../~.. Permi* Nc/~...../.../.....~.~.....~. ........
.............. 7 ...... .... ...........................
"( Date ........ .~. ~
---~ .......................,
o. lhi~ ~pplicatim mu~t b~ c~pl~t~l~ fill~ in b~ ~rit~r o~ in i~ ~nd ~mi~ed in tripli~ to
b. Plot plan sho~ino I~ation of lot and o{ buildinO~ ~ premiss, r~l~tion*hip to ~djoining pr*mise~ or
aree*, and ~ivi~ ~ d~toil~ d~ripti~ o{ I~out ofpr~ mu~t b~ drown on th~ dio~ram ~hich
c. ~ work c~red by thi* o~lic~tion m~ n~ b~ ~omm~ed b~{ore i~u~nc* o{ Building ~rmit.
d. H~n ~ppmwl o{ thi~ ~pplic~i~, ~ Buildi~ In~or will iss~ o Building P~rmit to th~
sh*ll ~ ~t on th* premi~ ~ail~bl~ {or in~ti~ ~r~t ~ ~rk.
e. ~o building ~h~ll b~ ~oupi~ or ~ in whol~ or in pa~ {or ~n~ pu~ose what~wr until ~
~holl h~v~ b*~n ~mnt~ by th~ Building In~ec~or.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to the
i~uildln.g. Zon.e Ordinance of t. he Town o.f. Southol.cl., Suffolk Cou~.ty, New York, and other applicable Laws, Ordinances or
egu at ons, tar the construchon of buddings, add~t,ons or alterohons, or for removal or demolition, ~ herein descr bed.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, end regulations, and to
admit authorized inspectors on premises and in buildings for necessary inspections.
.......... ........ .......
/ (Address of applicant) ~
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
................. ...................................................................................................................................................
Name of owner of premises ...... ..~.~.~...~...~..~.~.~..~...~...~...~...~....?m..~....~.~Z.~?~...~..~.~.~../.~A~. ................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No .....................................................
Plumber's License No .................................................
Electrician's License No .............................................
Other Trade's License No ...............................................
].
Location of land on which pro~0osed work will be done. Map No.: ........................................ Lot No .........................
Street and Number .......... J.~..x~...~.......~..~'....~..-.~ .......... ..~......(~.....'~...~...~:~....1~..~....~'.....~...
!
Municipality
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Exisiting use and occupancy ................................................................................................................................
b. Intended use and occupancy ............... ~.'~....~...~.J~...~.....(~... ....... ..'~......~.....~..-.~./....~.....~..~. ..........................................
3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ................
~ Repair .................. Removal .................. Demolition ........... ', ....... Other Work ...........~ .........................
..~.~ ~..~.. (Description)
4. Estimated 'Cost ................ :.,...~"~... ............................ Fee ..........................................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor .; ..........................
If garage, number of c~rs .............................................................................................................................................
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 ....../.~...~. ............... Depth ..../...~'.. .............. ·
Height ........ ~..~ ........ Number of Stories ..... ./. ..............................................................................................................
-~o0' 0 · ~Oc~
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 ( ) No
14. Name of Owner of premises .................................................... Address ................................ Phone No .......................
Name of Architect .............................................................. Address ................................ Phone No .......................
Name of Contractor ............................................................ Address ................................ Phone No .......................
PLOT DIAGRAM
Locate clearly and distinctly all 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.
COUNTY .......
................................................................................................. being duly sworn, deposes and says that he is the appHcam
(Name of individual signing contract)
above named.
He is 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
this application; that all statements contained Jn 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 ~be,~ me this ~ --
...........
Notary Pub~../.;.~.......~,./._~..~-~'~'.,~,.C~'~unty ..... 7~.~7'..;-/:.~..~i~r~, .........................
~- / / - ~',~gnarure o app ,canT~
JUDITH T. BOKEN
Notary Public, State of New York
No. 52-0344963 Suffolk
Commission Expires March 30,