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Home My WebLink About22689-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23742 Date JUNE 29~ 1995 THIS CERTIFIES that the buildin~ Location of Property 635 KIMBERLY LANE House No. County Tax Map No. 1000 Section 70 Subdivision ADDITION Street SOUTHOLD, NEW YORK Block 13 Filed Map No. Hamlet Lot 20.4 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAR~H 31, 1995 pursuant to which Building Permit No. 22689-Z dated APRIL 20, 1995 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOSEPH CORMACCHIA (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A FO~M NO.$ TOWN OF $OUTHOLD BUILDING DEPARTMENT '[OWN HAU. SOUTHOLD, N.Y. N£ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 22689 Z CounlyTax Map No. 1000 Section ......... Z.~... ....... Block ...... ,?,..,,~,. ........... LotNo...~....~...¢.,...,~... ........ pursuant to applic atlon dated ............... ~f~.. ~......,=~...~.., 19 ?.~..., and approved b y the Building Inspect,~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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: 1. 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 1% lead. 5. Commercial building, industrial building, multiple residences and similar buiidings 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildiugs 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 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. i. 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 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., Commercial $15.00 New Construction ........... Old Or Pre-existi~]g Building ................. Location of Property ..... D ............... ~ {.~ I~O.~ ....... ', ~bkf ~ID. House No. Stree~ Hamlet Onwer or Owners of Property...~ ....................................................... County lOOO, eetio ..... ..... ....... ...... Let .... ......... Subdivision Filed Map Lot Permit No. 2~.6.q,'l, .Date Of Permit. R llealth Dept. Approval .......................... Underwriters Approw~l ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $... ~, .QQ. ................. ¥ t ................ ..... CO ~-~37~ ~ APPLICANT Town Hall, §309§ Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD June 21, 1995 A~-thu~Johnstone P.O. Box 91 Southold, NY 11971 Re: Joseph Cornacchia - Prem: 635 Kimberly Lane, To Whom This May Concern: TM#1000-70-13-20.4 Southold NY BUILDING PERMIT # 22689-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed) NO Underwriters Certificate on file. xx The check is not on file. $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD June 21, 1995 Arthur Johnstone P.O. Box 91 Southold, NY 11971 Re: Joseph Cornacchia Prem: 635 Kimberly Lane, To Whom This May Concern: - TM#1000-70-13-20.4 Southold NY We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. xx The check is not on file. $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 22689-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 765-Z8~2 BUILDING DEPT. SPECTION [/-*~FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ~ [ ] FINAL DATE~~~_INSPECT~ 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] ~ULATION [/~"'FINAL [ ] FIREPLACE & CHIMNEY DATE INSPECTO~~~~ ,,~ , ! , FORM NO. 1 [1995 '!i~'tI TOWN OF SOUTHOLD ~R'3i; ~! B,Hn,~,~ D,CpARTM ENT~ i' TOWN HALL ~ ....... ~ TEL.; 765-1802 DJsapprove~ a/~ ....... ' ' - ''~LIOATION FOR BUILDING'PERMIT B~,\RD'OF HEALTH SURVEY ........ Cl,,,c,: .. SEPTIC FORH ............ ~:OT I PY ~ . HAIL TO: Date ....... ; ........... 19.. INSTRU~TI.ONS a. Ttds 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 sti'eet or areas, and giving a detailed descriptioh of layout of property muJt be drawn on the diagram which is part of this appL cation. c. ' The work covered by tl'fis application may not be commenced before issuance of Building Permit. . d. Upon approval of thls application, the Building Inspector will issued a Building Permit to the applicant. Such permi 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 Occupanc' shall have been granted t.,y ~e Building Inspector. APPLICATION IS HEREBY MADE to the Buildh~g Departmefit for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southbld, .Suffolk County, New York, and other applicable Laws/Ordinances o 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 tc admit authorized inspectors on premises and in building for necessary inspec, t. idh"~D . ~ - .. ..... ........ . ........ (Si°nature of s~p~licant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, 'agent, architect, engineer, generai contractor, electrician, plumber or builder. ..... '. ' · ' · ,.,% .eh p.' ' Name of owner of premises . . -5¢ · P.C~ q.X .c.¢.[.D ~.' .q,_ .......... . ....... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authoriied officer.' ; (Name and title of corporate officer) Bu lders License No. /.-~./..Q. [.. [4.~.'. ........ Plumber's License No ' Electrician's License No ....................... Other Trade's License No. Lgn'¢. Location of land on which proposed work will be'done...~ :~.~..~."DD..~¢?. I~ ......... d: ./>¢,.~..(/ ......... ............ ...... . i4 y House Number Street Hamlet CouhtyraxMapNo. 1000Section ...:..'*J'.0. .... . ..... Block ..... { 3 ' Lot..2.0.0: ~.. Subdivision ........ . ................... . ......... '. Filed Map No. (Name) ...... ........ Lot ............... Stat~ ex/sting use and occupancy of premises and intended use and occupancy of proposed construction: ' .Pr ' a. Ex/sting Use and occupancy .... ~ ............... ........ ~'3;R .! ;~¢'~ ~5~ ................. b. Intended use and occupancy . ~h,~¥ ~¢~*c,"','* ' ,'~ ¥~' '~ ....................... .~ ~r.,; '.,,. ;7i . .. · ,~rm,-~ ,,,, .!, ~:, . .'"',¢,.~0 .. ' ...... '3. Nature of work (check wl~ich applicable): New Building . ......... Addition .......... Alteration .... Repair .............. Removal ............... Demolition ..... ; .......... Qther Work..I~CC[<,~ ..... ; ..... ~ (Description) 4 Estimated Cost · (to be paid on filing this application) $. If dwelling, number of dwellin~ units'. ............. ,, Number o~f dwelling units on each floor ............ If garage, number of cars I 6 '1lb. i ................................. .......... "" . s ness, commercial or ed o cu , s nature and eXtent of.each type of use ................ 7. Dimensions of existing structuies, if any: Front ..... i ....... Rear ....... ' ..... Depth ....... '. Height ............... Number of Stories ..... i .......... ....................................... : DepthDimensi°ns :Df .... shme structure withl alterationsu~ .~., or additions:. Front ............. ,. · · · · Rear ............... . 8. ulmensions o~entire new construction Front ........ . r',~.. ' ~ .,' ' ' ' '. ...... .,,~,o-~ ............... l~umoer or Stones ................ . 9. Slzeoflot Front ' . · ~o~ ' ....~."'.' ........... . .......... 10. Date ,-¢ ~,,-,~h~.o ' '~ ................................... J.Jeptn ..................... ..................... I .......... ' ....... '... Name of Former Owner ......................... 1 I. Zone or use district in which p?emises are situated .... . .......... ' .............................. i ~..' .... 12. Does proposed construction vi?late any zoning law, ordmaz{ce or regulation: . ," . .'... ..... ~ ........... '13. Wflllbt beregraded '. ....... ' ......... ' , ~, ' ' ' ' · .... ~ ............. Will excess I111 oe removea ~rom premises: Yes No 14. NameName of Architect°f Owner of -' ""'/~'~'prel~ises ~...~..,ir.~r~t ~_i. 1 ' ...... ' ' i"' ' ' AddressAddress .'q'~,4./~-'; ....... .ZI~,' .~'~a~O*. ........... PhonePh°ne Ne.N° ........~.~" .j[~..~..¢... ~...~ .... . Name of Contractor . .,:~.~¢~.J. q4 .~.'7.~..~ .' ..........Address ~Flef. ,~.,.,~--.~v27'I~4~'... Phone No. ;7..~//. C .~'f?...ff.' .... this property within [300 feet of a tidal 'wetland? *Yes ........ No ......... 15.I.s. *If yes, SoutholdiTown Trustees Permit may. be required. ... i ' ' ' PLOTDIAGILMVi Locate clearly and distinctly all buildings, ~heth~r 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. i ' ' (N me o[ in~ivkmal~igning contract) above named. ' APP ROV, ED.AS NOTED / ,.,..,J' 7(~5'q802 9 .AM ~R THE FOLLOWING INSPECTIONS: 1. FOUNDATION ..' TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHAU.. MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION &'ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSIItUCIION ERRORS ·.. being duly sworn, depose~ and says that he is the applicant gent, cor'porate officer, etc.) . )f smd owner or owners, and is duly~ authorizT'd-~perform or have performed the said work and to make and file this pphcation; that all statements centered in this'application are t'rue to the best of his knowledge and belief; and that the fork will be performed in the manner ~et forth in the application filed therewith. ' ~wom to before me this . Cti~Ri t. GLEW ~TAR~ P~BLIC, State of ~ly~ " ..... · ................ ' %ali,:~: 4~7~5~ ~ ~ . ' ' (Signature of applicant) ~mm~ssion ~xo,res Oecember ~NV7 O70HIDOS I J I t ~( 72t-,-T&tl/V/ji =7,.0g,8§ ,90 N ,~6 'ZE= 7 ,DO'O&t,=bl