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Home My WebLink About21683-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22752 Date NOVEMBER 29, 1993 THIS CERTIFIES that the buildin~ ADDITION Location of Property 635 KIMBERLY LANE House No. County Tax Map No. 1000 Section 70 Block 13 subdivision Filed Map No. SOUTHOLD~ NEW YORK Street Hamlet Lot 20.4 Lot No. conforms substa~tially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER l0w 1993 pursuant to which Building Permit No. 21683-Z dated SEPTEMBER 28~ 1993 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 (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A JOSEPH M. CORNACCHIA ding Inspector Rev. 1/81 FORM NO.3 TOWN OF SOU'/HOLD BUILDING DEPA~TMENI' 'fOWN ~ SOUTHOLD, N.Y. N_O BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ............................................................. 19. .. 21683 Z Permission Is hereby granted to: .... ~.,./.... ~.....~.~ .~. .................. ...... ~.~.~......~ ~./....~ ................ .... ~.~.~....,...~.~.....z~.? ~ to.....~.-,,~,~ ...................................... ~- ~ ~.~.........-.-~,~-~ ~-~ ...... ~.~ ......... ~.'.,..~ .......... ~.~<.~.~...~ ............ ~......~~ at premises located at ........... ~..~....~'.. ........ .~.~. ~.~...~..~......~.'~*,~. ................................... County Tax Map No. 1000 Section ....... .?...~... .......... Block ........ .'.%~...~.. .......... LotNo .....~.......~...... pursuant to application dated ....... ~ ....... ~ .................. 19..~.., and approved by the Building Inspector. F~ ~..,.,~.~ ..... - '"~/ ~ Building Inspector Rev. 6/30/8'0 ow, sou ? ...... Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~PPLICATION FOR CERTIFICATE OF OCCUPANCY ~his 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 buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 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 th~ 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.O0 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $i0.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 (q'l'l'l~f~ Date .N~. ~. ~ ~ LocationNeW C°nstructi°n'~i~i~jof O1~ Or Pre-exicting~ ~ {tt~ Building...[.~~ ~,~ ............ ~ .~ Prope ~..~¢~}. ~..-~.p.,~.~.--q ~ . ............... House No. -~ Street Hamlet Onwer or Owners of Property...~.q~.~. ~.O~-~X_C . .. i . . 13 County Tax Map No 1000, Section .............. Block .... .. .......... Lot.... ~ .......... . Subdivision .................................... Filed Map ............ Lot ................... ... Permit No..~./.~.~..3 ..... Date Of Permit..?/~./.?.~ .............................. Applicant . . . Health Dept. Approval ...................... ... . Underwriters Approval ...................... . . . Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate.. w/ INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Brai[ding Irapec~or Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fife Inspector Telephone (516) 765-1802 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 7654823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD November 22, 1993 Hr. Joseph Cornacehia 635 Kimberly Lane SouEhold, NY 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XXX An application for Certificate of Occupancy is not on file~ (Enclosed) No Underwriters Certificate on file. xxx The check is (cutdate~/not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # BP# 21683Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. >'OUMDATIO:! { 2nd ] ~OUGH FR/i-IK & .PLUMBING ~SULATIO:I ?ER N. Y. STATE ENERGY .CODE.. FI:;AL ADDITION~L COMMEHTS: 7GS-'~802 BUILDING DEPT. INSPECTION [ ]. FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: [,.~INAL DATE 765-1802 BUILDING DEPT. INSPECTION [~FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FI~MING [ ] FINAL ~ REMARKS: ~ __,~ , _/. / ,r~ Breeze Construction '~_Sea 321 DBER ROAD !(ONKONKOMA, NY 11779 585-8033 7(=5" :~ZSZ OCCU?^NCY OR ~$ U~L~WFUL FORM NO. 1 TOWN OF SOUTHOLD !' BUILDING DEPARTMENT ~-' ' TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined . .~ ]~ 1973 ' Disapproved' a/c · BOARD OF HEAI..TIt SURVEY ......... CHECK ,~. ................ SEPTIC FORH ............. NOT I FY:. . HAIL TO: ~/~ ' ~' APPLICATION FOR BUILDING PERMiT ~ TOWN qF ;':~:w;'~" ~, ~ INSTRU TIONS a. Tlfis applicati°n must be c°mpletely filled in by Wpewfiter or in ink and submitted to the BulldOg inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan show~g location of lot and of bulldogs on premises, relationship to adjoining premises or pubic stkeets or areas, and giv~g a detaled description of layout of property must be drawn on the diagram which is pa~ of this app~- cation. c. ' The work covered by t~s application may not be commenced before issuance of Building Pemit. . d. Upon approval of this application, the Building Inspector will igsued a Bufld~g Pe~it to the app~cant. Such pemit , sh~ be kept on the premises available for ~spection throughout the work. . e. No building shall be occupied or used in whole or in p~t for any pumose whatev r ' ' :shall have been granted by the Building Inspector. - e until a Cemficate of Occup~cy ' ' · of a B~lding Pemit pu~uant to the APPLICATION IS HEREBY MADE to the Bulldog Depmme~t for the issuan~ other app~cable Mws, Ord~ces or Building Zone Ordinance of the Town of Southold, .Suffolk County, New York, ~ Regulations, for the construction of bufld~gs, additions or alterations, or for removal or demolition, as here~ desc~b~d. The appEcant agrees to comply with all app~cable laws, ordinan~fld~g code, hou i g code, and regulations, and to admit authorized ~specton on premises and ~ bulldog for necess~,'in~i;ns, q, . .... .......... ' ............ (Signature of applicant, or name, if a corporation) -- (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, genera~ 'contractor, electrician, plumber or builder. ........... .. i,.z. .Ca x.i r, m ..................... · ....... ' Ji lw0 as . ' asonthe .''' '* ~ ~;~ If a,,-lica . ~ ........ : ....... ( tax roll or latest~oEPART~ENT vv nt is .... v~,auun, signature o~ amy authorized officer' 765-1802 9 AM ~ 4 PM FOR FOLLOWING ........................................... ' ~. FOUNDATION - ~O ; (Name and title of co~orate officer) F OR POURED CONCRETE . , . 2. ROUGH - FRA~JNG & PLUMBING Builder s Dccnse No ....... 3. INSU~TION PJumber's ~icense No. 4. FINAL CONSTRUCTION MUST ......... . .......... ,SE COMPLETE FOR C.O. , ALL CONSTRUCTION SHA~ ~E~ lcctmcmn s License No ....................... THE REQUIREME~S OF THE N.~ STATE' CONS~UCTION & ENERG~ Othcr Tr~de's License No. ~C. ,~~{~. ~1, ~$ ' CODES, N~ BESPONSIBLE FOR . ................ so .............. House Number ' Street Hamlet ........... County Tax Map No. 000 Section ... · · .' Block " Lot 2 O, ~ Subdivision ............ · ..... . · ................... '. Filed Map No. (Name) .............. Lot ............... State ex/sting use and occupahcy of premises and intended use and occupancy of proposed constructiom a. Existing use and occupancy ~' ~7~A~ ' ~:"/'~ ,~'~::~ · hnd occupa . " b. Intended use ney ...... . ...... · ' ' -,,~...,L~' ~ ~ ~ ...,t 3. Nature of W, ork (check which applicable). New Building . Repair . ~ ' · ........ Addition .......... ,Al, teratinn ...... 4. Estimated Cost '7.~ ~' (Description) ....... Fee ..... ' (to be paid on filing this application) 5. If dwelling, number ofdwellin~ units ............... Number of dwelling units on each floor · If garage, number of cars .... i ' ' .............. ? ?d ifv ' ' 6. If business, co mercial or mix occupancy, spec nature and extent o · ' ................. 7. D,mens~ons ot ex(sting structures, if any' Front ~. f each type of use .............. , ..... ight tnb -' '''i .......... Kear ..... l~epth .............. He ............... Nu er of Stories ................... ' . Dimensions of shine structure With alterations or additions: Front .... . Rear pth . De .... ' ............ !. Height , · · '" ........ : · · Number of Stories 8. Dimensions of entire new construct Front ..... ' Rear .... De ........ i ht ? .oTt ......... . ........... He .............. Nu eror/es ............... pth 9. Size of lot: Front ....... ,~ ........ Rear ..... · ........... 10. Date of Purchase ....... , . . · ............ Depth ..................... ............ ' ....... Name of Former Owner 1. one or use district in whic r raises are situate ........ ' ............................ 3 ocs proposed construction rio ate any zonin aw, or na ce or regulation: · Will 10t be regraded ....... ;. ..................... · ' ' Will fill b i ......... 14 N f O ofp ................ excess e removed from prem ses: Yes N · nme o wrier remises ........... , ........ Add o N f A hite ress ................... Pho . amc o rc ct .......... : ............ ' ne No ........... e of C · · · Address .... ' .... Nam ontractor .......... . ....... ' .............. Phone No ........... ..: .... " 3O0 Ph N ty .......... Address ............ z ......one o .............. 15 I~ this proper within feet of a tidal wetland? *Yes ........ No ......... '' · If yes,~Southold Town Trustees Permit may be required. !' PLOT DIAGRAM Locate clearly and distinctly a/llbuildings, 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 inter/or or corner lot. . . .ou v N. · (Name. of individual signing~tract) ..... .... ';'i~ .,?'....~; i~ ~ ~¢~k[ ....... being duly Sworn, deposes =d says that he is the applicant bovename~. ' . ' . . :~ , .... ' (Contractor, agent corporate officer ~- ~ ........ ." ...... · ............ authorized to perfo~ or have perfo~ed the said work and to m~e and file this ~plication;.that all statements containe~d ~ this application are t'rue to the best of his knowledge and belief; and that the ork w~l be perfomed in the manner se~ forth in the application filed therewith.' yom to before me this ( , .' .......... ~ Publl~ on ~lre. OF BY THE BAY tVO. 6463 ~IOLD ~UTHOLD NTY, IV.. Y. 20.4 ~0' NO. 4961 g .... ~ 85~ 20' 307, E FO0 TPA TH DOOR 369.32' OER. 7~tFCED. TO PRESTIGE ABSTRACT .f 285.87' 89° 14' 00" W Prepered in ~ccord~nce wilh Ihe minimum slenderds for fl~ s~ve~ ~ ~t~d ~ ~ t~.& ~ ~roved and adopted r such u~e by The New York Stole Land Title Association. SURVEY OF' LOT 4 MAP OF PARADISE BY THE BAY '~ FILED NOV. 4, 1976 FILE NO. 6463 A T SOUTHOLD ~. TOWN OF SOUTHOLD ,~ SUFFOLK COUNTY, N Y. ~ 1000 - 70 - ,13 - 20.4 ~ Scale 1" ~ 40' June 3, 1988 A~EA = 2.019 acres '516] 765'% % O. BOX !4'AIN ROAD ~OUTHOLD, N.Y. 1197I LIC. NO. 49618 P/NE NECK N 85~ 20--~-'-~-'30" E ROAD 285.87' 369.32~ 89 14' 00" W C'E'R. TfFCE'D. PQ PRESTIGE ABSTRA CT Prepored in occordence wi~ Ihe nVaV4eum sloe<lords for ~fe sm'veys es esleb~aed by ~ LJ.A.L.S. ~ epproved ond odopted for such use by The New York Sfele Lond Tlfle Associelion. 88 - 392