HomeMy WebLinkAbout17864-z
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FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19685 Date JANUARY 25, 1991
THIS CERTIFIES that the building ACCESSORY
Location of Property 635 KIMBERLY LANE SOUTHOLB, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 70 Block 13 Lot 20.4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 2, 1988 pursuant to which
Building Permit No. 17864-Z dated FEBRUARY 23, 1989
was issued, and conforms to all of the requirements of the applicable
prova.sions of the law. 'i`he occupancy for which this certificate is
Issued is ACCESSORY POOL HOUSE, DECK & TRELLIS AS APPLIED FOR.
The certificate ~s issued to JOSEPH CORNACCHIA
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-138591 - 6/29/1990
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
D'08M NO. f
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~ 017864 Z Date ss
~9.g°l
Permission is hereby granted t : I ,
..wS.~r..~.... ~ ......G.=c!:~:r
to ...~rrs?~cvMrlrS :5,~'. .Q.^..^... ~.~......:F-~!:-x...1~..r.J!F,...Q-~-l.~-
~...~!:!!Jw~.y.. f.I.GL..... .
~........n.
.
of premiises located at ~P...w~...~~......L~..f.,!^:1 .
County Tox Map No 1000 Sect^io~n ....~.~f d- . Block ~ 3.. Lot No
pursuant to application dated ..L..rtR-SF^'~:1.!~ . 19.~ and approved by the
Building Inslpector
Fee S •A•v~...~t:•g
~ ~ ~ .JL.-o
Building Inspector
Rev 6/30/80
g~6 Form No. 6 hoc
.~'~~_y• i?q~r
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. Th1s 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.
6. 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 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, 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 - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate o£ Occupancy - Residential $15.00, Commercial $15.00
Date ~'2.'z
New Construction...~~'. Old Or Pre-exis//ting [Building. /
Location of Property ....................../~/.h?Rt"J1'.~ .(.C`7.~........:~d~L7~G(.d/~(......
House No. SYrdet Hamlet
J '
Onwer or Owners of Property.. 4!(.r? f?..... ,~J~~;rCl~{ C.~l
County Tax Map No 1000, Section....C. d .....Block....~~........Lot...Z.~:.~...........
Subdivision..~~./j./.~../.~
............................Filed Map.........'.j.'.Lot./.
Permit No..~l.~l.`!. ..Z~-..Date Of Permit ................Applicant?.llsef?h.~~: nd rr~,G ~~l~!G~
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate..
02> C/./re~~t
Fee Submitted: l..~t.........1,.'~.. ~6~.~..
~ ~ /
~.0~ fQbSS f sf APPLICANT
~sltrt-r;~,~ TCL 7G5-IEOZ
~~~~FfO[t{~^ T•~~PN pI' SOUTIIOLB
~1i4~.~lt~?(, OI•("iCii Ol' FIUILllING }tJSPCCTOR
~A~r~ i I~.~. Il~~l 7.7.8 ~
S1 ~n=,cy SOUL I[O!.f), N.Y. l 1971
~
~`r•3r"i•'%~ June 1l, 1990
Mr. Joseph Cornacchia
835 &imberly Lane
Southold, N.Y. i1971
To 43}lom This tday Con~crn,
Fie ~zre unable to complete your Certificate
oL~occupanr_y becau~c oL• the following reason.
J_?/ An :application £or Certificate o£ Ocounancy
is not on file. (ENCLOSED)
/~`ta Under:oriters Certificate on file.
,(~1'hc cl:ec}: is (~~Yf3cX.$i3~F~/not a:i file.) $25.00
l:n II~alth Dept. Approval on file.
N.o final in~pcct_ion ham beeu made.
PIc,1~e contact our office on this matter.
Thank you for your cooperation.
auildin~ Permit 11 ! ? $ 6 4 Z (POOL aousE s POOL)
Bullclincl DepL•.
/ fto Plumber Solder Certificate on file.
( all pcrmit•~ involving plumbing being
i:,nued after April 1,1~fZ4 )
1ELD i;..°.. ~~Jni ~I ~i.MM[.NT~ ~
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P,OUGH FRAIdE &
PLUMBING -
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IIdSULATIOP! PER N. Y.
STATE ENERGY
CODE
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THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGB 1
101508A ®UREAU OF ELECTRICITY
83 JOHN STREET. NEW YORK, NEW YORK 10038
pew JULY 03,1990 Application No. on file 612876A9/$9 W 138850
THIS CERTIFIES THAT
only the sfectrlcd equipment w described 6eloso and introduced by the oppltcont named on the above epplicstien number in the premises of
JOB CORNACCBIA, HII4BERLY DRIVE, 50UTAOLD, N.Y.
in theJdlominq location; ? Reesman[ ? 1At Fl. ? Ynd Ff. OUT .Sertion Bfock Lot i=
mae examined un JUNB 19 ,1990 and found to be in compliance with the requirements of [hie Buerd.
s
OUiN1FiWS AQB SINITCTfK RXTURlS RANOES COOKING DICKS OVENS OKN WASHERS EXHAUST TANS e
NCANDESCENi-FLUp1ESCENi OTHER AMT. K.W. AMT. K.W. AMi. K.W. AMT. K.W. AMT. H.P. _
z a a
DRYERS RIRNACE MOTORS WTUR! AMl1AfeCE IEEDERS SPECIAL E!C'?T TIM! CLOCKS ENl letli NEATlRS MLRTI-011TIET DIMMERS
AMT. K. W. pl N. P. GAS H. P. AMT. NO. A. W. G. AMT. AMP. AMi. AMK. TRANS. AMT. N. P. SYSTMIS AMT. WATTS
NO.Oi IRE[
1 20 1 40
SlRVICE WSWNNECT PIO.OF S E R V 1 C E
AMi. AMP. TY1F MEGIRR. 1 X tW 1 X tW S X 3W 3 X IW NO.OF CC. COND. A. W. G. NO. p HI-lFG A. W. G. NO.OF NEUTRALS A. W. G.
PER / Of CC.COND. p MI~U:G OF NEUTRAL
OTHER AH'ARATUS:
_ PANBLBOARDS:1-18 CIR. 125
G.F.C.I:-2
*(SWIMNING POOL) This certificate
covers compliance at the date of
inspection only. Because of unusua3
environments it is advisable to
have frequent test and/or repairs
made by a qualified person. /
~o~
G & G BLBCTRIC LIC.p3733-F, ~
P.o.BOX 885 TiENHtAL MANAfiER
SAG HARBOR NY, 17.963 ~ ~ ~
Peril
This certificate must not bs aberad in any manner; return to the office of the Eoerd if incorrect. Inspectors may be identified by [Mir credentials.
:a:~
COPY FOR BUILDING DEPARTMENT. TNIS COPY OF CERTII~ICAt~ MNIST !(OT BB ALTERED IN ANY
MAIiimQ
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1001071
BUREAU OF ELECTRICITY
83 JOHN STREET, NEW YORK, NEW YORK 10038
JUAIE 29,1990 665087$9189 N 138591
Dote Application No. on file
THIS CERTIFIES THAT
only the alectrlcd equipment w dsecrihed bebw and introducd 6Y the applicant nomad on the a6ooe epplicetfon number in the premises of
JOE CORNACCIA, KIABERLY ROAD, SOU'TAAOLD, N.Y.
in the olbwin loco Basetlent CABANA
I R 119999V ? /Rt Fl. ? Ynd Ff. Sertion Block Lot
wee examind on and found to he in compliance uifhthe reyuirernenG of this Board. -
Nx1URE At9E5 SWRCttEd RXTURES RANGES COOKING DECKS OVENS DISHWASHERS lXHAUST FANS
S NCANDESCENT pIUDRESCENT OTHEn AMT. K.W. AMr. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
12 13 id 11 1 2 F _
DRYERS R/RNAC[ MOTORS WTURE AMMIANCE MRDERS SPRCIAL R!C'ET TIME CLOCKS R!LL , UNIT HEATERS MUlT1.ODTIET DURMMN<. ' ,
AMT. K. W. dl M. P. GAS M. P. AMT. NO. A. W. G. AMT. AMP. AMT. AMPS. TRANS. AMT. N. p, SYSTEMS ANT. WMm
NO.OF fiET
SERVICE DISCONNECT NO.OF 5 E R V 1 C E
AMT. AMP. TrP! bIn11PR I J ]`M t / YY ] / ]W 3 / AW NO. DPER eCONG OF CC
COND. NO. w MFLEG OF~ N NO. OF NEUTRMS Gj NEUIGMAI
OTHER AMHIR/1TU5:
INTERIOR (TIRING ONLY OF CABANA-] ~
ELEC. tTATSR AEATERS::1-4.5 K.A. _
TRACK LIGHTING:-60
G & S CONTRACTOR LIC.8578-E
Box a15
SOUTAOLD, NY, 11.971
11 _
Per ice„-•~~
This nrtificaro must not be alrored in any manner; return ro the office of the Board if incwnd. Inspscrors may bs idantifiad by their crsdantiak.
• TEREDIN i~NY MANNER:
~ 7~~ ~ 7sS-iso2
BUILDING DEPT.
tNSPECTI~N
[ ]FOUNDATION 1ST ~ ] ROUGH PLBG.
FOUNDATION 2ND ( ]INSULATION
[ ]FRAMING [ FINAL
REMARKS: lG
DATE INSPECTOR
BOARD OF HEALTH
,~,,~~9_,_._.
~ " 3 SETS OF PLANS .
i~ i FORM N0.1 SURVEY .
~ Z~ ~~'~j~ TOWN OF SOUTHOLD CHECK
Vr BUILDING DEPARTMENT SEPTIC FORM
BLDG. DEPT. TOWN HALL
TOWN OFSOUTHOLD vOUTHOLD,NY 11971 NOTIFY
~j TEL.: 765-1802 CnLL
Examined ~3 ~ 191~`~ MAIL T0:
n~ t
Approved ~:5~4}:~,,~~. 19 S~ Permit No t ~.10~ ~ ~~D
Q ~ ~z.1~13
Disapproved a/c .
..,.....o. .
(Buildtng Inspector)
APPLICATION FOR BUILDING PERMIT J
Date .....r(~ 155
INSTRUCTIONS
a. This appltcation must be completely filled in by typewriter or to ink and submitted to the Buildtng Inspector, witi
sets of plans, accurate plot plan to scale. Fee according to schedule
b. Plot plan showing location of Iot and of bu[Idings on premtses, relationship to adjoining premtses or public stre
or areas, and giving a detazled description of layout of property must be drawn on the diagram which is part of this apl
cation.
c. The work covered by this appltcation may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the BuAdmg Inspector will issued a Buildtng Peimit to the applicant. Such pea
shall be kept on the premtses available for inspection throughout the work.
e. No building shall be occupied or used in whole or to part for any purpose whatever until a Certificate of Occupan
shall have been granted by the Butldmg Inspector.
APPLICATION IS HEREBY MADE to the Butldmg Department for the issuance of a Building Permit pursuant to t
Buildtng 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 descnb:
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and
admit authorized inspectois on premtses and in butldmg for necessary inspec ions.
(Siggature i applicant, or name, tf a corporation)
..:~~2~ , /J. SFf1', (~~}n . ,SouTN?4?w;tQ'1aJ
• ~ (Mailtng address of applicant) ~ /~t6~
State whether applicant is owner, lessee, agent, architect, endneer, general contractor, electrician, plumber or butld~
Czsr~a'fFtr1~aR
...NEB
Name of owner of premises . ~..V a Y 1. . , CDI~'1.II~C-GNI-X}-. • • . • . • . • . • . .
(as on the tax roil or latest deed)
If applicant is a corporation, signature of duly authorized officer
.
(Name and title of corporate officer)
Bwider's License No. t
par~.~ ~.'r... . • • • •
Plumber's License No . ! 7 y...
~ . , . , • . • •
Electrician's License No . . .
Other Trades License No . .
1. Location of land on which proposed work will be done. t7'. ~ ~ .
~a urh.4. D .
.
House Number Street Hamlet '
County Tax Map No 1000 Section Block 1.~ , , , , , , , Lot ...~Q: ] • . , ,
Subdivision 'A~s~ 1'3..,t4!~ Filed btap No . Lot .
-(Name)
2. Slate evsung use and occupancy of premis1e`s and intendePd use and occupancy of proposed construction
a. Existm~• use and occu anc ~ ` ' s~7.~15~~!'
o p y ....•~Z•~;lc~.-n
b. Intended use and occupancy • •
3. Nature of work (check which applscable) New Building ....X Addition .~..p~,t~ Alteration .
Repair , , t~'.. Removal Demolition ewr~r
2 (Descnptsor•
4. Estimated Cost r2..~.~~..`. 3~i Fee ~ ~ a. ~ ~ I ~ ~ t . .
(to-be paid on fling this alpphcauon)
5. if dtvelhng, number of dwelling units . Number of dwelling amts on each floor .
If gara;e, number of cars ~ .
6. If business, commercial or muted occupancy, specify naturF and extent of each type of use . .
7. Dmtensions of exisring structures, if any Front 1.~~.-`t _ Rear ....~.ni ~ Depth J... j . , , .
Hesght j. Number of Stones .
Dimensions of same structure with alterations or additions Front Rear .
Depth lletght .....Number of Stones , .
8. Dunenssons of entire new constructron Front ....:~.4~....... Rear Depth ! L7...... .
Hei;ht f~! . Number of Stones . _ . . . . .
9. Size of lot Front Rear.... Depth
10 Date of Purchase .Name of Former Owner
1 1. Zone or use distract m which premtses are situated .
12. Does proposed construction violate any zoning law, ordinance or regulation• .
13. Will lot be regraded . Will excess fill be removed from premtses: Yes
14 Name of Owner of premtses ,~gQNJik44+11}'~ ......Address ~~5.. IC1T?.1.+~ ..Phone No.:?(s5:- SI3.gr ~
Name of Architect , . , , , , , , , ,Address ...................Phone No............. .
.
Name of Contractor ~~'~Je~f .~'?w. ht~er~H(nt;ttti ..Address ...................Phone No .
tS.Is this property located wi[hin 300 feet of a tidal wetland? *YES....NO....
*If pes, Southold Town Trustees Permit may be required.
PLOT DIAGRAb4
Locate clearly and distinctly all buAdmgs, whether existing or proposed, and, indicate all set-back dunensions fry
property lines. Give street and block number or descnption according to deed, and show street names and indtcate when
intenor or corner lot.
STATE OP NE~~'R,K S S
COUivTY p ~-~-~1~~ ~ ,
P~c~} : ~ M!~~'.` ~ 1 h'st+C , , , . , being duly sworn, deposes and says that he is the applica
(Name of individual signtng contract)
above named. ~~11~~.,,,,~
Fie is the ......~.~?`~"f?~C.'TL1~.: L(r1~-'~.~~
ff (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 fle tl
application, that all statements contained m t}us application are true to the best of Sus knowledge and belief, and that t
work tvdl be pertonned m the manner se[ forth m the application filed therewith.
Sworn to before me this
~.^daxof. .~~.<~Cr19.4b
Notary Public, , • . County
d.A1i16 L CiLL~1N ~ ~4
MaMypeliNe, ~NewYark
QwlHbdio SuHolkCourtty (5t,natureofapptscat
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