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Home My WebLink About21238-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22324 Date MAY 13, 1993 THIS CERTIFIES that the building. ADDITION Location of Property 2855 CEDAR BEACH ROAD SOUTHOLD~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 91 Block 1 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 16~ 1993 pursuant to which Building Permit No. 21238-Z dated FEBRUARY 24~ 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 PERGOLA ADDITION OVER PART OF EXISTING ATTACHED DECK AS APPLIED FOR. The certificate is issued to MICHAEL BRAVERMAN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A B6ilding Inspector Rev. 1/81 FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°-N? 21238Z County Tax Mop No. 1000 Section ......... .~..,~.. ........ Block ...... ~ ............ Lot No..../... ................ pursuont to opplicotion dote~l ........ ~.~..~.~ ................................... , 19..~.....~.~ ond opproved by the Building Inspector. Fee 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 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings 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. 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 of Occupancy - Residential $15.00, Commercial $15.00 New Construction ...... Old Or Pre exzstlngD~:lJ~n~:.~'':ff'~-/~ Location of Property. ill ~5 C ' ~ /C>a~/ ,'?.~ ..... House No. Street Hamlet Onwer or Owners of Property ~f~g~ ~..~ ~//.~F~. .. County Tax Map No 1000, Section..~: ......... Block ...... : ........ Lot.../. .................. Subdivision Filed Map .. Lot ................. .. . i ", .... Permit No..:.~.~.~.~...Date Of Permit ................ App icant.. .h/...~...~.. Health Dept. Approval..W~. ................... Underwriters Approval....~.~. .................. Planning Board Approval ............... ~ Request for: Temporary Certificate. iiiiiii.il Final Certicate ..... f..... Fee Submitted: $... . ('~'~ APPLICANT INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspectbr Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 MAY 7, 1993 DANIEL FISCHER 38785 MAIN ROAD ORIENT, liY 11957 RE: HICltAEL BRAVERMAN 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. The check is ~u~8~r~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 ~ 21238-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOW~N BUILDING DEPT. CC: MICHAEL BRAVERMAN ,) ;OUNDA~ION (1st) ~OUNDATIOI! (2nd) ~OUGH FRAME & -PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL II ADDITIONA'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [~'~AL FRAMING . REMARKS: DATE , ~ INSPECTOR.. l /, Examined..~/.-'~. ~. ....... , 19~..~ Approved ...... ,197. .eermitNo. /.2. .fg Disapproved a/c ..................................... (Buildi o~nspector) APPLICATION FOR BUILDING PERMIT FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 BOARD OF HEALTH ......... 3 SETS OF' PLANS .......... SURVEY....- ............ ClIECK .... ::::::::::::::::::::: CALL . ~. MAIL TO: INSTRUCTIONS a. This application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 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 streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. '.~ .Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall6e 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 Occupancy shall have been granted by 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 or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply wit~ all applicable laws ordinances building codfi housing code and regulations and to admit anthorized inspectors:on pre~l~e-~ ~nd ~ building for necessary inspections.J -- (Signatur. e of applicant, or name, if a corporation) ?::75. .......... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... ..................................................................... Name of owner of premises . .~../~''ht'~ ~ ~-' (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No..../~... ~..~..~..A/...2~. ........ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be' done .................................................. -' House Number Street Hamlet County Tax Map No. 1000 Section ..... ¢/. .......... Block / Lot../. Snbdivision.. Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b Intehded use and .//. · occupancy .......................................... ......................... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteratio~'f~tz. .... Repair .............. RemOval .............. Demolition ............ ~l~r ~/~ ' ' 4. E~Umated Cost ~ (to be paid on filing this application) 5. If dwelling, number of dwellingiunits ! Number of dwelling units on each floor ....... · If garage number of cars ~ . 6 If business commercial or mixed occu anc s ............................................. pecify nature and extent of each type of use · , p Y, . ................ 7. Dimensions of existing structures if any' Front zx,¢~ ~ Re r - . ............ Hei-"' "~' · ...... -r.~. ·. a .............. Depth .. t;-[ ............... l,~urOoer of Stories ........................................................ Dimensions of same structur,~ with alterations or additions: Front .~ .... Rear .................. Depth ' Height Number of Stories 8. Dimensions of entire ' · new construction: Front Rear Depth Height ............... Nun~ber of Stories ............................................. : .......... 9 Si ell Font ' Re · ze et: r ........... ~ .... ar .............. Depth 10. Date of Purchase ............ ; ..... ......... Name of Former Owner ........................ 11. Zone or use district in which pr~mises are situated ........................................... ' 12. Does proposed construction vie!ate liny zoning law, ordinance or regulation: ...................... 13. Will lot be regraded ....... ;-'i ..... ~' ............. Will excess fill be removed from premises: Yes" 14. Name of Owner of ~remises ~.,,~.~ a~,~o ~ed~a.~ - I ............................ /~"~'"' ''g' ....Phone No. ?.d.~. 4f~.d. .... Name of Architect . .1 ................. Address ............ Phone No ................ Name of Contractor ]~ ..~/~ ......... Address~.S. 7.¢£~.~..M. ?...~.... Phone No. V,~;.:mS.~.* ..... 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or proposed, and. indicate all set-back dimensions fr~om property lines. Give street and block number or description according to deed, and show street names and indicate whet~er interior or corner lot. AP.PROVEd AS NOTED DATE~~'/'~/~/~ B.R #, ~/'~°~z~ NOTI~ ffUI[DING D~PAR~ AT 765-1802 9 AM ~ 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION ~O REQUIRED FOR POURED CONCRETE 2, ROUGH ~ FRAMING ~ PLUMBING 3 INSULATION 4. FiNAl. CONSTRUCTION MUST 8E COMPLETE FOR C.O. ALL CONSTRUCTION SHALL ME~ IHE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR D~SIG~ OEi CQNS~RH~;ION, ERRORS, STATEOF N~,C-YOi~KL--x/~ x S'S - (Name of individual signing contract) above named. He is the ...................... of said owner or owners, and is duly lauthorized}-o perform or have performed the said work and to make and file this application; that all statements contaiged in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner ~et forth in the application filed therewith. Sworn to before me tit~ -,- , . ............ . .day of.. y. Notary Public,...~ .~..~..¥.. ~L-----~'Z~'. County Notol¥ Public, State of NeW York ............ :wt. ........... No. 4879505 I (Signature of applicant) Qualified in Suffo k Coqnty ~ommls~ion Expirea December e,