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HomeMy WebLinkAbout19269-zFORM NO,, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20545 Date FEBRUARY 25, 1992 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 2855 CEDAR BEACH ROAD House No. Street 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 JULY 16, 1990 pursuant to which SOUTHOLD~ N.Y. Hamlet Building Permit No. 19269-Z dated JULY 26, 1990 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 & ENCLOSE EXISTING CARPORT TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. MICHAEL BRAVERMAN (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-182396 - APRIL 9r 1991 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 B~ilding Inspector TO~VN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. NO. BUILDING PE~IT (THIS PEP~AIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 926,? Z ~ .... ~.~ ................................... , ~..~ Permission is hereby gr~.,nte~ to: ~ ~ /~ /' t ,,~ /~ ~~~~_~...~...~.~~;....~.~~ ....~' ..... ,..~:~....,,..z/~.~ ,~ .~~.....~....~~....~..~....~.....~~;~ .......... ............................................... ~~~ ....................................................................... Cou,W Tax Map No. 1000 Sectio~ ...... ~ ......... Bilk .......... ~ ........ Lot No ........ ~ ............. pu~uant to application dat~ .... .~. ....................................... , 19.~., a~d approv~ ~ Building Inspector. Fee Rev. 6/30/80 ;1¢1 F£B 992 Form No. 6 TOWN OF SOUTIIOLD 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 - $i00.00 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 Date ....... ~;¢¢___~¢¢_..~ ........... ~ ................ ~ . New Construstion ........... 2 - 'Old Or Pre-exist'n Location of Property ................... House No. Street Hamlet Onwer or Owners of Property..~./.~...~...../.~../~...~.....~..... ................., ........................... ... County Tax Map No 1000, Section..~/. f ..... Block. / ...... Lot. L ........... Subdivision .................................. .. Filed Map ............ Lot .............. .. /~, ~ --~ ...... ~ ..... Applicant...~.~...~f~.. Permit Xo...~.¢ .......... Date Of Permit. Yb¢ .D .......... Health Dept. Approval .......................... Underwriters Approval..~.~.~I~Z ......... Planning Board Approval ..................... .. . Request for: Temporary Certificate ........... Final Certicate...~.. ...... Fee Submitted: $ ....... /.. .................... ¢ ¢¢x., ............. ............ THE NEW YORK BOARD OF FIRE UNDERWRITERS :LO00.1 '~] BUREAU OF ELECTRICITY ~-- Date ~]C t'~ 0~) , ~, ~)9'~ Applicatlon No. on ~ile THIS CERTIFIES THAT only the electrical equipment ~ ~seribed be~w a~ int~duced by t~ applicant ~med on the a~ve application number in the premises of in the /oltowlng b,cation; ~ Basement was examined on ~PR i'b 04, and found to be in compliance with the reqairements qf this Board. OUTLETSFIXTURE SWITCHES FIXTURES RANGES OVENS EXHAUST FANS OTHER DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: S E R V I C E ,,, .j/O^ w o NO OF NEUTR L$ OF NEUTRA[ :L 275 T()~N GENERAL MANAGER Per c ~ This certificate must not be altered in any manner; return to the office of the Board ~f incorrect. I~spectors may be identified by their credentials. INSPECTORS Victor Lessard Principal Building Inspecwr Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieezorek Ordinance Inspector 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 FEBRUARY 19,1992 DANIEL FISCHER RR BOX 79, MAIN ROAD ORIENT, NY 11957 Rg: MICItAEL BRAVERHAN 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 --~---_/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 $ 19269-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. CC: MICltAEL BRAVERI.~i.N ?'iELD · ........ FOUNDATION [1st) ?OUNDATION (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE Ye FI~AL ADDITIONA'L COMMENTS .Z 765.~1802 BUILDING DEPT. .INSPECTION [ ]~FOUNDATION 1ST [ ] FOUNDATION 2ND FRAMING ROUGH PLBG. INSULATION FINAL REMARKS ~ INSPECTOR~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING REMARKS: [~NAL DATE 765-1802 BUILDING DEPT. INSPECTION ] FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATIoN 2ND [~LATION FRAMING FINAL REMARKS: INSPECTOR 765-1802 BUILDING DEPT. INSPECTION INSPECTOR ,,~//..~///~ II, TOWN OF 'SOUTt:IOLD FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTH .~..o 3 SETS OF PLANS .O.'.f~2 ..... survey .... /~:.K ........... " cu~.cK ......... ~ ....... SEPTIC FORM ................ APproved .... .~.~..~. ..... , 19 .~Permit No .... Disapproved a/c ..................................... NOTIFY; CALL . .. ....,q.4 INSTRUCTIONS a. Tlfis appJication must be completely filled in by typewriter or in ink and submitted to the Building I~spector, 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 giv~g a det~led description of l~yout of property must be drawn on thc diagram which is p~ of t~s appH- carton. c. The work covered by t~s appHcafion may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector wffi issued a Building Pe~it to the appHc~t. Such pe~it shall be kept on the premises available for ~spection throu~out the work. e. No bulldog shall be occupied or used in whole or in part for any purpose whatever until a Ce~ificate of Occup~cy shall have been granted by the Bulldog Inspector. ' APPLICATION IS HEREBY MADE to the Bulldog Dep~ment for the issuance of a B~lding Pemit pu~uant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ~d other applicable ~ws. Ord~ces or Regulations, for the construction of bufld~gs, additions or alterations, or for femoral or demolition, as here~ described. ~e .applican5 agrees to comply with all applica~e laws, ordinances, bufld~g code/housing code, and reg~ations, and mit authorized ~spectom on premises and ~ bulldog for necessa~ inspectio~g~ ~ . (Signature ot ~pplicant, or nadP, ifd&~d~fi~idd)' ' ~ ,.~ ,., (Mailing address of applic~t) State wh~ther applic~n~ ~s owner, lesse~,.agent, ~chitect, engineer, general contractor, electrician, plumber or builder. ?~ ~,,~*. ~, , (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (~a~e aid title of ........... co~ora;e Plumber'S License No ......................... Otber_Trade's License No ..... ~ ......... ~. .... Location of land on which proposed work will be done, tIouse Number Street ................. ' ................................ · Hamlet yT Z./. · / / Count ax Ma o. 1000 Section ............... BlOck ' · · Lot ......... Subdivision Eiled Map No (Name) State existing t se and occupancy of premises and intended sse and occupancy of proposed construction: A. Existing use and occupancy.. ~ ..,.( B. Intended use and occupancy ..... ~t~ ~ ~. v ~ ~x.'.~w:,,>,~p~.,: :~;%'~ . Alteration .....~, ..... · 3. Nature of work (check which applicable): New Building ...... Addition .c;.~. Repair .............. Rbmoval .............. Demolition .............. 8wimmin g ,~gg, o~!_ Tennis Court ......... Accessory Building .......... eence ...... Other WGr~; ~ . ='.. ....... 4. Estimated Cost /e)0 $~.fj . ~' ' i' . ..... . ...... Fee ... a~.. Z ................... _...~,. / (to be paid on filing this applicet!on} 5. If dwelling, number of dwelling units . ../. ........... Number of dwelling units on each floor ................ If garaee number of cars 6. If business, commercial or mixed occupancy, specify.nature and extent of ea.c,h,gype of use . .77.... ~ ........... 7. Dimans ons of existing structures, ifany: Front...~..~ .... Rear .0e.'.~ ........ Depth .-~1~. Hei,.ht . /.t~.~] ..... Number of Stories . . ./. ............. ~,~a ................... ~;,~ .... Dimensions of same structure with alterations qro,a~ditions: Front .3.~. ............. Rear . ~..,4-- ............ r~e-th ~ ~ Hei-ht /~[g Number of Stories / 8. Dimensions of entire new construction: Front ....~.....c.c.~..e~.e... Rear . .~../ ........... Depth ~7.o..* ......... Hmoht .............. Number of Stones ................................... 9. Size of lot: Front ..... ./.o."q. i .... i ...... Rear... ~..o.o.' .............. Depth .. ~/.~/.,g.. :.-(.r.~?..d.~.,6~. ...... 10. Date of Purchase . ~.~qff. ~ ...................... Name of Former Owner ............................. 1 1. Zone or use district in which premises are situated../rffe.~.'/.~e./O'J~. ...................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: . .AS.O ........................... 13. Will lot be regraded ../.~.q ...................... Will excess fill be r~rnoved from premises: . Yes .~.. ~ No.~. Name Owner of premmes ad/'/. .............. ~: ..................................... 14. of ' ~/4d£~ ~'~'dt/OE ~/~,¢dr~ ~ ~ o t,~ 'Y,~/-dSr' .d~. lC'hone NO Name of Architect . . . Address . . Phone No ': ................................ : ...... Name of Contractor .~. d/(./.(t:...g: ~./.~.c.~.~/~ ....... Address~.~. ,ff9~'.7..f..~.'~.~'!..~./e.,,~.P. Phone,.No ..... :q .....~. ..... IS.Is this property located within 100 feet of a tidal wetland? ~YES .... NO--~f~.- · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate cleaxly and distinctly all buildings, whether existing Or proposed, and. indicate all set-back dimensions from property lines. Give street and b!ock number or description accordh~g to deed, and show street names and indicate whether interior or comer lot. /,~/-.e~ a~... APJ R0 D AS NOTED / FEE: '~ ~'.e"<7~.o BY: ~' ~OT~ 8~ ~A~T~ ~T ~0~0~ ~P~TtO~ 1. FOUNDATION ~O REQUIRED FOR POURED CONCR~E 2. ROUGH ~ FRAMING & PLUMBING 3. INSU~TION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE OF NEW YOR[, S.S STATE CONSTRUCTION & ENERGY COUNTY OF ................. CODES. NOT RESPONSIBLE FOR os~s;~ 0 c r I [R~ S ................................................. being duly swo~ p eg s e ~s applicant (Name of individual signing contract) above nam'ed. ~ 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 contaiued in this applic0,tion are true to the best of his knowledge and belief; and that the Work will be performed in thc manner set forth in thc application filed therewith. ,. Sworn to before me this ; . .............. ,/..? ...... day or ................... &.~..~/. 19 .~..~. Notary Public .... ~.e'.~.....~.:..~..-'%"'. 7.~..~-~... County _ No. 4707878, ~{'{olk _ _e~erdy~, (Signature of applicant)