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Home My WebLink About12914-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-15710 Date April 30, 1987 THIS CERTIFIES that the build~g INGROUND SWIMMING POOL & FENCE 690 Sleepy Hollow Lane Southold, New York Location of Property ~/~s~ County Tax Map No. 1000 Section 078 .Block I ..... Lot P/° I 0 Subdivision M/o Sleepy Hollow .Filed Map No..6.3.5.1 .... Lot No. 7 conforms substantially to. the Application for Building Permit heretofore filed in this office dated March 5, 1984 pursuant to which Building Permit No. 129 I4Z dated.....March ..... 6, ..1984 .... . .... . .... .. was issued, and conforms to all of the requirements of tile applicable provisions of the law. The occupancy for which this certificate is issued is ......... INGROUND SWIMMING POOL & FENCE AS APPLIED FOR The certificate is issued to RAYMOND & CECELIA KRUPSKI ..................... /o¥,,'o;, yf, fct z, x .................... of the aforesaid building. Suffolk County Department of Health Approval .... N/A UNDERWRITERS CERTIFICATE NO. N639352 PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 TOWH 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? 1291d Z hereby gronted to: ~.~..~.....:~.~..~. ......................................... ~~.~ ~' ,...~.~.~'~ ,o...~ ......... .~..~~...~......~ .......... ~ ................. ~;~o,~d at ..... .~..~..~ ....... ~...~..~.~...~~ .... ................................................................................... Coun'~ T~x Map N'o. 1000 Section .......~.~.~ .... Bilk ........... ) .......... Lot No....~.../..~ ...... pursuont to ~pplication doted ............... ~.~......~ ............... , 19. ., and approv~ by the Building Inspector. Fee $..../..~.; ............ Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR Ink, and submitted ~ ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of ell buildings, property lines, streets, and unu~al natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957)0 Non-conforming uses, or buildings and "pro-existing" land uses: 1. Accurate survey of pzoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: . ' 1. Certificate of occupancy New Dwelling. S25.00, Acce.~.~ory ..$10.00 Bua[ne.~:~ $50.00 2. Certificate of occupancy on pre-existing dwelling $ .50.00 3. Copy of certificate of occupancy $ 5.~00~ over 5 yeara $10.00 4.Vacant Land c.g. $ 20.00 '~. ~'1~ 5~. upd_ated, ~.O. $ 50.00 Date ~, ~ .................. 6. Alterat:~on $25.00 NewtOns truc~ion Old or Pre-existing Building Vacant Land Location of Proper ............... . ..... ~ .................. House JVc. Street Hamlet Owner or Owners of Property .~L~O,~., ~..~¢.(.. ~-.~ .~'{%"" .... ~.v; ~. ~, .~'~ .~ ................... Count'/Tax Map No. 100O Section ...0..~ ~ ...... Block ..... /, ......... Lot ................ e ' ' ' Filed Map No Lot No oubdlvlslOn ..... o, ...................................... '''' ......... Health Dept Approval Lebor Dept Approval · Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $..~.~, ......................... Construction on above described building end permit meets all applicable codes and regulations. Applicant .[~.0.~Q~,d, ?~-, L~-.(,~.L,~..~'¢.~ ~.J~".' ................. I~~~ ~,,~1 1000~'~44 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ' ~ ~ 85 JOHN STREET, NEW YORK, NEW yORK 10038 ~ , Mr. & Mrs. K~udski~ 690 Sleepy Hollow La., SouthOld, N.Y. in the /ollowing tocation~ [] Basement [] 1st FL wasex, minedon April ~, 1984 .XTU.~ F,XTO.ES OUTLETS ~ECEPTACLES SWITCHES ~LUORESCENT DRYERS FURNACE [] 2nd FI. Outside Section Block Lot and~ound to be in compliamce with the r~quirernents o~ this Board. RANGES OVENS DISH WASHERS EXHAUST FANS SYSTEMS E R NO. OF CC. COND, A W.O. pER ,~ OF CC. COND V I C E NO OF Hf-L~G A, W G. NO. OF NEUTRALS A. WG OTHER APPARATUS: i~G.F.C.i. , (Swimming Pool) This certificate covers compliance at~ the date of inspectior only. ~ecause of unusual environments and/or repairs made by a qualified per,on. 12 Dean CO~Y FORBUILDING DEPARTMENT. THIS COPY OF CERTIFICATE USTNO F~E~D INSPECTION COMMENTS FOUNDAT%ON ( 1 st) FOUNDATION ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR ILO. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advise yon that the lob under, building permit, no. 12914Z issued to RaymOnd KrupsK1 on 3/6/84 for Accessory ia completed and a fLrlal inspection has ( ) has not ( x )'been done. rn order to comp/ere this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a cheek for $10.00 payable to tile Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection (late 0ccnpancy or use ia unlawfnl without a Certificate of Occupancy. l'lea~e he]p us to clear up thl, a matter ao that legal action doe~ not have to be taken. Thank you for yo,r prompt attention. Very truly y~, Victor Lesaard Executive Administrator VI,: ga r encl . FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined...~\~& .~..., 19~..~. Approved...5.~'~. ~.~.\'.~.., 19'~. Pe~it No. ) ¢:g.)g. 5.. Application No .................. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter 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, d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit 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 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 with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessa~,~pections. ·/./..~. ~. ~ .~/~..... ~ ................. _ ~S?rfature of applic/a~at, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. N ne of owner of ...................................... (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 ........ .~./. .............. Plumber's License No ..... .~./~. ............. Electrician's License No...//.~..4. ~ .......... Other Trade's License No .................. 1. Location of land on which proposed work will be done .................................................. · ................. ...................... House Number Street Hamlet County Tax Map No. 1000 Section .... .~..~..~. ........ ]~lock ... ?. ........ Lot. ~ .~..~.../.t? .... Subdivision ~...~..~'..~..~..~//....~../-~...~.%~. ....... Filed Map No. ~ '-~' ~'/ Lot ~ (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....~./~...~/.~t~....?..~../..~.~../..~..~. ................................. b. Intended use and occupancy .................. . ............................... 3. Nature of work (check which applicable): New Building .......... Addition .. ~ ..... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... : (Description) 4. Estimated Cost .......................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling ,units ............... Number of dwelling units on each floor ................ If garage, number of cars ......................................................................... 6. If business, commercial or mlxe~ occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height Number of Stories .. ....................................................... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... ~.. Height ...................... Number of Stories ...................... 8. Dimensions of entire newconstructlon:i ' Front ............... Rear .............................. Depth Height . .............. Number of Stories ..................................................... /. ~.~. /../ 9. Size of lot: Front .... , ........... Rear ................. De ............... 10 Date of Purchase ' Name of Former Owner .' 11.. Zone or use district in which pr6mises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... . .~/..~. ........................ 13. Will lot be regraded ....... )/.~,-q. ................ Will excess fill be removed from premises: ~ No 14. Name of Owner of premises ~d//YY~4/~. ,~",~/t~:,~"./ Address ~..~ _¢,~/_,,a///, .<~_.. Phone No ,~'..~.~. ~..~,~J~. · ,,. ' ......... ';" ~ ~'~r~ ~ ......... Name of Architect ......... ,~d///~. ............. Address ................... ~on~o ...... 9 ......... Nam e o f Contract or --~dd//)~ d~-'2/~...~.~'~g .. A · .. d;. ...... dd ................................. / ............... PLOT DIAGRAM Locate clearly and distinctly alii buildings, whether existing or proposed, and~ indicate all set-back dim msions from · property lines. Give street and block humber or description according to deed, and show street names and indi :ate whether ' interior or corner lot. STATE OF NEW YORK, Io o COUNTY OF .... ............... (Name of individual sigffing contract) above named. ' being duly sworn, deposes and says that he is ~the applicant He 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 mak~ and file this applicationl that all statements contained in this application are true to the best of his knowledge and belief and that the application filed therewith. work will be performed in the mannqr set forth in the ' ' Sworn to before me this ......... : ............. ay o .............. , . Notary Public ............. i · ./ ....... Count~ _ /q ,~ _~7 , 0 0 _r ~o r'~ o 43: A A m 3'- 4" 5 COURSES 8'x 8~ 16"-"- CONCRETE 8LOCK CONTRACTOR... SWIM-KING POOLB~ INC. ROUTE ,25A g~o o~ u~ 0